Migration of an aneurysm clip to the sacral subarachnoid space.
METHODS
A 33-year-old woman was admitted for evaluation of vertigo. An unruptured fusiform aneurysm of left distal posterior inferior cerebellar artery was found and presumed to be the cause of her vertigo. The aneurysm was clipped using three clips and then the vertigo was relieved. However, she developed low back pain 53 months after the operation. On plain radiographic examination, a right-angled clip was found at the sacral level. Cerebral angiography revealed two clips remaining at the previous location and previous aneurysm was no longer visualized. Her symptom of back pain was resolved spontaneously over 2 weeks, and she is doing well without any particular inconvenience for following 72 months.


CONCLUSIONS
Clip loosening and migration is an extremely rare event in aneurysm surgery. If the aneurysm is secured and symptoms related to a migrated clip is resolved, the removal of one does not seem to be mandatory.
Kim
Yong Hwy
YH
Department of Neurosurgery, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, Seoul 110-744, South Korea.
Kim
Jeong Eun
JE
Kang
Hyun-Seung
HS
Han
Dae Hee
DH
D000328:Adult; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D017116:Low Back Pain / Q000209:etiology*; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods; D011128:Polyradiculopathy / Q000209:etiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D011843:Radiculopathy / Q000209:etiology; D011859:Radiography; D012447:Sacrum / Q000000981:diagnostic imaging / Q000473:pathology*; D013126:Spinal Nerve Roots / Q000293:injuries / Q000473:pathology / Q000503:physiopathology; D013346:Subarachnoid Space / Q000000981:diagnostic imaging / Q000473:pathology*; D013525:Surgical Instruments / Q000009:adverse effects*; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods; D014717:Vertigo / Q000209:etiology