title: The pretzel sign: angiographic pattern of tortuous intra-aneurysmal blood flow in a giant serpentine aneurysm.
abstract: Giant serpentine aneurysms (GSAs) form a specific subgroup of giant cerebral aneurysms that have pathognomonic angiographic features. We report the angiographic findings of a GSA demonstrating a striking convoluted dynamic flow pattern, which we have called the 'pretzel sign'. The aneurysm was successfully treated by permanent occlusion of the parent vessel using a detachable balloon. GSAs should be identified prior to treatment in view of their particular management requirements.
authors.affiliation: Department of Radiology, Cork University Hospital, Wilton, Cork, Ireland. nfanning@ireland.com
authors.forename: N F
authors.initials: NF
authors.lastname: Fanning
authors.forename: M O
authors.initials: MO
authors.lastname: Kelleher
authors.forename: D Q
authors.initials: DQ
authors.lastname: Ryder
mesh_terms: D000328:Adult; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003097:Collateral Circulation / Q000502:physiology; D004621:Embolization, Therapeutic / Q000379:methods; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D011149:Pons / Q000000981:diagnostic imaging; D011184:Postoperative Period; D011859:Radiography; D013702:Temporal Lobe / Q000000981:diagnostic imaging