Heart-shaped intracranial aneurysm

Abstract

A 45-year-old woman presented with severe headache for three hours. Non-contrast brain CT revealed subarachnoid hemorrhage, mostly in the prepontine cistern (Figure A). A catheter-based angiogram showed a heart-shaped aneurysm arising from the junction of the basilar artery and the left superior cerebellar artery (Figures B and C), which was then coiled uneventfully (Figure D). Cerebral aneurysm with a heart-shaped configuration is interesting and extremely rare, which is usually associated with vessel-wall degeneration under hemodynamic stress 1. Surgical clipping is challenging because of the complex anatomic environment and fragile aneurysmal wall; while an endovascular procedure, as a straightforward option, seems to be feasible and effective 2,3 .