Unusual Treatment of an Intracranial Aneurysm Contralateral to a Previous Common Carotid Ligation

Abstract

T h e p re sence of mul t ip le i n t r ac ran ia l aneurysms, as well as t h e occurrence of a n e u r y s m s in b i l a t e ra l s y m m e t r i c a l locations, has been well d o c u m e n t e d . 1-~ N u m e r o u s ques t ions arise concerning p a t i e n t s who h a v e u n d e r g o n e successful surgical t r e a t m e n t for a n i n t r a c r a n i a l a n e u r y s m and who subsequen t l y d i sp lay cl inical and a r t e r iograph ic evidence of a second a n e u r y s m on the c o n t r a l a t e r a l side. W a s t h e second a n e u r y s m p resen t in i t ia l ly b u t no t v isua l ized a r te r iographica l ly? D id t he p rev ious surgical app roach a l te r t he h e m o d y namics in such a way as to produce or f u r t h e r t he d e v e l o p m e n t of t he second aneu rysm? H o w can t he a n e u r y s m be t r e a t e d ? T h e fol lowing case is repor ted to record a n u n u s u a l a p p r o a c h to such a problem.