• Paul R Krafft, Howard Yonas, and Andrew P Carlson.
• Department of Neurosurgery, University of New Mexico, School of Medicine, Albuquerque, New Mexico, USA.
• World Neurosurg. 2016 Feb 1; 86: 512.e9-14.

BackgroundGiant serpentine aneurysms are complex intracranial lesions, associated with a poor prognosis if left untreated. Treatment usually involves surgical trapping of the aneurysm with arterio-arterial anastomosis; however, recent endovascular management has been implemented for the management of such aneurysms.Case DescriptionWe report the unique case of a 71-year-old woman who presented with visual deficits due to the mass effect of a giant serpentine aneurysm arising from the A1 segment of the anterior cerebral artery. Because of its location proximal to a widely patent anterior communicating artery, angiographic cure was achieved with sacrifice of the A1 segment. Clinical and radiographic follow-up demonstrated resolution of the presenting symptoms and near-complete obliteration of the aneurysm.ConclusionsThrombosed giant serpentine aneurysms can show dramatic resolution of mass effect with endovascular treatment.Copyright © 2016 Elsevier Inc. All rights reserved.

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