title: The insidious appearance of the dissecting aneurysm: Imaging findings and related pathophysiology. A report of two cases.
abstract: Intracranial dissecting aneurysms have been frequently reported to present with fairly challenging and time-variable imaging findings that can be mostly explained by the pathological mechanisms that underline the dissection. We present two cases of spontaneous dissecting aneurysm of the supraclinoid ICA, both clinically presenting with SAH, but characterized by different progression of clinical symptoms and imaging. However, in both cases an outpouch and a mild fusiform dilation of the supraclinoid ICA was present in the initial CTA performed after the occurrence of symptoms. These findings were well depicted by the MPR reformats performed retrospectively. We postulate that this finding may represent the point of initial transmural dissection and we recommend that careful analysis of the CTA MRP reformatted images should be performed in order to detect this finding promptly.
authors: Department of Neuroradiology, Montreal Neurological Institute and Hospital, McGill University, Canada.|Dipartimento di Diagnostica Radiologica e Bioimmagini, Policlinico Agostino Gemelli, Italy.
authors: Valeria
authors: V
authors: Onofrj
authors: Department of Neuroradiology, Montreal Neurological Institute and Hospital, McGill University, Canada.
authors: Maria
authors: M
authors: Cortes
authors: Department of Neuroradiology, Montreal Neurological Institute and Hospital, McGill University, Canada donatella.tampieri@mcgill.com.
authors: Donatella
authors: D
authors: Tampieri
mesh_terms: D015901:Angiography, Digital Subtraction; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002533:Cerebral Angiography; D000072226:Computed Tomography Angiography; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: CTA; Dissecting aneurysm; MPR reformat; supraclinoid ICA; transmural rupture