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Postcoiling Aneurysm Tilting: A Disturbing Finding?

Eric Sauvageaua, Jean Raymonda, Daniel Roya, Louis Juravskya, François Guilberta and Alain Weilla

a From the Department of Neuroradiology, Centre Hospitalier Universitaire de Montréal, Québec, Canada



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  		FIG 1. Case 1.

A and B, Immediate postembolization left vertebral angiogram. Lateral (A) and Towne’s (B) views show complete obliteration of the basilar tip aneurysm. (Note small coil protrusion in left P1 with a small clot.)

C and D, Left vertebral angiogram performed 5 months after embolization. Towne’s view (C) shows a small recurrence at the neck. Lateral view (D) shows backward tilting of the aneurysm when compared with the initial angiogram.

E, Axial proton density–weighted turbo spin-echo image (TR, 3500; TE, 22) 8 months after embolization shows aneurysm relationship with the interpedoncular cistern.



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  		FIG 2. Case 2.

A and B, Immediate postembolization left vertebral angiogram. Lateral (A) and Towne’s left anterior oblique (B) views show complete obliteration of basilar tip aneurysm.

C, Left vertebral angiogram obtained 30 months after initial embolization. Lateral view shows backward tilting of the aneurysm and posterior bending of the basilar trunk with an anterior recurrence of the aneurysm.

D and E, MR sagittal T1 spin-echo (TR, 595; TE, 14) image obtained 36 hours (D) and 3 years (E) after initial embolization. The posterior and downward migration of the coil mass is nicely depicted. On the final MR image (E), note the enlargement of the lateral and third ventricles with anterior compression of the aqueduct of sylvius. Note the recurrence of the anterior portion of the aneurysm.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X