Giant serpentine aneurysm: Neuroradiological and neurosurgical management in a left-handed patient.

Autor:	Romano A; NESMOS, Department of Neuroradiology, S.Andrea Hospital, University Sapienza, Rome, Italy., Moltoni G; NESMOS, Department of Neuroradiology, S.Andrea Hospital, University Sapienza, Rome, Italy., Piazza A; NESMOS, Department of Neuroradiology, S.Andrea Hospital, University Sapienza, Rome, Italy., Trasimeni G; NESMOS, Department of Neuroradiology, S.Andrea Hospital, University Sapienza, Rome, Italy., Miscusi M; NESMOS, Department of Neuroradiology, S.Andrea Hospital, University Sapienza, Rome, Italy., Palizzi S; NESMOS, Department of Neuroradiology, S.Andrea Hospital, University Sapienza, Rome, Italy., Romano A; NESMOS, Department of Neuroradiology, S.Andrea Hospital, University Sapienza, Rome, Italy., Raco A; NESMOS, Department of Neuroradiology, S.Andrea Hospital, University Sapienza, Rome, Italy., Bozzao A; NESMOS, Department of Neuroradiology, S.Andrea Hospital, University Sapienza, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Radiology case reports [Radiol Case Rep] 2023 Oct 04; Vol. 18 (12), pp. 4384-4388. Date of Electronic Publication: 2023 Oct 04 (Print Publication: 2023).
DOI:	10.1016/j.radcr.2023.09.014
Abstrakt:	Giant serpentine aneurysms are rare huge and partially thrombosed aneurysms, with an eccentric tortuous intra-aneurysmal vascular channel. Surgical treatment is often necessary due to the great mass effect. We describe a case of a left-handed woman with a giant serpentine aneurysm of the left middle cerebral artery whose management was complex. The challenge was to exclude the aneurysm from circulation, reduce the mass effect, and, mostly, preserve the language function. Since the patient was left-handed the language dominance needed to be assessed; functional MRI (fMRI) and Wada test (WT) showed a right dominance. Surgical treatment was performed, as a complication, the patient developed left fronto-basal ischemia with a slight paresis of the right hand but without any language deficit. Our case shows the importance of a multidisciplinary team in patient management, with a pivotal role of neuroradiological functional tests in presurgical planning. (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
Databáze:	MEDLINE
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