Giant saccular aneurysm of the intracranial vertebral artery: clinico-morphological case

Authors

DOI:

https://doi.org/10.26641/1997-9665.2026.2.35-40

Keywords:

giant saccular aneurysm, vertebral artery, endovascular embolization, pathological examination

Abstract

Background. Giant vertebrobasilar aneurysms are rare and prognostically unfavorable lesions of the central nervous system. They are characterized by a pseudotumorous course, progressive mass effect, brainstem compression, and a high risk of fatal outcomes. Despite advances in endovascular treatment, periprocedural complications remain an important clinical problem. Objective. To increase physicians’ awareness of the clinical course, morphogenesis, and complications of giant intracranial vertebral artery aneurysms. Methods. A clinico-morphological case of giant saccular aneurysm of the intracranial (V4) segment of the right vertebral artery in a 57-year-old man was analyzed. Spiral computed tomography, cerebral angiography, endovascular coil embolization, and pathological examination findings were evaluated. Macroscopic assessment of the aneurysmal sac, thrombotic masses, and brain changes was performed. Results. The patient developed progressive neurological deficit with bulbar syndrome and alternating sensory disturbances. Neuroimaging revealed a giant vertebral artery aneurysm with severe mass effect. Subtotal endovascular coil embolization was performed. Pathological examination demonstrated an aneurysmal sac measuring 65×50×45 mm filled with mural thrombi at different stages of organization. Brainstem compression and displacement, cerebral edema, and cerebellar tonsillar herniation through the foramen magnum were identified. Death resulted from progressive compression of the vital medullary centers. Conclusions. Giant intracranial vertebral artery aneurysms are associated with severe pseudotumorous manifestations and a high risk of fatal complications. Endovascular treatment may increase the mass effect because of thrombosis within the aneurysm. Comprehensive pathological examination is essential for understanding tanatogenesis and improving diagnostic and therapeutic strategies.

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Published

2026-05-29

How to Cite

Sakal , H., Potapov , S., Horhol , N., & Kykhtenko , O. (2026). Giant saccular aneurysm of the intracranial vertebral artery: clinico-morphological case. Морфологія / Morphologia / Morfologìâ, 20(2), 35–40. https://doi.org/10.26641/1997-9665.2026.2.35-40

Issue

Vol. 20 No. 2 (2026)

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