Cerebral cavernous malformations (CCM) can mimic other lesions such as thrombosed aneurysms. Completely thrombosed aneurysms (CTA) are rare, especially in non-giant aneurysms. We report a case of a 40-year-old man with a presumed insular CCM. A surgery was performed and revealed a thrombotic distal middle cerebral artery (MCA) aneurysm. The treatment consisted in sac incision and partial debulking. We reviewed the cases of thrombotic non-giant CTA and lesions mimicking CCM in the literature. Complete radiologic analysis and differential diagnosis remain crucial. For non-giant CTA, there is no clear consensus on their management, but they could be managed conservatively.

脑海绵状血管瘤（CCM）可以模仿其他病变，例如血栓性动脉瘤。完全血栓形成的动脉瘤（CTA）很少见，特别是在非巨大动脉瘤中。我们报告了一名 40 岁男性的病例，推测患有岛状 CCM。进行了手术，发现血栓性远端大脑中动脉（MCA）动脉瘤。治疗包括囊切开和部分减灭术。我们回顾了文献中血栓性非巨大 CTA 和类似 CCM 的病变病例。完整的放射学分析和鉴别诊断仍然至关重要。对于非巨头CTA，其管理尚无明确共识，但可以保守管理。