Fusiform intracranial aneurysms are a type of intracranial aneurysms with an elongated fusiform shape caused by atherosclerotic disease most common in the vertebrobasilar circulation.
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Epidemiology
3%-13% of all intracranial aneurysms
Clinical presentation
They can be incidental or asymptomatic, discovered during work-up for unrelated symptoms. They can present as a nonspecific headache without haemorrhage or other neurological signs or symptoms, for example:
transient ischaemic attack or complete stroke
mass effect with or without seizures
subarachnoid or parenchymal haemorrhage
Pathology
Fusiform aneurysms are non-saccular dilatations involving the entire vessel wall for a short distance. They are termed cylindrical if they involve a somewhat longer length. The circumferential arterial dilatation results from pathological involvement of the entire artery.
Aetiology
They are most commonly secondary to atherosclerotic disease but are also seen in mycotic aneurysms.
Location
most commonly located in the vertebrobasilar circulation
Treatment and prognosis
Most small and some large focal dilatations, especially those that are asymptomatic, should be treated conservatively unless serial neuroimaging assessment indicates significant enlargement over time.
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