Facharzt FMH Neurochirurgie Practice Questions - Facharzt FMH Für Neurochirurgie Spécialiste FMH En Neurochirurgie Exam

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A 48-year-old previously healthy woman is found on MRI/MRA to have an incidental, unruptured 7 mm saccular aneurysm of the right middle cerebral artery (MCA) bifurcation. High-resolution catheter angiography reveals a wide neck (dome-to-neck ratio 1.1) with both dominant M2 cortical branches arising directly from the aneurysm base. She has no family history of aneurysms. What is the most appropriate definitive management recommendation?

Lifetime conservative observation with repeat non-contrast CT every 5 years only Simple coil embolization without balloon or stent assistance to avoid antiplatelet therapy Microsurgical clipping via a right pterional / minipterional craniotomy Parent vessel sacrifice of the right M1 segment using endovascular permanent liquid embolics

Correct Answer:

Microsurgical clipping via a right pterional / minipterional craniotomy

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