Focal Increased Cortical Density in Immediate Postembolization CT Scans of Patients with Intracranial Aneurysms
A. Ozturka,
I. Saatcia,
A.G. Pamukb,
C. Erdogana,
I. Akmangita,
S. Geyika and
H.S. Cekirgea
a Department of Radiology, Hacettepe University Hospitals, Ankara, Turkey
b Department of Anesthesiology, Hacettepe University Hospitals, Ankara, Turkey
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Fig 1. Small right MCA aneurysm treated with balloon assistance (patient 51).
A, CT obtained 80 minutes after the treatment reveals increased cortical attenuation (arrows).
B–C, Follow-up CT examinations with a 4-hour interval; each shows partial (B) and total (C) resolution of the cortical increased attenuation.
D, DWI image of the MR image obtained immediately after the first CT (A) shows no corresponding abnormality.
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Fig 2. Graph shows the distribution of aneurysms according to their location and size. ICA indicates internal carotid artery; MCA, middle cerebral artery; Acom, anterior communicating artery; BA, basilar artery.
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Fig 3. Posttreatment angiogram (A) shows the completely occluded small aneurysm (arrows) at the vertebrobasilar junction of the fenestrated basilar artery (patient 20). Posttreatment CT image (B) reveals increased attenuation in the posterior cerebral artery territory bilaterally (arrow). Control CT scan (C) obtained 5 hours after the first one shows complete resolution of the finding.
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Fig 4. Small MCA aneurysm treated with no balloon assistance (patient 21). A, CT images obtained 38 minutes after the treatment reveal increased cortical attenuation in the left frontal region (arrows). Control CT examination (B) shows resolution of the finding.
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Fig 5. A–B, CT examinations performed 53 minutes after the endovascular treatment of the right MCA aneurysm by using a remodeling technique. Patient 60 shows blood within the suprasellar cistern (A) in addition to increased cortical attenuation (arrows) in the right frontal region (B). C–D, Follow-up CT scans obtained after 6 hours demonstrated the persistence of blood appearance within the suprasellar cistern (C) and complete resolution of the cortical hyperattenuation (D). E–G, FLAIR (E and F) and DWI (G) of MR images obtained after the first CT examination confirm the presence of blood (arrows) within the cisterns (E) with no MR imaging abnormality in the region of cortical hyperattenuation (F and G).
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Fig 6. Early (A) and late (B) postembolization CT scans of the patient who had a large ICA aneurysm (patient 8). CT scan obtained 45 minutes after the procedure (A) shows very prominent hyperattenuation in the ipsilateral cortex, resolving totally in the control CT scan obtained after 6 hours (B).
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