A patient presenting with a giant, fusiform middle cerebral artery aneurysm underwent extracranial to intracranial bypass grafting before permanent occlusion of the aneurysm. The patient was to return 4 months later for endovascular treatment. Arteriography obtained before obliteration revealed complete aneurysmal thrombosis. No further treatment was deemed necessary. Factors predisposing to thrombosis are discussed.
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