Giant cerebral aneurysm
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Giant cerebral aneurysms are ones that measure >25 mm in greatest dimension.
Giant cerebral aneurysms account for ~5% of all intracranial aneurysms 1,3. They occur in the 5th-7th decades and are more common in females 2.
Patients can present with symptoms and signs of mass effect or subarachnoid hemorrhage 1,2.
- internal elastic lamina de novo defect
- enlargement from a smaller aneurysm
Compared to non-giant cerebral aneurysms there is an increased incidence in the posterior circulation (~35%) 3.
Appearances will depend on whether the aneurysm is non-thrombosed, or partially or completely thrombosed.
- non-contrast: slightly hyperdense, well-defined round extra-axial masses 2
- may demonstrate a peripheral calcified rim
Treatment and prognosis
There are a variety of endovascular and open surgical techniques to treat these aneurysms. Endovascular options have a lower morbidity 3.
- 1. Castillo M. Neuroradiology Companion: Methods, Guidelines, and Imaging Fundamentals. LWW. ISBN:1451111754. Read it at Google Books - Find it at Amazon
- 2. Mehta RI, Salamon N, Zipser BD et-al. Best cases from the AFIP: giant intracranial aneurysm. Radiographics. 2010;30 (4): 1133-8. doi:10.1148/rg.304095199 - Pubmed citation
- 3. van Rooij WJ, Sluzewski M. Endovascular treatment of large and giant aneurysms. AJNR Am J Neuroradiol. 2008;30 (1): 12-8. doi:10.3174/ajnr.A1267 - Pubmed citation