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AJNR - American Journal of Neuroradiology

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Carotid Ophthalmic Aneurysm Rupture After Parent Vessel Occlusion

Frederick Vincent^b, Alain Weill^a, Daniel Roy^a, Jean Raymond^a and Francois Guilbert^a

^a Department of Radiology, University of Montreal, Notre-Dame hospital CHUM, 1560 Sherbrooke Est, Montreal PQ, Canada H2L 4M1
^b Department of Neurosurgery, University of Montreal, Notre-Dame hospital CHUM, 1560 Sherbrooke Est, Montreal PQ, Canada H2L 4M1

View larger version (100K): [in a new window]   FIG 1. Left carotid angiogram, anteroposterior view, shows a giant carotid ophthalmic aneurysm.

View larger version (101K): [in a new window]   FIG 2. Left carotid angiogram, lateral view, shows that the neck of the aneurysm is just distal to the ophthalmic artery origin.

View larger version (145K): [in a new window]   FIG 3. Angiogram, lateral view of the skull, shows inflation of the balloon at the junction between cavernous and carotid ophthalmic segment.

View larger version (127K): [in a new window]   FIG 4. Angiogram5, anteroposterior view, shows Injection of the right carotid artery after occlusion of the left internal carotid artery. Note a good anterior communicating artery supplying the entire left carotid artery territory.

View larger version (116K): [in a new window]   FIG 5. Angiogram5, anteroposterior view, late phase, shows injection of the right carotid artery after occlusion of the left internal carotid artery. Note a faint and delayed retrograde opacification (arrow) of the left carotid ophthalmic aneurysm.

View larger version (130K): [in a new window]   FIG 6. Nonenhanced CT scan shows an important and diffuse subarachnoid bleeding. Note that the aneurysm is outlined by blood.

View larger version (142K): [in a new window]   FIG 7. Right internal carotid angiogram, anteroposterior view, obtained a few hours after the bleeding, shows opacification of the left internal carotid artery territory, faint retrograde opacification of the left carotid ophthalmic artery aneurysm, and early vasospasm.

View larger version (129K): [in a new window]   FIG 8. Angiogram5, lateral unsubtracted view, obtained after injection of the right internal carotid artery, shows that the balloons did not deflate. Note stagnation of contrast within the aneurysm.