Abstract
Background The main complications after endovascular therapy of intracranial aneurysms are aneurysm rupture and thromboembolic events. Yet, the widespread use of magnetic resonance imaging (MRI) in follow-up of these patients also demonstrates other, rarely known complications such as aseptic meningitis and foreign body reaction. Case Presentation A small aneurysm in the right posterior communicating artery was treated with endovascular therapy in a 65 year old woman. Two weeks after successful interventional treatment, the patient developed a headache. On MRI performed five months after intervention, vasogenic edema was seen in the vascular territory of the right internal carotid artery. The edema and the symptoms diminished without specific treatment within a year. Interpretation The clinical and radiological presentation of this case are suggestive of a foreign body reaction, a treatable condition that radiologists and clinicians should be aware of.
Highlights
Endovascular therapy (EVT) of aneurysms is a common treatment for cerebral aneurysms [1]. e complication rate of this procedure is relatively low, with the main complications being procedural aneurysmal perforations and thromboembolic events [2]
A rarely reported complication a er EVT is delayed nonischemic cerebral enhancing (NICE) lesions [3]. ese lesions have partly been attributed to foreign body emboli and subsequent granulomatous reaction [4]. ere are some reports of foreign body reaction subsequent to EVT, yet only a few of them include imaging characteristics of these lesions and their development over time, especially in untreated cases showing the natural course
In this case we describe a probable foreign body reaction and its development over time, untreated as it was not recognized timely
Summary
Endovascular therapy (EVT) of aneurysms is a common treatment for cerebral aneurysms [1]. e complication rate of this procedure is relatively low, with the main complications being procedural aneurysmal perforations and thromboembolic events [2]. Ere are some reports of foreign body reaction subsequent to EVT, yet only a few of them include imaging characteristics of these lesions and their development over time, especially in untreated cases showing the natural course. A rarely reported complication a er EVT is delayed nonischemic cerebral enhancing (NICE) lesions [3]. In this case we describe a probable foreign body reaction and its development over time, untreated as it was not recognized timely. On admission an unenhanced Computer tomography (CT) of the head was performed. ere were no signs of
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