Aneurysmal rupture during computed tomography scanning

A unique case in which a berry aneurysm was observed to rupture during computed tomography scanning of the brain is reported. Two earlier case reports of aneurysmal rupture during computed tomography scanning are reviewed, followed by a discussion of possible mechanisms of rupture during contrast studies. Contrast medium infusion may have the potential to cause aneurysmal rupture by a direct anticoagulant effect, by affecting the endothelial membrane, by interacting with platelet release of vasoactive substances, by inducing vasodilation, by removing the protective arterial spasm, or by other unexplored mechanisms. The information to be gained by infusion of contrast medium in cases of aneurysmal rupture can be significant and the rarity of rerupture during contrast medium infusion does not appear to pose a significant risk in the vast majority of cases.