Partially thrombosed giant saccular aneurysm of the ICA

Case contributed by Ammar Haouimi


Chronic headaches.

Patient Data

Age: 40 years
Gender: Male

There is a well-defined homogeneously enhancing mass at the right supraclinoid region with a thick peripheral rim isodense to the cortical grey matter. No peripheral calcification is seen. No intraparenchymal, intraventricular or subarachnoid hemorrhage is seen.

The MRI sequences demonstrate an aneurysm of the right internal carotid artery (ICA) with the following features: 

  • saccular type
  • ovoid shape
  • measures (35 x 27 x 25 mm)
  • arising from the terminal segment (C7) of the ICA
  • partially thrombosed. The mural hematoma is seen as an incomplete peripheral rim of high signal on T1/FLAIR and low signal on T2/T2 GE
  • its lumen is of low signal on T1/FLAIR and high signal on T2 with bright and uniform enhancement on postcontrast sequences
  • maximal width of the neck = 2 mm
  • no apparent arterial branch taking off from the aneurysm
  • mass effect is noted on the optic chiasma and 3rd ventricle

Case Discussion

CT/MRI features of a partially thrombosed giant saccular aneurysm of the ICA.


Additional contributor: A. Ramdani, MD

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