Type:
Educational Exhibit
Keywords:
CNS, Catheter arteriography, CT-Angiography, MR-Angiography, Education, Aneurysms
Authors:
A. Ajjikuttira, A. Coulthard
DOI:
10.26044/ranzcr2023/C-23
Imaging findings OR Procedure details
We highlight the case of a female patient who initially presented complaining of hemianopia and dysarthria. Apart from hypertension and cigarette smoking, she was otherwise fit and well. There was no prior family history of cerebral aneurysms of note. Cerebral digital subtraction angiogram (DSA) was performed to exclude vasculitis as a cause for her presenting symptoms, and echocardiogram was undertaken to rule out embolic phenomenon. Her DSA was normal. An echocardiogram subsequently revealed a 5-centimetre left atrial myxoma, which was surgically resected.
7 years later, she presented to the emergency department (ED) after a fall. A non-contrast head CT showed multiple hyperdense focal lesions. Multiple fusiform aneurysms were subsequently noted on CT cerebral angiogram and confirmed on cerebral DSA. She remains on conservative management at our institution via yearly magnetic resonance angiogram, with no significant change to her aneurysms after 4 years.