Fig 6. Ruptured, right-sided, 18-mm carotido-ophthalmic aneurysm with intraparenchymal hemorrhage into the right basal frontal lobe and basal ganglia (A and B). The aneurysm expanded superiorly and became embedded into the basal frontal lobe. It developed unbalanced contact constraints with a pneumatized, right anterior clinoid process (A). A contact constraint with the right optic nerve and chiasma was suspected from the location of the aneurysm, and was confirmed surgically. The aneurysm presented with a bleb at the dome (A and B). Bone 3D reconstructions revealed bony erosions of the right optic gutter and right anterior clinoid process in relation to the mass effect from the aneurysm (C).

A, Coronal plane, multiplanar reconstruction of the high-resolution CT angiography (HCRTA), posteroanterior view. Asterisk, right anterior clinoid process; A, aneurysm; H, intraparenchymal hemorrhage in the right basal ganglia; arrowhead, bleb.

B, 3D reconstruction of HRCTA, superior view. Asterisk, right anterior clinoid process; arrowhead, bleb.

C, 3D bone reconstruction of the base of the skull from HRCTA images. White asterisk, right anterior clinoid process; black asterisk, left anterior clinoid process; arrows, bony erosion of right optic gutter and right anterior clinoid process compared with the left side.