Giant Serpentine Cerebral Aneurysm of the Middle Cerebral Artery: Case Report

A 43-year-old male presented with severe intermittent headaches since two years accompanied by multiple episodes of generalized seizures and left hand weakness. MRI scan and cerebral angiography confirmed the diagnosis of a giant serpentine cerebral aneurysm arising from the middle cerebral artery. The patient was admitted for a possible cerebral embolization after undergoing a Balloon Occlusion Test (BOT). Since he tolerated the occlusion test, he underwent coil embolization afterwards with successful occlusion followed by an uneventful recovery and no complications. Later on, the patient was discharged home in a stable and good general condition without any neurological deficits. A six-month angiography follow-up revealed a complete occlusion with no re-canalization of the coiled giant serpentine aneurysm. Therefore, we concluded that parent artery occlusion is a good and safe procedure providing that the patient tolerated both the occlusion and the hemodynamic stress tests.