A patient develops transient unique cerebral and cerebellar lesions after unruptured aneurysm coiling.
A patient develops transient unique cerebral and cerebellar lesions after unruptured aneurysm coiling.
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DOI：
10.1186/s12883-015-0303-7
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发表时间：
2015-03-31
期刊：
影响因子：
2.6
通讯作者：
Abe K
中科院分区：
文献类型：
--
作者：
Deguchi K;Kawahara Y;Deguchi S;Morimoto N;Kurata T;Ikeda Y;Ichikawa T;Tokunaga K;Kawai N;Sugiu K;Abe K
我们描述了一个在弹簧圈栓塞手术后出现的非常不寻常的并发症的病例，其中患者出现了短暂的独特的大脑和小脑病变。病变不仅通过磁共振成像（MRI）进行检查，还通过正电子发射断层扫描-计算机断层扫描（PET-CT）和质子磁共振波谱（1H-MRS）进行检查。一名 33 岁女性的基底动脉偶然出现了一个 3.7 × 3.3 毫米的未破裂脑动脉瘤 (CAn)，在球囊辅助下成功卷绕了该瘤。第 1 个月和第 2 个月的后续脑 MRI 显示，在液体衰减反转恢复 (FLAIR) 过程中，左侧小脑、双侧枕颞叶和左侧顶枕叶的几个白质高信号病变逐渐增加。这些是唯一与灌注 CAn 相关的病变。然而，在整个病程中，患者并未表现出任何其他症状，例如视力障碍。 11C-蛋氨酸-PET (MET-PET) 显示，与钆增强 MRI 增强区域相对应的病灶中蛋氨酸摄取明显增加。 MRS 显示病灶中 N-乙酰天冬氨酸/肌酸 (NAA/cr) 比率降低，胆碱/肌酸 (cho/cr) 比率轻微升高，并出现乳酸峰。 6 个月和 12 个月时的随访 MRI 显示，未经任何治疗，FLAIR 中最初的高信号病变逐渐减少。我们介绍一个弹簧圈手术后不寻常并发症的病例。尽管未经病理检查很难确定这种病因，但提高对弹簧圈栓塞手术潜在并发症的认识非常重要，因为介入手术已成为许多国家治疗脑血管疾病的首选。
We describe a case of a very unusual complication following a coiling procedure in which the patient developed transient unique cerebral and cerebellar lesions. Lesions were examined not only by magnetic resonance imaging (MRI) but also by positron emission tomography-computed tomography (PET-CT) and proton magnetic resonance spectroscopy (1H-MRS). A 33-year-old woman presented an incidental 3.7 × 3.3-mm unruptured cerebral aneurysm (CAn) in her basilar artery, which was successfully coiled with balloon assistance. A follow-up brain MRI at 1 and 2 months showed a gradual increase in several white matter hyperintense lesions in the left cerebellar, bilateral occipitotemporal and left parietoccipital lobe during fluid-attenuated inversion recovery (FLAIR). These were the only lesions associated with perfused CAn. However, the patient did not show any additional symptoms such as visual disturbance throughout the entire course. 11C-methionine-PET (MET-PET) showed an obvious increase in methionine uptake in the lesion corresponding to enhanced areas with gadolinium-enhanced MRI. MRS showed a decrease in the N-acetylaspartate/creatine (NAA/cr) ratio and a slight elevation of the choline/creatine (cho/cr) ratio and a lactate peak in the lesion. A follow-up MRI at 6 and 12 months showed a gradual decrease in the initial hyperintense lesions in FLAIR without any treatment. We present a case of an unusual complication after a coiling procedure. Although it is difficult to identify this etiology without a pathological examination, it is importance to increase awareness of such a potential complication arising from coiling procedures, because interventional procedures have become the first choice of treatment for cerebrovascular diseases in many countries.
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影响因子：
2
作者：
Skolarus, Lesli E.;Gemmete, Joseph J.;Pandey, Aditya
通讯作者：
Pandey, Aditya
影响因子：
4.8
作者：
Meyers, PM;Lavine, SD;Connolly, ES
通讯作者：
Connolly, ES
影响因子：
3.5
作者：
White, J. B.;Cloft, H. J.;Kallmes, D. F.
通讯作者：
Kallmes, D. F.
影响因子：
9.9
作者：
Herholz, K;Hölzer, T;Heiss, WD
通讯作者：
Heiss, WD
影响因子：
4.1
作者：
Horie, Nobutaka;Kitagawa, Naoki;Nagata, Izumi
通讯作者：
Nagata, Izumi