Non ruptured MCA aneurysms presenting with insular related symptoms.

OBJECTIVE To present a new semiological description of unruptured middle cerebral artery (MCA) aneurysms. METHODS We present a series of three MCA aneurysms presenting with progressive or paroxystic somatosensory symptoms in combination with visceral, motor, language or autonomic symptoms. RESULTS A surgical approach was proposed for two aneurysms, and both patients experienced complete resolution of their symptoms. The third aneurysm was successfully excluded by endovascular coiling but the symptoms persisted. CONCLUSIONS To our knowledge this is the first description of unruptured aneurysms presenting with insular-related symptoms.