CT angiography for the diagnosis of aneurysm in the bifurcation of the middle cerebral artery.

This study reports 10 aneurysms found in the bifurcation of the middle cerebral arteries (MCA) of seven patients, diagnosed by computed tomography angiography (CTA) and confirmed by digital subtraction angiography and surgery. Six of the 10 aneurysms bled and caused subarachnoid hemorrhage (SAH): the SAH was predominant in the Sylvian fissure where the aneurysms located. Eight aneurysms had a saccular pattern, while two had a fusiform pattern. Nine aneurysms were larger than 8 mm and were easily detected by CTA, while one aneurysm was 6 mm in diameter and was missed initially. It was found, however, after the direction of the CTA was readjusted. In conclusion, the hemorrhages of aneurysm in the bifurcation of the MCA predominated in the Sylvian fissure, and the size of the aneurysm is often big, and thus easily detected by CTA.