Vertebral arteries are usually paired major arteries of the neck. Typically, they originate from the subclavian arteries coursing superiorly along each side of neck, merging within the skull to form basilar arteries. Different variant anatomy including assymetry, complete or partial duplication, fenestration and variable origin have been explained in the literature. We have a case report of 54 year old gentle man who presented with acute headache and vomitting in our institute. CT angiogram revealed left posterior cerebral artery aneurysm causing subarachnoid hemorrhage. DSA further revealed bilateral vertebral arteries arising from the common carotid artery and left PCA aneurysm.

Aim of the Study To evaluate the accuracy of MRI for follow up after WEB implantation compared to gold standard DSA. Methods A total of 42 aneurysms treated with WEB were included. Two experienced readers analysed the anonymised postprocedural MRI, with TOF sequences with an without gadolinium, and DSA images independently, using the WEB Occlusion Score (WOS). Results From our data we found corresponding WOS results from MRI compared to DSA in 60.53% of the cases. With DSA as reference MRI revealed false positive results in 23.7%, and false negative results in 15.8% of the cases. Interrater agreement was 90.48%. The MRI sensitivity was 84.2%, the specificity 76.32%. Conclusions From this data WEB follow up with MRI alone bears a high risk of false findings and cannot replace DSA for a precise WOS assessment.Disclosure FW consults and proctors for Microvention. GK, MP and JM have no conflicts of interest.

BACKGROUNDThe current study reports the case of a 67-year-old gentleman who presented in our Institute with complaints of shortness of breath and cough for last 8 months. He was working in a steel industry for almost 40 years. On evaluation further, he was diagnosed to have occupational lung disease which was mimicking sarcoidosis and lymphoma.