A Case of Severe Delayed Vasospasm after Clipping Surgery for an Unruptured Intracranial Aneurysm.

Autor: Kim JG; Jeju National University School of Medicine, Jeju, Korea.; Department of Neurology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea., Kang CH; Jeju National University School of Medicine, Jeju, Korea.; Department of Neurology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea., Sheen JJ; Department of Neurosurgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea., Song Y; Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Rhim JK; Department of Neurosurgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
Jazyk: angličtina
Zdroj: Neurointervention [Neurointervention] 2024 Jul; Vol. 19 (2), pp. 123-128. Date of Electronic Publication: 2024 Jun 14.
DOI: 10.5469/neuroint.2024.00150
Abstrakt: Delayed ischemic stroke associated with intractable vasospasm after clipping of unruptured intracranial aneurysms (UIAs) has been rarely reported. We report a patient with delayed ischemic stroke associated with intractable vasospasm following UIA clipping. A middle-aged female underwent surgery for unruptured middle cerebral artery bifurcation aneurysms. The patient tolerated the neurosurgical procedure well. Seven days postoperatively, the headache was unbearable; a postcraniotomy headache persisted and abruptly presented with global aphasia and right-sided hemiplegia after a nap. Emergency digital subtraction angiography showed severe luminal narrowing with segmental vasoconstriction, consistent with severe vasospasm. The patient's neurological deficit improved after chemical angioplasty. Neurosurgeons should pay close attention to this treatable/preventive entity after neurological deterioration following UIA clipping, even in patients without subarachnoid hemorrhage.
Databáze: MEDLINE
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