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Images in Neurology |

Giant Aneurysm of the Internal Carotid Artery

Hojin Choi, MD; Seong-Ho Koh, MD, PhD; Bek-san Park, MD; Kyu-Yong Lee, MD, PhD; Young J. Lee, MD, PhD
Arch Neurol. 2012;69(3):409-410. doi:10.1001/archneurol.2011.1138.
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A 27-year-old woman presented with a 3-year history of recurrent visual defects in each of her eyes. On neurological examination, decreased visual acuity was observed in both eyes and a relative afferent pupillary defect, in the left eye. Magnetic resonance imaging revealed a well-enhanced mass lesion (Figure 1). Computed tomographic angiography and digital subtraction angiography showed an unruptured giant aneurysm in the left distal internal carotid artery that measured 5.5 cm in its maximal dimension (Figure 2A and B). The patient was treated surgically by clipping of the aneurysm. After clipping of the aneurysm, computed tomographic angiography and digital subtraction angiography demonstrated the absence of any residual contrast material within the aneurysm (Figure 2C and 2D). The neurological abnormality progressed no further in the postoperative period.

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Figure 1. A precontrast axial T1-weighted magnetic resonance image reveals a large mass (A), and a contrast-enhanced axial T1-weighted magnetic resonance image shows intense enhancement of the mass (B).

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Figure 2. Three-dimensional rendering of the computed tomographic angiography and digital subtraction angiography shows the unruptured 5.5-cm giant aneurysm in the left distal internal carotid artery before (A and B) and after (C and D) aneurysmal clipping with left frontotemporal craniotomy.

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