Cerebral vasospasm after coil embolization for unruptured anterior communicating artery aneurysm: illustrative case

Abstract

BACKGROUND Compared with several reports of cerebral vasospasm after clipping for unruptured cerebral aneurysm, only one study to date has reported cerebral vasospasm after coil embolization. Herein, the authors report a rare case of cerebral vasospasm after coil embolization for unruptured cerebral aneurysm. OBSERVATIONS A 58-year-old woman with an unruptured anterior communicating artery aneurysm was referred to our department. Stent-assisted coil embolization was performed for the aneurysm, and no obvious adverse events were observed on cerebral angiography obtained immediately after the operation. However, the patient developed mild headache and slight restlessness soon after the operation and new-onset disorientation, left hemispatial neglect, and left hemiplegia the day after the operation. Emergency brain magnetic resonance imaging and cerebral angiography indicated vasospasm in the right middle cerebral artery, and intra-arterial injection of fasudil hydrochloride hydrate was performed to dilate the middle cerebral artery. Blood flow in the middle cerebral artery immediately improved, and she was discharged without neurological deficits 8 days after the operation. LESSONS Immediate intervention is necessary to prevent cerebral infarction in patients with cerebral vasospasm, which may occur even after coil embolization for unruptured cerebral aneurysm.

Low-memory shape coils for intracranial aneurysm coiling: Initial and single-center experience with the i-ED coil

“…[ 8 ] While the Kaneka i-ED coils have been demonstrated in individual case reports with promising results, we believed that our series of 15 patients may offer some additional insight for neurointerventionalists considering low-memory shape coils for aneurysm treatment. [ 3 , 4 , 6 , 7 , 14 , 15 ] We outline our experience at a single center with these coils so that other neurointerventionalists might find use for it and incorporate them as an additional tool in their practice.…”