Background: The study investigates the relationship between aneurysm morphology and incidence angle measured by Computed Tomography Angiography (CTA) and the risk of intracranial aneurysm (IA) rupture. Materials and Methods: We analyzed data from 150 patients with intracranial aneurysms, comparing those with ruptured and non-ruptured aneurysms. Statistical methods were applied to identify key risk factors for rupture. Results: Significant differences were observed in aneurysm morphology, incidence angle, and risk scores between the ruptured and non-ruptured groups. Factors such as irregular aneurysm shape, larger diameter, aspect ratio (AR), size ratio (SR), and incidence angle were associated with higher rupture risk. Conclusion: CTA-measured aneurysm morphology and incidence angle, along with patient-specific factors, are crucial in assessing the risk of IA rupture. These findings can guide clinical decision-making and improve patient outcomes.

A 70-year-old obese retired patient with an extensive list of underlying medical conditions, including ischemic heart disease with coronary artery bypass grafting in 1999, hypertension, chronic renal failure, and atrial fibrillation was admitted to hospital in August 2008. He was diagnosed with subcutaneous abscess in the infraclavicular region of the right shoulder plus the left hallux metatarsophalangeal gout with secondary infection. He had a raised C-reactive protein (CRP) at 450 and was septic with positive blood culture for Staphylococcus aureus on admission. He underwent arthroscopic washout of the shoulder plus drainage of the foot abscess. He was commenced on antibiotics with a good initial response. However, he started spiking temperature with a raised CRP again. As transthoracic echocardiography (TTE) could not rule out infective endocarditis, he underwent transesophageal echocardiography (TEE), which showed a few indistinct echoes on the left ventricular side of the posterior mitral valve leaflet. Hence, he was treated for infective endocarditis with Teicoplanin and Clindamycin. He was discharged after the completion of his antibiotic treatment.

A 57 year old female presented with acute onset headache started from 1 month before the current visit. The headache was located on the left frontotemporal area and had increased during the month. On brain CT scan, there were bilateral round hyperdense lesions in the sylvian fissure which were flow void on brain MRI indicating aneurysms.

A 54-year-old man was referred to our hospital because of severe excruciating acute colicky central abdominal pain. The pain was associated with nausea, postprandial vomiting, and constipation. He had history of 15 kg weight loss during the last two months. He was opium addict, and cigarettes smoker (20 packsyear) with a negative history of diabetes mellitus and hypertension. He underwent a surgical operation two months before, when he had a similar attack of abdominal pain. The surgery was then revealed small bowel necrosis for which resection of 30 cm of small bowel was performed. General physical examination was unremarkable. There was mild tenderness in deep palpation of periumbilical area. Laboratory data including serum amylase were reported to be normal. The initial abdominal ultrasonography was normal. Upper gastrointestinal endoscopy and colonoscopy were also normal. On account of his severe abdominal pain, a multislice helical abdominal computerized tomography with contrast was requested (Figure1).