Case Of the Week (COW) 22 May 2016
PICA ANEUYRSM RUPTURE WITH SAH
Findings
Small narrow neck (0.7) aneurysm (2.7 mm) of right posterior inferior cerebellar artery noted. Few tiny branches noted arising from the aneurysm. Diffuse severe subarachnoid hemorrhage noted in the right cerebello medullary cistern, both cerebello pontine cistern, pre pontine cistern, inter peduncular cistern and right quadrigeminal and ambient cisterns and extending to the anterior cervical subarachnoid spaces of skull. Blood is also noted in the both sylvian cisterns. Intraventricular hemorrhage noted in the fourth ventricle as well in the third and both lateral ventricles. Mild hydrocephalus noted. Mild subarachnoid hemorrhage also noted in both temporo parietal and right occipital regions.
Discussion
Small narrow neck (0.7) aneurysm (2.7 mm) of right posterior inferior cerebellar artery – Ruptured. Diffuse subrachnoid hemorrhage in the cisterns and sulcal spaces as described above. Intraventricular hemorrhage. Aneurysms are focal abnormal dilatation of a blood vessel. They are also the most common cause of non-traumatic subarachnoid haemorrhage. On MRI T1 most of the patent aneurysm appears as flow void, or they may show heterogeneous signal intensity T2 typically hypointense.
PICA ANEUYRSM RUPTURE WITH SAH
Findings
Small narrow neck (0.7) aneurysm (2.7 mm) of right posterior inferior cerebellar artery noted. Few tiny branches noted arising from the aneurysm. Diffuse severe subarachnoid hemorrhage noted in the right cerebello medullary cistern, both cerebello pontine cistern, pre pontine cistern, inter peduncular cistern and right quadrigeminal and ambient cisterns and extending to the anterior cervical subarachnoid spaces of skull. Blood is also noted in the both sylvian cisterns. Intraventricular hemorrhage noted in the fourth ventricle as well in the third and both lateral ventricles. Mild hydrocephalus noted. Mild subarachnoid hemorrhage also noted in both temporo parietal and right occipital regions.
Discussion
Small narrow neck (0.7) aneurysm (2.7 mm) of right posterior inferior cerebellar artery – Ruptured. Diffuse subrachnoid hemorrhage in the cisterns and sulcal spaces as described above. Intraventricular hemorrhage. Aneurysms are focal abnormal dilatation of a blood vessel. They are also the most common cause of non-traumatic subarachnoid haemorrhage. On MRI T1 most of the patent aneurysm appears as flow void, or they may show heterogeneous signal intensity T2 typically hypointense.