Delayed Multiple Non-Ischemic Cerebral Enhanced Lesions After Endovascular Therapy For Left Internal Carotid Aneurysm: A Case Report

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Author(s): Yanli Cai, Lin Huang, Jianqiang Hao, Fei Xie*, Tianjin Ling, Seidu A. Richard

Journal Name: Current Medical Imaging
Formerly: Current Medical Imaging Reviews

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Introduction: Endovascular therapy (EVT) for intracranial arterial aneurysms is depicted with several complications. Very recently, delayed non-ischemic cerebral enhanced (NICE) lesions has 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 gold and silver since childhood. MRI revealed multiple abnormal lesions in the left temporal lobe, hippocampus, insula, 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 especial those used in coating endovascular equipment should be evaluated before every EVT for intracranial aneurysms.

Keywords: Allergy, Aneurysm, Endovascular, MRI, NICE lesions, Therapy.

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(E-pub Ahead of Print)
DOI: 10.2174/1573405617666210122085247
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