title: Regrowth and fatal rerupture despite proximal occlusion after coil embolization of a ruptured large basilar bifurcation aneurysm--case report.
abstract: A 40-year-old man suffered chronic progressive symptoms of brainstem compression after undergoing endosaccular coil placement in a ruptured large basilar bifurcation aneurysm. Radiographical examinations showed coil compaction and regrowth of the aneurysmal mass with perifocal mesencephalic edema. The symptoms did not resolve even after additional clip occlusion of the upper basilar artery and the patient died of rerupture. At present, direct surgical clipping using a skull base technique with or without hypothermic circulatory arrest or upper basilar artery occlusion with or without bypass surgery may be a better choice as an initial treatment for giant or large basilar bifurcation aneurysm with a wide neck.
authors.affiliation: Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan. yasui@msic.med.osaka-cu.ac.jp
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Yasui
authors.forename: Masaki
authors.initials: M
authors.lastname: Komiyama
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Iwai
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Matsusaka
authors.forename: Toshie
authors.initials: T
authors.lastname: Morikawa
authors.forename: Tomoya
authors.initials: T
authors.lastname: Ishiguro
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000628:therapy*; D001488:Basilar Artery; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation; D017809:Fatal Outcome; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D012008:Recurrence; D014057:Tomography, X-Ray Computed