VISUALIZATION OF INTRACRANIAL ANEURYSMS BY TRANSCRANIAL DUPLEX SONOGRAPHY

We examined 72 patients with 89 angiographically confirmed intracrania l aneurysms, using transcranial colour-coded duplex sonography (TCCD) to determine the location and size of the aneurysm. The patients were admitted for coil embolisation of their aneurysm following subarachnoi d haemorrhage or because of a cranial nerve palsy. Using a 2/2.25 MHz transducer, 42 aneurysms (47%) were seen satisfactorily through the te mporal bone window or foramen magnum. In 24 cases (27%) image quality was insufficient as a result of a poor bone window, of the aneurysm ha ving a diameter of less than 6 mm or of its being in an unfavourable l ocation. In 23 other cases (26%) it was not possible to detect the ane urysm. Thrombosed structures could be demonstrated using TCCD in 8 of 12 giant intracavernous or basilar artery aneurysms, and in 15 of 19 a neurysms treated by platinum coil embolisation. TCCD offers a noninvas ive method for monitoring progressive intra-aneurysmal thrombosis foll owing coil embolisation and for follow-up of patients with untreatable fusiform aneurysms, should this be required. Detection of small aneur ysms is limited by spatial resolution and insonation angles.