Abstract
A giant fusiform aneurysm of the middle cerebral artery is a disease that causes many difficulties for endovascular intervention as well as surgery. No 1 solution is optimal for all cases, however for post-bifurcation aneurysms, trapping the aneurysms with a reanastomosis reimplantation, an in situ side to side bypass is feasible and has good results. We reported a 28-year-old male patient, admitted to the hospital because of severe headache, Glasgow Coma Scale 13 points, left hemiplegia, was diagnosed with subarachnoid hemorrhage due to rupture of a giant fusiform aneurysm of the middle cerebral artery in the M2 segment, Hunt and Hess grade 4. The patient underwent microsurgery with clipping aneurysm combined with a low-flow technique connecting the superficial temporal artery to the middle cerebral artery. Our findings suggest that surgery to connect the superficial temporal artery to the M2 segment and at the same time obstructing the parent artery occlusion of selected giant MCA aneurysm is an option to consider.