MCA aneurysm

Case contributed by Ammar Haouimi
Diagnosis almost certain


Fall on stairs with head trauma 10 days ago. Incidental finding on follow-up CT.

Patient Data

Age: 60 years
Gender: Male

Multiple right hemispheric hemorrhagic contusions with surrounding edema, the largest is located in the temporal lobe with associated small subarachnoid hemorrhage well-visualized in the parietal regions. A mass effect is noted on the right lateral ventricle with no subfalcine herniation. No cranial vault fracture seen.

A small well-defined hyperdense structure is noted in the left insular region with bright and homogeneous enhancement as the middle cerebral artery (MCA). On 3D-CT, it appears in continuity with the MCA of saccular shape measuring 11 x 8 mm with a neck measuring 2.3 mm.

Case Discussion

MRI features of a saccular aneurysm of the insular segment of the MCA (incidental finding) discovered on CT for brain trauma.

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