Giant intracranial aneurysm water-hammer effect

A middle-aged man presented with new-onset vertigo and truncal imbalance. MR scan of brain showed an incidental giant partially thrombosed anterior communicating artery aneurysm with concentric blood products of varying age (figure 1). Subsequent catheter angiography showed the ‘water-hammer’ effect (video 1). Figure 1 MR scan of brain with intravenous gadolinium, showing an enhancing partially thrombosed anterior communicating artery...