Fact-sheet: Aneurysm of central nervous system
Updated on 09/17/2021 at 12:16 PM
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Definition
Deformation of the wall of a cerebral artery, most often in the form of a sac.
A giant intracranial aneurysm is defined as measuring more than 25 mm.
Partially thrombosed giant aneurysms (PTGA) constitute a distinct category owing to their particular pathophysiology and specific complications.
Clinical features
Frequent incidental finding on CT or MRI.
Manifestations are related to complications:
-mass effect on the adjacent parenchyma.
-ischemia due to embolic or compressive mechanisms involving perforating arteries.
-hemorrhage from transmural rupture: subarachnoid hemorrhage
CT
Non-contrast brain CT and CT angiography:
-diagnosis of subarachnoid hemorrhage
-assessment of the thrombosed and patent portions
-topographic assessment of the aneurysm and its morphological characteristics prior to X-Ray Angiography
MRI
MR angiography of the circle of Willis:
90% of intracranial aneurysms develop at the anterior part of the circle of Willis.
This is the examination of choice for PTGA, providing optimal assessment of the patent portion, the thrombosed portion, and the effect on the adjacent parenchyma.
Vascular intervention
Cerebral X-Ray Angiography:
performed for diagnostic and therapeutic purposes = embolization.
Minimizes PTGA.