eMedicine Specialties > Neurosurgery > Vascular

Cerebral Aneurysm: Multimedia

Author: Jonathan L Brisman, MD, Consulting Staff, Neurological Surgery, PC; Director, Cerebrovascular and Endovascular Neurosurgery, Winthrop University Hospital
Coauthor(s): Emad Soliman, MD, MSc, Consulting Staff, Department of Neurology, St John's Riverside Hospital; Abraham Kader, MD, Consulting Surgeon, Department of Neurosurgery, Virginia Hospital Center; Norvin Perez, MD, Clinical Assistant Professor of Emergency Medicine, Albert Einstein College of Medicine; Consulting Staff, Department of Emergency Medicine, Montefiore Medical Center
Contributor Information and Disclosures

Updated: May 22, 2009

Multimedia

Common locations of cerebral saccular aneurysms. ...Media file 1: Common locations of cerebral saccular aneurysms. The relative incidences are shown. Copyright © 2006 Massachusetts Medical Society. All rights reserved.
Common locations of cerebral saccular aneurysms. ...

Common locations of cerebral saccular aneurysms. The relative incidences are shown. Copyright © 2006 Massachusetts Medical Society. All rights reserved.

The white arrow on the black card marks the site ...Media file 2: The white arrow on the black card marks the site of a ruptured berry aneurysm in the circle of Willis. This is a major cause of subarachnoid hemorrhage.
The white arrow on the black card marks the site ...

The white arrow on the black card marks the site of a ruptured berry aneurysm in the circle of Willis. This is a major cause of subarachnoid hemorrhage.

The circle of Willis has been dissected, and 3 be...Media file 3: The circle of Willis has been dissected, and 3 berry aneurysms are observed. Multiple aneurysms are observed in about 20-30% of cases of berry aneurysm. Such aneurysms are congenital in the sense that the defect in the arterial wall may be present from birth, but the actual aneurysm develops over years, so rupture is most likely to occur in middle-aged adults.
The circle of Willis has been dissected, and 3 be...

The circle of Willis has been dissected, and 3 berry aneurysms are observed. Multiple aneurysms are observed in about 20-30% of cases of berry aneurysm. Such aneurysms are congenital in the sense that the defect in the arterial wall may be present from birth, but the actual aneurysm develops over years, so rupture is most likely to occur in middle-aged adults.

The subarachnoid hemorrhage from a ruptured aneur...Media file 4: The subarachnoid hemorrhage from a ruptured aneurysm is more of an irritant-producing vasospasm than a mass lesion.
The subarachnoid hemorrhage from a ruptured aneur...

The subarachnoid hemorrhage from a ruptured aneurysm is more of an irritant-producing vasospasm than a mass lesion.

Funduscopic photograph of a subhyaloid hemorrhage...Media file 5: Funduscopic photograph of a subhyaloid hemorrhage in the right eye of a 45-year-old woman with a ruptured aneurysm of the middle cerebral artery.
Funduscopic photograph of a subhyaloid hemorrhage...

Funduscopic photograph of a subhyaloid hemorrhage in the right eye of a 45-year-old woman with a ruptured aneurysm of the middle cerebral artery.

Shown here is a CT scan of an aneurysmal subarach...Media file 6: Shown here is a CT scan of an aneurysmal subarachnoid hemorrhage. The CT scan in a 55-year-old woman shows subarachnoid blood within the interpeduncular and ambient cisterns and the right sylvian fissure caused by a ruptured aneurysm at the junction of the right carotid artery and the posterior communicating artery.
Shown here is a CT scan of an aneurysmal subarach...

Shown here is a CT scan of an aneurysmal subarachnoid hemorrhage. The CT scan in a 55-year-old woman shows subarachnoid blood within the interpeduncular and ambient cisterns and the right sylvian fissure caused by a ruptured aneurysm at the junction of the right carotid artery and the posterior communicating artery.

A CT scan in an 82-year-old woman shows extensive...Media file 7: A CT scan in an 82-year-old woman shows extensive subarachnoid blood within the cortical sulci, intraventricular hemorrhage, and an intracerebral hematoma adjacent to a large ruptured aneurysm of the anterior communicating artery.
A CT scan in an 82-year-old woman shows extensive...

A CT scan in an 82-year-old woman shows extensive subarachnoid blood within the cortical sulci, intraventricular hemorrhage, and an intracerebral hematoma adjacent to a large ruptured aneurysm of the anterior communicating artery.

CT angiography (CTA) shows a large basilar tip an...Media file 8: CT angiography (CTA) shows a large basilar tip aneurysm. The adjacent ridges of the skull base anatomy relative to the aneurysm are appreciated.
CT angiography (CTA) shows a large basilar tip an...

CT angiography (CTA) shows a large basilar tip aneurysm. The adjacent ridges of the skull base anatomy relative to the aneurysm are appreciated.

Arteriogram that shows an unruptured aneurysm at ...Media file 9: Arteriogram that shows an unruptured aneurysm at the vertebrobasilar junction.
Arteriogram that shows an unruptured aneurysm at ...

Arteriogram that shows an unruptured aneurysm at the vertebrobasilar junction.

Magnetic resonance angiography (MRA). MRA demonst...Media file 10: Magnetic resonance angiography (MRA). MRA demonstrates an unruptured aneurysm at the vertebrobasilar junction (upper image) and a distal MCA aneurysm (lower image).
Magnetic resonance angiography (MRA). MRA demonst...

Magnetic resonance angiography (MRA). MRA demonstrates an unruptured aneurysm at the vertebrobasilar junction (upper image) and a distal MCA aneurysm (lower image).

Craniotomy and clipping of aneurysm. Skin incisio...Media file 11: Craniotomy and clipping of aneurysm. Skin incision and proposed craniotomy bone removal are indicated (A). Clip application to the neck of the aneurysm, permanently preventing blood flow into the aneurysm, is also shown (B). Copyright © 2006 Massachusetts Medical Society. All rights reserved.
Craniotomy and clipping of aneurysm. Skin incisio...

Craniotomy and clipping of aneurysm. Skin incision and proposed craniotomy bone removal are indicated (A). Clip application to the neck of the aneurysm, permanently preventing blood flow into the aneurysm, is also shown (B). Copyright © 2006 Massachusetts Medical Society. All rights reserved.

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Media file 12: Near infrared indocyanine green videoangiography demonstrates blood flowing into an ophthalmic artery aneurysm and the internal carotid artery from which it arises.
Near infrared indocyanine green videoangiography ...

Near infrared indocyanine green videoangiography demonstrates blood flowing into an ophthalmic artery aneurysm and the internal carotid artery from which it arises.

Endovascular coiling of cerebral aneurysm. Transf...Media file 13: Endovascular coiling of cerebral aneurysm. Transfemoral approach to gain access to the aneurysm via a small microcatheter (A) and final occlusion of the aneurysm with coils (B). Copyright © 2006 Massachusetts Medical Society. All rights reserved.
Endovascular coiling of cerebral aneurysm. Transf...

Endovascular coiling of cerebral aneurysm. Transfemoral approach to gain access to the aneurysm via a small microcatheter (A) and final occlusion of the aneurysm with coils (B). Copyright © 2006 Massachusetts Medical Society. All rights reserved.

(A)Newer generation coils. Different morphology c...Media file 14: (A)Newer generation coils. Different morphology coils (3-dimensional coil, left) and coils coated with varying substances (hydrogel polymer, right) are designed to increase initial aneurysm filling with coils and prevent recanalization. (B)Treatment of intracranial aneurysm by surgical clipping. A 52-year-old man had a 16-mm supraclinoid aneurysm of the carotid artery (see Image 12) that is shown after the placement of a single straight Sundt-Kees clip.
(A)Newer generation coils. Different morphology c...

(A)Newer generation coils. Different morphology coils (3-dimensional coil, left) and coils coated with varying substances (hydrogel polymer, right) are designed to increase initial aneurysm filling with coils and prevent recanalization. (B)Treatment of intracranial aneurysm by surgical clipping. A 52-year-old man had a 16-mm supraclinoid aneurysm of the carotid artery (see Image 12) that is shown after the placement of a single straight Sundt-Kees clip.

Treatment of an intracranial aneurysm by surgical...Media file 15: Treatment of an intracranial aneurysm by surgical clipping or endovascular coiling. Lateral carotid subtraction angiograms in a 52-year-old man show a 16-mm supraclinoid aneurysm of the carotid artery before treatment.
Treatment of an intracranial aneurysm by surgical...

Treatment of an intracranial aneurysm by surgical clipping or endovascular coiling. Lateral carotid subtraction angiograms in a 52-year-old man show a 16-mm supraclinoid aneurysm of the carotid artery before treatment.

Three-dimensional rotational digital subtraction ...Media file 16: Three-dimensional rotational digital subtraction angiogram, carotid injection, reveals a small anterior communicating artery aneurysm (arrow).
Three-dimensional rotational digital subtraction ...

Three-dimensional rotational digital subtraction angiogram, carotid injection, reveals a small anterior communicating artery aneurysm (arrow).

Endovascular coiling of a large basilar tip aneur...Media file 17: Endovascular coiling of a large basilar tip aneurysm (precoiling, upper image) using 2 stents (not visible) and then coiling (lower image).
Endovascular coiling of a large basilar tip aneur...

Endovascular coiling of a large basilar tip aneurysm (precoiling, upper image) using 2 stents (not visible) and then coiling (lower image).

Image of dissecting aneurysm that shows the lumen...Media file 18: Image of dissecting aneurysm that shows the lumen of blood vessel in relation to the aneurysm.
Image of dissecting aneurysm that shows the lumen...

Image of dissecting aneurysm that shows the lumen of blood vessel in relation to the aneurysm.

Novel treatment strategies for treatment of wide-...Media file 19: Novel treatment strategies for treatment of wide-necked aneurysms include balloon-assisted (above) and stent-assisted (below) techniques.
Novel treatment strategies for treatment of wide-...

Novel treatment strategies for treatment of wide-necked aneurysms include balloon-assisted (above) and stent-assisted (below) techniques.

Algorithm for the treatment of intracranial aneur...Media file 20: Algorithm for the treatment of intracranial aneurysms.
Algorithm for the treatment of intracranial aneur...

Algorithm for the treatment of intracranial aneurysms.

More on Cerebral Aneurysm

References

References

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Further Reading

Keywords

aneurysm, cerebral aneurysm, intracranial aneurysm, subarachnoid hemorrhage, clipping, coiling, circle of Willis, carotid, ectasia, intracranial aneurysm, saccular aneurysm, fusiform aneurysm, dissecting aneurysm, degenerative aneurysm, traumatic aneurysm, mycotic aneurysm, oncotic aneurysm, flow-related aneurysm, vasculopathy aneurysm, atherosclerotic aneurysms, false saccular aneurysm, pseudoaneurysm, drug-related aneurysms, arteriovenous malformations, AVM, aneurysm coiling, brain aneurysm surgery

Contributor Information and Disclosures

Author

Jonathan L Brisman, MD, Consulting Staff, Neurological Surgery, PC; Director, Cerebrovascular and Endovascular Neurosurgery, Winthrop University Hospital
Jonathan L Brisman, MD is a member of the following medical societies: American Association of Neurological Surgeons and Congress of Neurological Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Emad Soliman, MD, MSc, Consulting Staff, Department of Neurology, St John's Riverside Hospital
Emad Soliman, MD, MSc is a member of the following medical societies: American Academy of Neurology and American Medical Association
Disclosure: Nothing to disclose.

Abraham Kader, MD, Consulting Surgeon, Department of Neurosurgery, Virginia Hospital Center
Abraham Kader, MD is a member of the following medical societies: American Association of Neurological Surgeons, Medical Society of the State of New York, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Norvin Perez, MD, Clinical Assistant Professor of Emergency Medicine, Albert Einstein College of Medicine; Consulting Staff, Department of Emergency Medicine, Montefiore Medical Center
Norvin Perez, MD is a member of the following medical societies: American College of Emergency Physicians and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Paul L Penar, MD, Professor, Department of Surgery, Division of Neurosurgery, University of Vermont School of Medicine
Paul L Penar, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Neurological Surgeons, and Congress of Neurological Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Ryszard M Pluta, MD, PhD, Associate Professor, Neurosurgical Department Medical Research Center, Polish Academy of Sciences at Warsaw, Poland; Senior Researcher, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH
Ryszard M Pluta, MD, PhD is a member of the following medical societies: Congress of Neurological Surgeons and Polish Society of Neurosurgeons
Disclosure: Nothing to disclose.

CME Editor

Paolo Zamboni, MD, Professor of Surgery, Chief of Day Surgery Unit, Chair of Vascular Diseases Center, University of Ferrara, Italy
Paolo Zamboni, MD is a member of the following medical societies: American Venous Forum and New York Academy of Sciences
Disclosure: Nothing to disclose.

Chief Editor

Allen R Wyler, MD, Former Medical Director, Northstar Neuroscience, Inc
Allen R Wyler, MD is a member of the following medical societies: American Academy of Neurological and Orthopaedic Surgeons, American Association of Neurological Surgeons, and Society of Neurological Surgeons
Disclosure: Nothing to disclose.

 
 
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