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Fig. 1 | BMC Neurology

Fig. 1

From: Delayed extensive brain edema caused by the growth of a giant basilar apex aneurysm treated with basilar artery obliteration: a case report

Fig. 1

Preoperative computed tomography (CT) and digital subtraction angiography (DSA) demonstrated a basilar apex giant aneurysm occupying the interpeduncular fossa. a-d: Plain and contrast enhanced CT showed a giant calcified basilar artery aneurysm causing brain-stem compression. e-k: Diagnostic DSA with a right vertebral artery (VA) injection showing a basilar artery (BA) tip aneurysm. The diameters of the blood lumen measured 2.5 × 1.5 cm. The aneurism projected posteriorly into the interpeduncular cistern. A left robust PCoA was observed (red arrow in f). Based on the angiographic anatomy, trial balloon test occlusion was not required. Anteroposterior (g) and lateral (h) DSA with right VA injection showed partial filling of the aneurysm sac due to thrombosis. The aneurysm was wide-necked, with incorporation of both posterior cerebral arteries (PCAs) and superior cerebellar arteries (SCAs) into the neck (3D reconstructions, I-K). l-q: Postoperative DSA confirmed occlusion of the BA and filling of the top of the BA via the posterior communicating arteries (PCoAs) bilaterally (red arrows in L-O). DSA also revealed continued filling of the PCAs and SCAs through the PCoAs. Stagnant flow was also visible in the aneurysm, indicating a high likelihood of aneurysm thrombosis. In fact, there was a marked decrease in the diameter of the contrast filling in aneurysm blood lumen

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BMC Neurology

ISSN: 1471-2377

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