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Headache and MRI Changes after Endovascular Treatment of a Cerebral Aneurysm
Liv Jorunn Høllesli1,2, Martin W Kurz3,4,5, Gry Inger N Behzadi1,2
1Department of Radiology, Stavanger University Hospital, 4068 Stavanger, Norway.
Background:
The main complications after endovascular therapy of intracranial aneurysms are aneurysm rupture and thromboembolic events. Yet, the widespread use of magnetic resonance imaging (MRI) in follow-up of these patients also demonstrates other, rarely known complications such as aseptic meningitis and foreign body reaction.
Case Presentation:
A small aneurysm in the right posterior communicating artery was treated with endovascular therapy in a 65 year old woman. Two weeks after successful interventional treatment, the patient developed a headache. On MRI performed five months after intervention, vasogenic edema was seen in the vascular territory of the right internal carotid artery. The edema and the symptoms diminished without specific treatment within a year.
Interpretation:
The clinical and radiological presentation of this case are suggestive of a foreign body reaction, a treatable condition that radiologists and clinicians should be aware of.
Insights
Foreign body reactions can occur after endovascular therapy for intracranial aneurysms. This rare complication, presenting as vasogenic edema, is treatable and should be recognized by clinicians.
Area of Science:
- Neurology
- Radiology
- Interventional Cardiology
Background:
- Endovascular therapy for intracranial aneurysms carries risks like rupture and thromboembolism.
- Magnetic resonance imaging (MRI) surveillance reveals less common complications, including aseptic meningitis and foreign body reactions.
Observation:
- A 65-year-old woman developed a headache two weeks post-endovascular treatment for a posterior communicating artery aneurysm.
- Follow-up MRI five months later showed vasogenic edema in the right internal carotid artery territory.
Findings:
- The patient's symptoms and vasogenic edema resolved spontaneously within a year.
- The clinical and radiological findings suggest a foreign body reaction to the endovascular treatment.
Implications:
- Foreign body reactions are a treatable complication of endovascular aneurysm therapy.
- Radiologists and clinicians should consider foreign body reactions in the differential diagnosis for delayed neurological symptoms post-intervention.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...