A Case of Fully Thrombosed Middle Cerebral Artery Aneurysm Resembling Cavernous Malformation: A Detailed Case Study with Surgical Video and Literature Review - Summary - MDSpire

A Case of Fully Thrombosed Middle Cerebral Artery Aneurysm Resembling Cavernous Malformation: A Detailed Case Study with Surgical Video and Literature Review

  • By

  • Beatrice Zucca

  • Marissa Koscielski

  • Aaron Kakazu

  • Sanjit Shah

  • Mary Gaskill-Shipley

  • Matthew Smith

  • Charles Prestigiacomo

  • Jonathan Forbes

  • March 24, 2026

  • 0 min

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Objective:

To present a case of complete thrombosis of a middle cerebral artery aneurysm, highlighting its diagnostic challenges and surgical management in the context of existing literature.

Key Findings:
  • Complete thrombosis of MCA aneurysms is rare and often misdiagnosed as cavernous malformations, underscoring the need for heightened awareness among clinicians.
  • Intraoperative findings confirmed the presence of a fully thrombosed aneurysm, which has implications for surgical strategy.
  • Postoperative imaging showed complete resolution of the lesion and preservation of vascular structures, indicating successful intervention.
Interpretation:

The case underscores the importance of considering complete aneurysmal thrombosis in differential diagnoses for lesions in typical vascular locations, despite negative angiographic findings, and calls for improved diagnostic protocols.

Limitations:
  • High-resolution vessel wall MR imaging was not performed, which could have provided additional diagnostic insights and may have altered the clinical approach.
  • Only a single case is presented, limiting generalizability and highlighting the need for further studies to validate findings.
Conclusion:

This case highlights the diagnostic challenges posed by completely thrombosed aneurysms and the necessity for careful evaluation of radiographic features, advocating for a multidisciplinary approach in complex cases.

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