This patient was an 11-year-old who presented with sudden onset of left-sided weakness. Her imaging showed a lesion on the right side of her brain with associated right-sided infarcts. Her evaluation included an MRI and then an angiogram. The angiogram revealed a giant fusiform aneurysm of the middle cerebral artery (MCA).
A giant aneurysm is one that is over 2.5 cm in size. Giant fusiform aneurysms are a rare cerebrovascular pathology, especially in the pediatric population. They represent only approximately 5% of aneurysms.