Muraoka Shinsuke, Asai Takumi, Hamasaki Hajime, Fukui Takahiko, Suzuki Naoki, Nishizawa Toshihisa, Araki Yoshio, Saito Ryuta
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Aichi, Japan.
Department of Neurosurgery, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Aichi, Japan.
Neuroradiology. 2024 Mar;66(3):427-429. doi: 10.1007/s00234-024-03281-7. Epub 2024 Jan 12.
This report examines delayed leukoencephalopathy as a postoperative complication after the use of flow diverter (FD) devices for endovascular cerebral aneurysm treatment. A case involving a 78-year-old female treated with a pipeline embolization device for a left internal carotid artery aneurysm is presented. Despite adherence to dual anti-platelet therapy, the patient developed intermittent headaches and memory issues 3 months post-operation. MRI revealed T1-enhancing foci and T2 hyperintense signal abnormalities in the left cerebral hemisphere, without new ischemic lesions, indicating potential embolic events or foreign body reactions. Following aphasia, a change from clopidogrel to prasugrel and the initiation of steroid pulse therapy led to the resolution of symptoms and MRI abnormalities over 6 months. This case underscores the reversibility of delayed leukoencephalopathy with appropriate intervention.
本报告探讨了在使用血流导向（FD）装置进行血管内脑动脉瘤治疗后，迟发性白质脑病作为一种术后并发症的情况。报告了一例78岁女性患者，其左颈内动脉瘤采用管道栓塞装置进行治疗。尽管坚持双重抗血小板治疗，但患者在术后3个月出现间歇性头痛和记忆问题。MRI显示左脑半球有T1增强灶和T2高信号异常，无新的缺血性病变，提示可能存在栓塞事件或异物反应。在出现失语症后，将氯吡格雷改为普拉格雷并开始使用类固醇脉冲疗法，症状和MRI异常在6个月内得到缓解。该病例强调了适当干预后迟发性白质脑病的可逆性。
