case_images: PMC5903132_01
case_images: Digital subtraction angiography (a) obtained 5 years before admission. Magnetic resonance imaging (b-f) obtained on admission. a Left carotid angiography displays a large intracranial aneurysm (arrowhead; maximum diameter 21 mm) on the left internal carotid artery. b Diffusion-weighted imaging reveals a hyperintense signal on the left anterior choroidal artery territory (arrowhead). c-e Time-of-flight magnetic resonance angiography demonstrated poor visibility of the middle and anterior cerebral arteries and the inferior part of the giant aneurysm (maximum diameter 28 mm), suggesting aneurysm thrombosis (arrowheads).
case_images: crn-0010-0066-g01.jpg
case_images: PMC5903132_01_crn-0010-0066-g01.jpg
case_images: F1
case_images: Five years previously, he had had a large intracranial aneurysm on the left internal carotid artery (ICA) (Fig. 1a). Diffusion-weighted imaging (DWI) revealed a hyperintense signal on the left anterior choroidal artery territory (Fig. 1b). Time-of-flight magnetic resonance angiography (MRA) demonstrated poor visibility of the middle and anterior cerebral arteries and the inferior part of the giant aneurysm, suggesting aneurysm thrombosis (Fig. 1c-e).
case_images: Arterial spin labeling obtained on admission. Arterial spin labeling signals increased in the giant aneurysm (arrowheads) and decreased in the left hemisphere.
case_images: crn-0010-0066-g02.jpg
case_images: PMC5903132_01_crn-0010-0066-g02.jpg
case_images: F2
case_images: ASL signal increased in the giant aneurysm and decreased in the left hemisphere (Fig. 2a, b).