Unusual cisternal coil migration in the follow-up period after aneurysm perforation during endovascular coiling

Toshinari Meguro, Tatsuya Sasaki, Jun Haruma, Tomoyuki Tanabe, Kenichiro Muraoka, Kinya Terada, Nobuyuki Hirotsune, Shigeki Nishino

Research output: Contribution to journalArticle

Abstract

A 61-year-old woman suffered cisternal coil migration in the follow-up period after endovascular coil embolization for a ruptured cerebral aneurysm. She presented with sudden onset of headache. Computed tomography demonstrated diffuse subarachnoid hemorrhage, and cerebral angiography disclosed a left anterior choroidal artery aneurysm. The aneurysm was treated by endovascular embolization with Guglielmi detachable coils. During the embolization procedure, the microcatheter perforated the aneurysm. For direct closure of the perforation site with coils, the microcatheter was withdrawn and coils were deployed partially in the subarachnoid space and partially in the aneurysm sac. The coil mass was spread in the subarachnoid space around the aneurysm immediately after embolization. The patient was discharged with no neurological deficit. Three months later, follow-up radiography demonstrated obvious reduction in the size and compaction of the coil mass. Magnetic resonance angiography and digital subtraction angiography demonstrated stable occlusion of the aneurysm. The coil mass probably spread in the cistern around the aneurysm and was compacted by the shape memory of the coils and pulsation of the brain and vessels, as the subarachnoid clots around the aneurysm had disappeared. This case suggests that cisternal coil migration should be considered in the follow up of intracranial aneurysm treated with detachable coils.

Original languageEnglish
Pages (from-to)365-367
Number of pages3
JournalNeurologia medico-chirurgica
Volume51
Issue number5
DOIs
Publication statusPublished - Jun 8 2011
Externally publishedYes

Keywords

  • Cisternal coil migration
  • Coil embolization
  • Detachable coil
  • Perforation
  • Ruptured aneurysm

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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