Department of Neurology, The First People's Hospital of Ziyang, No. 66, Rende West Road, Ziyang, 641300, Sichuan, China.
Department of Cardiology, The First People's Hospital of Ziyang, No. 66, Rende West Road, Ziyang, 641300, Sichuan, China.
Curr Med Imaging. 2021;17(8):1031-1035. doi: 10.2174/1573405617666210122085247.
Endovascular therapy (EVT) for intracranial arterial aneurysms is depicted with several complications. Very recently, delayed non-ischemic cerebral enhanced (NICE) lesions have been identified as a rare complication associated with EVT. This complication always stands a higher chance of being missed in asymptomatic patients. We report a case of multiple NICE lesions in a known chronic hepatitis B infection and chronic gastritis patient with left internal carotid aneurysm (ICA) treated with detachable coils.
A 52 years old female with left ICA was treated with detachable coils via the endovascular route. Three weeks after the operation, she presented with numbness of her right limbs which was persistent and waked her up from sleep each night. She admitted skin allergies after wearing metals except for gold and silver since childhood. MRI revealed multiple abnormal lesions in the left temporal lobe, hippocampus, insula, and parietal lobe and some perifocal edema which were consistent with the diagnosis of delayed NICE lesions.
It is very important to report the occurrences of these lesions in literature because of their allergic origin. We advocate that allergy to metals especially those used in coating endovascular equipment should be evaluated before every EVT for intracranial aneurysms.
颅内动脉动脉瘤的血管内治疗（EVT）存在多种并发症。最近，发现延迟性非缺血性脑强化（NICE）病变是与 EVT 相关的罕见并发症。这种并发症在无症状患者中更容易被忽视。我们报告了一例已知慢性乙型肝炎感染和慢性胃炎患者的左颈内动脉（ICA）颅内动脉瘤，采用可解脱线圈进行治疗后出现多处 NICE 病变。
一名 52 岁女性，左颈内动脉采用可解脱线圈进行血管内治疗。术后 3 周，她出现右侧肢体麻木，持续存在，每晚都能把她从睡眠中唤醒。她从小除了金和银以外，对金属过敏。MRI 显示左颞叶、海马、岛叶和顶叶有多处异常病变，以及一些周围水肿，符合延迟性 NICE 病变的诊断。
由于这些病变是由过敏引起的，因此在文献中报告其发生情况非常重要。我们主张，在进行颅内动脉瘤的每一次 EVT 之前，都应该评估对金属的过敏情况，特别是那些用于涂覆血管内设备的金属。
