Late de novo basilar aneurysm after carotid artery injury

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Address correspondence to: Gavin W. Britz, M.D., M.P.H., Departments of Neurological Surgery and Radiology, University of Washington, Harborview Medical Center, Box 359766, 700 Ninth Avenue, Seattle, Washington 98104. email: gbritz@u.washington.edu.

© AANS, except where prohibited by US copyright law.

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    A: Noncontrast-enhanced CT scan demonstrating diffuse SAH, temporal horn dilation, and the aneurysm's location anterior to the upper pons. B: Computed tomographic angiogram demonstrating absent opacification of the right ICA and narrowed filling of the left ICA vessel (black arrow). C: Lateral projection vertebral angiogram demonstrating the basilar apex aneurysm. The posterior circulation supplies the PCoA vessels (black arrow) to provide collateral flow to the anterior and middle cerebral territories. D: Lateral projection of left and right common carotid angiograms. Bilateral ICA dissections and severe stenoses are noted, with external carotid artery collateralization via ethmoidal and middle meningeal vessels (asterisks).

References

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    Baumgartner RWArnold MBaumgartner IMosso MGönner FStuder A: Carotid dissection with and without ischemic events: local symptoms and cerebral artery findings. Neurology 57:8278322001

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  • 2

    Biffl WLRay CE JrMoore EEFranciose RJAly SHeyrosa MG: Treatment-related outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography. Ann Surg 235:6997072002

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