Progressive perianeurysmal edema induced after endovascular coil embolization - Report of three cases and review of the literature
Progressive perianeurysmal edema induced after endovascular coil embolization - Report of three cases and review of the literature
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DOI：
10.3171/jns.2007.106.5.916
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发表时间：
2007-05-01
影响因子：
4.1
通讯作者：
Nagata, Izumi
中科院分区：
文献类型：
--
作者：
Horie, Nobutaka;Kitagawa, Naoki;Nagata, Izumi
作者报告了3例血管内弹簧圈栓塞后脑动脉瘤周围进行性血管源性脑水肿的病例。由于动脉瘤尺寸较大且瘤颈较宽，所有3例病例的栓塞均不完全。随访磁共振成像显示，在初始治疗后3至6个月，动脉瘤周围新生血管源性脑水肿。水肿的进展与动脉瘤的再生长平行。所有三个动脉瘤都位于脑实质深处，并显示壁内增强，提示出血或炎症。根据这些病例的发现和文献回顾，我们认为脑深部较大动脉瘤的不完全闭塞可能导致管腔内血栓形成、动脉瘤搏动和壁内出血或炎症，所有这些都与动脉瘤再通和再生后的脑水肿有关。应该记住，较大动脉瘤的不完全栓塞可能导致这种恶性变化，这种并发症可能发生在血管内治疗后。
The authors report three cases of progressive vasogenic brain edema surrounding a cerebral aneurysm after endovascular coil embolization. In all three cases embolization was incomplete due to the aneurysms' large sizes and wide necks. Follow-up magnetic resonance imaging revealed de novo vasogenic brain edema surrounding the aneurysms 3 to 6 months after the initial treatment. The edema progressed in parallel with regrowth of the aneurysms. All three aneurysms were deep in the brain parenchyma and showed intramural enhancement, suggesting hemorrhage or inflammation. Each patient underwent a second embolization for the aneurysm regrowth, which resulted in improvement of the edema.Based on the findings in these cases and review of the literature, it is suggested that incomplete occlusion of larger aneurysms that are deep within the brain may lead to a disorganized intraluminal thrombosis, aneurysm pulsing, and intramural hemorrhage or inflammation, all of which are associated with brain edema following aneurysm recanalization and regrowth. It should be kept in mind that incomplete embolization of larger aneurysms may cause such malignant change and that this complication may occur after endovascular treatment.