Intracerebral hemorrhage caused by rupture of a giant aneurysm complicating superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease.

Abstract

Aneurysm formation at the anastomosis site after extracranial-intracranial (EC-IC) bypass surgery for major arterial occlusion or stenosis due to atherosclerosis has only been reported a few times previously. However, no case describing the formation of a giant aneurysm after EC-IC bypass surgery has been reported to date. Additionally, this complication associated with moyamoya disease is extremely rare, and only one case has been reported so far. We report a case of a 51-year-old woman having a rare complication of intracerebral hemorrhage due to rupture of a giant aneurysm that developed after superficial temporal artery-middle cerebral artery anastomosis for the treatment of moyamoya disease. To the best of our knowledge, this is the first reported case of a giant aneurysm, also the largest so far occurring after EC-IC bypass surgery and the second reported case of a rupture of an aneurysm formed after bypass surgery for moyamoya disease.