High-flow bypass and tandem microsurgical-endovascular occlusion of recurrent proximal middle cerebral artery aneurysms in a pediatric patient

Adib A. Abla, Andrew F. Ducruet, Robert F. Spetzler, R. Webster Crowley, Cameron G. McDougall, Felipe C. Albuquerque

Research output: Contribution to journalArticlepeer-review

Abstract

The authors report the case of a 7-year-old boy with headaches, in whom CT angiography showed multiple intracranial aneurysms from the terminus region of the right internal carotid artery through the proximal right middle cerebral artery (MCA). Initially, the patient underwent clip reconstruction of the M1 segment. Multiple microsurgical and endovascular treatments were required because the largest of these aneurysms recurred several times over the next 1.5 years. The first recurrence was treated with stent coiling and the second by microsurgical occlusion of the MCA combined with the use of a radial artery graft in a common carotid artery-to-MCA bypass. The aneurysm again recurred and was treated by proximal coil occlusion 15 months after the first treatment session. At a 7.5-year followup examination, the aneurysms remained occluded. This case highlights the benefit of combined endovascular and microsurgical techniques in the treatment of a complex and unusual case of proximal MCA aneurysmal disease. The patient, now 15 years old, is neurologically intact and able to participate in all activities.

Original languageEnglish (US)
Pages (from-to)365-369
Number of pages5
JournalJournal of Neurosurgery: Pediatrics
Volume10
Issue number5
DOIs
StatePublished - Nov 2012
Externally publishedYes

Keywords

  • Coil occlusion
  • Middle cerebral artery aneurysm
  • Radial artery bypass graft
  • Stent
  • Vascular disorders

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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