LICA Pseudoaneurysm

Findings:

CTA source images demonstrate multiple traumatic abnormalities including left temporoparietal fracture, left orbital fractures incompletely included with orbital gas, right subdural hematoma poorly demonstrated with mass effect and medial displacement of the right temporal lobe, with midline shift. There is also moderate opacification of the paranasal sinuses. Left proptosis is present. Evaluation of the included vascular structures demonstrates a pseudoaneurysm of the left internal carotid extending through a left posterior sphenoid wall post traumatic defect.

The follow-up CT images demonstrate significant enlargement of the left internal carotid pseudoaneurysm extending into the left sphenoid sinus. Associated sinus opacification is difficult to distinguish between hemorrhage, inflammatory disease, and portions of thrombosed pseudoaneurysm sac.

Discussion/Differential Diagnosis:

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