AUTHOR=Paitán Alexander Feliciano Vilcahuamán , Gibbon Frederico de Lima , Korotkov Dmitriy , Castillo Ileane Camallery , Moguel Ambar E. Riley , Salvagni Felipe Pereira , Chaddad-Neto Feres 

TITLE=Case report: Mirror paraclinoid aneurysm associated with mirror clinoidal meningioma

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1355865

DOI=10.3389/fneur.2024.1355865

ISSN=1664-2295

ABSTRACT=Introduction: Clinoidal meningiomas and paraclinoid aneurysms are individually uncommon, with the coexistence of mirror paraclinoid aneurysms and clinoidal meningiomas presenting an even rarer scenario. While the association between meningiomas and aneurysms is documented, the simultaneous presence of mirror lesions for both pathologies is not reported in the literature.We report a 62-year-old female with a three-month history of moderate bifrontal headaches. Magnetic Resonance Angiography (MRA) revealed mirror paraclinoid aneurysms, prompting surgical intervention. During the procedure, mirror clinoidal meningiomas were incidentally discovered. The left aneurysm was addressed first due to higher rupture risk, followed by the right aneurysm three months later. Both meningiomas were confirmed as Transitional Meningiomas (Grade 1; OMS, 2021). The aneurysms were successfully clipped, and the patient had an excellent postoperative outcome.This case represents a unique occurrence of mirror ophthalmic segment internal carotid artery aneurysms associated with mirror clinoidal meningiomas, a combination not previously reported. Despite the limitations of MRA in detecting small meningiomas, it remains a valuable non- invasive screening tool for neurovascular diseases. The case underscores the need for further research to elucidate the association between cerebral aneurysms and meningiomas.