Intradural Aneurysm Caused by Arterial Injury during Surgery: Treatment with Coil Embolization

Area of Science:

• Neurosurgery
• Interventional Neuroradiology
• Vascular Neurology

Background:

• Subarachnoid hemorrhage can result from ruptured intracranial aneurysms.
• Iatrogenic arterial injury during surgery can lead to posttraumatic aneurysms.
• Cerebral vasospasm is a common and severe complication of subarachnoid hemorrhage.

Purpose of the Study:

• To describe a case of subarachnoid hemorrhage from an iatrogenic intradural aneurysm.
• To detail a successful endovascular treatment strategy for this condition.
• To evaluate the efficacy of a combined endovascular approach for aneurysm occlusion and vasospasm management.

Main Methods:

• A patient with subarachnoid hemorrhage and vasospasm secondary to an iatrogenic aneurysm was treated.
• The treatment involved endovascular occlusion of the aneurysm using Guglielmi Detachable Coils (GDC) with parent artery preservation.
• Intra-arterial papaverine infusion was administered to address severe symptomatic vasospasm concurrently.

Main Results:

• The endovascular procedure successfully occluded the iatrogenic aneurysm.
• Significant angiographic resolution of cerebral vasospasm was achieved.
• The patient experienced an excellent clinical outcome following the one-stage procedure.

Conclusions:

• Endovascular treatment is a viable option for managing posttraumatic intracranial aneurysms.
• Combined GDC embolization and intra-arterial papaverine infusion can effectively treat complex cases.
• This one-stage approach offers a promising solution for iatrogenic aneurysms with associated vasospasm.