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Giant internal carotid artery aneurysm

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Headaches

Patient Data

Age: Adult

Very large low T2 mass which indents the midbrain and mesial temporal lobe.  Curvilinear signal loss is seen on gradient echo. MRA demonstrates an occluded left ICA with persistent flow across the ACOM to the left MCA.

CT angiography

ct

Single image from a CT demonstrates opacification of the lumen of a mostly thrombosed giant left surpaclinoid carotid aneurysm. 

Catheter angiogram confirms the very large terminal ICA aneurysm, which only represents a small part of the overall aneurysm, with the majority shown to be thrombosed on MRI. 

Case Discussion

This patient went on to be treated with balloon occlusion of the left internal carotid artery to decompress the aneurysm.

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