Abstract
We report an aneurysm that developed at the superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. A 52-year-old woman, who had a history of subarachnoid hemorrhage (SAH) 10 years before, was admitted with headache. At the previous SAH, 3 cerebral aneurysms were identified and 2 of them were successfully treated with neck clipping. The remaining right internal carotid giant aneurysm was treated with the proximal occlusion of the right internal carotid artery following the right STA-MCA anastomosis. She had gone well without neurological deficit until the current admission. CT scan on admission revealed intracerebral hemorrhage in the right frontal region. Angiography disclosed a saccular aneurysm at the site of the anastomosis. The aneurysm was successfully treated by neck clipping. The intraoperative findings showed that the aneurysm raised from the MCA wall opposite to the STA orifice. Histological examination of the aneurysm wall indicated a true aneurysmal formation. Congenital factors, as suggested by her history of multiple aneurysms, and hemodynamic stress to the recipient artery may have contributed to the aneurysm development.
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