case_images: PMC10927200_01
case_images: (a and b) First magnetic resonance angiography of the aneurysm, with a size of approximately 2 mm (arrow and arrowhead). (c and d) The aneurysm size increased to 10 mm in 2 weeks (arrow and arrowhead). (e and f) Contrast-enhanced magnetic resonance imaging demonstrates a contrast-enhanced lesion from the right cavernous sinus to the orbital apex, which communicates with the sphenoid sinus.
case_images: SNI-15-58-g001.jpg
case_images: PMC10927200_01_SNI-15-58-g001.jpg
case_images: F1
case_images: Magnetic resonance angiography revealed a 2-mm aneurysm in the C4 portion of the right internal carotid artery (ICA); however, the relationship between the aneurysm and her symptoms was unclear [Figures 1a and b]. Follow-up magnetic resonance imaging revealed an increase in the size of the aneurysm to 10 mm within two weeks [Figures 1c and d]; the patient was referred to our hospital for further evaluation. Contrast-enhanced magnetic resonance imaging revealed a contrast-enhanced lesion from the right cavernous sinus to the orbital apex, which was suspected of communicating with the sphenoid sinus [Figures 1e and f].
case_images: (a and b) First angiogram demonstrating the aneurysm in the cavernous portion of the right internal carotid artery with wall irregularities. (c and d) Angiogram after six weeks of medical treatment exhibiting the aneurysm dilatation and shape change. (e and f) Arterial phase and venous phase of angiogram one year after flow diverting stent placement. O'Kelly-Marotta grading scale: B3.
case_images: SNI-15-58-g002.jpg
case_images: PMC10927200_01_SNI-15-58-g002.jpg
case_images: F2
case_images: Moreover, the cavernous portion of the right ICA was dilated with wall irregularities caused by vascular invasion [Figures 2a and b]. Although she was afebrile and her beta-d-glucan levels lowered after medical treatment, the size of the aneurysm was enlarged, and its shape changed [Figures 2c and d]. Follow-up angiograms at six months and one year showed a partial decrease in aneurysm size, with O'Kelly-Marotta grading scales of B2 and B3, respectively [Figures 2e and f].