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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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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Case Lesson
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container_title Journal of neurosurgery. Case lessons
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creator Matsukawa, So
Ishii, Akira
Fushimi, Yasutaka
Abekura, Yu
Nagahori, Takashi
Kikuchi, Takayuki
Okawa, Masakazu
Yamao, Yukihiro
Sasaki, Natsuhi
Tsuji, Hirofumi
Akiyama, Ryo
Miyamoto, Susumu
description 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.
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Case lessons</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matsukawa, So</au><au>Ishii, Akira</au><au>Fushimi, Yasutaka</au><au>Abekura, Yu</au><au>Nagahori, Takashi</au><au>Kikuchi, Takayuki</au><au>Okawa, Masakazu</au><au>Yamao, Yukihiro</au><au>Sasaki, Natsuhi</au><au>Tsuji, Hirofumi</au><au>Akiyama, Ryo</au><au>Miyamoto, Susumu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Partially thrombosed giant basilar artery aneurysm with attenuated contrast enhancement of the intraluminal thrombus on vessel wall MRI after flow diversion treatment: illustrative case</atitle><jtitle>Journal of neurosurgery. Case lessons</jtitle><date>2023-10-02</date><risdate>2023</risdate><volume>6</volume><issue>14</issue><issn>2694-1902</issn><eissn>2694-1902</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>INCLUDE WHEN CITING Published October 2, 2023; DOI: 10.3171/CASE23307.</notes><notes>Disclosures Dr. Ishii reports personal fees for educational lectures and advisory board from Terumo outside the submitted work.</notes><abstract>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. 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title Partially thrombosed giant basilar artery aneurysm with attenuated contrast enhancement of the intraluminal thrombus on vessel wall MRI after flow diversion treatment: illustrative case
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