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Case series
Intracranial perianeurysmal cysts: case series and review of the literature
  1. Ee Shern Liang1,
  2. Michael Efendy2,
  3. Craig Winter3,
  4. Alan Coulthard1,4
  1. 1 Department of Medical Imaging, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
  2. 2 Caboolture Hospital, Caboolture, Queensland, Australia
  3. 3 Department of Neurosurgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
  4. 4 The University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
  1. Correspondence to Dr Ee Shern Liang, Department of Medical Imaging, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; shern86{at}


Background Intracranial perianeurysmal cysts are a rare finding associated with cerebral aneurysms. Patients may present with symptoms secondary to mass effect from perianeurysmal cysts requiring drainage. These lesions can masquerade as neoplasms if dedicated vascular imaging is not performed, leading to misdiagnosis.

Method A retrospective search of our database was done for intracranial aneurysms that have been treated between 1998 and 2020. A literature search was then performed on PubMed and Google Scholar with the search terms ‘aneurysm’, ‘intracranial/intracerebral’, ‘cyst’, and ‘perianeurysmal cyst’. Patient demographics, aneurysms and cysts characteristics were then summarized as a table and in the discussion.

Results Three cases where intracranial aneurysm had associated perianeurysmal cysts were found in our database. Combined with the available literature a total of 19 cases of perianeurysmal cysts have thus far been reported since this entity was first described in 2002. A significant number of perianeurysmal cysts (5/19) required intervention. In 5/19 cases the patient presented with a perianeurysmal cyst without a history of subarachnoid hemorrhage. Of the 10 cases where aneurysm follow-up was reported there were 5 cases where there was aneurysm recurrence necessitating re-treatment.

Conclusion Significant variability exists in the patient demographics, aneurysm and cyst characteristics of perianeurysmal cysts. This suggests that there is no single unified etiology and pathogenesis. These lesions are a rare finding and at present do not appear to carry diagnostic or prognostic significance. Management of perianeurysmal cysts is case-dependent and intervention should be considered when treating the related aneurysm, especially in patients with secondary symptoms.

  • aneurysm
  • brain
  • inflammatory response

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  • Contributors ESL: main author, planning, literature review, data collection. ME: planning, literature review, data collection, draft. CW: planning, draft, review. AC: planning, review, supervisor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.