Abstract
The rupture of a small aneurysm of the left middle cerebral artery (MCA) caused a typical headache attack, which was neglected by the patient. During the following week severe vasospasm resulted in a right hemiparesis and expressive aphasia. The clinical status of the patient at presentation was Hunt and Hess III with a Fisher grade of III. DSA 8 days after the subarachnoid hemorrhage (SAH) showed an aneurysm of the left MCA trifurcation with a fundus diameter of 6.5 mm and a neck width of 3.5 mm. There was severe vasospasm of the left anterior cerebral artery (ACA) and MCA. The aneurysm was occluded with detachable coils, using the dual microcatheter technique in order to prevent the displacement of the first coil by subsequent coils. Persistent symptomatic vasospasm required short-term IA infusion of milrinone (Corotrop, Sanofi Winthrop) and long-term (i.e., 3 days) IA infusion of nimodipine (Nimotop S, Bayer Vital). The delayed ischemic deficit of the patient resolved almost entirely. Long-term DSA follow-up examinations confirmed the complete occlusion of the aneurysm. The dual microcatheter technique is the main topic of this report.
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Aguilar Pérez, M., AlMatter, M., Henkes, H. (2018). Middle Cerebral Artery Bifurcation Aneurysm: Acute SAH, Ruptured MCA Trifurcation Aneurysm, Coil Occlusion Using Dual Microcatheter Technique. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-70267-4_5-2
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DOI: https://doi.org/10.1007/978-3-319-70267-4_5-2
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Middle Cerebral Artery Bifurcation Aneurysm: Acute SAH, Ruptured MCA Trifurcation Aneurysm, Coil Occlusion Using Dual Microcatheter Technique- Published:
- 06 August 2018
DOI: https://doi.org/10.1007/978-3-319-70267-4_5-2
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Middle Cerebral Artery Bifurcation Aneurysm: Acute SAH, Ruptured MCA Trifurcation Aneurysm, Coil Occlusion Using Dual Microcatheter Technique- Published:
- 26 December 2017
DOI: https://doi.org/10.1007/978-3-319-70267-4_5-1