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MCA Aneurysm Associated with a Hematoma

Last Updated: September 28, 2018

Clip Ligation of an MCA Aneurysm Associated with a Hematoma

Because of their location, lateral projection, and attachment of their dome to the temporal lobe, nearly 50% of ruptured middle cerebral artery (MCA) aneurysms present with intraparenchymal hematomas. Most (80%) of these hematomas are located in the temporal lobe.

Any patient with a spontaneous hematoma around and within the Sylvian fissure, with or without associated subarachnoid hemorrhage, should undergo vascular imaging to rule out an underlying vascular anomaly.

Indications for Surgery

Because of the distal location of MCA aneurysms and their wide-neck morphology, clip ligation is currently more successful and has lower risk than endovascular therapy for most patients. The emergent need for surgical decompression of a tempor...