FIG 3. A 48-year-old woman presented with an SAH secondary to an anterior communicating artery aneurysm rupture. Diagnostic IA-DSA showed multiple aneurysms.

A, TOF-3D-isosurface MRA (100/20/1), right periorbital view. There is some minor artifact due to patient movement. The anterior communicating artery aneurysm (short broad arrow) appears to arise from the right A1/A2 junction. A terminal left internal carotid artery aneurysm is also visible (long thin arrow).

B, TOF-MPR MRA (100/20/1), coronal slice through the anterior communicating artery complex. Scrolling through, no communication is seen between the left A1 segment (thin short arrow) and aneurysm (short broad arrow). The aneurysm is continuous with the right A2 segment (long arrow).

C, IA-DSA, left periorbital projection. The anterior communicating and left terminal internal carotid artery aneurysms are clearly seen (arrows). There are also two discrete middle cerebral artery aneurysms. The anterior communicating artery aneurysm only filled from a left-sided injection. If one were to have planned endovascular treatment on the basis of the MRA findings, the approach would have been via the right internal carotid artery.