Acta Neurochirurgica

, Volume 160, Issue 3, pp 579–582 | Cite as

Trapping and resection of cortical MCA mycotic aneurysm in eloquent area

How I Do it - Vascular



Mycotic aneurysms, although well recognized, are relatively rare intracranial vascular pathology. These aneurysms are typically located in distal cortical vessels. When these aneurysms are located in eloquent cerebral territories, they may become challenging to treat. Eloquent location may necessitate intraoperative angiographic evaluation to verify complete aneurysmal occlusion/obliteration and preservation of normal adjacent vasculture. Recently, ICG videoangiography has become a widely used intra-operative adjunct and is an important tool used to assess complete occlusion and vessel patency at the conclusion of clip reconstruction. In this report, we outline the comprehensive and concurrent utilization of both vascular imaging modalities to ensure safe and complete occlusion of a mycotic aneurysm.


We describe our experience with a patient with left M4, Rolandic, enlarging mycotic aneurysm that was treated in a comprehensive fashion with microsurgery and intra-operative angiography (IA).


ICG videoangiography, in combination with concurrent intraoperative angiography in the setting of complex vascular lesions, may support intraoperative decision-making and provide demonstration of complete occlusion in an immediate fashion. A hybrid operative suite allows for high-quality imaging confirming complete resection.


Mycotic Aneurysm Trapping Indocyanine green videoangiography Intraoperative cerebral angiography 


Compliance with ethical standards

Conflict of interests

We declare we have no conflict of interests.


  1. 1.
    Gibo H, Carver CC, Rhoton AL Jr, Lenkey C, Mitchell RJ (1985) Microsurgical anatomy of the middle cerebral artery. J Neurosurg 54:151–169CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Division of NeurosurgeryMaimonides Medical CenterBrooklynUSA
  2. 2.Department of NeurosurgeryHofstra North Shore–Long Island Jewish School of Medicine, North Shore University HospitalManhassetUSA
  3. 3.Department of RadiologyHofstra North Shore–Long Island Jewish School of Medicine, North Shore University HospitalManhassetUSA

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