Venous loop mimicking middle cerebral artery bifurcation aneurysm on computed tomographic angiography--case report.
BACKGROUND
CT angiography has been widely used for the detection of cerebral aneurysm. However, there are still limitations despite improving CT angiographic techniques. We describe the unusual case of the detection of a false-positive aneurysm on CT angiography.


METHODS
A 64-year-old man presented with a 14-day history of severe headache and nuchal rigidity. Brain CT demonstrated no subarachnoid hemorrhage, but cerebrospinal fluid appeared xanthochromic in 3 successive tubes after lumbar puncture. Subsequent CT angiography suggested an aneurysm at the bifurcation of the left MCA. However, at operation, prominent sylvian vein superimposed on the bifurcation of the left MCA, and there was no aneurysm. Follow-up monitoring with conventional angiography at 2 weeks showed no abnormal findings. The patient recovered uneventfully.


CONCLUSIONS
The case demonstrates that although CT angiography has a reportedly high specificity and sensitivity for the detection of intracranial aneurysm, careful interpretation is required to diagnose intracranial aneurysms.
Kim
Jae Hoon
JH
Department of Neurosurgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 471-701, Korea.
Cheong
Jin Hwan
JH
Bak
Koang Hum
KH
Kim
Choong Hyun
CH
Kim
Jae Min
JM
D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000002:abnormalities* / Q000601:surgery; D003399:Craniotomy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D005189:False Positive Reactions; D006261:Headache / Q000209:etiology; D046648:Hematoma, Subdural, Intracranial / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000592:standards*