Cerebral Aneurysm Debuting As Rupture During Diagnostic CT Angiography: An Unexpected Worst-case Scenario

Previously-asymptomatic intracranial aneurysm rupture during cerebral angiography is an extremely rare phenomenon. There is a small risk of rupture of these aneurysms during digital subtraction angiography (DSA), but no case of spontaneous rupture during computed tomographic angiography (CTA) has been reported. A concise case of a 40-year-old woman referred for workup of an asymptomatic intracranial aneurysm who experienced acute rupture at the time of identification of a second aneurysm is described. This case highlights the potential for rupture at the time of scan acquisition and the importance of maintaining a high level of suspicion in the setting of neurological deterioration, as well as the potential need by all medical imaging professionals to identify an emergency and activate an urgent response.