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Updated: Jul 31, 2026
18:50
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Cell-mediated allergy to a cerebral aneurysm clip: case report
I B Ross1, R J Warrington, W C Halliday
1Section of Neurosurgery, University of Manitoba and Health Sciences Center, Winnipeg, Canada.
Neurosurgery
|November 5, 1998
Summary
A patient developed severe itching after receiving a cobalt alloy aneurysm clip. Allergy testing confirmed hypersensitivity to nickel and cobalt, and symptom resolution followed clip removal, highlighting implant material risks.
Area of Science:
- Neurosurgery
- Allergy and Immunology
- Materials Science
Background:
- Titanium aneurysm clips are increasingly used due to better imaging than stainless steel.
- Stainless steel aneurysm clips contain cobalt and nickel alloys.
- A 36-year-old woman experienced severe pruritus post-craniotomy for a cerebral aneurysm.
Observation:
- The patient's pruritus was intense and persistent postoperatively.
- Skin patch testing indicated a severe allergic reaction to nickel and cobalt.
- Histological analysis revealed a Type IV delayed hypersensitivity reaction.
Findings:
- Surgical removal of the stainless steel aneurysm clip and wires led to complete symptom resolution.
- The case demonstrates a cell-mediated immunological reaction to a cobalt alloy aneurysm clip.
- Stainless steel implants can trigger hypersensitivity reactions in susceptible individuals.
Implications:
- Clinicians should consider metal hypersensitivity in patients with unexplained pruritus after neurosurgery.
- The choice of aneurysm clip material may be critical in preventing adverse immune responses.
- Further research is needed to understand the prevalence and mechanisms of hypersensitivity to neurosurgical implants.
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