PMC8168707_01
Initial axial noncontrast head CT demonstrating SAH in the basal cisterns extending into primarily the left Sylvian fissure with mild prominence of the temporal horns bilaterally.
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F1
CT demonstrated extensive SAH in the basal cisterns around the midbrain extending into the left Sylvian fissure with mild prominence of the bilateral temporal horns [Figure 1]. CT angiogram (CTA) of head and neck demonstrated a small left posterior communicating (p-comm) aneurysm [Figure 2] along with bilateral airspace disease at the lung apices, compatible with pneumonia [Figure 3].
CTA head with contrast of the left ICA with 3D reconstruction demonstrating left posterior and interior projecting aneurysm.
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F2
CT demonstrated extensive SAH in the basal cisterns around the midbrain extending into the left Sylvian fissure with mild prominence of the bilateral temporal horns [Figure 1]. CT angiogram (CTA) of head and neck demonstrated a small left posterior communicating (p-comm) aneurysm [Figure 2] along with bilateral airspace disease at the lung apices, compatible with pneumonia [Figure 3].
Axial CT through the lung apices demonstrating multifocal bilateral airspace disease compatible with pneumonia.
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F3
CT demonstrated extensive SAH in the basal cisterns around the midbrain extending into the left Sylvian fissure with mild prominence of the bilateral temporal horns [Figure 1]. CT angiogram (CTA) of head and neck demonstrated a small left posterior communicating (p-comm) aneurysm [Figure 2] along with bilateral airspace disease at the lung apices, compatible with pneumonia [Figure 3].
Lateral cerebral angiogram of the left ICA demonstrating left posterior and interior projecting aneurysm.
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F4
Diagnostic cerebral angiography of the left internal carotid artery (ICA) revealed a dominant left p-comm artery filling the posterior cerebral artery on the left with small aneurysm emanating from the junction of the left ICA and left p-comm artery, pointing posteriorly and inferiorly measuring 4 x 6 x 4 mm [Figure 4].
Lateral cerebral angiogram of the left ICA demonstrating coiled aneurysm with no residual filling.
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F5
A total of six Gugliemi detachable coils (GDCs) were placed within the aneurysm leading to > 95% aneurysm obliteration [Figure 5].
PMC8168707_02
CT head without contrast demonstrating prominent blood in the basal cisterns and Sylvian fissure bilaterally with the right temporal encephalomalacia and cranial defect from previous gunshot wound to the head.
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F6
CTA head demonstrating bilobed anterior communicating artery aneurysm with 3D reconstruction.
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F7
CTA demonstrated a bilobed anterior communicating artery aneurysm [Figure 7]. Clinical grades demonstrated
AP (a) and lateral (b) cerebral angiogram projections of the left ICA demonstrating bilobed ACOM aneurysm.
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F8
Diagnostic angiography of the left ICA revealed a large multilobulated bulbous aneurysm of the anterior communicating artery [Figure 8].
AP (a) and lateral (b) cerebral angiograms of the left ICA demonstrating successful coil embolization of the ACOM aneurysm with minimal residual filling along the neck.
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F9
Coil embolization was successful with complete aneurysm obliteration with minimal contrast filling along the neck and no evidence of occlusion of either the communicating segment or the distal A2's or proximal A1 segments right and left sides [Figure 9].