This is an aneurysm of the right anterior cerebral artery (MCA). In October 1998 the aneurysm was successfully coiledb y percutaneous transluminal embolization with GDC coils (platinum spiral) after a subarachnoid hemorrhage Hunt & Hess I°. In 03/2004 (5 1/2 years after embolization), the aneurysm became symptomatic, the patient developed epilepsy. Because of an increase in size and re-established blood circluation (prone to rupture and bleeding) the aneurysm was clipped and surgically removed. You can see the lesion in the right temporal lobe, the significant perifocal edema and the artifacts caused by the coils. Without knowledge of patient history one would have to consider an intracranial abscess or a meningeoma of the right temporal sphenoid wing as differential diagnosis (although the artifacts caused by the coils would not be explainable then). Thus even in the absence of anamnestic data the most likely diagnosis is a giant aneurysm of the middle cerebral artery on the right.
