Ruptured basilar tip aneurysm

Case contributed by Yaïr Glick , 22 Apr 2023

Diagnosis certain

Changed by Yaïr Glick, 23 Apr 2023

Disclosures - updated 4 May 2022: Nothing to disclose

Updates to Study Attributes

Findings was changed:

Non-contrast CT head

extensive bilateral subarachnoid hemorrhage - perimesencephalic; in all the basal cisterns; in the narrowed third ventricle, Sylvian aqueduct, and fourth ventricle; in the premedullary cistern; in the Sylvian cisterns and fissures; in the interhemispheric fissure; and bifrontal
the temporal horns of the lateral ventricles are dilated - early sign of hydrocephalus
the cerebral and cerebellar sulci are effaced - suggestive of brain edema

CT angiogram

pedunculated aneurysm with a "nipple" at the basilar tip measuring 3 mm in diameter and 5.5 mm in length, deviating to the left P1
the intracranial arteries appear slightly narrowed, perhaps due to cerebral edema
the neck arteries are patent

Findings was changed:

3-month follow-up MRI:

on MRA,: filling defect between basilar tip and left PCA, representing the embolization coils in the aneurysm
no evidence of new aneurysm
on SWI,: blood degradation products on the tentorial leaflets and in the basal cisterns, as well as small amount mainly in the biparietal sulci and bifrontal sulci around the vertex
two tiny foci of susceptibility inartifact in the right cerebellar hemisphere and one in the left hemisphere
above the tentorium: several ~~unspecific~~nonspecific abnormal white matter foci on the right, single one on the left - probably representing microangiopathy
no abnormal port-contrast enhancement

Title was changed:

~~Rupture~~Ruptured basilar tip aneurysm

Title was removed:

~~Rupture basilar tip aneurysm~~

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Title was added:

Ruptured basilar tip aneurysm

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