Rupture of intracranial aneurysm during computerized tomography

Area of Science:

• Neurology
• Radiology
• Neurosurgery

Background:

• Parasellar masses are often evaluated using computed tomography (CT) scans.
• Intracranial aneurysms can present with subarachnoid hemorrhage, a serious neurological emergency.

Observation:

• A patient with a suspected parasellar mass developed a sudden, distinctive "starburst" pattern on CT during contrast injection.
• This unusual imaging finding coincided with acute clinical deterioration.

Findings:

• Subsequent CT and necropsy confirmed a ruptured aneurysm in the right parasellar region.
• The "starburst" pattern on CT was directly associated with a large subarachnoid hemorrhage.

Implications:

• This case illustrates a novel and previously undescribed CT appearance of a rupturing intracranial aneurysm.
• Recognizing this "starburst" sign may aid in the rapid diagnosis of ruptured aneurysms and subarachnoid hemorrhage.