title: Enhancing brain lesions after endovascular treatment of aneurysms.
abstract: Complications of endovascular therapy of aneurysms mainly include aneurysm rupture and thromboembolic events. The widespread use of MR imaging for follow-up of these patients revealed various nonvascular complications such as aseptic meningitis, hydrocephalus, and perianeurysmal brain edema. We present 7 patients from 5 different institutions that developed MR imaging-enhancing brain lesions after endovascular therapy of aneurysms, detected after a median time of 63 days. The number of lesions ranged from 4-46 (median of 10.5), sized 2-20 mm, and were mostly in the same vascular territory used for access. Three patients presented with symptoms attributable to these lesions. After a median follow-up of 21.5 months, the number of lesions increased in 2, was stable in 1, decreased in 3, and disappeared in 1. The imaging and clinical characteristics suggested a foreign body reaction. We could find no correlation to a specific device, but a possible source may be the generic hydrophilic coating.
authors.affiliation: From the Radiology Department (J.P.C.), Hospital Clínico de la Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: J P
authors.initials: JP
authors.lastname: Cruz
authors.affiliation: Divisions of Neuroradiology (T.M.), St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Marotta
authors.affiliation: Department of Surgery (C.O.), University of Edmonton, Edmonton, Alberta, Canada.
authors.forename: C
authors.initials: C
authors.lastname: O'Kelly
authors.affiliation: Division of Interventional Neuroradiology (M.H.), Københavns Universitet, Copenhagen, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Holtmannspötter
authors.affiliation: Service de Neuroradiologié (G.S.), Hôpital de Bicêtre, Kremlin Bicêtre, France.
authors.forename: G
authors.initials: G
authors.lastname: Saliou
authors.affiliation: Toronto Western Hospital (R.W., T.K., R.A.), Toronto, Ontario, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Willinsky
authors.affiliation: Toronto Western Hospital (R.W., T.K., R.A.), Toronto, Ontario, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Krings
authors.affiliation: Toronto Western Hospital (R.W., T.K., R.A.), Toronto, Ontario, Canada. ronit.agid@uhn.ca.
authors.forename: R
authors.initials: R
authors.lastname: Agid
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000209:etiology*; D004621:Embolization, Therapeutic / Q000009:adverse effects; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D002532:Intracranial Aneurysm / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged