PMC10351959_01
Axial section of CT (A) showing a SAH centered on the right Sylvian fissure. 3D-CTA (B) and (C) showed a dumbbell-shaped saccular aneurysm (arrow) with a maximum diameter of 13 mm in the right MCA.
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He underwent head computed tomography (CT), which revealed a subarachnoid hemorrhage (SAH) (Fig. 1). On the basis of the aneurysm branching anteriorly to the right frontal lobe from the tip (Fig. 1), we diagnosed it as a right M2 dissecting aneurysm.
(A) and (B) show preoperative cerebral angiography (frontal and lateral view). (C) and (D) show preoperative angiography and VRT-image (same frontal oblique angle). After coil embolization, the aneurysm and parent vessel were utterly occluded (E and F). CT scan on the day after surgery (G) shows a low-density area in the right frontal lobe consistent with an occlusion area.
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The hematoma did not increase in size (Fig. 2).
PMC10351959_02
(A) and (B) show preoperative cerebral angiography (frontal and lateral view). (C) and (D) show preoperative angiography and VRT-image (same frontal oblique angle). After coil embolization, the aneurysm and parent vessel were utterly occluded (E and F). CT scan on the day after surgery (G) shows a low-density area in the right frontal lobe consistent with an occlusion area.
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The hematoma did not increase in size (Fig. 2).
Postoperative MRI after one year (A; MRA, B; T2-weighted image), the aneurysm, right M2 was not shown, and the cerebral tissue around the aneurysm had encephalomalacia. Postoperative 3D-CTA did not show after one year (C), the aneurysm, and right M2.
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One year after the surgery, 3D-CTA and Magnetic Resonance Imaging (MRI) evaluation revealed no significant right M2 findings, and the cerebral tissue around the aneurysm had encephalomalacia (Fig. 3).