title: [Ruptured middle cerebral artery aneurysm successfully treated by intra-aneurysmal GDC embolization in a patient with idiopathic thrombocytopenic purpura: a case report].
abstract: We report a case of a ruptured middle cerebral artery (MCA) aneurysm treated by an intra-aneurysmal Guglielmi detachable coil (GDC) embolization in a patient with idiopathic thrombocytopenic purpura (ITP). A 57-year-old female, who had been suffering from ITP for 4 years, experienced sudden severe headache. She was diagnosed as having subarachnoid hemorrhage due to a ruptured MCA aneurysm and the hematological examination showed moderate thrombocytopenia. Considering the risk of open surgery, we treated the aneurysm by intra-aneurysmal GDC embolization in the acute stage and platelet transfusion was carried out after the therapy. She had a good clinical course and recovered without any complications or neurological symptoms. The follow-up cerebral angiogram at 1 week and 2 years after the treatment showed complete obliteration of the aneurysm. Recently, endovascular treatment tends to be applied to surgically high-risk patients. A GDC embolization for a patient with thrombocytopenia has rarely been reported and the risk and efficacy is unknown. So, we conclude that for a patient with thrombocytopenia, intra-aneurysmal GDC embolization could be adopted as one of the less invasive treatment for ruptured aneurysm.
authors.affiliation: Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Iwasaki
authors.forename: M
authors.initials: M
authors.lastname: Ezura
authors.forename: A
authors.initials: A
authors.lastname: Takahashi
authors.forename: T
authors.initials: T
authors.lastname: Yoshimoto
mesh_terms: D017542:Aneurysm, Ruptured / Q000150:complications / Q000628:therapy*; D002908:Chronic Disease; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications*; D016896:Treatment Outcome