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Giant saccular aneurysm of the left internal carotid artery, case 1

   

Giant internal carotid artery aneurysm, 1.5 T

This 62 year old female presented with a left ophthalmoplegia of sudden onset.

The initial CT scan and the subsequent conventional MRI revealed a giant intracavernous internal carotid artery aneurysm.

Fig.1 The 3D TOF MR angiogram (above) confirms the diagnosis of the aneurysm. However, the aneurysmal sac is incompletely visualized, hence partial intraluminal thrombosis cannot be ruled out. Note also the non-visualization of the left middle cerebral artery (similar phenomenon as in Giant internal carotid artery aneurysm: patient case 2).

On the 2D TOF MR angiogram (below) the entire aneurysmal sac is delineated. In equivocal cases, the 2D TOF technique is a useful adjunct in the MRA of giant aneurysms, due to its insensitivity to intravolume spin saturation, compared to the 3D TOF technique.

   

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Fig. 1

Giant saccular aneurysm of the left internal carotid artery, case 1, Fig. 1