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Journal of Korean Neurosurgical Society 2007;42(3): 235-237.
Early Rupture after Coiling of Unruptured Aneurysm.
Jun Kyeung Ko, Sang Weon Lee, Tae Hong Lee, Chang Hwa Choi
1Department of Neurosurgery, School of Medicine, Pusan National University, Busan, Korea. sangweonlee@pusan.ac.kr
2Department of Radiology, School of Medicine, Pusan National University, Busan, Korea.
ABSTRACT
We describe a case of an unruptured basilar top aneurysm that was associated with early rupture after incomplete coiling. A 62-year-old woman with a history of several small infarctions has undergone coiling of unruptured basilar top aneurysm. Two weeks after initial coiling the patient presented with Hunt and Hess grade IV subarachnoid hemorrhage consistent with a ruptured basilar top aneurysm. Repeat angiography revealed a rupture of recanalized basilar top aneurysm. Second embolization with additional coils resulted in complete occlusion. However, her neurological status was not improved afterward and she was transferred to department of rehabilitation one month after hemorrhage with comatous state. To our knowledge, this is the first case of fatal early rupture after coiling of unruptured aneurysm. It has been speculated that coiling could cause injury to aneurysmal wall and facilitate rupture.
Key Words: Cerebral aneurysm; Coiling; Early rupture
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