Partially thrombosed giant basilar artery aneurysm with attenuated contrast enhancement of the intraluminal thrombus on vessel wall MRI after flow diversion treatment: illustrative case

BACKGROUND The effect of vessel wall magnetic resonance imaging (VW-MRI) enhancement in partially thrombosed aneurysms has previously indicated aneurysmal instability and a rupture risk. However, whether the contrast effect of the wall changes before or after flow diversion treatment is still under...

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Bibliographic Details
Published in:Journal of neurosurgery. Case lessons 2023-10, Vol.6 (14)
Main Authors: Matsukawa, So, Ishii, Akira, Fushimi, Yasutaka, Abekura, Yu, Nagahori, Takashi, Kikuchi, Takayuki, Okawa, Masakazu, Yamao, Yukihiro, Sasaki, Natsuhi, Tsuji, Hirofumi, Akiyama, Ryo, Miyamoto, Susumu
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Language:English
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Summary:BACKGROUND The effect of vessel wall magnetic resonance imaging (VW-MRI) enhancement in partially thrombosed aneurysms has previously indicated aneurysmal instability and a rupture risk. However, whether the contrast effect of the wall changes before or after flow diversion treatment is still under investigation. OBSERVATIONS The authors report a case of a partially thrombosed basilar artery aneurysm that increased in size over a short period, worsened brainstem compression symptoms, and was treated with a flow diverter stent with good results. In this case, VW-MRI after surgery showed a reduced contrast effect on the intraluminal thrombus within the aneurysm. The aneurysm thrombosed and markedly regressed over the next 5 months, with remarkable improvement in the brainstem compression symptoms. LESSONS This finding on VW-MRI may indicate an attenuation of neovascularization in the thrombus wall and be a sign of aneurysm stabilization.
ISSN:2694-1902
2694-1902
DOI:10.3171/CASE23307