Unusual delayed hydrocephalus after bare platinum coil embolization of an unruptured aneurysm.
A 69-year-old woman developed hydrocephalus after the embolization of an incidentally detected unruptured large internal carotid artery aneurysm with bare platinum coils. Endovascular embolization resulted in near-total aneurysm occlusion. She complained of mild headache 18 hours after the procedure and magnetic resonance (MR) imaging performed on the 6(th) post-treatment day revealed wall enhancement and perianeurysmal brain edema. Follow-up MR imaging showed recanalization of the aneurysm and gradual ventricular enlargement. She presented with typical symptoms of hydrocephalus including disorientation, gait disturbance, and urine incontinence at 7 months post-embolization. We removed 30 ml of cerebrospinal fluid by lumbar tap, which improved her condition without symptom recurrence for 2 months. She did not require shunt placement. Post-interventional hydrocephalus is known in patients with unruptured aneurysms embolized with bioactive second-generation coils. This case shows that hydrocephalus can occur after aneurysm embolization with bare platinum coils without intracranial hemorrhage.
Misaki
Kouichi
K
Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan.
Uchiyama
Naoyuki
N
Mohri
Masanao
M
Hirota
Yuichi
Y
Hayashi
Yutaka
Y
Hamada
Jun-ichiro
J
D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000628:therapy*; D001929:Brain Edema / Q000175:diagnosis / Q000628:therapy; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000628:therapy*; D002343:Carotid Artery, Internal; D002552:Cerebral Ventricles / Q000473:pathology; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D010984:Platinum; D012008:Recurrence; D013129:Spinal Puncture
D010984:Platinum