Advanced

AJNR - American Journal of Neuroradiology

Published ahead of print on October 5, 2007
doi: 10.3174/ajnr.A0726

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted 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 Gilad, R. Articles by Patel, A.B. Search for Related Content PubMed PubMed Citation Articles by Gilad, R. Articles by Patel, A.B.

Migrating Subdural Hematoma without Subarachnoid Hemorrhage in the Case of a Patient with a Ruptured Aneurysm in the Intrasellar Anterior Communicating Artery

R. Gilad^a, G.M. Fatterpekar^b, D.M. Johnson^c and A.B. Patel^c

^a Departments of Neurosurgery, Mount Sinai School of Medicine, New York, New York
^b Departments of Radiology, Mount Sinai School of Medicine, New York, New York
^c Departments of Neurosurgery and Radiology, Mount Sinai School of Medicine, New York, New York

View larger version (96K): [in this window] [in a new window]   Fig 1. A, Sagittal, noncontrast T1WI demonstrates an extensive SDH dorsal to the clivus (black arrows). Closer inspection reveals an inferiorly projecting flow void extending from the suprasellar region into the sella turcica (open arrow), which raises the possibility of an aneurysm of the AcomA. Increased signal intensity seen along the roof of the sella (white arrow) is consistent with hemorrhage dissecting along the diaphragma sella. B, Axial T2WI demonstrates a saccular outpouching (white arrow) consistent with an aneurysm arising from the AcomA.

View larger version (100K): [in this window] [in a new window]   Fig 2. Conventional angiogram obtained from a right internal carotid artery injection (A) precoiling AP view and (B) unsubtracted postcoiling lateral view demonstrates an aneurysm of the AcomA (black arrows) projecting inferiorly into the expected location of the sella turcica. Note the inset skull x-ray in the upper right-hand corner showing the coil mass in the sella turcica.

View larger version (131K): [in this window] [in a new window]   Fig 3. Sagittal noncontrast T1WI MR imaging of the cervical, thoracic, and upper lumbar spine demonstrates a circumferential high signal intensity (arrows) in the intradural extramedullary space consistent with a SDH of the spine.