The aneurysm close to the skull base was wiped off by bone subtraction on 3D CTA images

An old woman presented with a hematoma in the right frontal gyrus rectus, hematocele in ventricles and subarachnoid space on Computed tomography imagings(CT). Three-dimensional bone subtraction computed tomography (3DBSCTA) was performed with a 16 slices multidetector-row CT scanner applying the volume rendering technique and a saccular aneurysm located on the A2 segment of the right cerebral anterior artery was revealed. The aneurysm was clipped with a right pterional craniotomy. Another fusiform aneurysm of the right orbital frontal artery was found accidently in surgery. The aneurysm was not shown on the three-dimensional computed tomography (3DCTA) imagings with bone subtraction. The case merits attention, because missed diagnosis of the aneurysm close to the skull base was attributed to bone subtraction on 3D CTA images, which has not been reported.