Blood blister-like aneurysm

Case contributed by Dr Dalia Ibrahim

Presentation

Recent subarachnoid hemorrhage

Patient Data

Age: 50 years old
Gender: Male
Modality: CT

Broad based bulge (blood blister like) projects at the dorsal/lateral wall of the supraclinoid portion of the right internal carotid artery just its bifurcation. It measures about 4mm in max diameter. It was a wide neck.

Modality: Annotated image

Blood-blister like aneurysm (arrows)

Case Discussion

Blood blister-like aneurysm is a broad based bulge at nonbranch point of a vessel.

Clinical presentation

Middle aged patients with angio negative subarachnoid hemorrhage.

Radiographic features

  • shape: blood blister-like or half domed shallow outpouching with wide neck
  • common sites: supraclinoid ICA (dorsal wall), less likely MCA, ACA, basilar artery
  • size: usually small (<6mm) mean (3mm) 1
  • rapid change in size and morphology on follow up aniograms
  • CT angiography: often negative
  • digital subtraction angiography: is the best diagnostic tool

Differential diagnosis

  • saccular aneurysm
  • vessel infundibulum
  • vasospasm
  • atherosclerotic vascular disease
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Case Information

rID: 48186
Case created: 23rd Sep 2016
Last edited: 24th Sep 2016
System: Vascular
Inclusion in quiz mode: Included

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