Blood blister-like aneurysm

Discussion:

Blood blister-like aneurysm is a broad-based bulge at a nonbranch point of a vessel.

Clinical presentation

Middle-aged patients, angiographically negative for subarachnoid hemorrhage.

Radiographic features

  • shape: blood blister-like or half-domed shallow outpouching with wide neck
  • common sites: supraclinoid ICA (dorsal wall), less likely MCA, ACA, basilar artery
  • size: usually small (<6mm) mean (3mm) 1
  • rapid change in size and morphology on follow up angiograms
  • CT angiography: often negative
  • digital subtraction angiography: the best diagnostic tool

Differential diagnosis

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