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AJNR - American Journal of Neuroradiology

A–C, Right internal carotid angiograms from the referring institution. Left anterior oblique views before (A), 22 days after (B), and 33 days after (C) clipping of a ruptured ACoA aneurysm (arrowhead, A). There were no abnormal findings in the territory of the MCA before surgery. Follow-up studies showed a newly formed aneurysm in the MCA (arrow, B), which enlarged later (arrow, C).

D, Right internal carotid angiogram, left anterior oblique view, 2 months after surgery, shows the 2.5-mm aneurysm in the right MCA.

E, Left anterior oblique view of the nonsubtracted right internal carotid angiogram immediately after embolization indicates total obliteration of the aneurysm by delivered coils.

F, Right internal carotid angiogram, left anterior oblique view, 3 months after embolization, shows continuous total obliteration of the aneurysm.

A, Preoperative contrast-enhanced T1-weighted MR image sagittal view, shows a 3-cm tuberculum sellae meningioma encasing the ACoA.

B, Preoperative right internal carotid angiogram, anteroposterior view, shows elevation of the right A1 portion and occlusion of the left A1 portion, but no aneurysms.

C, Postoperative contrast-enhanced T1-weighted MR image, sagittal view, shows 70% removal of the tumor.

D, Right internal carotid angiogram, anteroposterior view, 1 month after surgery, shows a newly developed 3- x 5-mm aneurysm of the ACoA.

E, Right internal carotid angiogram, anteroposterior view, 2 months after surgery, shows a 6- x 8-mm aneurysm that enlarged progressively.

F, Right internal carotid angiogram, anteroposterior view, immediately after embolization, shows most complete obliteration of the aneurysm with a small remnant near the orifice (arrow). (fig 2 continued on page 38.)

G–J, Plain skull radiographs, anteroposterior (G, I) and lateral (H, J) views, immediately (G, H) and 4 months (I, J) after embolization. The position of the coils remains stable.