Online Images in the Medical Sciences| Volume 365, ISSUE 5, e75-e76, May 2023

Giant intracranial aneurysm with thrombus and calcification

Published:December 20, 2022DOI:
      A 25-year-old man reported to our department with a history of fever (about 39˚F), headache, nausea, vomiting, sporadic convulsions of the limbs lasting up to 10 days and blindness of the left eye for the past 1 month. The computed tomography (CT) scan revealed a high-density mass measuring 3.5 × 2.8 × 4.3 cm, with multiple calcifications in the suprasellar cisterna region (Fig. 1A). The initial assessment indicated craniophrayngioma. Following this the patient underwent further magnetic resonance imaging (MRI) examination, which detected mixed high and low signals with annular hypointensity at the margin. Moreover, the bilateral frontal lobes and brainstem were compressed (Fig. 1B, C). Enhanced MRI revealed that the mass had thick strip enhancement, marginal annular enhancement, and few patchy areas without enhancement (Fig. 1D, E, F). Since the image showed the mass in close proximity to the neighboring vessels, it was suspected to be a thrombotic aneurysm. Subsequently, a CT angiography confirmed that the lesion was likely to have originated from the ocular segment of the left internal carotid artery (Fig. 1G, H, I). The patient underwent interventional embolization of the aneurysm (Fig. 2) and recovered without any complications.
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