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Giant aneurysm of the internal carotid artery

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Chronic headaches with left hemiparesis.

Patient Data

Age: 75 years
Gender: Male

The nonenhanced CT demonstrate a large lobulated hyperdense mass (60x50 mm) within the right cavernous sinus with calcified wall, displacing the temporal and frontal lobes, filling the optochiasmatic cistern medially, and the prepontine and ambient cisterns posteriorly with surrounding edema. The postcontrast sequence as well as the 3D-CTA show an opacified saccular aneurysm of the terminal portion of the right internal carotid artery (segment C7), measuring (15x10 mm). A mass effect is noted on the midline structures with obstructive hydrocephalus. 

Case Discussion

CTA features are most consistent of a giant partially thrombosed saccular aneurysm of the terminal segment (C7) of the right internal carotid artery.

 

Additional contributors/ R. Bouguelaa, MD,  A. Ramdani, MD 

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