Mechanisms of Perianeurysmal Edema following Endovascular Embolization of Aneurysms

Abstract

After coil embolization for an aneurysm, edema surrounding the aneurysm revealed by magnetic resonance imaging (MRI) is rarely seen and is usually associated with neurological symptoms. Perianeurysmal edema was found by postoperative MRI in three out of 182 patients with cerebral aneurysm, which was treated with Guglielmi Detachable Coil (GDC), and neurological symptoms developed simultaneously.

In cases where neurological symptoms improved with conservative medical treatment, a temporary increase in the volume of an aneurysm, due to coil and thrombus formation, may result in edema. In cases where symptoms were not alleviated with conservative medical treatment, persistent water-hammer effect against the residual lumen of the aneurysm as well as an increase in the volume of aneurysm by hemorrhage in the aneurysmal wall may contribute to the development of perianeurysmal edema. Consideration of the mechanism of edema development by neurological symptoms, MRI findings, and angiographic findings is needed in order to select appropriate treatment.

Keywords

cerebral aneurysm endovascular embolization perianeurysmal edema

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References

Russell

Nelson

Jafar

: Neurological deterioration after coil embolization of a giant basilar apex aneurysm with resolution following parent artery clip ligation. J Neurosurg 97: 705–708, 2002.

Iihara

Murao

: Continued growth of and increased symptoms from a thrombosed giant aneurysm of the vertebral artery after complete endovascular occlusion and trapping: The role of vasa vasorum. J neurosurg 98: 407–413, 2003.

Heros

Kolluri

: Giant intracranial aneurysms presenting with massive cerebral edema. Neurosurgery 15: 572–577, 1984.

Hammoud

Gailloud

: Acute vasogenic edema induced by thrombosis of a giant intracranial aneurysm: A cause of pseudostroke after therapeutic occlusion of the parent vessel. Am J Neuroradiol 24: 1237–1239, 2003.

Halbach

Higashida

: The efficacy of endosaccular aneurysm occlusion in alleviating neurological deficits produced by mass effect. J Neurosurg 80: 659–666, 1994.

Mericle

Wakhloo

: Delayed aneurysm regrowth and recanalization after Guglielmi detachable coil treatment. J Neurosurg 89: 142–145, 1998.

Choi

David

: Giant intracranial aneurysms: Development, clinical presentation and treatment. European Journal of Radiology 46: 178–194, 2003.

Yamada

Shrier

: Cerebral giant aneurysm with extensive vasogenic edema. Radiation medicine 16: 305–307, 1998.