Magnetic Resonance Vessel Wall Imaging Reveals Rupture Site in Subarachnoid Hemorrhage with Multiple Cerebral Aneurysms Rei KONDO 1 , Tetsu YAMAKI 1 , Wataru MOURI 1 , Shinji SATO 1 , Shinjiro SAITO 1 , Morio NAGAHATA 2 , Satoko NAGAHATA 2 , Takamasa KAYAMA 3 1Department of Neurosurgery, Yamagata City Hospital SAISEIKAN 2Department of Diagnostic and Interventional Neuroradiology, Yamagata City Hospital SAISEIKAN 3Department of Neurosurgery, Faculty of Medicine, Yamagata University Keyword: multiple intracranial aneurysm , magnetic resonance imaging , vessel wall imaging , subarachnoid hemorrhage , rupture site pp.1147-1150
Published Date 2014/12/10
DOI https://doi.org/10.11477/mf.1436200050
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 We report a case of subarachnoid hemorrhage(SAH)with multiple cerebral aneurysms, in which magnetic resonance vessel wall imaging(MR-VWI)revealed the rupture site. A 68-year-old woman presented with SAH. Computed tomography(CT)showed diffuse SAH(Fisher group 3). 3D-CT angiography revealed two intracranial aneurysms:a 4.2-mm anterior communicating artery aneurysm(Acom An)and a 5.8-mm basilar tip aneurysm(BAtip An). As the BAtip An was the larger of the two, it was deemed the most likely site of rupture;however, high-resolution MR-VWI with gadolinium showed thick wall enhancement in the Acom An and no enhancement in the BAtip An. Thus, we performed a craniotomy for the Acom An. Intraoperative findings confirmed the rupture site at the Acom An. We concluded that high resolution MR-VWI may be useful for identifying the rupture site in patients with spontaneous SAH and multiple cerebral aneurysms.

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