Left vertebral artery aneurysm

Case contributed by Dr Henry Knipe

Presentation

Cough and shortness of breath for a few days.

Patient Data

Age: 90
Gender: Male
X-ray

Large left mediastinal mass with stent and peripheral calcification.

CT

There is an aneurysm at the expected origin of the left vertebral artery. The aneurysm has extensive concentric mural thrombus and fills via a  patent neck with a broad based attachment to the subclavian artery. 

The left vertebral artery distal to the aneurysm does not opacify with contrast except in its distal portion where it fills retrograde from the basilar artery. Distally the subclavian artery is of normal calibre and opacifies normally.

Case Discussion

Vascular causes such as aneurysms should be recalled as a cause for mediastinal masses. The stent within the mass is a pretty big give away in this case. 

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Case information

rID: 40289
Case created: 16th Oct 2015
Last edited: 7th Nov 2015
Systems: Vascular, Chest
Inclusion in quiz mode: Included

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