Middle Cerebral Artery Bifurcation Aneurysm: Wall Enhancement in MRI Vessel Wall Imaging Correlates with Histological Findings

  • Charlotte FlühEmail author
  • Naomi Larsen
  • Michael Synowitz
Living reference work entry


Here we present the case of a 57-year-old female patient with an unruptured, broad-necked 10 × 8 mm left MCA bifurcation aneurysm, which was clipped via a left pterional approach. The clipping procedure was performed in conjunction with intraoperative indocyanine green (ICG) angiography, and postoperative DSA was performed. Prior to the procedure, the patient underwent MRI vessel wall imaging, which showed significant contrast enhancement of the aneurysm sac, in addition to standard cranial MRI and DSA. The operation was performed without complication, and the postoperative course was uneventful. Histopathological analysis of the aneurysm sac revealed features of inflammation and neovascularization. The correlation of vessel wall imaging and histological findings is the main topic of this chapter.


Middle cerebral artery bifurcation Microsurgical clipping MRI vessel wall imaging 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Charlotte Flüh
    • 1
    Email author
  • Naomi Larsen
    • 1
  • Michael Synowitz
    • 1
  1. 1.Klinik für NeurochirurgieUniversitätsklinikum Schleswig-Holstein, Campus KielKielGermany

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