title: Cerebral aneurysm debuting as rupture during diagnostic CT angiography: An unexpected worst-case scenario.
abstract: Previously-asymptomatic intracranial aneurysm rupture during cerebral angiography is an extremely rare phenomenon. There is a small risk of rupture of these aneurysms during digital subtraction angiography (DSA), but no case of spontaneous rupture during computed tomographic angiography (CTA) has been reported. A concise case of a 40-year-old woman referred for workup of an asymptomatic intracranial aneurysm who experienced acute rupture at the time of identification of a second aneurysm is described. This case highlights the potential for rupture at the time of scan acquisition and the importance of maintaining a high level of suspicion in the setting of neurological deterioration, as well as the potential need by all medical imaging professionals to identify an emergency and activate an urgent response.
authors.affiliation: Department of Medical Imaging, St. Michael's Hospital, Toronto, Canada adam.dmytriw@uhn.ca.
authors.forename: Adam A
authors.initials: AA
authors.lastname: Dmytriw
authors.affiliation: Department of Neurosurgery, St. Michael's Hospital, Toronto, Canada.
authors.forename: Jaime L
authors.initials: JL
authors.lastname: Martinez
authors.affiliation: Department of Neurosurgery, St. Michael's Hospital, Toronto, Canada.
authors.forename: Julian
authors.initials: J
authors.lastname: Spears
authors.affiliation: Department of Medical Imaging, St. Michael's Hospital, Toronto, Canada.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Marotta
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging* / Q000209:etiology; D002533:Cerebral Angiography / Q000009:adverse effects*; D000072226:Computed Tomography Angiography / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging*
keywords: Intracranial aneurysm; computed tomographic angiography; critical care; non-invasive imaging; rupture