Cross-Circulation Thrombectomy for Acute Middle Cerebral Artery Occlusion from Dislodged Thrombus of a Giant Internal Carotid Aneurysm: A Case Report.

OBJECTIVE

Giant aneurysms of the cavernous segment of the internal carotid artery presenting as acute ischemic stroke (AIS) are rare and often misdiagnosed. Limited treatment experience further complicates management.

CASE PRESENTATION: A 70-year-old female presented with acute right middle cerebral artery (MCA) occlusion due to a dislodged thrombus from a giant internal carotid aneurysm. Emergency multimodal brain imaging techniques, including CT, CTA, and DSA, were used to clarify the diagnosis. Given the giant aneurysm's interference, cross-circulation thrombectomy via the anterior communicating artery was performed to revascularize the occluded artery. The patient achieved a relatively good outcome due to timely reperfusion.

CONCLUSION

This case highlights the importance of advanced imaging and innovative surgical techniques in managing complex cerebrovascular conditions, offering insights for future treatment of giant intracranial aneurysms with cerebral embolization.