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Basilar artery aneurysm

Case Study
Philips CT Clinical Science Philips Healthcare

Clinical history

This 67-year-old female patient was evaluated on the Brilliance 40-channel scanner for recent head trauma. The CT scan of the brain revealed an incidentally discovered basilar artery tip aneurysm. CTA of the neck and Circle of Willis were performed for treatment planning purposes.

Scan parameters

  • 40 x .625 mm
  • 0.5 sec.
  • 120 kV
  • 365 mAs/slice
  • 0.67 mm thickness
  • 8 sec. scan time
  • 134 mm scan length
  • 6 cc/second for a total of 80 cc's followed by 50 cc's saline
 Volume rendered image showing a posterior view of the basilar artery tip aneurysm VR shows right carotid bifurcation atherosclerotic calcification VIP image demonstrating the Circle of Willis and basilar tip artery aneurysm
Volume rendered image showing a posterior view of the basilar artery tip aneurysm
VR shows right carotid bifurcation atherosclerotic calcification
VIP image demonstrating the Circle of Willis and basilar tip artery aneurysm
 Endo image showing basilar aneurysm Angio demonstrating post coil embolization of the basilar aneurysm Para-sagittal MIP image illustrating the vertebral artery origin stenosis
Endo image showing basilar aneurysm
Angio demonstrating post coil embolization of the basilar aneurysm
Para-sagittal MIP image illustrating the vertebral artery origin stenosis

Diagnosis

The CTA examination of the aortic arch shows normal great vessel branching. There is moderate bilateral carotid bifurcation atherosclerotic calcification, but no significant flow-limiting stenosis. The right vertebral artery is dominant. There is approximately 50% stenosis at the origin of the left vertebral artery.

 

Examination of the intracranial circulation shows a 10 mm basilar artery tip aneurysm with a relatively narrow neck. The aneurysm points superiorly and demonstrates some mild lobulation near its dome. No additional aneurysm is identified.

Clinical significance

Though cerebral aneurysms can cause headaches, blurred vision, or neck pain, they often present no symptoms and therefore go unnoticed. The fortunate incidental discovery of this basilar artery aneurysm allowed intervention to be performed before serious complications could arise. This exam provided a totally non-invasive treatement plan for coil embolization including assessement of the access vessels, and the aneurysm volume and dimensions. A successful complete coil embolization of the basilar artery aneurysm was achieved.

 

Philips Brilliance CT 40-channel system provides the speed for pure aterial phase imaging with a reduced amount of IV contrast. In addition, our isotropic CTA scan data provides excellent spatial resolution to confidently differentiate minute vascular structures using our Brilliance Workspace applications tools such as volume rendering, Slab Volume Intensity Projection (VIP) and MIP. These benefits allow the physician to easily evaluate the results and define a treatment plan.



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Feb 10, 2006

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Case Study
Brilliance 40-channel, Workstation
aneurysm, aorta, atherosclerosis, brain, Brilliance Version 1.2, calcification, carotids, Circle of Willis, Extended Brilliance Workspace Version 1.0, Extended Brilliance Workspace Version 2.0, Head, head CTA, MIP, Neck, neck CTA, Neuro, stenosis, trauma, treatment planning, Vascular, VIP
 

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