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The incidence of the blood blister-like aneurysm (blister aneurysm) is very small, and the diagnosis and the management have been reported to be difficult because the blister aneurysm arises on an unusual site and has very thin wall with an obscure neck. There is high surgical risk of massive intraoperative bleeding because of fragile component of the aneurysm. Surgery for the lesion requires specific surgical technique because blister aneurysm has an obscure neck involving arterial wall of the parent artery. In cases of intraoperative rupture, special techniques such as repair of a tear at the base of the aneurysm with suturing and/or encircling clip is required. Consequently, surgical result and the prognosis have been reported to be associated with generally poor outcomes. During the past 7 years, the author experienced 4 cases of blister aneurysm, in which 3 cases manifested subarachnoid hemorrhage (SAH) and 1 case was unruptured (accompanied with ruptured internal carotid-ophthalmic aneurysm). These 4 blister aneurysms arose at non-branching sites of the internal carotid artery (ICA). This report summarized 4 blister aneurysms which the author encountered during the past 7 years.

Aneurysm at Nonbranching Sites of the Internal Carotid Artery: Blood Blister-like Aneurysm. Report of 4 cases