title: Angioplasty and coiling of ruptured aneurysm with symptomatic vasospasm: technical case report.
abstract: BACKGROUND
  Treating a ruptured cerebral aneurysm during symptomatic vasospasm is very difficult. We describe the successful endovascular treatment of such a case and discuss its efficacy.
  
  
  METHODS
  A 34-year-old man had a sudden onset of severe headache. One week later, he was referred to our institute with gradually progressing right hemiparesis and global aphasia. Cerebral angiography demonstrated severe vasospasm of the left internal carotid artery system and an anterior communicating artery aneurysm. With the patient under general anesthesia, 90% occlusion of the aneurysm was achieved with detachable coils after successful dilatation of the spastic vessels. The patient had an uneventful postoperative course and his neurologic symptoms were improved. Seven months after the endovascular treatment, the enlarged neck remnant of the aneurysm was successfully clipped without difficulty.
  
  
  CONCLUSIONS
  The simultaneous treatment of a ruptured aneurysm and vasospasm with percutaneous transluminal angioplasty and coils can produce a better outcome for the patient.
authors.affiliation: Department of Neurological Surgery, Okayama University Medical School, Okayama, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugiu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Katsumata
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ono
authors.forename: Takashi
authors.initials: T
authors.lastname: Tamiya
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohmoto
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications / Q000473:pathology / Q000601:surgery*; D017130:Angioplasty / Q000379:methods*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000209:etiology*