Surgical treatment of middle cerebral artery aneurysms

MCA aneurysms are a common cause of SAH. They are often associated with multiple aneurysms and a familial tendency to aneurysm formation. Most MCA aneurysms arise at the division of the main MCA trunk. Ruptured MCA aneurysms are more frequently associated with lateralizing symptoms and signs than are other aneurysms. Intracerebral hemorrhage and late epilepsy are also common. MCA aneurysms may be approached by medial transsylvian, lateral transsylvian, or transcortical routes. The transcortical route is generally used only in cases with significant intracerebral hematoma. MCA aneurysms are usually not suitable for endovascular treatment.