OBJECT: The goal of this study was to identify the origins of spontaneous fusiform @entity438 . METHODS: One hundred two cases of spontaneous fusiform MCA @entity439 were reviewed, including 40 from the authors' institutions and 62 identified from the literature. The mean age at symptom onset was 38 years, and the male/female ratio was 1.4:1. At presentation, the MCA lumen was stenosed or occluded in 12 @entity1 , focally dilated in 57, and appeared " @entity9155 " in 33. Most lesions originated from the M1 or M2 segments, and most (80%) presented with @entity1109 or were discovered incidentally. The presenting clinical features correlated with morphological findings in the @entity439 , which could be observed to progress from a small focal dilation or vessel narrowing to a @entity9155 channel. @entity548 was the most common presentation in small lesions; the incidence of @entity548 progressively diminished with larger lesions. @entity1 with stenoses or occluded vessels most often presented with @entity63 symptoms, and occasionally with @entity548 . Giant focal dilations or @entity9155 @entity439 were rarely associated with @entity548 ; clinical presentation was most often prompted by mass effect or @entity64 . CONCLUSIONS: Analysis of results after various treatments indicates that for symptomatic lesions, therapies that reverse intraaneurysmal blood flow and augment distal cerebral perfusion are associated with better outcomes than other strategies, including conservative management. Based on the spectrum of clinical, pathological, neuroimaging, and intraoperative findings, dissection is proposed as the underlying cause of these lesions.

Spontaneous fusiform XXXX : characteristics and a proposed mechanism of formation.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['thromboembolic stroke'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhage', 'bleeding', 'Hemorrhage', 'acute bleeding'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemic'] @entity1109 :: ('MESH:D012678', 'Disease') :: ['nonhemorrhagic symptoms'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms'] @entity9155 :: ('CHEBI:46670', 'Chemical') :: ['serpentine'] @entity438 :: ('MESH:D002532', 'Disease') :: ['middle cerebral artery (MCA) aneurysms']
@entity438 :: (MESH:D002532,Disease) :: ['middle cerebral artery aneurysms']
