title: Delayed Hydrocephalus and Perianeurysmal Cyst Formation After Stent-Assisted Coil Embolization of a Large, Unruptured Basilar Apex Aneurysm: A Case Report and Literature Review.
abstract: OBJECTIVE
  Endovascular aneurysm embolization possesses a unique set of infrequently seen complications distinct from those associated with microsurgical clipping, which may arise after an otherwise uncomplicated coil embolization procedure, including postembolization, hydrocephalus, and perianeurysmal cyst formation.
  
  
  METHODS
  The authors report an illustrative case of 2 rarely seen complications of aneurysm embolization with literature review.
  
  
  METHODS
  We present a case of a basilar apex aneurysm that was treated with endovascular coil embolization with multiple Cerecyte (Micrus Endovascular, San Jose, Calif) coils and 2 Enterprise (Codman & Shurtleff, Inc, Raynham, Mass) stents.
  
  
  RESULTS
  Postembolization angiography demonstrated complete aneurysm obliteration without distal branch occlusion or other complication. Twenty-two months after the embolization, however, the patient presented with progressively worsening headaches. Repeat magnetic resonance imaging revealed hydrocephalus and a perianeurysmal cyst measuring 1 × 2 cm adjacent to the previously coiled basilar apex aneurysm. After endoscopic third ventriculostomy, the patient experienced significant relief of her headaches and was discharged to rehabilitation.
  
  
  CONCLUSIONS
  Clinicians should be aware that worsening or new neuro-ophthalmic findings may be the presenting sign of postembolization hydrocephalus or perianeurysmal cyst formation.
authors.affiliation: From the *Department of Neurosurgery, Houston Methodist Hospital; †Department of Neurosurgery, Weill Cornell Medical College; ‡Department of Ophthalmology, Houston Methodist Hospital; §Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College; ∥Department of Radiology, Houston Methodist Hospital; ¶Department of Radiology, Weill Cornell Medical College; **Baylor College of Medicine, Houston, TX; ††Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, IA; and ‡‡Department of Ophthalmology, **††‡‡MD Anderson Cancer Center, The University of Texas Medical Branch, Galveston, TX.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Barber
authors.forename: Nagham
authors.initials: N
authors.lastname: Al-Zubidi
authors.forename: Orlando M
authors.initials: OM
authors.lastname: Diaz
authors.forename: Y Jonathan
authors.initials: YJ
authors.lastname: Zhang
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Lee