Journal article
Vessel Wall Imaging in Angiogram-Negative Diffuse Subarachnoid Hemorrhage Reveals a Ruptured Lenticulostriate Aneurysm
Neurointervention, v 19(2), pp 118-122
01 Jul 2024
PMID: 38835141
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
A patient presented with acute onset headache and subsequent unconsciousness. The neurologic exam showed left-sided myoclonic jerking and right flaccid hemiparalysis. Noncontrast computed tomography revealed diffuse subarachnoid hemorrhage (SAH) with acute hydrocephalus. Initial digital subtraction angiography (DSA) showed no culprit source for SAH. Repeat DSA on day 7 after initial presentation raised suspicion for left internal carotid artery ophthalmic segment and left lateral lenticulostriate artery (LSA) aneurysms. A magnetic resonance vessel wall imaging (VWI) exam was performed given the presence of multiple potential culprit aneurysms. Vessel wall enhancement around the dome of the left LSA aneurysm suggested rupture, which then facilitated treatment with surgical clipping. LSA aneurysms are exceedingly rare and challenging to treat. Given the associated high degree of morbidity, expedient diagnosis is critical to direct management. VWI could be a valuable tool for detecting ruptured aneurysms in the setting of angiogram-negative SAH.
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Details
- Title
- Vessel Wall Imaging in Angiogram-Negative Diffuse Subarachnoid Hemorrhage Reveals a Ruptured Lenticulostriate Aneurysm
- Creators
- Huy Quang Phi - Drexel UniversitySuehyb Ghazi Alkhatib - University of PennsylvaniaScott Bruce Raymond - University of VermontOmar Aftab Choudhri - University of PennsylvaniaJae Won Song - University of Pennsylvania
- Publication Details
- Neurointervention, v 19(2), pp 118-122
- Publisher
- Korean Society of Interventional Neuroradiology
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001246730400001
- Scopus ID
- 2-s2.0-85197385174
- Other Identifier
- 991022202522404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology