Okuma Yu, Meguro Toshinari, Shimoda Kentaro, Miyara Santiago, Hirotsune Nobuyuki
Department of Neurological Surgery, Sonoda Daiichi Hospital, Tokyo, Japan.
Department of Neurological Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
Brain Circ. 2023 Jun 30;9(2):64-67. doi: 10.4103/bc.bc_72_22. eCollection 2023 Apr-Jun.
Endovascular cerebral aneurysmal coil embolization is becoming more popular than direct aneurysmal neck clipping due to its noninferiority in long-term outcomes and being less invasive. Neuroradiologists often find postoperative symptoms such as headache and fever after unruptured aneurysmal coil embolization, however, they have not paid much attention because symptoms almost always resolve spontaneously within a few days. Since the concept of this syndrome has not been standardized, we named it postcoiling syndrome (PCS). In this short review, we reviewed the criteria, risk factors, mechanisms, significance, and treatment of PCS based on a few pieces of literature. Almost all literature has regarded that some kind of bioactive reaction might be involved in PCS. Preliminary data showed the possibility of inhibition of PCS by histamine-2 receptor antagonists. PCS also might have the potential of more predictive maker than previously reported risk factors for recurrence after aneurysm coil embolization. Further investigation is needed in the future, including the accumulation of cases, unification of concepts, and mid-to-long-term follow-up.
由于血管内脑动脉瘤弹簧圈栓塞术在长期疗效上并不逊色且侵入性较小,它正变得比直接动脉瘤颈夹闭术更受欢迎。然而,神经放射科医生经常发现未破裂动脉瘤弹簧圈栓塞术后出现头痛和发热等症状,但他们对此并未给予太多关注,因为症状几乎总是在几天内自行缓解。由于该综合征的概念尚未标准化,我们将其命名为弹簧圈植入后综合征(PCS)。在这篇简短的综述中,我们基于少量文献回顾了PCS的标准、危险因素、机制、意义及治疗方法。几乎所有文献都认为PCS可能涉及某种生物活性反应。初步数据显示组胺-2受体拮抗剂有抑制PCS的可能性。与先前报道的动脉瘤弹簧圈栓塞术后复发危险因素相比,PCS可能也有更强的预测指标潜力。未来需要进一步研究,包括病例积累、概念统一以及中长期随访。