Two cases of rapidly enlarged blood blister-like aneurysm of internal carotid artery successfully treated by coil embolization alone: case report

• Published in: Journal of Neuroendovascular Therapy Vol. 5; no. 1; pp. 50 - 56
• Main Authors: HIROTA, Nobuo, TOKUUE, Kazuki, KATOH, Akihito, HOKAKU, Hiromu, SAKURAI, Takashi, MIYO, Takayasu, TSUYUMU, Matsutaira
• Format: Journal Article
• Language: English
• Published: The Japanese Society for Neuroendovascular Therapy 2011
• Subjects: aneurysmal enlargement; blood blisterlike aneurysm; coil embolization
• ISSN: 1882-4072; 2186-2494
• DOI: 10.5797/jnet.5.50

Objective: To report two cases of rapidly enlarged bloodblister like aneurysm (BBA) of internal carotid artery, which were successfully treated by aneurysmal coiling. Case presentation: Case 1: A 44 year old woman suffering from subarachnoid hemorrhage (SAH) was referred to our hospital. 3DCT angiography revealed BBA, though surgical treatment could not be done immediately because of the administration of antiTNFα monoclonal antibody for rheumatoid arthritis. The aneurysm had been enlarged for a few days after the onset, therefore aneurysmal coiling was done. The clinical course was good with mRS 0 and rerupture or regrowth of the aneurysm not observed 2 years after the treatment. Case 2: A 39 year old man suffering from SAH was admitted. Digital subtraction angiography demonstrated BBA which had been enlarged for a few days after the onset. It was treated by aneurysmal coiling after the enlargement. The patient was discharged from the hospital without any neurological deficit. Recanalization of the aneurysmal neck had been seen after the treatment, however regrowth or dome filling was not observed on MR angiography performed 1 year after the onset. Conclusion: Coil embolization can be one of the treatment options for saccularshaped BBA in the acute stage; however, strict observation is needed against recanalization and regrowth of the aneurysm.