Partially thrombosed anterior communicating artery aneurysm mimicking a suprasellar tumor: Microsurgical reconstruction after aneurysmotomy and ultrasonic thrombectomy.
- 1Department of Neurosurgery, Faculdade de Medicina de São José do Rio Preto and Hospital de Base (FUNFARME), São José do Rio Preto, Brazil.
- 2Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil.
- 3Department of Neurosurgery, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Abstract
Background
Partially thrombosed intracranial aneurysms are uncommon lesions that may mimic intracranial neoplasms because of their heterogeneous radiological appearance and mass effect. When associated with broad-neck morphology and incorporation of adjacent vessels, treatment may require complex microsurgical reconstruction.Case description
A 69-year-old woman with hypertension and type 2 diabetes mellitus underwent investigation after a mild traumatic brain injury. Initial computed tomography (CT) demonstrated a suprasellar lesion suggestive of a neoplastic process. CT angiography and digital subtraction angiography subsequently revealed a partially thrombosed anterior communicating artery aneurysm measuring 19 × 10 mm with a 6.6-mm neck and incorporation of the right A2 segment into the aneurysm neck. The patient underwent elective microsurgical treatment through a right fronto-orbital approach. Following temporary vascular control, aneurysmotomy and ultrasonic thrombectomy using the Clarity® system were performed. Definitive reconstruction required sequential placement of eight permanent clips while preserving both A2 segments. Intraoperative fluorescein angiography confirmed adequate vessel patency. The patient remained neurologically intact, with a modified Rankin Scale score of 0 at 90-day follow-up.Conclusion
Partially thrombosed anterior communicating artery aneurysms may mimic suprasellar tumors and represent an important diagnostic challenge. In selected cases with branch incorporation, broad-neck morphology, and significant thrombotic burden, microsurgical reconstruction remains a safe and effective treatment strategy. Aneurysmotomy combined with ultrasonic thrombectomy facilitates visualization of the true aneurysm neck and may assist complex clip reconstruction.
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BibTeX
@article{filho2026partially,
title = {{Partially thrombosed anterior communicating artery aneurysm mimicking a suprasellar tumor: Microsurgical reconstruction after aneurysmotomy and ultrasonic thrombectomy.}},
author = {José Luis Quelho Filho and Pedro Henrique Argentato Brassarola and Paulo Eduardo Albuquerque Zito Raffa and Leonardo Vieira Nunes and Leonardo Peixoto Garcia and Rodrigo Shibaki and Lucas Crociati Meguins and Eberval Gadelha Figueiredo},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_783_2026},
url = {https://europepmc.org/article/MED/42974251},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Partially thrombosed anterior communicating artery aneurysm mimicking a suprasellar tumor: Microsurgical reconstruction after aneurysmotomy and ultrasonic thrombectomy.
AU - José Luis Quelho Filho
AU - Pedro Henrique Argentato Brassarola
AU - Paulo Eduardo Albuquerque Zito Raffa
AU - Leonardo Vieira Nunes
AU - Leonardo Peixoto Garcia
AU - Rodrigo Shibaki
AU - Lucas Crociati Meguins
AU - Eberval Gadelha Figueiredo
PY - 2026
DA - 2026/10/02
JO - Surgical neurology international
DO - 10.25259/sni_783_2026
UR - https://europepmc.org/article/MED/42974251
AB - Background Partially thrombosed intracranial aneurysms are uncommon lesions that may mimic intracranial neoplasms because of their heterogeneous radiological appearance and mass effect. When associated with broad-neck morphology and incorporation of adjacent vessels, treatment may require complex microsurgical reconstruction.Case description A 69-year-old woman with hypertension and type 2 diabetes mellitus underwent investigation after a mild traumatic brain injury. Initial computed tomography (CT) demonstrated a suprasellar lesion suggestive of a neoplastic process. CT angiography and digital subtraction angiography subsequently revealed a partially thrombosed anterior communicating artery aneurysm measuring 19 × 10 mm with a 6.6-mm neck and incorporation of the right A2 segment into the aneurysm neck. The patient underwent elective microsurgical treatment through a right fronto-orbital approach. Following temporary vascular control, aneurysmotomy and ultrasonic thrombectomy using the Clarity® system were performed. Definitive reconstruction required sequential placement of eight permanent clips while preserving both A2 segments. Intraoperative fluorescein angiography confirmed adequate vessel patency. The patient remained neurologically intact, with a modified Rankin Scale score of 0 at 90-day follow-up.Conclusion Partially thrombosed anterior communicating artery aneurysms may mimic suprasellar tumors and represent an important diagnostic challenge. In selected cases with branch incorporation, broad-neck morphology, and significant thrombotic burden, microsurgical reconstruction remains a safe and effective treatment strategy. Aneurysmotomy combined with ultrasonic thrombectomy facilitates visualization of the true aneurysm neck and may assist complex clip reconstruction.
SN - 2229-5097
SN - 2152-7806
ER -