Giant serpentine vertebrobasilar aneurysm with vertebral artery hypoplasia and fenestration- a case report.
OBJECT Spiral computed tomography (SCT) and, more recently, multislice SCT (MSCT) angiography have established roles in studying subarachnoid hemorrhage (SAH). Potential advantages in MSCT angiography include rapid acquisition, ready availability, ease of monitoring, high spatial resolution, some temporal resolution, and relative freedom from artifacts. The authors assert that these attributes make MSCT angiography the initial imaging method of choice in the assessment of not just SAH but all intracranial vascular pathophysiologies, particularly in children. METHODS The installation of a MSCT unit sparked the authors' interest in using MSCT angiography and MSCT venography in cases in which they would have formerly performed magnetic resonance (MR) angiography, MR venography, or catheter angiography as an initial investigational method. They retrospectively evaluated seven cases in which they had used the former imaging techniques to study intracranial vascular pathophysiologies. All scans were obtained on a Siemens Sensation 16-slice scanner, and postprocessing was performed on a Leonardo Workstation. RESULTS Multislice spiral CT consistently provided useful vascular imaging of a wide variety of intracranial vascular pathophysiologies and an alternative imaging modality in patients considered to be too unstable for more time-consuming investigations. CONCLUSIONS Multislice spiral CT offers advantages over MR imaging in the assessment of intracranial vascular pathophysiologies and frequently allows complete avoidance or deferral of catheter angiography.