Tratamiento de un aneurisma serpentino gigante de arteria cerebral media con bypass de alto flujo desde la arteria carótida interna petrosa

a case report of a giant serpentine type aneurysm arising from the m1 segment of the middle cerebral artery (mca) treated with a high-flow external saphenous vein graft from the petrous segment of the internal carotid artery is presented. the steps and challenges of this demanding surgical technique are also described. the elements to be taken into consideration in the indication, design and realization of the bypass surgery in the treatment of the mca aneurysms are discused.