ArticleNeurosurgery practice2026
Microsurgical Trapping, Flow Diversion and Early Chemotherapy for a Ruptured Neoplastic Middle Cerebral Artery Aneurysm Secondary to Choriocarcinoma.
Article in Neurosurgery practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and importanceRuptured neoplastic cerebral aneurysms (NCAs) due to choriocarcinoma are rare. They are found most commonly in distal middle cerebral artery (MCA) and carry a high risk of rerupture, morbidity and mortality. We present a case of choriocarcinoma-associated NCA managed by a combination of microsurgical-trapping, flow diversion, and low-dose induction chemotherapy initiated in the early postoperative period. CLINICAL PRESENTATION: This 3-month postpartum young woman developed subarachnoid hemorrhage in the left sylvian fissure due to an irregular left MCA trifurcation fusosaccular aneurysm. Serum and cerebrospinal fluid beta human chorionic gonadotrophin (β-hCG) levels were elevated. While undergoing a systemic workup, she reruptured and was taken for emergent craniectomy, with microsurgical trapping and excisional biopsy of the ruptured vessel segment. Rest of the unruptured diseased segment in inferior MCA trunk was flow diverted 5 days later using a Pipeline Vantage device (Medtronic) designed for smaller and more distal vessels. In an attempt to halt disease progression and prevent rerupture, 2 low-dose induction chemotherapy cycles (etoposide and cisplatin) were administered immediately over the following 2 weeks. She was later transitioned to etoposide, methotrexate, actinomycin-D + cyclophosphamide, vincristine chemotherapy. She gradually improved and serum β-hCG levels normalized over 4 weeks after surgery. At 6-month follow-up, she had slight disability (modified Rankin Scale 2), and angiogram revealed resolution of inferior MCA aneurysmal dilatation.
conclusionThis case highlights a strategic synergistic application of microsurgical and endovascular modalities with chemotherapy while balancing the risks of aneurysm rerupture, stent thrombosis, and intracranial hemorrhage. It is also the first reported case of a ruptured NCA treated with flow diversion.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.