Basilar top aneurysm

stent-assisted endovascular coiling complex basilar top aneurysm

1. Dr. Shahnawaz Alam Neuroradiological Case Discussion

2. Brief History & examination: Middle age female, Right handedness, H/o supplemented by her son C/o: Not able to speak with right side weakness x 24 days, sudden in onset, progressive H/o: sudden severe HA asst. with nausea and vomiting, Neck tightness with pain, LOC + O/E: Vitals: PR-86, BP-132/84,RR-18,Spo2 98% on RA,GCS- E3V2M5, Bilateral pupils ERL,2mm Power: Rt. UL & LL-3/5 , Lt.-5/5, DTR 2+, Tone & Bulk- Normal Hunt and Hess grade-4, WFNS 4, Modified Fisher 4 Plan: CT-Angio brain with 3D-reconstruction- clipping vs coiling.

3. Enlarged 3D view of basilar top aneurysm showing aneurysm and both PCA Measurements

4. Repeated vascular measurements to assess for stent size

5. Endovascular Coil & Stent DISCUSSION

6. Endovascular Coils

7. Stents

8. Thank You ! References: Osborn Brain Imaging ; 2 nd edition Seven Aneurysms Tenets and Techniques by Michael T. Lawton, Professor of Neurological Surgery Chief of Vascular and Skull Base Neurosurgery Department of Neurological Surgery University of California, San Francisco