ICA Bifurcation Aneurysm

A 38-year-old-male was admitted with sudden onset of severe global headache and vomiting, followed by altereation in sensorium. CT brain showed subarachnoid and intraventricular hemorrhage (Fig 1). MRI brain revealed deep seated right sided thalamic hematoma due to ruptured internal carotid artery bifurcation aneurysm (Fig 2), confirmed by cerebral digital subtraction angiography (Fig 3). He underwent clipping of the aneurysm by transciliary supraorbital keyhole minicraniotomy (see video). Postoperative angiography showed complete occlusion of the aneurysm (Fig 4). When discharged ten days later, there was no neurological deficit (Fig 5).



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