Advanced

AJNR - American Journal of Neuroradiology

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Klisch, J. Articles by Schumacher, M. Search for Related Content PubMed PubMed Citation Articles by Klisch, J. Articles by Schumacher, M.

Active Bleeding from Ruptured Cerebral Aneurysms during Diagnostic Angiography: Emergency Treatment

Joachim Klisch^a, Astrid Weyerbrock^b, Uwe Spetzger^b and Martin Schumacher^a

^a Department of Neuroradiology, University of Freiburg, Freiburg, Germany
^b Department of Neurosurgery, University of Freiburg, Freiburg, Germany

View larger version (162K): [in a new window]   FIG 1. Case 1. A, Right ICA angiogram (anteroposterior view [left] and lateral-oblique view [right], arterial phase) shows an MCA aneurysm. During angiography, blood pressure dropped and an episode of bradycardia and mild local vasospasm of proximal MCA branches developed without visible extravasation. B, CT scans obtained immediately after angiography shows an SAH located in the right sylvian fissure.

View larger version (74K): [in a new window]   FIG 2. Case 2. Left ICA angiograms (anteroposterior view, early arterial, and early venous phases) demonstrates active bleeding into the lentiform nucleus from an MCA aneurysm and mild local vasospasm.

View larger version (69K): [in a new window]   FIG 3. Right ICA angiogram, anteroposterior view. Active bleeding from the reruptured anterior communicating artery aneurysm during the angiography is visible (left two pictures). The dome of the aneurysm is completely lacerated. Extravasation of contrast material into the chiasmal cistern is visible. The diameter of the neck is 1.9 mm, and the diameter of the fundus 4.5 mm. After detachment of the first coil, bleeding continued, and protrusion of the coil into the subarachnoid space was imminent. Closure of the aneurysm with parent vessel occlusion of the A1-A2 segment of the right anterior cerebral artery (right two pictures).