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Fig 1. Case 4. A 52-year-old woman with progressive visual loss in the left eye beginning 5 days following coiling of a left paraclinoid aneurysm. A, Preoperative MR imaging: T2-weighted axial image shows an aneurysm arising from the paraclinoid portion of the left ICA. B, Preoperative MR imaging: T1-weighted axial image following administration of gadolinium shows marked enhancement of the aneurysm. C, Preoperative MR imaging: T1-weighted coronal image following administration of gadolinium shows marked enhancement of the aneurysm. D, Five days after coiling: T2-weighted axial MR image shows a heterogeneous signal intensity from within the aneurysm, consistent with coil packing. E, Five days after coiling: T1-weighted axial MR image following administration of gadolinium shows that most of the aneurysm no longer enhances; however, there is generalized irregular enhancement surrounding it. F, Five days after coiling: T1-weighted coronal MR image following administration of gadolinium shows a thin layer of irregular enhancement either in the wall of the aneurysm or in adjacent tissue. G, Six months after coiling: T2-weighted axial MR image shows that the aneurysm is slightly larger (1–2 mm) than before coiling. H, Six months after coiling: T1-weighted axial MR image following administration of gadolinium shows areas of persistent slight enhancement around the margin of the coiled aneurysm. I, Six months after coiling: T1-weighted coronal MR image following administration of gadolinium shows a thin margin of irregular enhancement around the coiled aneurysm.
