PMC6122285_01
Preprocedural angiography showed a right large cavernous internal carotid artery aneurysm (a). Postprocedural angiography showed a remarkable reduction of the blood flow to the aneurysm (b)
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F1
The procedure was performed in 61 min without any complications [Figure 1a and b], though diffusion-weighted imaging (DWI) after the procedure revealed a few scattered hyperintensities in the right hemisphere [Figure 2a and b].
T2-weighted magnetic resonance imaging after the procedure showed no edema (a) and diffusion-weighted imaging showed a few hyperintensities in the right hemisphere (b). Magnetic resonance imaging 28 days after the procedure showed multiple edematous lesions in the right hemisphere (c), although there were no remarkable changes in diffusion-weighted imaging (d). Magnetic resonance imaging 42 days after the procedure showed a progression of edemas (e), though there were no remarkable changes on diffusion-weighted imaging (f). Magnetic resonance imaging after three courses of steroid pulse therapy (81 days after the procedure) showed a regression of edemas (g), and Gd-enhanced T1-weighted magnetic resonance imaging showed residual multiple enhancing lesions (h)
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F2
The procedure was performed in 61 min without any complications [Figure 1a and b], though diffusion-weighted imaging (DWI) after the procedure revealed a few scattered hyperintensities in the right hemisphere [Figure 2a and b]. Fifteen days after the procedure, left hemiparesis developed and multiple edematous lesions were revealed in the right hemisphere on magnetic resonance imaging (MRI) 28 days after the procedure [Figure 2c and d]. The hemiparesis gradually progressed, and the edematous lesions were enlarged on MRI [Figure 2e and f]. Subsequently, hemiparesis was improved in association with the improvement of edemas [Figure 2g]. Eighty-one days after the procedure, the edemas were diminished, though nodular enhancing lesions were persistent on contrast-enhanced MRI [Figure 2h].