Brainstem infarction after delayed thrombosis of a stented vertebral artery fusiform aneurysm: Case report

Elad I. Levy, Alan S. Boulos, Bernard Bendok, Stanley H. Kim, Adnan I. Qureshi, Lee R. Guterman, L. Nelson Hopkins, Sean D. Lavine, Randall T. Higashida, Robert H. Rosenwasser

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

OBJECTIVE AND IMPORTANCE: Recent technological advances have provided clinicians with stents that can be navigated throughout the tortuous proximal vessels of the posterior intracranial circulation. There have been few reports of fusiform and wide-necked aneurysms treated with stents. Of the known risks involved in stent placement in the intracranial circulation, delayed stent thrombosis has not been well described. CLINICAL PRESENTATION: A 34-year-old man who experienced the sudden onset of a severe headache with increasing lethargy was found on computed tomographic imaging to have a subarachnoid hemorrhage. Angiography revealed a left vertebral artery fusiform aneurysm that incorporated the posteroinferior cerebellar artery origin. INTERVENTION: A low-porosity Magic Wallstent (Boston Scientific, Natick, MA) wasplaced in the left vertebral artery across the aneurysm and the origin of the posteroinferior cerebellar artery. Angiography performed 9 days later revealed significant reduction in filling of the aneurysm. The patient returned 3 months after stent placement with severe neurological deterioration from a brainstem infarction caused by complete thrombotic occlusion of the left vertebral artery at the stented segment of the vessel. CONCLUSION: Stenting of fusiform aneurysms has provided an alternative to surgical clipping or parent vessel reconstruction. With the increasing frequency of intracranial stent placement for various cerebrovascular disease entities, we must become aware of potential complications associated with these procedures. Such awareness may influence decision-making processes regarding treatment and follow-up care.

Original languageEnglish (US)
Pages (from-to)1280-1285
Number of pages6
JournalNeurosurgery
Volume51
Issue number5
DOIs
StatePublished - Nov 1 2002
Externally publishedYes

Fingerprint

Brain Stem Infarctions
Vertebral Artery
Stents
Aneurysm
Thrombosis
Angiography
Arteries
Cerebrovascular Disorders
Aftercare
Lethargy
Magic
Porosity
Subarachnoid Hemorrhage
Headache
Decision Making

Keywords

  • Aneurysm
  • Endovascular
  • Fusiform
  • Intracranial stent

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Levy, E. I., Boulos, A. S., Bendok, B., Kim, S. H., Qureshi, A. I., Guterman, L. R., ... Rosenwasser, R. H. (2002). Brainstem infarction after delayed thrombosis of a stented vertebral artery fusiform aneurysm: Case report. Neurosurgery, 51(5), 1280-1285. https://doi.org/10.1097/00006123-200211000-00026

Brainstem infarction after delayed thrombosis of a stented vertebral artery fusiform aneurysm : Case report. / Levy, Elad I.; Boulos, Alan S.; Bendok, Bernard; Kim, Stanley H.; Qureshi, Adnan I.; Guterman, Lee R.; Hopkins, L. Nelson; Lavine, Sean D.; Higashida, Randall T.; Rosenwasser, Robert H.

In: Neurosurgery, Vol. 51, No. 5, 01.11.2002, p. 1280-1285.

Research output: Contribution to journalArticle

Levy, EI, Boulos, AS, Bendok, B, Kim, SH, Qureshi, AI, Guterman, LR, Hopkins, LN, Lavine, SD, Higashida, RT & Rosenwasser, RH 2002, 'Brainstem infarction after delayed thrombosis of a stented vertebral artery fusiform aneurysm: Case report', Neurosurgery, vol. 51, no. 5, pp. 1280-1285. https://doi.org/10.1097/00006123-200211000-00026
Levy, Elad I. ; Boulos, Alan S. ; Bendok, Bernard ; Kim, Stanley H. ; Qureshi, Adnan I. ; Guterman, Lee R. ; Hopkins, L. Nelson ; Lavine, Sean D. ; Higashida, Randall T. ; Rosenwasser, Robert H. / Brainstem infarction after delayed thrombosis of a stented vertebral artery fusiform aneurysm : Case report. In: Neurosurgery. 2002 ; Vol. 51, No. 5. pp. 1280-1285.
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