Commentary

Gelal et al present a direct case of a giant fusiform basilar aneurysm causing hydrocephalus. It is intriguing to note that the lesion was not detected by conventional angiography but only by MR angiography. My only suggestion is that 3D CT angiography may have identified this lesion before conventional or MR angiography. In our experience, the long-term prognosis of these patients, with or without shunting, is poor and inevitably leads to fatal hemorrhage.