Document Detail


Development of a pontine cyst after endovascular coil occlusion of a basilar artery trunk aneurysm: case report.
MedLine Citation:
PMID:  12590696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE AND IMPORTANCE: Cyst formation within the brain parenchyma after endovascular coil occlusion of an intracranial aneurysm is a previously undescribed occurrence. We describe a 70-year-old woman who presented with a symptomatic pontine cyst 1 year after uncomplicated stenting and Guglielmi detachable coil occlusion of an unruptured basilar artery trunk aneurysm. CLINICAL PRESENTATION: A 70-year-old woman presented with an episode of transient dysequilibrium and gait difficulty. Magnetic resonance imaging and cerebral angiography demonstrated a 15-mm distal basilar artery trunk aneurysm. Endovascular stenting and coil occlusion of the aneurysm were performed without technical complications. One year after the initial treatment, the patient developed progressive dysarthria, dysphagia, diplopia, and left hemiparesis. A large pontomesencephalic cyst adjacent to the coiled basilar aneurysm was identified on magnetic resonance imaging scans. INTERVENTION: A subtemporal craniotomy and decompression of the pontomesencephalic cyst were performed. The patient's symptoms of brainstem dysfunction improved temporarily but recurred within 2 months, necessitating reoperation for cyst drainage and placement of a cyst-peritoneal shunt. CONCLUSION: Intra-axial cyst formation after stenting and endovascular occlusion of an intracranial aneurysm is an unusual occurrence and should be considered in the differential diagnosis of new neurological deficits after endovascular treatment. The pathophysiological mechanism of cyst formation in this case is not known.
Authors:
Jonathan A Friedman; Jon I McIver; Frederic P Collignon; Douglas A Nichols; David G Piepgras
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  52     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-02-19     Completed Date:  2003-04-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  694-9; discussion 698-9     Citation Subset:  IM    
Affiliation:
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA. friedman.jonathan@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Balloon Occlusion / adverse effects*
Blood Vessel Prosthesis Implantation / adverse effects*
Brain Diseases / etiology*,  pathology,  radiography*
Brain Stem / pathology*,  radiography*
Cerebral Angiography
Cysts / etiology*,  pathology,  radiography*
Female
Humans
Intracranial Aneurysm / pathology,  radiography*,  therapy*
Magnetic Resonance Imaging

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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