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Delayed angiographic appearance of a large basilar aneurysm
Surgical Neurology
|October 1, 1984
Summary
A follow-up cerebral angiogram revealed a basilar bifurcation aneurysm that was initially missed. Repeating studies after subarachnoid hemorrhage can detect delayed aneurysm visualization.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroradiology
Background:
- Subarachnoid hemorrhage (SAH) necessitates prompt diagnosis and management of potential vascular abnormalities.
- Cerebral angiography is a standard diagnostic tool for identifying the source of SAH, such as aneurysms.
Observation:
- A four-vessel cerebral angiogram performed one day after a subarachnoid hemorrhage presented as normal.
- A repeat angiogram conducted 40 days later identified a large aneurysm at the basilar bifurcation.
Findings:
- The initial negative angiogram is hypothesized to be due to early, transient thrombosis within the aneurysm.
- This case highlights the potential for delayed visualization of aneurysms in the context of subarachnoid hemorrhage.
Implications:
- Repeating cerebral angiographic studies in select cases of subarachnoid hemorrhage may be clinically beneficial.
- This approach can aid in the diagnosis of aneurysms that are not immediately apparent, potentially altering patient management.