Spontaneous fusiform middle cerebral artery aneurysms: characteristics and a proposed mechanism of formation

Abstract

Analysis of results after various treatments indicates that for symptomatic lesions, therapies that reverse intraaneurysmal blood flow and augment distal cerebral perfusion are associated with better outcomes than other strategies, including conservative management. Based on the spectrum of clinical, pathological, neuroimaging, and intraoperative findings, dissection is proposed as the underlying cause of these lesions.

Progressive cervicocranial arteriopathy with dilatations and stenoses: case report

“…Damage to the IEL and to the intima may be crucial to the pathogenesis of FAs since these components are extremely important to vessel strength [4][5][6][7]11 . Observations in animals and humans support this hypothesis.…”

“…The presence of dilatations in cervical or cranial arteries is a phenomenon that has received diverse and somewhat imprecise denominations, such as dilatative arteriopathy 1 , arterial dysplasia 2 , dolichoectasia 3 and fusiform aneurysms (FAs) [4][5][6] . The last two terms seem to designate different degrees of progression of the same disease.…”

“…The most frequent findings in affected arteries have been loss of medial layer components, collagen fiber degeneration, fibrosis, atherosclerotic changes and parietal thrombosis 7,8,10,11 . FAs have been associated with trauma, infection, inflammation, atherosclerosis, arterial dissection or neoplasms 4 . However, in some cases no obvious predisposing factors or causes can be determined.…”

Intracranial Fusiform Aneurysms: It's Pathogenesis, Clinical Characteristics and Managements

“…They represent about 3%-13% of all intracranial aneurysms 2) and are usually located in the vertebrobasilar system [7][8][9] . Fusiform aneurysms in the anterior circulation remain rare and occur mostly in the middle cerebral artery and internal carotid artery 6,13) . There are some sporadic case reports about the treatment of fusiform aneurysms 2,4,13,34) and a few reports on the clinical characteristics, pathogenesis and treatment methods of these aneurysms in large series [6][7][8]11) .…”

“…This type of aneurysm may be caused by dissection or atherosclerosis 6) , by disorders of collagen and elastin metabolism, by infections and-very rarely-by neoplastic invasion of the arterial wall 34) . Fusiform aneurysms have different underlying pathologies, hemodynamics, anatomical distributions, natural histories and treatments than do the saccular variety 6) . The patient often has symptoms and signs of occlusion, arterial rupture, or a mass effect.…”