Department of Neurology and Radiology, St. Lukes Roosevelt Hospital, New York, NY 10025, USA.
J Neuroimaging. 2012 Jan;22(1):85-8. doi: 10.1111/j.1552-6569.2010.00495.x. Epub 2010 Jun 21.
A neurologically intact 37-year-old woman presented with an acute severe frontal headache after a month of intermittent headaches. Multimodal radiological examination including computed tomography scan, magnetic resonance imaging, and conventional angiography demonstrated a 1 cm mass in the anterior interhemispheric region with heterogenous calcifications. Of note, MR revealed restricted diffusion within the mass. The presumptive diagnosis of dermoid tumor was made and the patient was scheduled for surgical resection. On operative exploration, a 1 cm thrombosed aneurysm was revealed. Thrombosed aneurysms must be considered in the differential diagnosis for midline cerebral masses with negative angiogram and restricted diffusion. This distinction has implications for the clinical management of the patient.
一位 37 岁的神经功能正常的女性，在经历了一个月的间歇性头痛后，突发严重的额部头痛。多模态影像学检查包括 CT 扫描、磁共振成像和常规血管造影显示在前半球间区域有一个 1 厘米的肿块，伴有混杂性钙化。值得注意的是，磁共振显示肿块内弥散受限。初步诊断为皮样瘤，患者被安排行手术切除。术中探查发现 1 厘米大的血栓性动脉瘤。对于中线脑肿块、血管造影阴性和弥散受限的患者，必须考虑血栓性动脉瘤的鉴别诊断。这种区别对患者的临床处理有影响。
