Immediate CT findings following embolization of cerebral aneurysms: suggestion of blood–brain barrier or vascular permeability change

Abstract

Although endovascular techniques are widely used for the treatment of cerebral aneurysms, the immediate postprocedural brain CT findings have not been reported. Therefore, in the present study we assessed the immediate postprocedural brain CT findings following the uneventful coil embolization of cerebral aneurysms. Included in the study were 59 patients with 61 cerebral aneurysms after uncomplicated coil embolization. Acute subarachnoid hemorrhage was present with 32 of the 61 aneurysms. All patients underwent a brain CT scan just before and within 2 h after the endovascular treatment. If the postprocedural CT scan revealed any new findings, a follow-up CT scan and/or MRI were performed within 24 h. The variables related to the abnormal CT findings were also evaluated. Among the 61 immediate brain CT scans, 26 (43%) showed abnormal findings, including cortical contrast enhancement (n=21, 34%), subarachnoid contrast enhancement (n=8, 13%), intraventricular contrast enhancement (n=5, 8%), and striatal contrast enhancement (n=2, 3%). Single or mixed CT findings were also seen. None of the 61 aneurysms was associated with new neurological symptoms after endovascular treatment, and all patients made an uneventful recovery. Abnormal findings were more likely to be found with lower body weight and with increased corrected amounts of contrast material and heparin (P<0.05). After uneventful endovascular treatment of cerebral aneurysms, the immediate brain CT findings can reveal various patterns of abnormal contrast enhancement. Recognizing the immediate brain CT findings is important, as they can mimic various diseases.