Fig 1.

Thrombosis of an intracranial aneurysm and parent artery with early recanalization (case 9). A 63-year-old man had acute aphasia and right hemiparesis (NIHSS score, 21). A, Plain CT scan 2 hours after stroke onset shows a left MCA hyperattenuation, and the presence of a berry aneurysm is suspected on the apparent enlargement of the artery. B, Volume-rendering of CT angiography revealed a left M1-M2 occlusion, and a thrombosed left MCA aneurysm is not detectable. Intravenous thrombolysis was not performed, and after lumbar puncture excluding a meningeal hemorrhage, he was treated with aspirin, 250 mg/day. C, Time-of-flight MR angiography performed the day after shows recanalization of the left MCA aneurysm. He was discharged and sent home on day 8 with persistent aphasia (NIHSS score, 8), and surgical obliteration (clipping) of his aneurysm was performed 6 weeks later (aneurysm anatomy did not allow an intra-arterial procedure).