Patient no | Aneurysm location | Neurologic finding | Date of neurologic change | Complication | Intervention taken | Intraprocedural issues |
---|---|---|---|---|---|---|
1 | Superior hypophyseal | Worsening ipsilateral visual acuity | POD 1 | None; transient symptoms | Decadron | Large aneurysm, recoiling |
2 | Ophthalmic | Pronator drift noted after cessation of heparin/dextran drips | POD 1 | TIA; no permanent deficit | Resumption of heparin/dextran drips×24 hours | None |
3 | Vertebral V4 segment (sidewall) | Left cranial nerve VI and VII palsy noted after procedure | POD 0 | Brainstem stroke | None | None |
4 | Basilar apex | Hemianopsia noted after 36 hours post-op | POD 2 | Cortical stroke | Resumption of heparin/dextran drips×24 hours | None |
5 | Basilar apex | Decreased hemibody sensation | POD 2 | Small thalamic stroke | None | Aneurysm >2 cm, 3rd trimester pregnancy |
6 | Ophthalmic | Left hemiplegia, neglect | POD 0 | Cortical stroke | Angiography, thrombolysis | Aneurysm >2 cm |
7 | Posterior communicating artery | Quadrantanopia | POD 0 | TIA; no permanent deficit | None; continuation of heparin/dextran drips | Herniation of coil loops into parent vessel necessitating stent placement |
8 | Ophthalmic | Aphasia noted after cessation of heparin/dextran drips | POD 1 | TIA; no permanent deficit | Heparin bolus, resumption of heparin/dextran drips | None |
9 | Basilar apex | Hyperemesis | POD 0 | None | None | Intraoperative rupture |
10 | Ophthalmic | Hemiparesis, neglect | POD 0 | Cortical stroke | Supportive stroke care | Intraoperative vessel perforation |
11 | Basilar apex | Coma, moribund state | POD 0 | Devastating hemorrhage | Withdrawal of care | Intraoperative rupture |
POD, postoperative day; TIA, transient ischemic attack.