Explore the intriguing case of a false positive angiographic aneurysm at the M1 bifurcation of the middle cerebral artery and uncover the implications for vascular neurosurgery practices.
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False positive angiographic aneurysm of the anterior segment of the M1 bifurcation of the middle cerebral artery: a case report.
Xiao et al., Front Neurol 2023
DOI: 10.3389/fneur.2023.1327878
Case Report: False Positive Aneurysm Diagnosis Due to Arterial Occlusion
A rare case of a false positive aneurysm diagnosis on vascular imaging is presented, involving a 69-year-old woman with a left frontal lobe subacute infarct. Imaging techniques, including computed tomographic angiography (CTA) and digital subtraction angiography (DSA), suggested aneurysms at two locations in the middle cerebral artery (MCA). However, upon craniotomy, only the aneurysm at the MCA bifurcation was confirmed. The suspected aneurysm at the anterior segment of the M1 bifurcation was instead a severe atherosclerotic occlusion, with the occluded stump mimicking an aneurysm on imaging.
Significance: This case underscores the importance of careful interpretation of cerebrovascular CTA or DSA in diagnosing aneurysms, particularly when they are located in atypical positions and accompanied by ischemic cerebrovascular disease. It serves as a reminder that occlusions can present as aneurysm-like structures, potentially leading to misdiagnosis.
Contribution to Literature: The report adds to the limited number of cases documenting false positive aneurysm diagnoses due to arterial occlusions, emphasizing the need for cautious assessment in similar clinical scenarios.