De Novo Aneurysm Formation 6 and 22 Months after Initial Presentation in Two Patients
Rick Obraya,c,
Richard Clatterbuckb,c,
Alessandro Olvib,c,
Rafael Tamargob,c,
Kieran J. Murphya,c and
Philippe Gaillouda,c
a Division of Interventional Neuroradiology, Johns Hopkins Hospital, Baltimore, MD 21287
b Department of Radiology and Radiological Sciences, and Cerebrovascular Surgery, Johns Hopkins Hospital, Baltimore, MD 21287
C Department of Neurological Surgery, Johns Hopkins Hospital, Baltimore, MD 21287
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FIG 1. Patient 1, a 32-year-old woman with two de novo aneurysms.
A, DSA, right carotid injection, lateral view, showing adequate clipping of a right MCA aneurysm and absence of additional aneurysms in the distal right ICA.
B, DSA, right carotid injection, lateral view, showing a new aneurysm in the right PComA region (arrow). A second new lesion appears as a double attenuation sign in the anterior choroidal region (arrowhead).
C, DSA, right carotid injection, contralateral oblique view, demonstrating both de novo aneurysm (arrows).
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FIG 2. Patient 2, a 27-year-old woman with two de novo aneurysms.
A, DSA, right carotid injection, oblique view, revealing a right PComA aneurysm (arrowhead). Note the normal appearance of the carotid termination.
B, DSA, right carotid injection, oblique view, showing a complex de novo aneurysm at the carotid termination, with combined saccular and fusiform characteristics (arrowheads). A second lesion is seen above the clip placed 22 months before on the initial PComA aneurysm.
C, DSA, right carotid injection, lateral view, confirming the presence of two separate new aneurysms, one located at the carotid termination (arrowhead), and the other in the PComA region (arrow).
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