Multiple blood blister-like supraclinoid internal carotid artery aneurysms

Case contributed by Bálint Botz
Diagnosis probable

Presentation

Prior operation due to left parieto-occipital GBM, received radio-chemotherapy. Follow-up.

Patient Data

Age: 60 years
Gender: Female
This study is a stack
Axial
TOF
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Axial
T1 C+
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Axial
T2
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Sagittal
T1
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Coronal
FLAIR
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Axial
SWI
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Axial
DWI
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Axial
FLAIR C+
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Info
  • Multiple 3-5 mm broad based outpouchings of both supraclinoid internal carotid arteries best appreciated on TOF MRA. 
  • Status post prior left parietal resection with resultant gliosis, and rim like susceptibility artifacts due to blood products. Small foci of spontanously T1 hypointensity and diffusion restriction are also in line with recent prior operation. 

Case Discussion

Blood blister-like supraclinoid ICA aneurysms are hard to appreciate without TOF due to high signal on postcontrast imaging e.g. in the adjacent cavernous sinus. This patient had multiple prior MRIs, but this was the first exam where TOF MRA was also acquired. 

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