Barber Sean M, Al-Zubidi Nagham, Diaz Orlando M, Zhang Y Jonathan, Lee Andrew G
From the *Department of Neurosurgery, Houston Methodist Hospital; †Department of Neurosurgery, Weill Cornell Medical College; ‡Department of Ophthalmology, Houston Methodist Hospital; §Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College; ∥Department of Radiology, Houston Methodist Hospital; ¶Department of Radiology, Weill Cornell Medical College; **Baylor College of Medicine, Houston, TX; ††Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, IA; and ‡‡Department of Ophthalmology, **††‡‡MD Anderson Cancer Center, The University of Texas Medical Branch, Galveston, TX.
Asia Pac J Ophthalmol (Phila). 2014 Nov-Dec;3(6):354-60. doi: 10.1097/APO.0000000000000029.
Endovascular aneurysm embolization possesses a unique set of infrequently seen complications distinct from those associated with microsurgical clipping, which may arise after an otherwise uncomplicated coil embolization procedure, including postembolization, hydrocephalus, and perianeurysmal cyst formation.
The authors report an illustrative case of 2 rarely seen complications of aneurysm embolization with literature review.
We present a case of a basilar apex aneurysm that was treated with endovascular coil embolization with multiple Cerecyte (Micrus Endovascular, San Jose, Calif) coils and 2 Enterprise (Codman & Shurtleff, Inc, Raynham, Mass) stents.
Postembolization angiography demonstrated complete aneurysm obliteration without distal branch occlusion or other complication. Twenty-two months after the embolization, however, the patient presented with progressively worsening headaches. Repeat magnetic resonance imaging revealed hydrocephalus and a perianeurysmal cyst measuring 1 × 2 cm adjacent to the previously coiled basilar apex aneurysm. After endoscopic third ventriculostomy, the patient experienced significant relief of her headaches and was discharged to rehabilitation.
Clinicians should be aware that worsening or new neuro-ophthalmic findings may be the presenting sign of postembolization hydrocephalus or perianeurysmal cyst formation.
血管内动脉瘤栓塞术具有一系列独特的、不常见的并发症，与显微外科夹闭术相关的并发症不同，这些并发症可能在原本简单的弹簧圈栓塞术后出现，包括栓塞后脑积水和动脉瘤周围囊肿形成。
作者报告一例动脉瘤栓塞术罕见并发症的病例并进行文献复习。
我们呈现一例基底动脉尖动脉瘤病例，采用多个Cerecyte（Micrus Endovascular公司，加利福尼亚州圣何塞）弹簧圈和2个Enterprise（Codman & Shurtleff公司，马萨诸塞州雷纳姆）支架进行血管内弹簧圈栓塞治疗。
栓塞后血管造影显示动脉瘤完全闭塞，无远端分支闭塞或其他并发症。然而，栓塞22个月后，患者出现头痛逐渐加重。复查磁共振成像显示脑积水以及在先前栓塞的基底动脉尖动脉瘤旁有一个1×2 cm的动脉瘤周围囊肿。内镜下第三脑室造瘘术后，患者头痛明显缓解并出院接受康复治疗。
临床医生应意识到，神经眼科症状恶化或出现新症状可能是栓塞后脑积水或动脉瘤周围囊肿形成的表现。
Zotero 插件