PMC3205493_01
Cranial computed tomography performed on admission demonstrates diffuse subarachnoid hemorrhage in the basal cistern
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F1
SAH (Hunt and Kosnik grade 2, WFNS grade 1,Fisher group 3) [Figure 1]. She was introduced to our hospital 4 days post onset.
Three-dimensional computed tomography angiogram revealing two aneurysms (arrow) on the left persistent trigeminal artery variant, (arrow head). Note the clip from the earlier procedure to address a previously ruptured left internal carotid-posterior communicating artery aneurysm (open arrow)
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F2
CT angiogram (3D-CTA) and cerebral angiography showed bilateral PTAV and two aneurysms originating at the left side of the vessel [Figures 2, 3]. Comparison with the earlier studies showed that the size of the aneurysms had not changed and we were unable to identify the ruptured aneurysm.
(a) Left internal carotid angiogram showing that the left PTAV supplies the ipsilateral anterior inferior cerebellar artery region (arrow). Note the two aneurysms originating from the vessel. (b) Right internal carotid angiogram showing that the left persistent trigeminal artery variant, supplies the ipsilateral anterior inferior cerebellar artery and the posterior inferior cerebellar artery region (arrow head)
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F3
CT angiogram (3D-CTA) and cerebral angiography showed bilateral PTAV and two aneurysms originating at the left side of the vessel [Figures 2, 3]. Comparison with the earlier studies showed that the size of the aneurysms had not changed and we were unable to identify the ruptured aneurysm.
Image obtained before clipping and wrapping the aneurysm. The left persistent trigeminal artery variant, penetrated through the isolated dural foramen below Meckel's cave and lateral to the dorsum sella (arrow). AN: aneurysm, TN: trigeminal nerve, MC: Meckel's cave
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F4
The left PTAV penetrated the isolated dural foramen below Meckel's cave and lateral to the dorsum sellae [Figure 4].
Three-dimensional computed tomography angiogram obtained after surgical treatment. The saccular aneurysm was clipped (arrow) and the fusiform aneurysm was clipped and wrapped (arrow head)
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F5
It was clipped and the fusiform aneurysm was clipped and wrapped [Figure 5].