PMC2718118_01
A 50-year-old woman with giant intracranial aneurysm.. A. Precontrast CT scan shows a large oval-shaped mass with increased attenuation representing thrombus (arrows) and slight peripheral calcification (arrowheads) in the right frontal region. Peripheral edema may also be observed.. B. Postcontrast CT scan demonstrates peripheral and central enhancenment. The enhanced central tubular structure represents the serpentine vascular channel (arrow).. C. T2-weighted sagittal image shows a large thrombosed aneurysm (arrows) with peripheral edema (arrowheads) in the right frontal area.. D. Postcontrast T1-weighted sagittal image shows an enhancing tubular structure (arrow) indicating the serpentine vascular channel.. E, F. Angiograms of the right internal carotid artery. Anteroposterior (E) and lateral (F) arterial-phase angiograms show the ectatic vascular channel involving the upper trunk of the right middle cerebral artery and corresponding to the vascular channel identified on MR images.. G, H. Anteroposterior (G) and lateral (H) capillary phase angiograms more clearly demonstrate the tortuous vascular channel of the serpentine aneurysm and show delayed filling of normal cortical branches of the superior division (arrowheads).
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F1
Slight calcification was noted in the peripheral portion of the mass (Figs. 1A, 1B). MR images revealed the presence of a giant, partially thrombosed aneurysm with residual flow through a serpiginous lumen within its thrombosed portion (Figs. 1C, 1D). The serpiginous lumen filled slowly and supplied blood to two distal right middle cerebral artery branches arising directly from the lateral aspect of the giant aneurysm (Figs. 1E-1H).