case_images: PMC10637549_01
case_images: (A) CT scan with intracerebral hematoma. (B) CTA before surgery with an aneurysm on the trifurcation of the Middle cerebral artery (MCA).
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case_images: fig1
case_images: CT scan of the head showed an intracerebral hematoma in the right parietal-temporal lobe measuring 6 x 2.6 cm and a subarachnoid hemorrhage (SAH) on the right side. CTA showed a 10 x 7 mm large aneurysm at the trifurcation of the right middle cerebral artery (MCA) (Figure 1).
case_images: PMC10637549_02
case_images: (A) DSA showing AComA aneurysm. (B) 3D DSA model of the aneurysm. (C) Intraoperative view of the clipped aneurysm and anterior cerebral arteries with A1, A2, and the communicating segment. (D) Same intraoperative view of vessels filled with indocyanine green dye.
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case_images: PMC10637549_02_fneur-14-1182576-g002.jpg
case_images: fig2
case_images: DSA was performed, but endovascular embolization of the aneurysm was unsuccessful due to its wide base (Figure 2). With ICG-A, the aneurysm was excluded after placing the clip, and both A1 and A2 segments were transitory (Figure 2).
case_images: PMC10637549_03
case_images: DSA demonstrating AVM from a lateral (A) and anterior (B) perspective. Cortical AVM after placement of a surgical clip on the feeding artery (C). (D) Shows intraoperative angiography with indocyanine green dye. Image after removal of the AVM (E). (F) Shows the intraoperative angiography with indocyanine green dye that did not show any coloration.
case_images: fneur-14-1182576-g003.jpg
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case_images: fig3
case_images: The AVM measured 3.5 cm in diameter (Figure 3). With the help of ICG-A, we located the feeding artery and placed a surgical clip on it (Figure 3). After the removal of the AVM, we used ICG-A to rule out any remnants (Figure 3).
case_images: PMC10637549_04
case_images: Preoperative DSA showing bisaccular aneurysm on MCA and coils after embolization of bilateral ACI (A). Postoperative DSA with good closure of the aneurysm (B). A surgical clip was placed on the aneurysm on MCA (C). (D) Shows intraoperative angiography with indocyanine green dye.
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case_images: fig4
case_images: ICG-A showed good exclusion of the artery from the circulation, and all branches of the MCA were free (Figure 4). Angiography 6 months after the procedure showed the complete exclusion of the aneurysm after the procedure (Figure 4B); the GOS score was 5, and mRS was 1.
case_images: PMC10637549_05
case_images: DSA before surgery showing an aneurysm on the MCA bifurcation, 5.4 x 4 mm in size (A,B). (C,D) Show DSA images after surgery.
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case_images: PMC10637549_05_fneur-14-1182576-g005.jpg
case_images: fig5
case_images: The aneurysm was at the bifurcation of the MCA, with a 3 mm wide neck measuring 5.5 x 4 mm (Figure 5).