Abstract: Objective To explore the imaging features, diagnosis and treatment strategies of intracranial lageniform aneurysms.
Methods The clinical characteristics and therapeutic outcomes of 6 patients with intracranial lageniform aneurysms were
retrospectively analyzed. Results All the 6 aneurysms, including 5 anterior communicating artery aneurysms and 1 middle
cerebral artery (MCA) aneurysm, were diagnosed by CT, DSA and (or) MRA. Pretreatment CT revealed subarachnoid
hemorrhage and intracranial hematoma surrounding the ruptured aneurysm. Three dimensional DSA showed that all the
lageniform aneurysms contained two parts, the larger false aneurysm and the smaller true aneurysms. All the 5 Acom
aneurysms were coiled and the MCA aneurysm was clipped. Two patients with coiling developed serious brain edema, and
acute decompressive craniectomy was performed to 1 of them. Pathological examination of the surgical specimens confirmed
that pseudoaneurysm formed the larger part of the lageniform aneurysm. One patient died of brain hernia, and the other 5
patients were discharged with good GOS. All the patients showed stable neurological status during the 3-month follow-up.
Conclusion Lageniform aneurysm is a complex aneurysm consisting in larger part of false aneurysm and in smaller part of
true aneurysm, and early intervention with individualized surgeries is recommended.