The pretzel sign is seen on DSA and is indicative of a serpentine aneurysm 1.
The sign refers to the sinusoid configuration of the intra-aneurysmal vascular channel seen in serpentine aneurysms, giving it the appearance of a pretzel.
- 1. Fanning NF, Kelleher MO, Ryder DQ. The pretzel sign: angiographic pattern of tortuous intra-aneurysmal blood flow in a giant serpentine aneurysm. (2003) British journal of neurosurgery. 17 (1): 67-71. Pubmed