Complete cohort - Case 67 of 83
Case 82
Assigned out-of-fold recommendation
Coil embolization alone
Alternative: Balloon-assisted coil embolization
View A is AP; View B is lateral, as confirmed by the data provider.
Case summary
A 60-year-old female presented with a thunderclap headache and a documented left supraclinoid ICA aneurysm measuring 3.8 mm x 5.2 mm with a 1.9 mm neck.
Image observation
On the supplied views, the aneurysm appears as a distinct contrast-filled outpouching arising from the supraclinoid internal carotid artery.
Model-generated clinical rationale
The documented aneurysm dimensions and neck width suggest a morphology that may be amenable to endovascular coiling. However, the specific dome-to-neck ratio and the presence of a small posterior communicating artery are not fully detailed in the narrative to definitively rule out the need for balloon assistance.
Model uncertainty
The OOF classifier showed a relatively clear preference for Coil embolization alone over Balloon-assisted coil embolization, but its scores are not probabilities of clinical correctness.
Clinical uncertainty / missing factor
The precise geometric configuration of the aneurysm neck and its relationship to the posterior communicating artery origin are not explicitly defined, limiting the certainty of coil stability without adjunctive devices.
Explicit evidence used
Left supraclinoid ICA aneurysm 3.8 mm x 5.2 mm x 3.8 mm with 1.9 mm neck | Small posterior communicating artery without significant contribution