Detection of blood blister-like aneurysm and intramural hematoma with high-resolution magnetic resonance imaging Case report

作者：Horie Nobutaka^*; Morikawa Minoru; Fukuda Shuji; Hayashi Kentaro; Suyama Kazuhiko; Nagata Izumi

来源：Journal of Neurosurgery, 2011, 115(6): 1206-1209.

DOI：10.3171/2011.8.JNS11909

• blood blister-like aneurysm
• intramural hematoma
• high-resolution magnetic resonance imaging
• dissection
• vascular disorders

Blood blister-like aneurysms (BBAs) tend to have a more precipitous clinical course, enlarging rapidly and rebleeding frequently. Nevertheless, they often present a diagnostic challenge because of the characteristic morphological features of a wide neck and shallow outpouching of the medial wall. The authors present the case of a 34-year-old woman who suffered a subarachnoid hemorrhage whose cause could not be determined on the initial imaging with digital subtraction (DS) angiography and CT angiography. Interestingly, MR imaging studies obtained on the 7th day revealed an intramural hematoma on the dorsal wall of the left internal carotid artery, which helped in the diagnosis of BBA on the third DS angiography study obtained on the 8th day, and in the surgical intervention on the 10th day. This case supports the hypothesis that focal dissection contributes to the formation of BBAs. Use of MR imaging in the subacute stage, in addition to DS and CT angiography, might be helpful in the diagnosis of BBAs. (DOI: 10.3171/2011.8.JNS11909)

• 出版日期2011-12