PMC10159313_01
(a) The preoperative state fluid attenuated inversion recovery image in magnetic resonance imaging detected a substantial aneurysm located in the right posterior communicating artery, displaying high intensity in the brain parenchyma surrounding the aneurysm (arrow). (b) The fluid attenuated inversion recovery image of the magnetic resonance imaging scan taken 1 year postsurgery showed resolution of aneurysm-induced pressure drainage at the medial temporal lobe, and the high intensity surrounding the aneurysm had also disappeared.
SNI-14-152-g001.jpg
PMC10159313_01_SNI-14-152-g001.jpg
F1
The MRI scan revealed a substantial aneurysm at the bifurcation of the right posterior communicating artery, and the aneurysm was situated within the amygdala, showing high intensity on the fluid attenuated inversion recovery image in the cerebral parenchyma surrounding the aneurysm [Figure 1]. One year after surgery, an MRI revealed resolution of aneurysm-induced pressure drainage at the medial temporal lobe, and the high intensity surrounding the aneurysm had also disappeared [Figure 1].
The preoperative cerebral angiogram confirmed the presence of a 14-millimeter aneurysm in the right posterior communicating artery.
SNI-14-152-g002.jpg
PMC10159313_01_SNI-14-152-g002.jpg
F2
A cerebral angiogram confirmed the presence of a 14-millimeter aneurysm in the right posterior communicating artery [Figure 2].
Intraoperative findings of surgical clipping (a) We attained access to the aneurysm (asterisk) with trans-sylvian approach. The aneurysm was found to be in proximity to the temporal lobe (black arrowheads). The black and white arrows indicate the proximal and distal neck of the aneurysm, respectively. (b) Following temporary occlusion of the cervical segment of the internal carotid artery (ICA), neck clipping of the aneurysm was performed with a straight clip. The posterior communicating artery (white arrowheads) was confirmed between the optic nerve and the ICA and preserved.
SNI-14-152-g003.jpg
PMC10159313_01_SNI-14-152-g003.jpg
F3
ICA [Figure 3]. In the postoperative period, the patient experienced no new symptoms, and the smelly symptoms were resolved by the 2nd postoperative day.