Arterial Spin Labeling Imaging of a Giant Aneurysm Leading to Subarachnoid Hemorrhage following Cerebral Infarction

Autor: Tatsuya Ueno, Tatsuya Sasaki, Masatoshi Iwamura, Tomoya Kon, Jin-ichi Nunomura, Hiroshi Midorikawa, Masahiko Tomiyama
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Case Reports in Neurology, Vol 10, Iss 1, Pp 66-71 (2018)
Druh dokumentu: article
ISSN: 1662-680X
DOI: 10.1159/000487587
Popis: An 83-year-old Japanese man was admitted with dysarthria and right hemiparesis. He had had a large intracranial aneurysm on the left internal carotid artery 5 years before admission and had been followed up under conservative treatment. On admission, diffusion-weighted imaging revealed a hyperintense signal on the left anterior choroidal artery territory. Time-of-flight magnetic resonance angiography demonstrated poor visibility of the middle and anterior cerebral arteries and the inferior giant aneurysm, suggesting distal emboli from aneurysm thrombosis or a reduction of blood outflow due to aneurysm thrombosis. Arterial spin labeling (ASL) signal increased in the giant aneurysm, suggesting blood stagnation within the aneurysmal sac, and decreased in the left hemisphere. We diagnosed cerebral infarction due to aneurysm thrombosis, and started antithrombotic therapy. On day 2, he suddenly died of subarachnoid hemorrhage due to rupturing of the giant aneurysm. When thrombosis occurs in a giant aneurysm, increasing ASL signal within the aneurysm and decreasing ASL signal with poor visibility on magnetic resonance angiography in the same arterial territory may indicate the danger of impending rupture of the giant aneurysm.
Databáze: Directory of Open Access Journals