Journal of Korean Neurosurgical Society

  • 제42권3호
  • /
  • Pages.235-237
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  • 2007
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지

Early Rupture after Coiling of Unruptured Aneurysm

  • Ko, Jun-Kyeung (Department of Neurosurgery, School of Medicine Pusan National University) ;
  • Lee, Sang-Weon (Department of Neurosurgery, School of Medicine Pusan National University) ;
  • Lee, Tae-Hong (Department of Radiology, School of Medicine Pusan National University) ;
  • Choi, Chang-Hwa (Department of Neurosurgery, School of Medicine Pusan National University)
  • 발행 : 2007.09.28
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초록

We describe a case of an unruptured basilar top aneurysm that was associated with early rupture after incomplete coiling. A 62-year-old woman with a history of several small infarctions has undergone coiling of unruptured basilar top aneurysm. Two weeks after initial coiling the patient presented with Hunt and Hess grade IV subarachnoid hemorrhage consistent with a ruptured basilar top aneurysm. Repeat angiography revealed a rupture of recanalized basilar top aneurysm. Second embolization with additional coils resulted in complete occlusion. However, her neurological status was not improved afterward and she was transferred to department of rehabilitation one month after hemorrhage with comatous state. To our knowledge, this is the first case of fatal early rupture after coiling of unruptured aneurysm. It has been speculated that coiling could cause injury to aneurysmal wall and facilitate rupture.

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참고문헌

  1. Bendszus M, Hagel C, Maurer M, Schutz A, Vince GH, Monoranu MC, et al : Fatal recurrent subarachnoid hemorrhage after complete endovascular aneurysm occlusion. Am J Neuroradiol 27 : 2058-2060, 2006
  2. Chang HS : Simulation of the natural history of cerebral aneurysms based on data from the International Study of Unruptured Intracranial Aneurysms. J Neurosurg 104 : 188-194, 2006 https://doi.org/10.3171/jns.2006.104.2.188
  3. Hodgson TJ, Carroll T, Jellinek DA : Subarachnoid hemorrhage due to late recurrence of a previously unruptured aneurysm after complete endovascular occlusion. Am J Neuroradiol 19 : 1939-1941, 1998
  4. Horowitz MB, Jungreis CA, Genevro J : Delayed rupture of a previously coiled unruptured anterior communicating artery aneurysm. Case report. Neurosurgery 51 : 804-806, 2002 https://doi.org/10.1097/00006123-200209000-00035
  5. Mericle RA, Wakhloo AK, Lopes DK, Lanzino G, Guterman LR, Hopkins LN : Delayed aneurysm regrowth and recanalization after Guglielmi detachable coil treatment. Case report. J Neurosurg 89 : 142-145, 1998 https://doi.org/10.3171/jns.1998.89.1.0142
  6. Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, et al : International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms : a randomised trial. Lancet 360 : 1267-1274, 2002 https://doi.org/10.1016/S0140-6736(02)11314-6
  7. Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, et al : International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms : a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366 : 809-817, 2005 https://doi.org/10.1016/S0140-6736(05)67214-5
  8. Sluzewski M, van Rooij WJ : Early rebleeding after coiling of ruptured cerebral aneurysms : incidence, morbidity, and risk factors. Am J Neuroradiol 26 : 1739-1743, 2005
  9. Sluzewski M, van Rooij WJ, Rinkel GJ, Wijnalda D : Endovascular treatment of ruptured intracranial aneurysms with detachable coils: long-term clinical and serial angiographic results. Radiology 227 : 720-724, 2003 https://doi.org/10.1148/radiol.2273020656
  10. Wiebers DO, Whisnant JP, Huston J 3rd, Meissner I, Brown RD Jr, Piepgras DG, et al : Unruptured intracranial aneurysms : natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 362 : 103-110, 2003 https://doi.org/10.1016/S0140-6736(03)13860-3