case_images: PMC10629291_01
case_images: Initial presentation. (a) A non-contrast computed tomography scan of the brain revealed a large acute intraventricular hemorrhage almost filling all the horns of the ventricles with minimal subarachnoid hemorrhage. (b) Anteroposterior and (c) lateral projection digital subtraction angiography after right vertebral artery injection showing distally placed aneurysm arise from the left medial posterior choroidal artery which is directed upward and medially (arrow).
case_images: SNI-14-370-g001.jpg
case_images: PMC10629291_01_SNI-14-370-g001.jpg
case_images: F1
case_images: A non-contrast computed tomography (CT) scan of the brain revealed a large acute intraventricular with minimal subarachnoid hemorrhage [Figure 1a]. The neck of the aneurysm was 0.6 mm and the dome sized 1.4 x 1.2 mm was directed upward and medially [Figures 1b and c].
case_images: Endovascular Glue embolization. (a) Super-selective digital subtraction angiography (DSA) showing the tortuosity of the parent vessel and the angioarchitecture of the distally placed aneurysm arising from the left medial posterior choroidal artery. (b) Check DSA showing the complete obliteration of the aneurysm with maintained parent vessels and distal flow (black arrow). Postprocedure (c), non-contrast computed tomography head, and (d), skull fluoroscopy showing the glue cast (white arrow).
case_images: SNI-14-370-g002.jpg
case_images: PMC10629291_01_SNI-14-370-g002.jpg
case_images: F2
case_images: Medical, Bloomington, IN, USA), NavienTM Intracranial Support Catheter (Covidien Vascular Therapies, Mansfield, MA, USA), MarathonTM microcatheter (010) (Medtronic, Minneapolis, Minnesota, USA), and MirageTM microguidewire, (008) (EV3, Mansfield, MA, USA). Moreover, we performed super-selective angiography to look for the angioarchitecture of the aneurysm and the parent vessel [Figure 2a]. Tuttlingen, Germany), was mixed in a 1:3 ratio with Lipiodol  UltraFluid (Guerbet, Villepinte, France) and used for the embolization of both the aneurysmal sac and the affected portion of the parent artery [Figure 2b]. The patient was kept intubated, closely monitored in the neurosurgical intensive care unit, and extubated on postoperative day 1. Serial check non-contrast CT revealed a resolving hemorrhage with glue cast in situ [Figures 2c and d].
case_images: Postoperative magnetic resonance imaging. (a) Axial view susceptibility weighted image showing abnormal blooming (arrow) at the junction of the trigone and left occipital horn of the lateral ventricle likely depicting the glue cast. (b) Diffusion-weighted image showing no evidence of infarct or any abnormal diffusion restriction.
case_images: SNI-14-370-g003.jpg
case_images: PMC10629291_01_SNI-14-370-g003.jpg
case_images: F3
case_images: Postoperative magnetic resonance imaging brain showed abnormal blooming in the area of the trigone and left occipital horn junction with no infarct or hemorrhage [Figures 3a and b].