From pitfall to misdiagnosis and life-threatening treatment.
Sixty-four-section multidetector computed tomography angiography (64-SMCTA) is increasingly used for screening and surgical planning of ruptured intracranial aneurysms due to its high sensitivity and positivity and it is less invasive than digital subtraction angiography (DSA). Combination of both is the best tool when diagnosis is inconclusive. Sometimes the use of 64-SMCTA alone may cause interpretation pitfall and unnecessary life-threatening treatment. This case report is about 64-SMCTA interpretation pitfall, a false positive result that occasioned surgery for clipping an intracranial aneurysm which was not found during surgical procedure. The patient survived the life-threatening surgery and she has been doing well over the last two years. A perceptual error and lack of conspicuity due to some limitations of the scanner to disclose a normal anatomic variant were responsible for this false positive. Whenever 64-SMCTA renders inconspicuous images, this result must be seen as inconclusive and hence a meticulous differential diagnosis and DSA are required before any surgical planning.
Department of Neurological Surgery, Hospital Universitario de Sancti Spiritus Camilo Cienfuegos, Cuba. jorgefelix70@hpss.ssp.sld.cu
J F C
JF
Rosildo
D000328:Adult; D002533:Cerebral Angiography; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D061330:Multidetector Computed Tomography; D019564:Unnecessary Procedures; D055815:Young Adult