Article Figures & Data
Figures
- Fig 1.
Thrombosis of an intracranial aneurysm and parent artery with early recanalization (case 9). A 63-year-old man had acute aphasia and right hemiparesis (NIHSS score, 21). A, Plain CT scan 2 hours after stroke onset shows a left MCA hyperattenuation, and the presence of a berry aneurysm is suspected on the apparent enlargement of the artery. B, Volume-rendering of CT angiography revealed a left M1-M2 occlusion, and a thrombosed left MCA aneurysm is not detectable. Intravenous thrombolysis was not performed, and after lumbar puncture excluding a meningeal hemorrhage, he was treated with aspirin, 250 mg/day. C, Time-of-flight MR angiography performed the day after shows recanalization of the left MCA aneurysm. He was discharged and sent home on day 8 with persistent aphasia (NIHSS score, 8), and surgical obliteration (clipping) of his aneurysm was performed 6 weeks later (aneurysm anatomy did not allow an intra-arterial procedure).
- Fig 2.
Early SAH after ischemic stroke distal to a PICA aneurysm (case 5). A 53-year-old man presented with sudden onset of vertigo, unsteady gait, and right cerebellar syndrome. Findings of CT performed 6 hours after onset were normal, and aspirin, 250 mg daily, was started. A, Apparent diffusion coefficient cartography of a diffusion-weighted sequence 48 hours later shows diffusion restriction on the right PICA territory. B, Maximum intensity projection of MR contrast angiography shows perfect vertebral and basilar artery patency and a right proximal 4 × 3 mm berry PICA aneurysm, with occlusion of the PICA beyond the aneurysm. During MR imaging, he suddenly complained of severe headache and had rapid deterioration of consciousness, requiring intubation. C, Plain CT scan at the pontocerebellar angle level shows massive SAH. He was transferred into an intensive care unit, where he died a few hours later.
