We have experienced four cases of supergiant cerebral aneurysm, each greater than 6.0cm in diameter. Two of these cases were saccular aneurysms of the anterior communicating artery and middle cerebral artery, or which necks were clipped with resection of the aneurysms. Another patient had a fusiform aneurysm of the middle cerebral artery, which was resected accompanied by a reconstructive procedure of cerebral blood flow. The last patient had a fusiform aneurysm of the internal carotid artery. Following internal carotid artery occlusion surgery with superficial temporal artery-middle cerebral artery anastomosis, the aneurysm completely disappeared radiologically within several months. Two cases showed not only focal signs caused by an aneurysmal compression effect but also papilledema caused by intracranial hypertension. The other two cases will also show similar symptoms and signs due to intracranial hypertension in the near future unless adequate surgical treatment is performed. We have, therefore, classified these four cases as supergiant cerebral aneurysms. Although many cases of a giant cerebral aneurysm have been reported in the recent literature, there has been no case of an unruptured giant aneurysm causing increased intracranial pressure, except for our two cases and three other cases.1)3) We think we should select the operative method by which these aneurysms can be made to disappear
