Acute vasogenic edema induced by thrombosis of a giant intracranial aneurysm: a cause of pseudostroke after therapeutic occlusion of the parent vessel.

A 16-year-old male adolescent presenting with acute retro-orbital pain underwent emergent internal carotid occlusion for a giant cavernous aneurysm. Three weeks later, the patient complained of headache and right hemiparesis, which suggested an acute stroke. CT and MR imaging revealed vasogenic brain edema without infarct. The symptoms rapidly resolved with steroid therapy. Follow-up CT showed resolution of the edema. The imaging characteristics, clinical implications, and etiology of vasogenic edema occurring after thrombosis of a giant intracranial aneurysm are discussed.

[1]  M. Nadjmi,et al.  Giant aneurysms in CT and angiography , 2004, Neuroradiology.

[2]  A. Weill,et al.  Delayed stroke secondary to increasing mass effect after endovascular treatment of a giant aneurysm by parent vessel occlusion. , 2001, AJNR. American journal of neuroradiology.

[3]  A. Norbash,et al.  Silent thromboembolic events associated with the treatment of unruptured cerebral aneurysms by use of Guglielmi detachable coils: prospective study applying diffusion-weighted imaging. , 2001, AJNR. American journal of neuroradiology.

[4]  K. Houkin,et al.  Aggravation of brainstem symptoms caused by a large superior cerebellar artery aneurysm after embolization by Guglielmi detachable coils--case report. , 1999, Neurologia medico-chirurgica.

[5]  D. Shrier,et al.  Cerebral giant aneurysm with extensive vasogenic edema. , 1998, Radiation medicine.

[6]  A. Tanaka,et al.  Extensive edema in the thalamus caused by thrombosed basilar artery aneurysm. , 1998, Neurologia medico-chirurgica.

[7]  R. Sevick,et al.  Spontaneous thrombosis of an unruptured anterior communicating artery aneurysm. An unusual cause of ischemic stroke. , 1995, Stroke.

[8]  C. Strother,et al.  Thrombus formation and structure and the evolution of mass effect in intracranial aneurysms treated by balloon embolization: emphasis on MR findings. , 1989, AJNR. American journal of neuroradiology.

[9]  R. Heros,et al.  Giant intracranial aneurysms presenting with massive cerebral edema. , 1984, Neurosurgery.

[10]  Geraldo Pianetti Filho,et al.  Giant aneurysm of the middle cerebral artery: a case report , 1978 .

[11]  K. Shulman,et al.  GIANT ANEURYSM OF MIDDLE CEREBRAL ARTERY: A CASE REPORT. , 1965, Journal of neurosurgery.