Subtypes:
These can be Intracranial or extracranial
- Intracranial Pseudoaneurysm (Cerebral Pseudoaneurysm)
- Extracranial cervical artery pseudoaneursym (cervical pseudoaneurysm):
Diagnosis:
- Focal dilation of a vessel wall that is not outlined by the layers of normal arterial wall. Usually, a hematoma that communicates with the vessel lumen.
CT:
- Hematoma adjacent to vessel. Enhancing focus within a hematoma.
CTA:
- Contrast may fill the pseudoaneurysm
MRI:
- T1: hyperintense hematoma
- T2: typical for hematoma age
- FLAIR: hyperintense hematoma, acutely
- GRE: hypointense
- DWI: foci of restriction may occur (ischemia)
Catheter Angiogram:
- Pseudoaneurysm slowly fills and empties with contrast
- Mass effect on parent vessel from hematoma
Treatment:
Options are:
- Observation
- Endovascular therapy: coiling (unassisted), stent-assisted coiling, multiple overlapping stents, liquid embolic agents, vessel sacrifice