KEY FACTS Terminology Atherosclerotic vascular disease fusiform aneurysm (ASVD FA) ASVD → abnormal dilation, tortuosity of intracranial arteries Aneurysms with separate inflow, outflow ostia Imaging Exaggerated arterial ectasia(s) + focal fusiform/saccular enlargement Long segment irregular fusiform or ovoid arterial dilatation…
KEY FACTS Terminology Extensive ectatic, elongated vertebrobasilar artery (VBA) Usually associated with decreased blood flow velocity Imaging General findings Irregular, elongated, tortuous VBA Usually 6-12 mm, can be giant (> 2.5 cm) Focal arterial dilatation = fusiform aneurysm CT Hyperdense…
KEY FACTS Terminology Intracranial saccular aneurysm (SA) Outpouching affecting only part of arterial circumference Lacks internal elastic lamina ± tunica media Imaging Round/lobulated arterial outpouching Usually arises from bifurcations of circle of Willis (COW), supraclinoid internal carotid and middle cerebral…
KEY FACTS Terminology Unique type of subarachnoid hemorrhage (SAH) Localized to sulci over top (“convexity”) of brain Imaging NECT: Hyperdensity in 1 or several adjacent dorsolateral convexity sulci Spares basal, perimesencephalic cisterns MR Sulcal cerebrospinal fluid (CSF) replaced by isointense…
KEY FACTS Terminology Subarachnoid hemorrhage (SAH) centered immediately anterior to midbrain ± pons No source demonstrated at CTA/DSA/MRA Imaging NECT: Hyperdense prepontine, perimesencephalic cerebrospinal fluid (CSF) Often involves interpeduncular, ambient, quadrigeminal cisterns ± thin extension into posterior suprasellar, proximal sylvian/interhemispheric…
KEY FACTS Terminology Subarachnoid hemorrhage (SAH) caused by ruptured aneurysm (aSAH) Saccular aneurysm (SA) > > dissecting aneurysm (DA) Imaging CT/CTA Hyperdense sulci on NECT Distribution varies with aneurysm location Suprasellar cistern (IC-PCoA, ACoA aneurysms) Sylvian fissure (middle cerebral artery…
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KEY FACTS Terminology Thrombotic occlusion of deep cerebral veins Usually affects both internal cerebral veins (ICVs) ± vein of Galen (VOG), straight sinus (SS) May occur with more widespread dural sinus thrombosis Imaging NECT Hyperdense ICV ± VOG, SS Hypodense…
KEY FACTS Terminology Cortical/cerebral venous thrombosis (CVT) Dural sinus thrombosis (DST) CVT with DST > isolated CVT without DST Imaging NECT Cord sign (hyperdense vein) Involved veins usually enlarged (distended with clot), irregular ± petechial parenchymal hemorrhage, edema CECT If…
KEY FACTS Terminology Cavernous sinus (CS) Blood clot in CS Imaging CT Bone CT – Look for sinus infection, erosive changes CECT – Nonenhancing filling defects (clot) inside enhancing dural walls of cavernous sinus (CS) – CS margins convex (not…