Treatment of fusiform aneurysms of the peripheral cerebral arteries. Report of two cases.

Two patients with fusiform aneurysms and at least one previous subarachnoid hemorrhage were treated by excision of the aneurysms and reconstruction of the arteries. The first case presented with two fusiform aneurysms, the larger of which involved the angular and the smaller one the temporal branch of the left middle cerebral artery (MCA). Both aneurysms were totally excised. The angular artery was reconstructed with a 1.5 cm long arterial graft taken from the left superficial temporal artery. Excision of the temporal aneurysm was followed by an end-to-end suture of the central and distal parts of the vessel. The second case had a fusiform aneurysms involving the temporal branch of the left MCA. The aneurysm was excised and an arterial graft 1 cm long cut from the superficial temporal artery was used in reconstruction of the affected vessel. In each case left carotid angiography was done 1 week postoperatively. In the first case the angiogram showed that the angular artery reconstructed with a graft was patent, whereas the temporal artery reconstructed without a graft was not visualized. In the second patient, whose temporal artery was reconstructed with a graft, angiography did not show the reconstructed artery. Left carotid angiography was repeated 1 year after the operation in both cases, and all the reconstructed vessels were well visualized.