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    J Korean Soc Radiol. 2012 Aug;67(2):79-83. Korean.
    Published online Aug 31, 2012.
    https://doi.org/10.3348/jksr.2012.67.2.79
    Copyright © 2012 The Korean Society of Radiology
    Case Report

    Traumatic Intracranial Aneurysm in the Clinoid Segment of the Internal Carotid Artery: A Case Report

    Dae Jung Kim, MD,1 Hyun Sook Kim, MD,1 Hee In Kang, MD,2 Yoon Young Jeong, MD,1 and Yun Sun Choi, MD1
      • 1Department of Radiology, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea.
      • 2Department of Neurosurgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea.
    • Corresponding author: Hyun-Sook Kim, MD. Department of Radiology, Eulji Hospital, Eulji University School of Medicine, 14 Hangeulbiseok-gil, Nowon-gu, Seoul 139-872, Korea. Tel. 82-2-970-8290, Fax. 82-2-970-8346, Email: khs46359@eulji.ac.kr
    Received January 30, 2012; Accepted May 28, 2012.

    Abstract

    Traumatic aneurysms need an accurate diagnosis and active treatment because they present the risk of rupturing within a week after trauma in 50% of cases. We report a traumatic aneurysm arising from the medial wall of the clinoid segment of the internal carotid artery. The aneurysm was observed on a CT angiography and a transfemoral cerebral angiography and treated successfully with endovascular stent deployment.

    Keywords
    Traumatic Aneurysm; Internal Carotid Artery, Clinoid; Angiography, Computed Tomography

    Figures

    Fig. 1
    A 16-year-old man with a motor cycle accident. Axial temporal bone CT images (A) (1-mm slice thickness) show tiny spot of air in the left foramen lacerum (white arrow) and bony discontinuity in the anterior wall of the left foramen lacerum (white arrowhead) and wavy subtle separation of the left petroclival suture (black arrow) and suspected hemotympanum (black arrowhead) and high attenuation in the left mastoid antrum (open arrowhead). Axial CT angiography images (B) (0.6-mm slice thickness) show bony irregularity in the lateral wall of left sphenoid sinus (open arrow).

    Fig. 2
    CT angiography. Axial images (A) (0.6-mm slice thickness) show medial wall aneurysm in the clinoid segment of the left internal carotid artery (arrows). Three-dimensional-reformation image (B) shows about 2.2 × 1.3 mm aneurysm and intimal flap (black arrow).

    Fig. 3
    Three-dimensional-reformation images of transfemoral cerebral angiography. Image taken on the seventh day of the accident (A) shows 2.9 × 2.4 × 1.3 mm aneurysm in the clinoid segment of the left internal carotid artery (arrow). Follow-up image, a week later (B), shows growing of the 3.1 × 2.6 × 1.7 mm aneurysm (arrow).

    Fig. 4
    Follow-up three-dimensional-reformation image of CT angiography, obtained 4 months later after endovascular stent deployment, shows decreased size of the aneurysm in the clinoid segment of the left internal carotid artery (arrow).

    References

      1. Stallmeyer MJ, Morales RE, Flanders AE. Imaging of traumatic neurovascular injury. Radiol Clin North Am 2006;44:13–39. vii.
      1. Bae HG. In: Cerebrovascular surgery. Seoul: Korea Medical Book Publisher; 2010. pp. 305-311.pp. 349-351.pp. 515-526.pp. 561-563.
      1. Liang JT, Huo LR, Bao YH, Zhang HQ, Wang ZY, Ling F. Intracranial aneurysms in adolescents. Childs Nerv Syst 2011;27:1101–1107.
      1. Javalkar V, Banerjee AD, Nanda A. Paraclinoid carotid aneurysms. J Clin Neurosci 2011;18:13–22.
      1. Kumamaru KK, Hoppel BE, Mather RT, Rybicki FJ. CT angiography: current technology and clinical usr. Radiol Clin North Am 2010;48:213–235. vii.
      1. Brzozowski K, Frankowska E, Piasecki P, Zięcina P, Zukowski P, Bogusławska-Walecka R. The use of routine imaging data in diagnosis of cerebral pseudoaneurysm prior to angiography. Eur J Radiol 2011;80:e401–e409.
      1. Tomandl BF, Köstner NC, Schempershofe M, Huk WJ, Strauss C, Anker L, et al. CT angiography of intracranial aneurysms: a focus on postprocessing. Radiographics 2004;24:637–655.
      1. Vega C, Kwoon JV, Lavine SD. Intracranial aneurysms: current evidence and clinical practice. Am Fam Physician 2002;66:601–608.
    MeSH Terms
    Aneurysm
    Angiography
    Carotid Artery, Internal
    Cerebral Angiography
    Intracranial Aneurysm
    Stents
    Metrics
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