Title:Delayed Multiple Non-ischemic Cerebral Enhanced Lesions After Endovascular Therapy For Left Internal Carotid Aneurysm: A Case Report
Volume: 17
Author(s): Yanli Cai, Lin Huang, Jianqiang Hao, Fei Xie*, Tianjin Ling and Seidu A. Richard
Affiliation:
- Department of Neurosurgery, The First People’s Hospital of Ziyang, No. 66, Rende West Road, Ziyang, 641300, Sichuan,China
Keywords:
Allergy, aneurysm, endovascular, MRI, NICE lesions, therapy.
Abstract:
Introduction: Endovascular therapy (EVT) for intracranial arterial aneurysms is depicted
with several complications. Very recently, delayed non-ischemic cerebral enhanced (NICE) lesions
have been identified as a rare complication associated with EVT. This complication always
stands a higher chance of being missed in asymptomatic patients. We report a case of multiple
NICE lesions in a known chronic hepatitis B infection and chronic gastritis patient with left internal
carotid aneurysm (ICA) treated with detachable coils.
Case Presentation: A 52 years old female with left ICA was treated with detachable coils via the
endovascular route. Three weeks after the operation, she presented with numbness of her right
limbs which was persistent and waked her up from sleep each night. She admitted skin allergies after
wearing metals except for gold and silver since childhood. MRI revealed multiple abnormal lesions
in the left temporal lobe, hippocampus, insula, and parietal lobe and some perifocal edema
which were consistent with the diagnosis of delayed NICE lesions.
Conclusion: It is very important to report the occurrences of these lesions in literature because of
their allergic origin. We advocate that allergy to metals especially those used in coating endovascular
equipment should be evaluated before every EVT for intracranial aneurysms.
