Aneurysm at Nonbranching Sites of the Internal Carotid Artery: Blood Blister-like Aneurysm. Report of 4 cases

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I encountered 4 cases of blood blister-like aneurysm (3 ruptured and 1 unruptured) during the past 7 years. The unruptured one was accompanied by a ruptured internal carotid-ophthalmic aneurysm. These aneurysms constitute 3.4% of the total of 117 aneurysms managed by open or endovascular surgery during the same period. In these 4 cases, the lesion arose at the nonbranching site on internal carotid artery. The 4 aneurysms were operated upon via a transsylvian approach. A combination of both wrapping and clipping was done in 3 cases, and for the remaining 1 (ruptured) clipping only. The aneurysm managed by clipping only suffered postoperative massive bleeding because of an inappropriate obliteration of the proximal aneurysmal neck. The other 2 ruptured aneurysms that underwent both wrapping and clipping did not suffer any bleeding postoperatively, and 1 patient with an unruptured aneurysm has been in good condition. I detail the course of these 4 cases and problems concerning management for blood blister-like aneurysm.
一般社団法人日本脳卒中の外科学会の論文