case studies

Middle Cerebral Artery Aneurysm

Introduction
MRI's superiority in imaging the brain is due to its high soft tissue contrast resolution while its multi-planer capability enables anatomy to be viewed from different directions.

Patient History
A 48 year old male presented with sudden severe headaches for 7- 10 days with sensations in legs. Gradual slow recovery. He saw a neurologist who referred him for MRI brain and MRA Circle of Willis.

Methodology
MRI Brain Dual echo axial (fig 1)
T2 axial FLAIR, T2 COR TSE, T1 sag SE (fig 2) 5mm slice thickness/3D vol 1mm slices.
MRA 3D TOF (Time of Flight) COW (Circle of Willis) (fig 3).
MIP's (Maximum Intensity Projections) were obtained from the 3D raw data (fig 4).

Scanner used: Siemens 1.5T Magnetom Symphony, using a CP Head Array Coil.

Radiologist Report
A 1 cm x 7 mm aneurysm at the junction of the M1 and M2 segments of the right middle cerebral artery. High signal is seen in the right sylvian fissure, consistent with presence of methaemoglobin, due to recent subarachnoid haemorrhage (1 to 2 weeks ago).

No other intracranial abnormality is seen.

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