Case Report: De novo multiple intracranial aneurysms following extracranial–intracranial bypass and proximal occlusion for a giant serpentine aneurysm

This case illustrates an unusual pattern of early, multiple, non-anastomotic <i>de novo</i> MCA aneurysms developing after double-barrel STA-MCA bypass and proximal clipping. The findings highlight how revascularization can alter local pressure gradients and redistribute flow in ways that relieve hemodynamic stress on classic collateral pathways yet create new regions of focal wall shear stress along the ipsilateral MCA.