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Four patients died, all of whom had presented with aneurysmal rupture. We have summarized the reported cases of LSA aneurysms, with their clinical presentation, management, and outcomes, for physicians who may be confronted with this diagnosis. Future studies that use available classification systems and include as much detail as possible should be encouraged to fully elucidate the optimal management strategy for these patients. We have summarized the reported cases of LSA aneurysms, with their clinical presentation, management, and outco