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American Journal of Neuroradiology 26:200-201, January 2005
© 2005 American Society of Neuroradiology

Letter

Rupture of a Cerebral Aneurysm during MR Imaging: Leakage of Gadolinium into the Subarachnoid Space

Rodney S. Allana,b, Geoffrey Parkerc and Martin McGee-Collettd

a Westmead Hospital, Neurosurgery, Sydney, NSW, Australia
b Royal Prince Alfred Hospital, Neurosurgery, Sydney, NSW, Australia
c Royal Prince Alfred Hospital, Radiology, Sydney, NSW, Australia
d Royal Prince Alfred Hospital, Neurosurgery, Sydney, NSW, Australia

Dear Editor: We wish to report a recent, notable case and present the remarkable images we obtained from it. A 62-year-old woman was undergoing routine MR imaging to investigate the cause of left arm and facial pain. While in the unit and shortly after the administration of gadolinium, she developed a severe headache and vomiting. After initial assessment, the radiologist obtained further MR images of her brain. These revealed extravasation of contrast medium into the subarachnoid space. The patient was taken immediately to the angiography suite, where the presence of a left internal carotid aneurysm was confirmed. This aneurysm was repaired by craniotomy, and the patient made a satisfactory recovery. There are reports in the literature documenting the MR imaging appearance of acute subarachnoid hemorrhage (1); however, our search of the literature yielded no reports of a subarachnoid hemorrhage (SAH) occurring during MR imaging. This report illustrates the unique MR imaging appearances of gadolinium leakage into the subarachnoid space after development of an SAH.



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  		FIG 1. Noncontrast T1-weighted axial MR image of the area of the circle of Willis.



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  		FIG 2. Postgadolinium T1-weighted axial MR image of the area of the circle of Willis.



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  		FIG 3. Left internal carotid digital subtraction angiogram showing left internal carotid artery aneurysm.

References

  1. Woodcock RJ Jr., Short J, Do HM, Jensen ME, Kallmes DF. Imaging of acute subarachnoid hemorrhage with a fluid-attenuated inversion recovery sequence in an animal model: comparison with non-contrast-enhanced CT. AJNR Am J Neuroradiol 2001;22:1698–1703[Abstract/Free Full Text]





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