Novel use of 4D-CTA in imaging of intranidal aneurysms in an acutely ruptured arteriovenous malformation: is this the way forward?

J Neurointerv Surg. 2016 Sep;8(9):e36. doi: 10.1136/neurintsurg-2015-011784.rep. Epub 2015 Jul 15.

Abstract

Ruptured arteriovenous malformation (AVM) is a frequent cause of intracranial hemorrhage. The presence of associated aneurysms, especially intranidal aneurysms, is considered to increase the risk of re-hemorrhage. We present two cases where an intranidal aneurysm was demonstrated on four-dimensional CT angiography (time-resolved CT angiography) (4D-CTA). These features were confirmed by digital subtraction angiography (catheter arterial angiogram). This is the first report of an intranidal aneurysm demonstrated by 4D-CTA. 4D-CTA can offer a comprehensive evaluation of the angioarchitecture and flow dynamics of an AVM for appropriate classification and management.

Keywords: Aneurysm; Angiography; Arteriovenous Malformation; CT Angiography; Hemorrhage.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angiography, Digital Subtraction*
  • Arteriovenous Malformations / diagnostic imaging*
  • Cerebral Angiography / methods*
  • Cerebral Hemorrhage / diagnostic imaging*
  • Comorbidity
  • Computed Tomography Angiography / methods*
  • Female
  • Four-Dimensional Computed Tomography / methods*
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Male
  • Rupture, Spontaneous