Patient with 8mm basilar tip aneurysm. Headaches. 37 years old female Left subclavian artery: There is no evidence for arteriovenous fistula. There is no evidence for vertebral dissection.Right subclavian artery: There is no evidence for arteriovenous fistula. No evidence for vertebral dissection.Left vertebral artery:There is opacification of both posterior cerebral arteries. The right anterior/inferior cerebellar arteries and both PICAs are large whereas the left left AICA is small. The right SCA is duplicated. The vertebral arteries are codominant. Venous and parenchymal phases are unremarkable. The PCOMAs fill in a reverse fashion. The right PCOMA is larger than the left.There is a lobulated basilar tip aneurysm present measuring approximately 5.5 mm x 5.5 x 3.5 mm dimensions which has a narrow neck. Right vertebral artery:There is opacification of both posterior cerebral arteries. The right anterior/inferior cerebellar arteries and both PICAs are large whereas the left left AICA is small. The right SCA is duplicated. The vertebral arteries are codominant. Venous and parenchymal phases are unremarkable. The PCOMAs fill in a reverse fashion. The right PCOMA is smaller than the left. There is extracranial origin of the right PICA.There is a lobulated basilar tip aneurysm present measuring approximately 5.5 mm x 5.5 x 3.5 mm dimensions which has a narrow neck. Right common carotid artery: No stenosis at the carotid bifurcation on the basis of NASCET criteria. No evidence for carotid dissection.Right internal carotid artery: There is opacification of the right anterior and middle cerebral arteries. Venous and parenchymal phases were within normal limits.The left PCOMA is small.There is a 3.5x2.5 mm aneurysm off the origin of the right anterior temporal artery of the MCA which is directed inferiorlyLeft common carotid artery: No evidence for carotid stenosis on the basis of NASCET criteria. No evidence for carotid dissection.Left internal carotid artery: There is opacification of the left anterior and middle cerebral arteries. Venous and parenchymal phases were within normal limits. No evidence for aneurysm, AVM or AV fistula. The left PCOMA is large.There is a 2mm broad neck aneurysm at the left MCA bifurcation.Intraprocedural angiograms:Serial arteriograms performed the during aneurysm coiling demonstrate serial occlusion of the aneurysm. At the end of the procedure there is no opacification of the aneurysm.Right common iliac artery: No contraindications to closure device.
1.5mm basilar tip aneurysm as described above.2.3.5mm right MCA aneurysm as described above.3.2 mm left MCA aneurysm as described above.4.Embolization of basilar tip aneurysm using Target coils (company Stryker). These are MRI compatible up to 3T.5.Findings were discussed with Dr Ardelt at the end of the procedure.