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BMC Neurology
Published in: BMC Neurology 1/2015

Open Access 01-12-2015 | Case report

A patient develops transient unique cerebral and cerebellar lesions after unruptured aneurysm coiling

Authors: Kentaro Deguchi, Yuko Kawahara, Shoko Deguchi, Nobutoshi Morimoto, Tomoko Kurata, Yoshio Ikeda, Tomotsugu Ichikawa, Koji Tokunaga, Nobuyuki Kawai, Kenji Sugiu, Koji Abe

Published in: BMC Neurology | Issue 1/2015

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Abstract

Background

We describe a case of a very unusual complication following a coiling procedure in which the patient developed transient unique cerebral and cerebellar lesions. Lesions were examined not only by magnetic resonance imaging (MRI) but also by positron emission tomography-computed tomography (PET-CT) and proton magnetic resonance spectroscopy (1H-MRS).

Case presentation

A 33-year-old woman presented an incidental 3.7 × 3.3-mm unruptured cerebral aneurysm (CAn) in her basilar artery, which was successfully coiled with balloon assistance. A follow-up brain MRI at 1 and 2 months showed a gradual increase in several white matter hyperintense lesions in the left cerebellar, bilateral occipitotemporal and left parietoccipital lobe during fluid-attenuated inversion recovery (FLAIR). These were the only lesions associated with perfused CAn. However, the patient did not show any additional symptoms such as visual disturbance throughout the entire course. 11C-methionine-PET (MET-PET) showed an obvious increase in methionine uptake in the lesion corresponding to enhanced areas with gadolinium-enhanced MRI. MRS showed a decrease in the N-acetylaspartate/creatine (NAA/cr) ratio and a slight elevation of the choline/creatine (cho/cr) ratio and a lactate peak in the lesion. A follow-up MRI at 6 and 12 months showed a gradual decrease in the initial hyperintense lesions in FLAIR without any treatment.

Conclusion

We present a case of an unusual complication after a coiling procedure. Although it is difficult to identify this etiology without a pathological examination, it is importance to increase awareness of such a potential complication arising from coiling procedures, because interventional procedures have become the first choice of treatment for cerebrovascular diseases in many countries.
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Metadata
Title
A patient develops transient unique cerebral and cerebellar lesions after unruptured aneurysm coiling
Authors
Kentaro Deguchi
Yuko Kawahara
Shoko Deguchi
Nobutoshi Morimoto
Tomoko Kurata
Yoshio Ikeda
Tomotsugu Ichikawa
Koji Tokunaga
Nobuyuki Kawai
Kenji Sugiu
Koji Abe
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2015
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-015-0303-7

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