Fusiform intracranial aneurysm

Last revised by Mostafa Elfeky on 27 Nov 2023

Fusiform intracranial aneurysms are a type of intracranial aneurysms with an elongated fusiform shape caused by atherosclerotic disease most common in the vertebrobasilar circulation.

They can be incidental or asymptomatic, discovered during work-up for unrelated symptoms. They can present as a nonspecific headache without hemorrhage or other neurological signs or symptoms, for example:

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.

They are most commonly secondary to atherosclerotic disease but are also seen in mycotic aneurysms.

  • most commonly located in the vertebrobasilar circulation

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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Cases and figures

  • Case 1: basilar artery aneurysm
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  • Case 2: basilar artery aneurysm
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