Reconstruction of the MCA bifurcation after excision of a giant aneurysm. Technical note.

A patient with a giant aneurysm of the left middle cerebral artery (MCA) presented with a history of subarachnoid hemorrhage and ischemic symptoms. When the aneurysm was explored, its base was found to be very firm and atherosclerotic. Temporary clips were applied to the MCA, the aneurysm was excised, and the MCA bifurcation was reconstructed using microsurgical techniques. Good flow in the reconstructed MCA trunk was demonstrated by intracranial Doppler ultrasonography. A description of the operative procedure is presented.