Surgical and Endovascular Management of Patients With Giant Cerebral Aneurysms

Giant cerebral aneurysms (GCAs) represent 5% of intracranial aneurysms and often present with neurologic symptoms secondary to the compression of the surrounding brain. The management of these formidable lesions has evolved over the recent years. Surgical management continues to be the mainstay of treatment for GCAs, and many special considerations must be contemplated for any individual GCA before an operation because each GCA is unique and should be treated as such. Endovascular management of GCAs has shown much promise, especially with regard to flow diversion. These devices are still in their infancy but have demonstrated success in the treatment of GCAs in recent studies. In conclusion, it is imperative that GCAs be managed by a team of cerebrovascular physicians with years of experience in managing these complex aneurysms.