Vessel Wall Imaging After Subarachnoid Hemorrhage in Patients with Multiple Intracranial Aneurysms: A Cautionary Case

被引:6
作者
Zolnourian, Ardalan [1 ]
Borg, Nicholas [1 ]
Akhigbe, Taiwo [1 ]
Macdonald, Jason [2 ]
Bulters, Diederik [1 ]
机构
[1] Wessex Neurol Ctr, Dept Neurosurg, Southampton, Hants, England
[2] Wessex Neurol Ctr, Dept Neuroradiol, Southampton, Hants, England
关键词
Intracranial aneurysm; Subarachnoid hemorrhage; Vessel wall imaging; CEREBRAL VASOCONSTRICTION SYNDROME; MRI; ENHANCEMENT;
D O I
10.1016/j.wneu.2019.04.130
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND: Almost 30% of patients with subarachnoid hemorrhage (SAH) are found to have multiple aneurysms. This can potentially present a serious management dilemma when planning treatment. Magnetic resonance imaging vessel wall imaging (VWI) has been proposed as a reliable technique in differentiating between ruptured and unruptured aneurysms in patients with multiple intracranial aneurysms who present with SAH. Expert consensus now supports this as a possible use for the technique. CASE DESCRIPTION: Here we present a patient presenting a particular clinical dilemma with SAH and a left third nerve palsy and transient speech disturbance who had circumferential enhancement in the left larger 3.5-mm irregular middle cerebral artery aneurysm and no detectable enhancement in what was angiographically either a 1.5-mm smooth noncompressive left posterior communicating artery aneurysm or infundibulum, but was proved at surgery to be the culprit aneurysm. CONCLUSION: Although a case of concurrent false positive and false negative in the same patient has not previously been reported, the positive predictive value of VWI for rupture status is known to be much lower than its negative predictive value, and a case like this might be expected to occur in 0.6% of patients. Therefore, whereas VWI is a valuable tool, it should be used in conjunction with, and not in lieu of, traditional indicators of aneurysm rupture.
引用
收藏
页码:414 / 417
页数:4
相关论文
共 50 条
[41]   The Use of Intracranial Vessel Wall Imaging in Clinical Practice [J].
Hedjoudje, Abderrahmane ;
Darcourt, Jean ;
Bonneville, Fabrice ;
Edjlali, Myriam .
RADIOLOGIC CLINICS OF NORTH AMERICA, 2023, 61 (03) :521-533
[42]   Repeated screening for intracranial aneurysms in familial subarachnoid hemorrhage [J].
Wermer, MJH ;
Rinkel, GJE ;
van Gijn, J .
STROKE, 2003, 34 (12) :2788-2791
[44]   SCREENING FOR UNRUPTURED FAMILIAL INTRACRANIAL ANEURYSMS - SUBARACHNOID HEMORRHAGE 2 YEARS AFTER ANGIOGRAPHY NEGATIVE FOR ANEURYSMS [J].
SCHIEVINK, WI ;
LIMBURG, M ;
DREISSEN, JJR ;
PEETERS, FLM ;
TERBERG, HWM .
NEUROSURGERY, 1991, 29 (03) :434-438
[45]   Combined Susceptibility-Weighted Imaging and Vessel Wall Imaging of Unruptured Intracranial Aneurysms Presenting with Sentinel Headache [J].
Gupta, Pooja ;
Kannath, Santhosh K. ;
Thomas, Bejoy ;
Chandrasekharan, Kesavadas ;
Singh, Gurpreet .
NEUROLOGY INDIA, 2025, 73 (02) :251-256
[46]   Vessel Wall Imaging Predicts the Presence of Atherosclerotic Lesions in Unruptured Intracranial Aneurysms [J].
Hashimoto, Yukishige ;
Matsushige, Toshinori ;
Shimonaga, Koji ;
Hosogai, Masahiro ;
Kaneko, Mayumi ;
Ono, Chiaki ;
Mizoue, Tatsuya .
WORLD NEUROSURGERY, 2019, 132 :e775-e782
[47]   Quantitative assessment of microstructural evolution of intracranial aneurysm wall by vessel wall imaging [J].
Endo, Hidenori ;
Mori, Naoko ;
Mugikura, Shunji ;
Niizuma, Kuniyasu ;
Omodaka, Shunsuke ;
Takase, Kei ;
Tominaga, Teiji .
NEURORADIOLOGY, 2022, 64 (07) :1343-1350
[48]   Intracranial pressure after subarachnoid hemorrhage [J].
A Lombardo ;
T Zoerle ;
ER Zanier ;
L Longhi ;
N Stocchetti .
Critical Care, 17 (Suppl 2)
[49]   Subarachnoid hemorrhage from intracranial dissecting aneurysms of the anterior circulation - Two case reports [J].
Hashimoto, H ;
Iida, J ;
Shin, Y ;
Hironaka, Y ;
Sakaki, T .
NEUROLOGIA MEDICO-CHIRURGICA, 1999, 39 (06) :442-446
[50]   Subarachnoid hemorrhage in the presence of both intracranial dissecting and saccular aneurysms - Two case reports [J].
Akiyama, Yasuhiko ;
Moritake, Kouzo ;
Miyazaki, Takeshi ;
Nagai, Hidemasa .
NEUROLOGIA MEDICO-CHIRURGICA, 2007, 47 (02) :65-69