Internal carotid artery aneurysm

Case contributed by Kamel Mahmoud Alkhateeb
Diagnosis certain

Presentation

Severe thunderclap-type headache and projectile Vomiting.

Patient Data

Age: 40 years
Gender: Female
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+
arterial phase
This study is a stack
Coronal C+
arterial phase
This study is a stack
Sagittal C+
arterial phase
This study is a stack
3D
VR
This study is a stack
3D
VR
Download
Info

Acute subarachnoid haemorrhage is seen in the right temporoparietal distribution within the right Sylvian fissure and adjacent sulci and extending to the right basal cisterns.

Evidence of saccular aneurysm in the supra clinoid segment of the right internal carotid artery at the region of its bifurcation into MCA, ACA, and posterior communicating artery, measuring about 7x4 mm.

Annotated image
3D
VR
3D
VR
Axial C+
arterial phase
Sagittal C+
arterial phase
Coronal C+
arterial phase
Download
Info

The annotated images clarify the study findings.

Case Discussion

A 40-year-old lady with a history of lap cholecystectomy 3 days ago, had a sudden severe thunderclap-type headache and projectile vomiting and came to ER department. CT studies show recent subarachnoid haemorrhage secondary to a ruptured internal carotid artery saccular aneurysm.

The patient underwent coil embolisation of the ruptured aneurysm. Then decompressive craniotomy and haematoma evacuation were done in the next two days.

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