Incidental left MCA aneurysm post minor head injury

Abstract

Middle cerebral artery (MCA) aneurysms account for approximately 21% of cerebral aneurysms. The most
frequent location for MCA aneurysms is the M1–M2 bifurcation, while less commonly, they may arise near the
lenticulostriate arteries or anterior temporal branch origin. In cases of bilateral MCA aneurysms, determining the
ruptured aneurysm can be challenging. This study highlights factors influencing rupture, including the ratio of
perpendicular height to neck diameter, flow angle, and the angular relationship between M1 and M2 segments.
Due to their relatively superficial position in the Sylvian fissure, MCA aneurysms are more accessible than other
aneurysms, although their neck-to-dome ratio complicates treatment. Given that MCA branches may arise from
the sac or neck, surgical clipping is often preferred over coil embolization. This report underscores the need for
neurosurgeons to engage in comprehensive research on the unique characteristics, treatment approaches, and
intraoperative considerations for managing MCA aneurysms.