Double-barrel STA-MCA bypass for a giant thrombosed supraclinoid ICA aneurysm with gangliocapsular infarct – A case report

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Case Report

Author Details : S. Venkatesan, S. Balaji*

Volume : 9, Issue : 3, Year : 2023

Article Page : 165-169

https://doi.org/10.18231/j.ijn.2023.032

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Abstract

Extracranial-intracranial (EC-IC) bypass is an essential tool for cerebral revascularization procedure. Superficial temporal artery–middle cerebral artery (STA-MCA) bypass was usually performed using one stem of the STA only. In an attempt to augment the flow and to direct the flow to different ischemic areas of the brain, a “double-barrel” technique is used, in which both branches of the STA are used to revascularize distinct MCA territories. Though there are many advancements in endovascular procedures, still STA MCA bypass plays a role in selected cases. We report a 50 years old female with giant thrombosed supraclinoid segment internal carotid artery (ICA) aneurysm with gangliocapsular infarct presented with vision loss, and limb weakness. Patient underwent double barrel STA-MCA bypass, post operatively patient improved of symptoms and patient was discharged in a stable condition. Though endovascular techniques have evolved exponentially over the last few years, and most of these complex aneurysms can be treated using flow-diverting techniques.Though the need for microsurgical intervention is diminished iin this endovascular era, still the surgeons should think about these revascularization procedures as it gives life-long durable solution.
 

Keywords: Double-barrel STA-MCA bypass, Giant thrombosed supraclinoid aneurysm, CT perfusion, Gangliocapsular infarct

How to cite : Venkatesan S, Balaji S, Double-barrel STA-MCA bypass for a giant thrombosed supraclinoid ICA aneurysm with gangliocapsular infarct – A case report. IP Indian J Neurosci 2023;9(3):165-169

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