RARE M2-M3 JUNCTION ANEURYSM OPERATED AT IVY HOSPITAL MOHALI BY DR VINEET SAGGAR

Most of the aneurysms occur at the bifurcation  of major vessels as we all know.  MCA aneurysms  generally  occur at bifurcation  of  MCA (MIDDLE CEREBRAL ARTERY) . However  this aneurysm was at further branching  of frontal division of MCA at M2-M3 junction and supplying frontal lobe  . It posed a different  challenges  as aneurysm  was embedded in frontal lobe paren chyma . Also vessels beyond bifurcation are very delicate and frontal and temporal trunks generally  trifurcate or more hence aneurysm  is surrounded by multiple  delicate 1-2mm vessels . Clipping  some times carries risk of kinking these vessels . In this case aneurysm  was bilobed and was clipped using two clips to avoid kinking of trifurcation. Patient  had uneventful  recovery.

CT ANGIO  SHOWING RIGHT SIDED M2-M3 JUNCTION ANEURYSM. 

POST OPERATIVE  SCANS  OF THE PATIENT AFTER 48 HRS