Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Ein-Kerem, P.O. Box 12000, Jerusalem 91120, Israel.
J Clin Neurosci. 2012 Mar;19(3):474-6. doi: 10.1016/j.jocn.2011.08.008. Epub 2012 Jan 26.
We report a patient with a giant unruptured supraclinoid aneurysm treated by endovascular embolization by means of bare coils and implantation of a flow diverterstent. Eight weeks after the embolization, she presented with uncinate seizures. Neuroradiological examination revealed de novo postembolization perianeurysmal edema, which has been described only rarely. A brief course of oral steroids successfully controlled the seizures. Perianeurysmal edema must be considered a potential complication after embolization of large aneurysms with coils and other means, and needs to be considered as a differential diagnosis in patients with unusual neurological symptoms at either the acute or delayed stages. To our knowledge, this is the first report of postembolization perianeurysmal edema occurring after successful occlusion by means of bare coils and a flow diverterstent. This report contributes to the growing evidence on adverse post-coiling inflammatory reactions, and specifically on perianeurysmal edema.
我们报告了一例接受裸栓和血流导向支架栓塞治疗的巨大未破裂前循环动脉瘤患者。栓塞后 8 周,患者出现钩回发作。神经影像学检查显示新出现的栓塞后瘤周水肿,这种情况很少见。短期口服类固醇治疗成功控制了发作。瘤周水肿必须被认为是使用线圈和其他方法栓塞大动脉瘤后的潜在并发症,并且需要在急性或延迟阶段出现不常见神经症状的患者中作为鉴别诊断。据我们所知,这是首例报道使用裸栓和血流导向支架成功闭塞后出现栓塞后瘤周水肿的病例。本报告有助于增加关于线圈后炎症反应的不良事件的证据,特别是关于瘤周水肿的证据。