Immediate CT findings following embolization of cerebral aneurysms: suggestion of blood–brain barrier or vascular permeability change

• Published in: Neuroradiology Vol. 50; no. 3; pp. 259 - 266
• Main Authors: Baik, Seung Kug, Kim, Yong Sun, Lee, Hui Jung, Park, Jaechan, Kim, Gab Chul
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.03.2008; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Aneurysms; Biological and medical sciences; Blood-Brain Barrier; Brain; Capillary Permeability; Cardiovascular system; Chi-Square Distribution; Diagnosis, Differential; Embolization, Therapeutic; Female; Humans; Imaging; Interventional Neuroradiology; Intracranial Aneurysm - complications; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - therapy; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Nervous system; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiology; Subarachnoid Hemorrhage - diagnostic imaging; Subarachnoid Hemorrhage - etiology; Subarachnoid Hemorrhage - therapy; Tomography; Tomography, X-Ray Computed; Treatment Outcome; Coil embolization; Computed tomography; Aneurysm; Contrast reaction; Blood–brain barrier; Nervous system diseases; Radiodiagnosis; Central nervous system; Cardiovascular disease; Permeability; Blood brain barrier; Coil; Encephalon; Vascular disease; Aneurysm; Coil embolization; Contrast reaction; Embolization; Computerized axial tomography; Blood-brain barrier; Computed tomography
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-007-0332-z

Introduction Although endovascular techniques are widely used for the treatment of cerebral aneurysms, the immediate postprocedural brain CT findings have not been reported. Therefore, in the present study we assessed the immediate postprocedural brain CT findings following the uneventful coil embolization of cerebral aneurysms. Methods Included in the study were 59 patients with 61 cerebral aneurysms after uncomplicated coil embolization. Acute subarachnoid hemorrhage was present with 32 of the 61 aneurysms. All patients underwent a brain CT scan just before and within 2 h after the endovascular treatment. If the postprocedural CT scan revealed any new findings, a follow-up CT scan and/or MRI were performed within 24 h. The variables related to the abnormal CT findings were also evaluated. Results Among the 61 immediate brain CT scans, 26 (43%) showed abnormal findings, including cortical contrast enhancement ( n =21, 34%), subarachnoid contrast enhancement ( n =8, 13%), intraventricular contrast enhancement ( n =5, 8%), and striatal contrast enhancement ( n =2, 3%). Single or mixed CT findings were also seen. None of the 61 aneurysms was associated with new neurological symptoms after endovascular treatment, and all patients made an uneventful recovery. Abnormal findings were more likely to be found with lower body weight and with increased corrected amounts of contrast material and heparin ( P <0.05). Conclusion After uneventful endovascular treatment of cerebral aneurysms, the immediate brain CT findings can reveal various patterns of abnormal contrast enhancement. Recognizing the immediate brain CT findings is important, as they can mimic various diseases.