Severe inflammatory reaction of the optic system after endovascular treatment of a supraophthalmic aneurysm with bioactive coils

Abstract

We report on a patient who, after a symptom-free interval, developed severe vision impairment and whose MR imaging demonstrated extensive edema in the central nervous tissue neighboring the treated aneurysm. To our knowledge, this is an unreported complication of endovascular treatment of aneurysms.

Fig 1.

A, Conventional DSA of the right ICA. The finding is a large supraophthalmic aneurysm (arrowheads) and a second medially cavernous aneurysm (double arrow). D, DSA after coil occlusion of both aneurysms. B, C, E, and F, T2-weighted and T1-weighted contrast-enhanced images 4 days (B and C) and 9 days (E and F) after intervention. MR image at the fourth postinterventional day shows edema in both optic tracts and thickening and signal-intensity elevation in the right optic nerve and chiasm (double arrows in B). C, T1-weighted postcontrast image shows enhancement at the rim of the aneurysm and the chiasm. MR images 9 days postintervention (E and F) show that edema and swelling have regressed, as well as the enhancement.