Middle cerebral artery branch occlusion mimicking a saccular aneurysm on 3D digital subtraction angiography.
The angiographic appearance of an intracranial arterial occlusion is typically distinct from that of a saccular aneurysm, with only a few reported cases of occlusion simulating aneurysm. At the same time, a small percentage of symptomatic intracranial aneurysms present with a stroke. Accurate diagnosis of these conditions is crucial, as their treatment differs. The authors report on a case of middle cerebral artery occlusion that mimicked the appearance of an aneurysm on angiography in the setting of acute stroke. The true diagnosis was not elucidated until repeated angiography 6 months later revealed recanalization of the previously occluded middle cerebral artery branch. This angiographic pitfall is important to consider when acute stroke is suspected as the mode of presentation of a saccular aneurysm.
Pearl
Monica Smith
MS
Division of Interventional Neuroradiology, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
Tamargo
Rafael
R
Gailloud
Philippe
P
D000328:Adult; D015901:Angiography, Digital Subtraction; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology