Four-Dimensional Computed Tomography Angiography Demonstrating a Ruptured Basilar Artery Aneurysm Causing Anterior Cerebral Circulation Arrest

J Stroke Cerebrovasc Dis. 2016 Sep;25(9):e146-7. doi: 10.1016/j.jstrokecerebrovasdis.2016.05.016. Epub 2016 May 30.


A 61-year-old woman suffered a pronounced subarachnoid hemorrhage. Conventional computed tomography angiography (CTA) showed no enhancement of the intracranial vasculature, whereas there was normal contrast enhancement of bilateral external carotid artery branches. Subsequent four-dimensional computed tomography angiography (4D-CTA) demonstrated active contrast leakage out of a ruptured basilar tip aneurysm, whereas there was no enhancement of the anterior circulation at any time point, consistent with intracranial anterior circulation arrest. This case illustrates that 4D-CTA is superior to conventional CTA for the evaluation of intracranial flow dynamics and delayed intracranial vascular contrast filling.

Keywords: 4D-CTA; Brain; CTA; cerebrovascular disease; computed tomography.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, Ruptured / complications
  • Aneurysm, Ruptured / diagnostic imaging*
  • Cerebrovascular Circulation / physiology*
  • Computed Tomography Angiography / methods*
  • Female
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / diagnostic imaging*
  • Middle Aged
  • Subarachnoid Hemorrhage / etiology*