Figure 4.
42-year-old patient who presented with severe headache. On axial non-contrast CT head (A), there is subarachnoid hemorrhage in the left suprasellar cistern. On CTA head coronal reconstruction (B), cone-shaped outpouching projecting from the superior aspect of the left carotid terminus (arrow) was presumed to represent infundibulum due to its configuration and the appearance of a branch artery arising from its apex. Coronal T 1-weighted pre- (C) and post-contrast (D) HR-VWI redemonstrates the cone-shaped outpouching that shows AWE at its dome, a finding associated with aneurysm vulnerability, and not present in infundibula. 3D digital subtraction angiographic reconstruction (E) confirms the superiorly projecting carotid terminus outpouching does not have branches and represents aneurysm. The ruptured aneurysm was subsequently treated surgically.