{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T09:04:27Z","timestamp":1774429467142,"version":"3.50.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Complete aneurysmal thrombosis is a rare occurrence in which a combination of thrombus and plaque contributes to the complete obliteration of the lumen of an aneurysm, rendering it occult on angiographic imaging. To date, there is a paucity of information in the literature describing the clinical\/radiographic presentation and operative management of complete thrombosed aneurysms of the middle cerebral artery. A focused literature review was performed to identify previously reported cases of complete MCA aneurysm thrombosis. Five cases meeting these criteria were identified, of which four underwent open microsurgical management and one was treated endovascularly. We report a clinical case of a 35-year-old female who presented with severe exacerbation of baseline headaches. Radiographic features were suggestive of a ruptured cavernous malformation. In the operating room, a large and completely thrombosed aneurysm of the superior M2 was encountered. The aneurysm was treated with ultrasonic evacuation of the thrombus and plaque, followed by definitive clip reconstruction. Completely thrombosed aneurysms are rare entities that can masquerade cavernous malformations (CCM) and\/or intra-axial neoplasms. Following a literature review, we highlight nuances of diagnosis and discuss pearls of surgical management along with the inclusion of a narrated, operative video.<\/jats:p>","DOI":"10.1007\/s00701-026-06841-3","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T20:04:19Z","timestamp":1774382659000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Completely thrombosed middle cerebral artery aneurysm mimicking cavernous malformation: illustrative case report with operative video and review of the literature"],"prefix":"10.1007","volume":"168","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2980-1242","authenticated-orcid":false,"given":"Beatrice","family":"Zucca","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marissa","family":"Koscielski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Kakazu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjit","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Gaskill-Shipley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Prestigiacomo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Forbes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"issue":"8","key":"6841_CR1","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1179\/016164103771953961","volume":"25","author":"JE Cohen","year":"2003","unstructured":"Cohen JE, Rajz G, Umansky F, Spektor S (2003) Thrombosis and recanalization of symptomatic nongiant saccular aneurysm. Neurol Res 25(8):857\u2013859. https:\/\/doi.org\/10.1179\/016164103771953961","journal-title":"Neurol Res"},{"issue":"3","key":"6841_CR2","doi-asserted-by":"publisher","first-page":"450","DOI":"10.3171\/jns.1978.48.3.0450","volume":"48","author":"G Edner","year":"1978","unstructured":"Edner G, Forster DM, Steiner L, Bergvall U (1978) Spontaneous healing of intracranial aneurysms after subarachnoid hemorrhage. Case report. J Neurosurg 48(3):450\u2013454. https:\/\/doi.org\/10.3171\/jns.1978.48.3.0450","journal-title":"J Neurosurg"},{"issue":"11","key":"6841_CR3","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1016\/S1474-4422(25)00264-9","volume":"24","author":"N Etminan","year":"2025","unstructured":"Etminan N, Ruigrok YM, Hackenberg KAM, Vergouwen MDI, Krings T, Rinkel GJE (2025) Epidemiology, pathogenesis, and emerging concepts in unruptured intracranial aneurysms. 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J Clin Neurosci 10(4):460\u2013464. https:\/\/doi.org\/10.1016\/S0967-5868(03)00092-4","journal-title":"J Clin Neurosci"}],"container-title":["Acta Neurochirurgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00701-026-06841-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-026-06841-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-026-06841-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:42:54Z","timestamp":1774420974000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00701-026-06841-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,24]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6841"],"URL":"https:\/\/doi.org\/10.1007\/s00701-026-06841-3","relation":{},"ISSN":["0942-0940"],"issn-type":[{"value":"0942-0940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,24]]},"assertion":[{"value":"14 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Cincinnati Medical Center, Department of Neurosurgery (Cincinnati, OH) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. In alignment with institutional policy for single-patient case reports, the Institutional Review Board (IRB) determined that formal IRB approval was not required and was therefore waived, as the report describes an individual clinical case without identifiable patient information. Written informed consent for publication was obtained from the patient (or the patient\u2019s legal representative).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent was obtained from the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"83"}}