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MR Angiography for the Long-Term Follow-Up of Dissecting Aneurysms of the Extracranial Internal Carotid Artery

Hocine Djouhri1, Benoît Guillon2, Laurent Brunereau1, Claude Lévy1, Valérie Bousson1, Valérie Biousse2, Lionel Arrivé1 and Jean Michel Tubiana1

1 Service de Radiologie, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France.
2 Sevice de Neurologie, Hôpital Lariboisière, 2 rue Ambroise Paré, 75010 Paris, France.



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  		Fig. 1A. —46-year-old man with left-sided Horner's syndrome and headaches. Carotid arteriogram shows aneurysmal type of dissection (arrow) with small aneurysm located in subpetrous segment of left internal carotid artery (ICA). Note kink redundancy and luminal stenosis (arrowhead).

 


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  		Fig. 1B. —46-year-old man with left-sided Horner's syndrome and headaches. Coronal MR angiogram obtained 3 months after A shows unchanged aneurysm. Note good correlation with conventional angiography (arrow) and resolution of luminal stenosis.

 


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  		Fig. 1C. —46-year-old man with left-sided Horner's syndrome and headaches. Follow-up coronal MR angiogram obtained 24 months after B shows unchanged aneurysm.

 


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  		Fig. 1D. —46-year-old man with left-sided Horner's syndrome and headaches. Follow-up axial MR angiogram centered on dissected ICA clearly reveals unchanged aneurysm because of higher resolution.

 


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  		Fig. 2A. —45-year-old man with right-sided painful Horner's syndrome. Carotid arteriogram shows aneurysmal type of dissection (arrow) with saccular aneurysm located in mid cervical segment of right internal carotid artery (ICA). Note luminal stenosis (arrowhead).

 


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  		Fig. 2B. —45-year-old man with right-sided painful Horner's syndrome. Coronal MR angiogram obtained 3 months after A shows unchanged aneurysm (arrow). Note good correlation with arteriogram and resolution of luminal stenosis.

 


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  		Fig. 2C. —45-year-old man with right-sided painful Horner's syndrome. Follow-up MR angiogram obtained 48 months after B. Aneurysm is unclear.

 


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  		Fig. 2D. —45-year-old man with right-sided painful Horner's syndrome. Follow-up axial MR angiogram centered on dissected ICA shows residual aneurysm (arrow) because of higher resolution. This aneurysm decreased in size more than 50%.

 

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