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CASE REPORT
Nickel-associated delayed multiple white matter lesions after stent-assisted coil embolization of intracranial unruptured aneurysm
  1. Hun Soo Park1,
  2. Ichiro Nakagawa1,
  3. Shohei Yokoyama1,
  4. Daisuke Wajima1,
  5. Takeshi Wada2,
  6. Yasushi Motoyama1,
  7. Kimihiko Kichikawa2,
  8. Hiroyuki Nakase1
  1. 1Department of Neurosurgery, Nara Medical University, Kashihara, Nara, Japan
  2. 2Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
  1. Correspondence to Dr Ichiro Nakagawa, Department of Neurosurgery, Nara Medical University, Kashihara, Nara 6348522, Japan; nakagawa{at}naramed-u.ac.jp

Abstract

Metal-induced encephalopathy after stent-assisted coil embolization is extremely rare. The present report describes two patients who presented with symptomatic intracranial parenchymal edematous lesions after stent-assisted coil embolization. A 64-year-old woman underwent stent-assisted coil embolization for a left internal carotid artery aneurysm; 21 days after the procedure she presented with right hand weakness and MRI revealed multifocal white matter lesions. Another woman aged 52 years underwent stent-assisted coil embolization for right vertebral artery aneurysm; 18 days after the procedure she presented with left-sided sensory disturbance and MRI demonstrated multiple white matter lesions. Treatment in both cases resulted in improvement of these lesions after steroid pulse therapy, and the patients had no associated morbidity 4 months after the procedures. Clinicians should monitor for neurologic symptoms and postoperative delayed radiologic parenchymal edematous changes associated with the metal allergic reaction after nitinol stent-assisted coil embolization.

  • Aneurysm
  • Inflammatory Response
  • Stent

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Footnotes

  • Republished with permission from BMJ Case Reports Published 20 February 2017; doi:10.1136/bcr-2017-013005

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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