Blood blister-like aneurysm

Case contributed by Dr Dalia Ibrahim

Presentation

Recent subarachnoid hemorrhage

Patient Data

Age: 50 years
Gender: Male
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 maximum diameter. It has a wide neck.

Annotated image

Blood-blister like aneurysm (arrows)

Case Discussion

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

Clinical presentation

Middle-aged patients, angiographically negative for subarachnoid haemorrhage.

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 angiograms
  • CT angiography: often negative
  • digital subtraction angiography: the best diagnostic tool

Differential diagnosis

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Case information

rID: 48186
Published: 23rd Sep 2016
Last edited: 1st Oct 2018
System: Vascular
Inclusion in quiz mode: Included

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