Several reports have mentioned formation of new saccular aneurysms in
previously normal-appearing vessels, but de novo fusiform aneurysms ha
ve not been reported. We describe three children who initially present
ed with giant fusiform aneurysms involving the cervical and petrous po
rtions of the internal carotid artery and were treated with balloon oc
clusion. Between 2 and 6 years later, they were found to have new gian
t fusiform aneurysms in the vertebrobasilar system.