Development of the syndrome of reversible cerebral vasoconstriction after clipping of an asymptomatic aneurysm of the middle cerebral artery
https://doi.org/10.56618/2071-2693_2023_15_2_134
Abstract
The article presents a clinical case of the development of diffuse angiospasm after clipping of an asymptomatic aneurysm of the middle cerebral artery in a 60-year-old woman. The operation was uneventful, temporary clipping was not performed. The patient was discharged on the 10th day after the operation in a satisfactory condition. On the 12th day, severe headache appeared, hemiparesis and loss of the right visual fields developed. Additional examination by MSCT revealed ischemic zones in the parietal-occipital and temporal regions on the left, MSCT angiography revealed pronounced angiospasm in the carotid and vertebrobasilar basins. Against the background of the appointment of nimotop, the symptoms regressed and after 9 days, angiospasm completely resolved, no new foci of ischemia appeared. The article also provides an overview of the few similar observations by other researchers.
About the Authors
P. G. Shnyakin
FSBEI НЕ «Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University»
Russian Federation
Russian Federation
1, Partizan Zheleznyak Str., Krasnoyarsk, 660022
A. S. Loseva
FSBEI НЕ «Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University»
Russian Federation
Russian Federation
1, Partizan Zheleznyak Str., Krasnoyarsk, 660022
References
1. Bloomfield S M. Delayed cerebral vasospasm after uncomplicated operation on an unruptured aneurysm: case report. Neurosurgery 1985;№ 17(5):792–796. https://doi.org/10.1097/00006123‑198511000‑00011
2. Kitazawa K. Postoperative vasospasm of unruptured paraclinoid carotid aneurysms: analysis of 30 cases. Journal of Clinical Neuroscience 2005; № 12(2):150–155. https://doi.org/10.1016/j.jocn.2004.02.023
3. Hashimoto H. A case of unexpected symptomatic vasospasm after clipping surgery for an unruptured, intracranial aneurysm. J. Stroke Cerebrovasc. Dis. 2016; 25(3)2: 5–27. https://doi.org/10.1016/j.jstr okecerebrovasdis.2015.11.029
4. Campe C. Vasospasm and delayed cerebral ischemia after uneventful clipping of an unruptured intracranial aneurysm — a case report. BMC. Neurol. 2019; 19(1): 226. https://doi.org/10.1186/s12883‑019‑1458‑4
5. Peterson C. M. Unruptured aneurysmal clipping complicated by delayed and refractory vasospasm: case report. BMC Neurol. 2020; № 20(1): 334. https://doi.org/10.1186/s12883‑020‑01925‑8
6. Tsyben A. Cerebral vasospasm and delayed ischaemic deficit following elective aneurysm clipping. Journal of Clinical Neuroscience 2016; 34: 33–38. https://doi.org/10.1016/j.jocn.2016.06.006
7. Vachata P. Delayed ischemic neurological deficit after uneventful elective clipping of unruptured intracranial aneurysms. Brain Sciences 2020; 10(8): 495. https://doi.org/10.3390/brainsci10080495
8. Cuoco J. A. Recurrent Cerebral Vasospasm and Delayed Cerebral Ischemia Weeks Subsequent to Elective Clipping of an Unruptured Middle Cerebral Artery Aneurysm. World Neurosurgery 2020; 141: 52–58. https://doi.org/10.1016/j.wneu.2020.05.235
9. Knight J.A. 2nd. Contralateral vasospasm in an uncomplicated elective anterior communicating artery aneurysm clipping. World Neurosurgery 2020; 138: 214–217. https://doi.org/10.1016/j.wneu.2020.02.136
10. Paolini S. Cerebral vasospasm in patients with unruptured intracranial aneurysms. Acta Neurochirurgica (Wien). 2005; 147(11): 1181–1188. https://doi.org/10.1007/s00701‑005‑0613‑4
11. Raynor R.B. Severe vasospasm with an unruptured aneurysm: case report. Neurosurgery 1980; 6(1): 92–95. https://doi.org/10.1097/00006123‑198001000‑00014
12. Yang K. Clinical and angiographical delayed cerebral vasospasms after uncomplicated surgical clipping of unruptured intracranial aneurysms: illustrated review and two case reports. Turkish Neurosurgery 2015; 25(4): 662–665. https://doi.org/10.5137/1019–5149.jtn.9912–13.1
13. V. V. Narodova, A. Vertebral artery dissection in practice of vascular neurology department. Siberian medical review 2015; 6: 81–85 (In Russ.). https://doi.org/10.2033 3/25000136‑2015‑6‑81‑85
14. Sergeev A. V. reversible cerebral vasoconstriction syndrome. Neurologichesky zhurnal 2012; 3: 4–11 (In Russ.).
15. Calabrese L.H. Narrative review: reversible cerebral vasoconstriction syndromes. Annals of Internal Medicine 2007;146(1): 34–44. https://doi.org/10.7326/0003‑4819‑146‑1‑200701020‑00007
16. Chen S. P. Recurrent primary thunderclap headache and benign CNS angiopathy: spectra of the same disorder? Neurology 2006; 67: 2164–2169. https://doi.org/10.1212/01.wnl.0000249115.63436.6d
17. Miller T. R. Reversible Cerebral Vasoconstriction Syndrome, Part 1: Epidemiology, Pathogenesis, and Clinical Course. American Journal of Neuroradiology 2015; 36(8):1392–9. Epub 2015 Jan 15. https://doi.org/10.3174/ajnr.a4214
18. Santos L. Reversible cerebral vasoconstriction syndrome — A narrative revision of the literature. Porto Biomedical Journal 2016; 1(2): 65–71. https://doi.org/10.1016/j.pbj.2016.04.002
19. Imai M. Reversible Cerebral Vasoconstriction Syndrome Patients with a History of Migraine: A Retrospective Case-control Study 2022 Jul. https://doi.org/10.2169/internalmedicine.9776–22
Review
For citations:
Shnyakin P.G., Loseva A.S. Development of the syndrome of reversible cerebral vasoconstriction after clipping of an asymptomatic aneurysm of the middle cerebral artery. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2023;15(2):134-139. (In Russ.) https://doi.org/10.56618/2071-2693_2023_15_2_134
Views:
41
Email this article 