title: A patient develops transient unique cerebral and cerebellar lesions after unruptured aneurysm coiling.
abstract: BACKGROUND
  We describe a case of a very unusual complication following a coiling procedure in which the patient developed transient unique cerebral and cerebellar lesions. Lesions were examined not only by magnetic resonance imaging (MRI) but also by positron emission tomography-computed tomography (PET-CT) and proton magnetic resonance spectroscopy ((1)H-MRS).
  
  
  METHODS
  A 33-year-old woman presented an incidental 3.7 × 3.3-mm unruptured cerebral aneurysm (CAn) in her basilar artery, which was successfully coiled with balloon assistance. A follow-up brain MRI at 1 and 2 months showed a gradual increase in several white matter hyperintense lesions in the left cerebellar, bilateral occipitotemporal and left parietoccipital lobe during fluid-attenuated inversion recovery (FLAIR). These were the only lesions associated with perfused CAn. However, the patient did not show any additional symptoms such as visual disturbance throughout the entire course. (11)C-methionine-PET (MET-PET) showed an obvious increase in methionine uptake in the lesion corresponding to enhanced areas with gadolinium-enhanced MRI. MRS showed a decrease in the N-acetylaspartate/creatine (NAA/cr) ratio and a slight elevation of the choline/creatine (cho/cr) ratio and a lactate peak in the lesion. A follow-up MRI at 6 and 12 months showed a gradual decrease in the initial hyperintense lesions in FLAIR without any treatment.
  
  
  CONCLUSIONS
  We present a case of an unusual complication after a coiling procedure. Although it is difficult to identify this etiology without a pathological examination, it is importance to increase awareness of such a potential complication arising from coiling procedures, because interventional procedures have become the first choice of treatment for cerebrovascular diseases in many countries.
authors.affiliation: Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan. degu@cc.okayama-u.ac.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Deguchi
authors.affiliation: Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan. phhx2f23@s.okayama-u.ac.jp.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kawahara
authors.affiliation: Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan. shokon@cc.okayama-u.ac.jp.
authors.forename: Shoko
authors.initials: S
authors.lastname: Deguchi
authors.affiliation: Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan. morinobu@cc.okayama-u.ac.jp.
authors.forename: Nobutoshi
authors.initials: N
authors.lastname: Morimoto
authors.affiliation: Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan. toko11@cc.okayama-u.ac.jp.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kurata
authors.affiliation: Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan. ikeday006@gunma-u.ac.jp.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Departments of Neurosurgery, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan. tomoichi@cc.okayama-u.ac.jp.
authors.forename: Tomotsugu
authors.initials: T
authors.lastname: Ichikawa
authors.affiliation: Departments of Neurosurgery, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan. kojitoku@md.okayama-u.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Tokunaga
authors.affiliation: Department of Neurological Surgery, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, 761-0793, Japan. nobu@kms.ac.jp.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kawai
authors.affiliation: Departments of Neurosurgery, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan. ksugiu@md.okayama-u.ac.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugiu
authors.affiliation: Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan. abekabek@cc.okayama-u.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Abe
mesh_terms: D000328:Adult; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000473:pathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D066244:Proton Magnetic Resonance Spectroscopy; D014057:Tomography, X-Ray Computed