Introduction: Cerebral aneurysm is a common cause of intracranial hemorrhage, stroke, and death. It is treated with vascular surgeries, such as artery clipping and coil embolism. However, surgery itself is a risk factor that may cause rupture of aneurysm, and leads to irreversible brain damage, and even death.
Endovascular coiling is the procedure of choice to obliterate the aneurysm by a minimally invasive procedure.
Patient concerns: A 68-year-old female came to our hospital with thunderclap headache and sudden loss of consciousness.
Diagnosis: Non contrast CT, CT Angiography (CTA), Digital Subtraction Angiography (DSA) and 3D rotational angiography of the head shows a right Middle cerebral artery (MCA) bifurcation aneurysm arising and incorporating the origin of superior trunk of M2 and measuring 4.7 x 3.7 mm with the neck measuring 3.7 mm. There was also subarachnoid hemorrhage in the right Sylvain fissure with edema in the right temporo-parietal lobe.
Interventions: Considering the size and location of this MCA aneurysm, endovascular coil embolization was performed to obliterate the aneurysm.
Outcome: Post procedure, there was no abnormality detected. Six weeks after surgery, the patient’s muscle tone in both upper and lower extremities were grade V. CTA confirmed no MCA aneurysm.
Lessons: Therefore endovascular coiling is a safe and effective method to obliterate the aneurysm and prevent recurrence of subarachnoid aneurysm.
Abbreviations: CT= Computed tomography, CTA = CT Angiography, DSA = Digital Subtraction Angiography, MCA = Middle Cerebral Artery.