Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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February 23, 2009
Petrous ICA Aneurysm
- Petrous ICA aneurysms can be traumatic or mycotic in origin, but in the majority of cases, there is no obvious cause, and such lesions are considered congenital in origin.
- Patients tend to present with symptoms in the third decade of life; these commonly include headaches, diplopia, facial numbness, facial palsy, pulsatile tinnitus, or hearing loss.
- If flow is slow, MRI can have loss of flow void on T1 with hyperintensity on T2/FLAIR and show Gd enhancement as well as be confused with schwannoma, meningioma or metastasis. Presence of pulsation artifact along phase encoding axis suggests a vascular lesion.
- Currently, treatment options include conservative management with serial imaging, endovascular ICA balloon occlusion, endovascular coil placement, covered stent, or surgery.
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