Department of Neurosurgery, North Shore Hospital, Manhasset, New York, USA.
Neurosurgery. 2012 Nov;71(5):E1047-52; discussion E1052. doi: 10.1227/NEU.0b013e318268fecb.
Contrast extravasation on computed tomography angiography (CTA) is becoming more common, with increasing use of CTA for myriad intracranial vascular pathologies. This article describes the first 2 documented cases of contrast extravasation from a nonaneurysmal basilar artery source seen on CTA and discusses possible pathophysiologic mechanisms.
We present 2 cases of diffuse atraumatic subarachnoid hemorrhage in which the CTA showed an abnormality in association with the basilar artery highly suggestive of a ruptured aneurysm. Follow-up digital subtraction angiography, however, was completely negative. Subsequent repeat digital subtraction angiography failed to reveal a vascular lesion. Both patients were treated for complications associated with SAH, but given the negative digital subtraction angiography, no intervention was performed.
Because of the frequent use of CTA, contrast extravasation is an increasingly common observation. Physicians should be aware that basilar artery extravasation can mimic the appearance of an aneurysm.
随着 CTA 在无数颅内血管病变中的广泛应用，CTA 上的对比外渗越来越常见。本文描述了首例 2 例 CTA 上见到的非动脉瘤性基底动脉来源的对比外渗，并讨论了可能的病理生理机制。
我们介绍了 2 例弥漫性非创伤性蛛网膜下腔出血患者，其 CTA 显示基底动脉异常，高度提示破裂的动脉瘤。然而，随后的数字减影血管造影（DSA）完全为阴性。进一步的重复 DSA 未能发现血管病变。两名患者均因蛛网膜下腔出血相关并发症而接受治疗，但由于 DSA 为阴性，未进行任何干预。
由于 CTA 的频繁使用，对比外渗是一种越来越常见的观察结果。医生应该意识到基底动脉外渗可以模拟动脉瘤的外观。
