• Ahmadreza Rafiei, Ahmad Hafez, Behnam Rezai Jahromi, Riku Kivisaari, Bruno Canato, Joham Choque, Roberto Colasanti, Sharafeddin Fransua, Hanna Lehto, Hugo Andrade-Barazarte, and Juha Hernesniemi.
• Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland.
• Neurosurgery. 2017 Dec 1; 81 (6): 949-957.

BackgroundParaclinoid aneurysms are among the most challenging aneurysms to treat. Computed tomography (CT) angiography helps in evaluating the radiological characteristics of these aneurysms next to bony structures.ObjectiveTo present the CT angiography characteristics of paraclinoid aneurysms in order to better understand such pathology.MethodsThe study examined CT angiography-based anatomical characteristics obtained retrospectively from 136 patients with 144 paraclinoid aneurysms selected from single-defined catchment populations in Finland. We examined the diameters of the parent artery (internal carotid artery), the location of the aneurysm, its dimensions (width, height, neck), and aneurysm wall irregularity.ResultsWe analyzed 144 paraclinoid aneurysms in 136 patients admitted to the hospital during 2000-2014. Multivariable analysis reveals that rupture aneurysms have the following radiological features: aneurysm larger than 5 mm in diameter (P = .006), irregular wall (P = .046), superior location, larger aspect ratio (P = .039), and neck wider than parent artery (P < .001).ConclusionSmaller diameter of the internal carotid artery and superior location, as well as a large and irregular aneurysm wall, are radiological characteristics of ruptured paraclinoid aneurysms, which CT angiography can measure easily.©Crown copyright 2017.

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