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Neuroradiology

, Volume 60, Issue 7, pp 665–667 | Cite as

Cerebral aneurysm rebleed with ventricular breakthrough captured by four-dimensional CT angiography

  • Wulphert VenderinkEmail author
  • Frank van Megen
  • Joost de Vries
  • Frederick J. A. Meijer
Letter to the Editor
  • 134 Downloads

Case report

A 44-year-old female presented at our hospital after collapse with headache and decrease of consciousness. The patient was directly transferred for head CT, which demonstrated a large subarachnoid hemorrhage located in the insular cistern on the right side (Fig.  1). At this moment, there was no intraventricular hemorrhage (IVH). During acquisition of a subsequent dynamic CT angiography, also referred to as 4D-CTA, the patient suffered an aneurysmal rebleed with leakage of contrast out of a middle cerebral artery (MCA) aneurysm on the right side with spread in the insular cistern. Furthermore, intraventricular breakthrough was seen with spread of contrast agent into the right lateral ventricle, the third and fourth ventricles with outflow into the subarachnoid space at the level of the greater foramen (Figs.  2 and 3, videos 1, 2, and 3). The patient underwent surgical clipping of the aneurysm with evacuation of the insular cistern hematoma. A week after admission, the...

Notes

Acknowledgements

We thank Rashindra Manniesing and Midas Meijs from the Diagnostic Image Analysis Group (DIAG) for providing the 4D-CTA color-mapping image.

Compliance with ethical standards

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

All study data was anonymized and is not traceable to the patient.

Supplementary material

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiology and Nuclear MedicineRadboud University NijmegenNijmegenThe Netherlands
  2. 2.Department of Radiology and Nuclear MedicineRadboud University Medical CenterNijmegenThe Netherlands
  3. 3.Department of NeurosurgeryRadboud University NijmegenNijmegenThe Netherlands

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