Published online Nov 6, 2023. doi: 10.12998/wjcc.v11.i31.7712
Peer-review started: September 13, 2023
First decision: September 14, 2023
Revised: September 21, 2023
Accepted: October 26, 2023
Article in press: October 26, 2023
Published online: November 6, 2023
Processing time: 54 Days and 2.9 Hours
Intracranial fusiform aneurysms are rare, spindle-shaped, and nonsaccular arterial dilatations that may be caused by dissection.
A 48-year-old man complained of wake-up onset of dysarthria and left-sided weakness. Diffusion-weighted magnetic resonance imaging of the brain revealed an infarction in the territories of the right middle and posterior cerebral arteries. Computed tomography angiography showed fusiform aneurysms in the right vertebral artery and bilateral petrous segments of the internal carotid arteries (ICAs). Despite conservative management, malignant ischemic stroke recurred in the contralateral ICA territory within a day of the onset of the index stroke.
We report a rare case of successive malignant strokes in a patient with multiple fusiform aneurysms. Herein, we emphasize that clinicians should consider aggressive treatment for patients with ischemic stroke and multiple fusiform aneurysms.
Core Tip: Intracranial fusiform aneurysms are spindle-shaped and nonsaccular arterial dilatations. Dissection is the most common cause of fusiform aneurysms. Intracranial dissection is an important cause of ischemic stroke, especially in young patients at low risk for atherosclerosis. The treatment of intracranial fusiform aneurysms is still under debate; however, clinicians should consider aggressive treatment in patients with ischemic stroke with multiple fusiform aneurysms.