J Cerebrovasc Endovasc Neurosurg.  2018 Mar;20(1):24-27. 10.7461/jcen.2018.20.1.24.

A Pseudoaneurysm Associated with a Ruptured Cerebral Aneurysm: Hypothesis on the Formation of the PA and Feasibility of Endovascular Treatment

• Kim JH
• Chang CH
• Jung YJ

• KMID: 2422556
• DOI: http://doi.org/10.7461/jcen.2018.20.1.24

Abstract

An intracranial pseudoaneurysm (PA) is a very rare disease and is known to occur in less than 1% of intracranial aneurysms. The pathophysiology and the modality of the proper treatment of PA have not yet been clearly established. We report a case of PA associated with ruptured cerebral aneurysms which was successfully treated by coil embolization, and also discuss the possible hypothesis on the formation of the PA and feasibility of endovascular treatments.

Keyword

Aneurysm; false; Subarachnoid hemorrhage; Angiography; digital subtraction

MeSH Terms

Aneurysm
Aneurysm, False*
Angiography
Embolization, Therapeutic
Intracranial Aneurysm*
Rare Diseases
Subarachnoid Hemorrhage

Figure

• 

  Fig. 1 Image collections of the case. (A) CT shows high density on the basal cistern. (B) CT angiogram shows a PcomA aneurysm with an elongated irregular shape. (C) A CT scan after rebleeding shows massive higher density. (D) 3D DSA shows a PA (arrow) arising from the previously ruptured PcomA aneurysm which did not observed on the initial CT (image B). (E) Delayed washout of contrast medium from the irregularly shaped portion of the aneurysm during the venous phases. (F) Frame coil delivered almost to the proximal true part of the aneurysm. (G) Post procedural angiogram shows no contrast filling within the aneurysm or PA. CT = computed tomography; PcomA = posterior communicating artery; DSA = digital subtraction angiography; PA = pseudoaneurysm.

Reference

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