Long-term follow-up of giant serpentine MCA aneurysm treated with EC-IC bypass and proximal occlusion.

Giant serpentine aneurysms are a rare but important subset of giant aneurysms, with unique management considerations. We present long-term follow-up clinical and imaging features of a giant serpentine middle cerebral artery lesion treated with extracranial-intracranial bypass and proximal occlusion more than a decade earlier. Calcification of the obliterated aneurysm sac and durability of this management strategy are demonstrated.