Endovascular coil transfixing a cranial nerve five years after embolisation

Area of Science:

• Neurosurgery
• Endovascular Therapy
• Neurology

Background:

• Endovascular coiling is a common treatment for intracranial aneurysms.
• Potential complications include coil migration, mass effect, and parent artery compromise.

Observation:

• A 59-year-old man developed diplopia and ptosis five years after endovascular coiling of a right internal carotid artery aneurysm.
• Follow-up angiography revealed aneurysm recanalization and a coil mass effect.
• Surgical exploration identified a coil penetrating the oculomotor nerve.

Findings:

• This is the first reported case of an endovascular coil transfixing a cranial nerve.
• Coil impaction and mass effect can lead to delayed neurological deficits.
• Aneurysm recanalization occurred despite initial successful coiling.

Implications:

• Cranial nerve injury is a potential, albeit rare, complication of endovascular coiling.
• Long-term surveillance is crucial for patients treated with endovascular coiling.
• Surgical intervention may be necessary for managing complex coil-related complications.