American Journal of Neuroradiology 2009;30:1688.
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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1624
INTERVENTIONAL
Pedunculated Basilar Terminus Aneurysm with Pseudo-Septation due to Anterior Herniation through a Perforated Membrane of Liliequist
From the Departments of Radiology (L.H.-B.), Neurosurgery (L.H.-B., P.N.V.), and Neurology (L.H.-B., P.N.V.), Medical College of Wisconsin, Milwaukee, Wis; and Departments of Neurology and Neurosurgery (P.N.V.), Henry Ford Hospital, Detroit, Mich.
Please address correspondence to Lotfi Hacein-Bey, Radiological Associates of Sacramento Medical Group, 1500 Expo Pkwy, Sacramento, CA, 95815; e-mail: lhaceinbey{at}yahoo.com
SUMMARY: Septations within cerebral arteries or aneurysms are exceedingly rare in the absence of associated fenestrations. We report an unusual unruptured pedunculated basilar apex aneurysm, with a "pseudoseptation" between the main aneurysmal sac and an anterior compartment, which was, in fact, represented by a perforation in the membrane of Liliequist, permitting anterior aneurysmal herniation into the carotid-chiasmatic cistern. The patient was successfully treated with detachable coils. This case is unusual on 2 accounts: 1) the aneurysm's appearance, and 2) the presence of a large fenestration in the membrane of Liliequist, of which anatomic features are herein reviewed.