Rapid Growth of an Internal Carotid Anterior Wall Aneurysm

We present three cases with ruptured internal carotid anterior aneurysm which grew rapidly within a few days. All of them were females aged 54–75 years. Overt aneurysmal dilatation was not apparent except for a small bulging shadow on the initial angiogram but was visualized on a follow-up angiogram. We operated on all 3 cases. The aneurysm wall was thin and premature rupture occurred during the microscopic procedure. We suspect that our cases were not ordinary saccular aneurysms but dissecting aneurysms and that the rapid growth resulted from extension of the arterial wall dissection.