Radiological pitfalls of a large intracranial dissecting aneurysm

Aboukaïs, Rabih; Zaïri, Fahed; Bourgeois, Philippe; Thines, L.; Lejeune, J.-P.

doi:10.5137/1019-5149.jtn.9057-13.1

Cited by 1 publication

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References 4 publications

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“…6 Dissecting aneurysms are delusive entities characterized by a dynamic, often rapidly changing radiologic presentation, especially during the hyperacute phase, when the point of the initial parietal rupture and the extension of the dissection may not be visualized. 7,8 This challenging presentation can be explained by the pathological mechanisms that accompany the dissection, such as transmural dissection, leading to SAH, or sub-intimal dissection with sub-adventitial hemorrhage leading to the formation of an intramural hematoma. Depending on the efficacy of the repairing mechanisms of the intramural rupture, a narrowed vessel with adjacent ectatic segments, a fusiform dolicho-vessel, or a partially thrombosed aneurysm may form from the dissected vessel, which will be reflected into imaging.…”

Section: Introductionmentioning

confidence: 99%

The insidious appearance of the dissecting aneurysm: Imaging findings and related pathophysiology. A report of two cases

2016

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Intracranial dissecting aneurysms have been frequently reported to present with fairly challenging and time-variable imaging findings that can be mostly explained by the pathological mechanisms that underline the dissection. We present two cases of spontaneous dissecting aneurysm of the supraclinoid ICA, both clinically presenting with SAH, but characterized by different progression of clinical symptoms and imaging. However, in both cases an outpouch and a mild fusiform dilation of the supraclinoid ICA was present in the initial CTA performed after the occurrence of symptoms. These findings were well depicted by the MPR reformats performed retrospectively. We postulate that this finding may represent the point of initial transmural dissection and we recommend that careful analysis of the CTA MRP reformatted images should be performed in order to detect this finding promptly.

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Section: Introductionmentioning

confidence: 99%