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. Author manuscript; available in PMC: 2017 Oct 1.
Published in final edited form as: Neurosurg Clin N Am. 2016 Aug 10;27(4):409–439. doi: 10.1016/j.nec.2016.05.011

Figure 14. Postraumatic pseudoaneurysm.

Figure 14

This 43-year-old man presented with headache and visual symptoms 3 months after suffering facial fractures in a motor vehicle accident. Noncontrast CT reveals a large hyperdense mass (arrows) within the anterior skull base (A) eroding the sphenoid bone, sella and the orbits (arrow) (B). Sagittal reformatted CT angiography images performed the same day show the central area of the mass enhancing (asterisk) to the same extent as the adjacent intracranial arteries (C). In addition, there is an apparent narrow-necked connection (arrow) between the enhancing portion and the left cavernous internal carotid artery (D), consistent with a pseudoaneurysm. Note that the central low density (A, asterisk) within the higher density, thrombosed portion of the pseudoaneurysm correlates with the central nonthrombosed, enhancing area (E, arrow) on the postcontrast images. 3D reformatted images of the circle of Willis (F) highlight the relationship of the pseudoaneurysm (asterisk); note that only the nonthrombosed portion is visualized) to the left internal carotid artery (arrow). Catheter angiography images following injection of the left internal carotid artery show the appearance of the pseudoaneurysm (asterisk) before (G) and after (H) treatment with endovascular coil embolization.