We present five cases of giant serpentine aneurysms (large, partially
thrombosed aneurysms containing tortuous vascular channels with a sepa
rate entrance and outflow pathway) and review 28 cases reported in the
literature. Giant serpentine aneurysms should be considered as a subg
roup of giant aneurysms, distinct from saccular and fusiform varieties
, given their unique clinical presentation and radiographic features.