Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of posterior reversible encephalopathy syndrome associated with coil embolization of a basilar apex aneurysm

Hiroyuki Naito, M.D.1), Yu Yamazaki, M.D., Ph.D.1), Tetsuya Takahashi, M.D., Ph.D.1), Kazuhide Ochi, M.D., Ph.D.1), Yoshihiro Kiura, M.D., Ph.D.2) and Masayasu Matsumoto, M.D., Ph.D.1)

1)Department of Neurology, Hiroshima University Hospital
2)Department of Neurosurgery, Hiroshima University Hospital

About three weeks after successful coil embolization of a basilar apex aneurysm, a 66-year-old woman developed occipital headaches. T2 and FLAIR MRI brain images demonstrated multiple new hyperintense lesions in the posterior circulation territory including cerebellum, right superior cerebellar peduncle, left thalamus and bilateral temporooccipital lobes and she was subsequently hospitalized. Findings suggestive of other underlying disease were not observed, although an increased protein level was noted in cerebrospinal fluid (69 mg/dl). Headache and clinical findings improved approximately 12 weeks after coil embolization. MRI findings also showed improvement. These clinical and radiological findings made this patient a distinctive case of posterior reversible encephalopathy syndrome (PRES) associated with coil embolization suggesting that clinicians should be aware that PRES can present as comparatively mild symptoms several weeks after coil embolization.
Full Text of this Article in Japanese PDF (6919K)

(CLINICA NEUROL, 53: 518|525, 2013)
key words: cerebral angiography, headache, leukoencephalopathy, MRI, posterior reversible encephalopathy syndrome (PRES)

(Received: 20-Oct-12)