Cerebral vasospasm after coil embolization for unruptured anterior communicating artery aneurysm: illustrative case

被引：0

作者：

Fukutome, Kenji ^{[1
]}

Aketa, Shuta ^{[1
]}

Fukumori, Junji ^{[1
]}

Mitsui, Takaaki ^{[1
]}

Nakajima, Tsukasa ^{[1
]}

Hayami, Hiromichi ^{[1
]}

Matsuoka, Ryuta ^{[1
]}

Tei, Rinsei ^{[1
]}

Shin, Yasushi ^{[1
]}

Motoyama, Yasushi ^{[1
]}

机构：

[1] Osaka Police Hosp, Dept Neurosurg, Osaka, Japan

来源：

JOURNAL OF NEUROSURGERY-CASE LESSONS | 2022年 / 3卷 / 19期

关键词：

adverse event; coil embolization; fasudil; unruptured aneurysm; vasospasm; SYMPTOMATIC VASOSPASM;

D O I：

10.3171/CASE2288

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

BACKGROUND Compared with several reports of cerebral vasospasm after clipping for unruptured cerebral aneurysm, only one study to date has reported cerebral vasospasm after coil embolization. Herein, the authors report a rare case of cerebral vasospasm after coil embolization for unruptured cerebral aneurysm. OBSERVATIONS A 58-year-old woman with an unruptured anterior communicating artery aneurysm was referred to our department. Stent-assisted coil embolization was performed for the aneurysm, and no obvious adverse events were observed on cerebral angiography obtained immediately after the operation. However, the patient developed mild headache and slight restlessness soon after the operation and new-onset disorientation, left hemispatial neglect, and left hemiplegia the day after the operation. Emergency brain magnetic resonance imaging and cerebral angiography indicated vasospasm in the right middle cerebral artery, and intra-arterial injection of fasudil hydrochloride hydrate was performed to dilate the middle cerebral artery. Blood flow in the middle cerebral artery immediately improved, and she was discharged without neurological deficits 8 days after the operation. LESSONS Immediate intervention is necessary to prevent cerebral infarction in patients with cerebral vasospasm, which may occur even after coil embolization for unruptured cerebral aneurysm.

引用

页数：5

共 21 条

[1]

Bloomfield SM, Sonntag VK., Delayed cerebral vasospasm after uncomplicated operation on an unruptured aneurysm: case report, Neurosurgery, 17, 5, pp. 792-796, (1985)

[2]

DeLong WB., Severe vasospasm with an unruptured aneurysm, Neurosurgery, 6, 6, (1980)

[3]

Friedman P, Gass HH, Magidson M., Vasospasm with an unruptured and unoperated aneurysm, Surg Neurol, 19, 1, pp. 21-25, (1983)

[4]

Hashimoto H, Kameda M, Yasuhara T, Date I., A case of unex-pected symptomatic vasospasm after clipping surgery for an unrup-tured intracranial aneurysm, J Stroke Cerebrovasc Dis, 25, 3, pp. e25-e27, (2016)

[5]

Kitazawa K, Hongo K, Tanaka Y, Oikawa S, Kyoshima K, Kobayashi S., Postoperative vasospasm of unruptured paraclinoid carotid aneurysms: analysis of 30 cases, J Clin Neurosci, 12, 2, pp. 150-155, (2005)

[6]

Paolini S, Kanaan Y, Wagenbach A, Fraser K, Lanzino G., Cerebral vasospasm in patients with unruptured intracranial aneurysms, Acta Neurochir (Wien), 147, 11, pp. 1181-1188, (2005)

[7]

Raynor RB, Messer HD., Severe vasospasm with an unruptured aneurysm: case report, Neurosurgery, 6, 1, pp. 92-95, (1980)

[8]

Tsyben A, Paldor I, Laidlaw J., Cerebral vasospasm and delayed ischaemic deficit following elective aneurysm clipping, J Clin Neuro-sci, 34, pp. 33-38, (2016)

[9]

Yang K, Ahn JS, Park JC, Kwon DH, Kwun BD., Clinical and angio-graphical delayed cerebral vasospasms after uncomplicated surgical clipping of unruptured intracranial aneurysms: illustrated review and two case reports, Turk Neurosurg, 25, 4, pp. 662-665, (2015)

[10]

Yasui T, Komiyama M, Iwai Y, Et al., Postoperative ischemic compli-cations in the surgical treatment of unruptured intracranial aneur-ysms, Surg Cereb Stroke, 31, 2, pp. 104-110, (2003)

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