Abstract
We report a case of subarachnoid hemorrhage with a ruptured aneurysm in the anterior communicating artery. On multiphase dynamic contrast-enhanced four-dimensional computed tomography angiography (4D CTA), we observed active bleeding from the aneurysm that manifested over time with a corkscrew-like, spindle-like, and lobulated appearance and nebulous enhancement, characteristics reported only individually previously. The volume data for 4D CTA is easy to obtain with newly developed multidetector-row computed tomography, and 4D CTA can be used for evaluating anatomical aspects, hemodynamics, and treatment selection in cases of a ruptured cerebral aneurysm.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kim J, Smith A, Hemphill JC 3rd, Smith WS, Lu Y, Dillon WP, et al. Contrast extravasation on CT predicts mortality in primary intracerebral hemorrhage. AJNR Am J Neuroradiol 2008;29:520–525.
Gosselin MV, Vieco PT. Active hemorrhage of intracranial aneurysms: diagnosis by CT angiography. J Comput Assist Tomogr 1997;21:22–24.
Nakatsuka M, Mizuno S, Uchida A. Extravasation on threedimensional CT angiography in patients with acute subarachnoid hemorrhage and ruptured aneurysm. Neuroradiology 2002;44:25–30.
Hashiguchi A, Mimata C, Ichimura H, Morikoka M, Kuratsu J. Rebleeding of ruptured cerebral aneurysms during three-dimensional computed tomographic angiography: report of two cases and literature review. Neurosurg Rev 2007;30: 151–154.
Chong JY, Yi HJ, Kim KM, Lee SR. Extravasation from the distal anterior choroidal artery aneurysm in moyamoya patient during computed tomographic angiography. J Korean Neurosurg Soc 2007;41:340–342.
Ryu CW, Kim SJ, Lee DH, Suh DC, Kwun BD. Extravasation of intracranial aneurysm during computed tomography angiography: mimicking a blood vessel. J Comput Assist Tomogr 2005;29:677–679.
Holodny AI, Farkas J, Schlenk R, Maniker A. Demonstration of an actively bleeding aneurysm by CT angiography. AJNR Am J Neuroradiol 2003;24:962–964.
Nagai M, Koizumi Y, Tsukue J, Watanabe E. A case of extravasation from a cerebral aneurysm during 3-dimensional computed tomography angiography. Surg Neurol 2008;69:411–413.
Desai S, Friedman JA, Hlavin J, Kash F. Actively bleeding intracranial aneurysm demonstrated by CT angiography. Clin Neurol Neurosurg 2009;111:94–96.
Suzuki K, Morita S, Masukawa A, Machida H, Ueno E. Diagnosing a large slowly enhanced cerebral aneurysm using four-dimensional multiphase dynamic contrast-enhanced computed tomography angiography. Jpn J Radiol 2010;28:680–683.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Suzuki, K., Morita, S., Masukawa, A. et al. Ruptured aneurysm with extravasation observed in four-dimensional computed tomography angiography. Jpn J Radiol 29, 348–352 (2011). https://doi.org/10.1007/s11604-010-0550-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11604-010-0550-x