PMC3291711_01
The brain computed tomography revealed an 18x18 mm sized mass compressing the midbrain.
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F1
Brain computed tomography revealed an 18x18 mm sized mass in interpeducular cistern (Fig. 1), and diagnostic cerebral angiography showed a canalized portion sized 6.8x5.6 mm (Fig. 2).
The cerebral angiography shows that the patent portion of the aneurysm has an inverted triangular shape and measured 6.8x5.6 mm. A : Anteropostrior view. B : Lateral view.
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F2
Brain computed tomography revealed an 18x18 mm sized mass in interpeducular cistern (Fig. 1), and diagnostic cerebral angiography showed a canalized portion sized 6.8x5.6 mm (Fig. 2). Therapeutic, Fremont, CA, USA) was deployed from the right posterior cerebral artery (PCA, P1) to the basilar artery. The left PCA was supplied from the left internal carotid artery via the PcomA, and was not visualized in vertebral angiography (Fig. 2).
Cerebral angiographs during and after the procedure. A : During procedure. A 3.5x20 mm stent is being deployed from the right PCA to the basilar artery, because the left PCA, which is supplied from the left internal carotid artery via PCom, is not visualized by vertebral angiography. B : After procedure. The aneurysm is found to have been completely obliterated by immediate post-operative angiography and the right PCA is patent. The coils pushed into the thrombosed portion are also visualized. PCA : posterior cerebral artery, PCom : posterior communicating.
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F3
The aneurysm pulsation was ceased after complete coiling (Fig. 3).
Postoperative brain MRI. A : On postoperative day 1, brain MRI shows a 18x18 mm sized mass compressing the adjacent structures in the interpeduncular cistern. B : At 21 months postoperatively, most of the thrombosed aneurysm has disappeared and the interpeduncular cistern is clearly observed. MRI : magnetic resonance imaging.
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F4
Follow-up brain MRI on postoperative month 21 revealed an obviously shrunken thrombosed aneurysm and the whole interpeduncular cistern (Fig. 4), and the compaction of coiled mass from thrombosed portion to forward and downward direction was shown in cerebral angiography (Fig. 5).