{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T02:08:35Z","timestamp":1773799715944,"version":"3.50.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Fenestrations or divisions of the vascular lumen into separate channels appear to be common anatomical variations in patients with intracranial aneurysms. The most frequent sites of occurrence are the anterior communicating artery (ACom), followed by vertebrobasilar and middle cerebral artery (MCA) locations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 61-year-old female was brought to the emergency department after experiencing severe headache with abrupt onset, nausea, and vomiting. Clinical examination on arrival showed a drowsy patient (GCS 14), with neck stiffness, but no cranial nerve palsies or other neurological deficits (Hunt-Hess 2). Non-contrast head CT and CT angiography revealed subarachnoid and intraventricular hemorrhage (modified Fisher 4) and two saccular aneurysms, one located on the right supraclinoid ICA with peripheral calcifications, measuring 20 \u00d7 12 mm, the second on the left MCA bifurcation, 6 \u00d7 4 mm. 3D rotational angiography revealed a right ICA fenestration located between the ophthalmic (OA) and posterior communicating artery (PCom). The proximal part of the fenestration harbored a large saccular aneurysm projecting superiorly with the neck engulfing the origin of the fenestration; due to the favorable neck and geometry of the aneurysm, endovascular coil occlusion was chosen as a treatment option without balloon or stent assistance. The decision was taken to clip the MCA aneurysm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Supraclinoid ICA fenestrations are rare anatomical variations. Endovascular treatment of supraclinoid ICA fenestration-related aneurysms is feasible and safe, with the notable concern of perforators originating from the limbs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.966642","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T07:59:39Z","timestamp":1667980779000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Endovascular treatment of an aneurysm associated with fenestration of the supraclinoid internal carotid artery: Case report and review of the literature"],"prefix":"10.3389","volume":"13","author":[{"given":"Rare\u1e63 Cristian","family":"Filep","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"Constantin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emil Marian","family":"Arb\u01cena\u1e63i","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian Vasile","family":"Mure\u1e63an","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliza","family":"Russu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucian","family":"M\u01cerginean","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.3174\/ajnr.A1563","article-title":"Fenestrations of intracranial arteries detected with 3D rotational angiography","volume":"30","author":"van Rooij","year":"2009","journal-title":"AJNR Am J Neuroradiol."},{"key":"B2","first-page":"634","article-title":"Fenestration of the supraclinoid internal carotid artery with rupture of associated aneurysm","volume":"5","author":"Yock","year":"1984","journal-title":"AJNR Am J Neuroradiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1017\/S0317167100026317","article-title":"Fenestration of the supraclinoid internal carotid artery","volume":"14","author":"Findlay","year":"1987","journal-title":"Can J Neurol Sci."},{"key":"B4","doi-asserted-by":"publisher","first-page":"740","DOI":"10.2176\/nmc.31.740","article-title":"Fenestration of the intracranial internal carotid artery\u2013case report","volume":"31","author":"Takano","year":"1991","journal-title":"Neurol Med Chir."},{"key":"B5","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1016\/0090-3019(92)90154-F","article-title":"Fenestration of the supraclinoid internal carotid artery associated with carotid bifurcation aneurysm","volume":"37","author":"Hattori","year":"1992","journal-title":"Surg Neurol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"438","DOI":"10.3171\/jns.1993.79.3.0438","article-title":"Supraclinoid internal carotid artery fenestration with an associated aneurysm. 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