Female, 79 years old, with left hemiplegia from stroke, reported aneurysms of the left ICA and right MCA. A 4 x 2 mm aneurysm is evident projecting inferiorly from the supraclinoid left ICA. A 1 to 2 mm superiorly directed outpouching is present at the right MCA bifurcation. No additional aneurysm is identified. The right ICA is of smaller caliber than the left, as are the right MCA branches which demonstrate discontiguous flow related signal compatible with prior ischemia in this distribution. No additional high-grade vascular compromise is suspected.Since the prior MRI, ex vacuo dilatation of the right lateral ventricle has developed. A presumed cavernous malformation is redemonstrated in the midbrain.
1.A 4 x 2 mm aneurysm is present along the left supraclinoid ICA.2.A 1 to 2 mm aneurysm is evident at the right MCA bifurcation.3.Vascular compromise is redemonstrated involving the right ICA and MCA branches compatible with known prior ischemia in this distribution.