MICROSURGICAL TREATMENT OF MIDDLE CEREBRAL ARTERY ANEURYSMS

Abstract

Since the publication of the International Subarachnoid Aneurysm Trial (ISAT), there has been a significant change in the way cerebral aneurysms are treated. In many centers, there has been a drastic decrease in the number of cases treated by microsurgery, with endovascular treatment becoming the modality of choice. Middle cerebral artery (MCA) aneurysms, however, pose a real challenge to endovascular treatment, due to the tortuosity of the vessel and to the high rate of wide neck aneurysmas in this location, often with branches originating from the neck of the aneurysm itself. Our study provides a literature review, comparing the results of surgical and endovascular treatment for MCA aneurysms. Additionally, case examples will be presented with surgical videos, showing the nuances of the microsurgical technique required to manage these aneurysms. The clinical and radiological results of more than 120 cases are presented and compared to the results of endovascular treatment in a large treatment center in Brazil.

Keywords

• MIDDLE CEREBRAL ARTERY ANEURYSMS