Large doughnut-shaped internal carotid artery aneurysm

ArticleinActa neurologica Belgica 112(2):231-2 · February 2012with6 Reads
DOI: 10.1007/s13760-012-0043-z · Source: PubMed
  • [Show abstract] [Hide abstract] ABSTRACT: 240 patients with giant aneurysms admitted to 10 Italian centres were evaluated regarding radiological features and relationships to the outcome. Visualization of the aneurysm without contrast was obtained on CT scan in 49% of patients with aneurysms between 2 and 2.5 cm in diameter (A 1 group) and in 80% of patients with larger aneurysms (A 2 group). Contrast enhancement was homogeneous in 49% of patients, not homogeneous–with central or peripheral hypodensity — in 47% of patients, absent in 4% of patients. Ventricular shift was present in 17% of A1 patients and in 36% of A 2 patients. Hypodense areas were observed in 12% of cases, and calcifications in 19% of cases; bone erosions were rare. On angiography, the most common aneurysmal locations were the intracavernous carotid (21% of cases) and the middle cerebral artery (23% of cases). A neck could be identified on angiography in only 14% of patients, and stenosis of afferent vessel in 16% of patients. Vasospasm was rarely observed on angiography (17% of A 1 and 10% of A 2 patients). Aneurysmal thrombosis (partial, subtotal or total) was present in 48% of A 1 and 76% of A 2 patients (p < 0.001); partial peripheral thrombosis was most commonly observed (one half of cases). Round or oval shapes were most commonly observed, while fusiform, irregular, serpentine or doughnut shapes were rare. A few clinical/radiological relations were considered, such as the relation between partial thrombosis and haemorrhage, symptoms of expanding mass lesion, ischaemic episodes, aneurysmal location. In regard to outcome — and independently form treatment employed — the highest recovery rate was observed for intracavernous and carotid-ophthalmic aneurysms, and the lowest for carotid bifurcation aneurysms.
    Article · Feb 1988
  • [Show abstract] [Hide abstract] ABSTRACT: To evaluate the usefulness of three-dimensional CT angiography (CTA), in which contrast material is used to create reformations of dynamic scans, in the diagnosis and the preoperative evaluation of cerebral aneurysms. We used 3-D CTA to examine 65 patients with suspected or angiographically verified cerebral aneurysms. A blind study was performed to evaluate the diagnostic accuracy of 3-D CTA for cerebral aneurysms with the use of conventional angiography as the reference standard. In 50 patients, conventional angiography revealed 73 cerebral aneurysms ranging from 2 to 32 mm in maximum diameter. Three of the 73 cerebral aneurysms were located outside the imaging volume of 3-D CTA. The sensitivities of the two neuroradiologists for the remaining 70 aneurysms were 67% and 70%, respectively. Although 3-D CTA depicted cerebral aneurysms 5 mm or larger with good accuracy, it was less useful for the detection of smaller aneurysms. For the evaluation of giant aneurysms, this technique elucidated the relationships among the aneurysm, surrounding arteries, and neighboring bone structure. Three-dimensional CTA is useful for the diagnosis of cerebral aneurysms with diameters of 5 mm or more. This technique is especially useful in the preoperative evaluation of giant aneurysms.
    Full-text · Article · Apr 1996