Surgical treatment strategies for intracranial fusiform aneurysms secondary to cardiac myxomas: illustrative case.

Abstract

Background: Intracranial myxomatous aneurysms secondary to cardiac myxomas are rare. Fusiform aneurysms, often multiple and predominantly involving distal vessels, represent the predominant manifestation. To date, there remains no consensus on the optimal management strategy for these fusiform aneurysms.

Observations: The authors present the first case of a patient who underwent resection of a middle cerebral artery aneurysm and M3-superficial temporal artery (STA)-M3 end-to-end anastomosis bypass surgery 10 years following cardiac myxoma resection. They also review case reports on the treatment, neurological symptoms, and prognosis of fusiform aneurysms secondary to cardiac myxomas since 2005.

Lessons: Treatment options for aneurysms encompass conservative management, embolization, radiation therapy, clipping, resection, and combined bypass procedures. Among the cases included this report, only 1 patient died during follow-up; the rest of the patients had a good prognosis. Although the natural course of unruptured, seemingly benign aneurysms seems favorable, many patients experience concurrent neurological symptoms. Aneurysm resection combined with M3-STA-M3 end-to-end anastomosis bypass is an effective treatment for fusiform aneurysms and reducing the risk of cerebral ischemia. https://thejns.org/doi/10.3171/CASE2590.