Two cases of giant intracerebral aneurysm simulating neoplasm on ct scan; one with coexistent chronic subdural hematoma

Neuroradiologic and neuropathologic findings with growing giant intracranial aneurysm. Review of the literature

The neuroradiologic observations on a case of growing giant intracranial aneurysm originating from a small saccular aneurysm are described in detail. The reports in the literature of growing giant aneurysms are reviewed. The computed tomographic and angiographic findings are described and special diagnostic difficulties analyzed. A correlation between the computed tomographic and neuropathologic findings is made, and the pathogenetic mechanisms of enlargement of aneurysms are discussed.

Extracranial-intracranial arterial bypass for giant aneurysms

We describe in detail one case, and briefly mention another where occlusion of a main vessel was necessary for removal of an aneurysm sac. The combined surgery of extracranial-intracranial bypass and the removal of the aneurysm at a second operation four to five weeks later is reported. The two-stage procedure is preferable to the one-stage proceeding for better assessment of the patency of the anastomosis and the possibility of undertaking a second attempt at anastomosis if the first bypass should become occluded.

Computed tomography in the diagnosis of subarachnoid haemorrhage and ruptured aneurysm

One hundred consecutive patients with subarachnoid haemorrhage were investigated by computed tomography (CT) within five days of the bleeding. In 19 cases CT indicated other sources than a ruptured aneurysm, most often a cerebellar haematoma. The other 81 patients did not all undergo angiography. It could be estimated by extrapolation that an aneurysm would be demonstrated in 66 of the 68 patients in whom CST showed extravasated blood in the basal cisterns, and in only five of the remaining 13 patients. In a consecutive series of 50 patients with bleeding from a verified aneurysm, CT showed some extravasated blood in all cases and a haematoma in half of these. In 74% the site of the haemorrhage correctly predicted the site of the ruptured aneurysm. Intravenous contrast medium visualized the aneurysm on CT in 15 of 25 cases; this can improve the identification of the bleeding aneurysm to 88%. Rebleeding occurred in 21 patients, and was obvious in Ct in 19. If available, CT should be the first investigation in patients with first and recurrent subarachnoid haemorrhage.

Giant aneurysm of anterior communicating artery simulating 3rd ventricular tumor

This is a case report of an anterior communicating artery aneurysm simulating a 3rd ventricular tumor with obstructive hydrocephalus demonstrated on CT scan. Angiography showed the "tumor" to be an aneurysm. We believe that giant aneurysms of the anterior communicating artery should be included in the differential diagnosis of suspected 3rd ventricular tumors along with suprasellar masses as seen on CT scans.

Complementary values of static and dynamic scintigraphy, computerized tomography and angiography in the diagnosis of a partially thrombosed giant intracranial aneurysm

The case history is presented of a 17 year-old male admitted with right hemiplegia and motor aphasia. Static and dynamic scintigraphy allowed prediction of a giant aneurysm in the deep left frontotemporal region, and this supposition was confirmed by CT and carotid angiography. CT also revealed the aneurysm to extend farther medially than the other two examinations had indicated, the medial portion of the aneurysm being thrombosed. Evaluation of the diagnostic information obtained from the three procedures, combined with the clinical data, makes possible a reconstruction of the probable course of events. The presenting signs were probably caused by a newly formed thrombus within the aneurysm. Death, which occurred after five days, was apparently due to subarachnoid hemorrhage.

Giant serpentine intracranial aneurysm after carotid ligation. Case report

A case is reported of a giant aneursym of the intracavernous portion of the left internal carotid artery that was treated initially with a left common carotid artery ligation. Six months later the aneurysm was partially removed. During this time the development and evolution of thrombus formation, a serpentine channel, and a hypervascular capsule was easily followed with recreated computerized tomography and angiography of the aneurysm.