BIẾN CHỨNG SAU ĐIỀU TRỊ NÚT VÒNG XOẮN KIM LOẠI VỠ PHÌNH ĐỈNH ĐỘNG MẠCH THÂN NỀN: BÁO CÁO CA LÂM SÀNG

Abstract

Ruptured basilar tip aneurysms (BTA) may result in fatal subarachnoid hemorrhage (SAH) and mortality could be as high. Recent reports have shown that endovascular has become an important option for treating these aneurysms. However, there was no sufficient experience referring to the complications of ruptured BTA that were occluded incompletely. We report the case of a 65-year-old man presenting SAH due to ruptured BTA. The patient had multiple cerebral aneurysms and was intervened a dome of the BTA, which was the direct cause of the SAH. We used the helical coil Axium^TM and Axium^TM Prime to pack the aneurysm sac. A control angiogram demonstrated good placement of coils with incomplete occlusion of the aneurysm. Four days after treatment, the patient had a severe clinical deterioration, and a computed tomography showed image of rebleeding, vasospasm, ventricular dilatation and severe cerebral edema. The patient was treated with extraventricular drainage (EVD). Patient died on day seventh because of poor general condition: Deep coma, dilated pupils, hypotension, cardiac arrest. The purpose of this report is to discuss the risk factors, clinical signs and management of complications after endovascular treatment in ruptured BTA.