Department of Neurosurgery, National Hospital Organization Toyohashi Medical Center, 50 Imure-cho hamamichigami, Toyohashi 440-8510, Aichi, Japan.
Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan.
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104869. doi: 10.1016/j.jstrokecerebrovasdis.2020.104869. Epub 2020 May 13.
Delayed intraparenchymal hemorrhage (DIPH) is one of the complications of flow diverter (FD) treatment, however, the mechanism is unclear. We present the case of a 54-year-old woman with a partially thrombosed large internal carotid artery aneurysm. She presented intraparenchymal hemorrhage in the right parietal lobe three days after the successful FD treatment. We performed endoscopic hematoma removal, and then her consciousness disturbance was fully recovered. IMP single-photon emission computed tomography showed significant increase of cerebral blood flow in the right hemisphere. We diagnosed DIPH associated with hyperperfusion after FD treatment. It is necessary to consider that DIPH due to hyperperfusion may occur after FD treatment.
延迟性脑实质血肿（DIPH）是血流导向装置（FD）治疗的并发症之一，但发病机制尚不清楚。我们报告了 1 例部分血栓形成的大型颈内动脉动脉瘤患者，女性，54 岁。FD 治疗后 3 天，患者出现右侧顶叶脑实质血肿。我们进行了内镜血肿清除术，随后患者的意识障碍完全恢复。IMP 单光子发射计算机断层扫描显示右侧大脑半球脑血流明显增加。我们诊断为 FD 治疗后并发的 DIPH 合并高灌注。FD 治疗后可能发生高灌注引起的 DIPH，需要考虑到这一点。
