PMC3284869_01
Unenhanced computed tomography scan of her brain showing diffuse subarachnoid hemorrhage in the basal cisterns. Abnormal hyperdense signals in the prepontine cistern indicate an underlying vascular lesion.
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F1
A computerized tomography scan showed diffuse hemorrhage in her subarachnoid spaces with a small area of focal hyperdensity in the prepontine area, raising suspicion of an aneurysm of the basilar artery (Figure 1).
Selective injection in the left internal carotid artery on digital subtraction angiography showing the internal carotid artery terminating into the ophthalmic artery with no contribution to cerebral vasculature.
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F2
Her anterior and middle cerebral arteries could not be visualized on the angiograms (Figures 2,3 and 4); however, her external carotid arteries and their branches were normal.
Selective injection of the right vertebral artery showing an enlarged posterior communicating artery opacifying the supra-ophthalmic segments of the internal carotid artery with exclusive contribution to the anterior circulation bilaterally. There is fusiform dilatation of the right posterior communicating artery at the basilar end, suggestive of a fusiform aneurysm of the right posterior communicating artery.
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F4
Her anterior and middle cerebral arteries could not be visualized on the angiograms (Figures 2,3 and 4); however, her external carotid arteries and their branches were normal. A fusiform aneurysm of the right posterior communicating artery was also noted at its basilar end (Figures 4, 5 and 6).
Early arterial phase of the right vertebral artery injection, delineating the configuration of a fusiform aneurysm at the basilar end of the right posterior communicating artery. It appears that the origin of the right P1 segment of the posterior cerebral artery is incorporated in the aneurysm segment and the posterior communicating artery distal to the aneurysm is obtuse. The ipsilateral supraclinoidal artery is also perfused by this injection.
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F5
A fusiform aneurysm of the right posterior communicating artery was also noted at its basilar end (Figures 4, 5 and 6).
Magnified view of the right vertebral injection highlighting the anatomical details described in Figures 4 and 5.
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F6
A fusiform aneurysm of the right posterior communicating artery was also noted at its basilar end (Figures 4, 5 and 6).