Pace Jonathan, Nelson Jeffrey, Ray Abhishek, Hu Yin
24575 University Hospitals Cleveland Medical Center , Neurological Institute, Department of Neurological Surgery, Cleveland, OH, USA.
Interv Neuroradiol. 2017 Dec;23(6):601-604. doi: 10.1177/1591019917729822. Epub 2017 Sep 28.
A middle-aged patient presented for elective embolization of an incidentally found right internal carotid aneurysm. An angiogram was performed, during which the left internal carotid artery was visualized to evaluate a second, small aneurysm. During the embolization of the right internal carotid artery aneurysm, a catheter-induced vasospasm was identified that prompted treatment with intra-arterial verapamil. The procedure was uncomplicated; a postoperative rotational flat-panel computed tomography scan was performed on the angiography table that demonstrated right hemisphere contrast staining. The patient developed a right middle cerebral artery (MCA) syndrome after extubation with repeat cerebral angiography negative for occlusion and magnetic resonance imaging negative for stroke. The patient was observed for 48 hours, during which time the patient had slowly improved. At a six-week follow up visit, the patient had fully recovered. We present an interesting case of a verapamil-induced breakdown of the blood-brain barrier and self-limited right MCA syndrome.
一名中年患者因偶然发现的右侧颈内动脉瘤前来进行择期栓塞治疗。进行了血管造影，在此过程中观察左侧颈内动脉以评估第二个小动脉瘤。在右侧颈内动脉瘤栓塞过程中，发现了导管诱发的血管痉挛，遂用动脉内维拉帕米进行治疗。手术过程顺利；术后在血管造影台上进行了旋转平板计算机断层扫描，显示右半球造影剂染色。患者拔管后出现右大脑中动脉（MCA）综合征，复查脑血管造影未发现闭塞，磁共振成像也未发现中风。对患者观察了48小时，在此期间患者病情逐渐好转。在六周的随访中，患者已完全康复。我们报告了一例有趣的维拉帕米诱发血脑屏障破坏和自限性右MCA综合征的病例。
