Postcoiling syndrome including headache and fever after endovascular cerebral aneurysmal coil embolization: A narrative review

Abstract

Endovascular cerebral aneurysmal coil embolization is becoming more popular than direct aneurysmal neck clipping due to its noninferiority in long-term outcomes and being less invasive. Neuroradiologists often find postoperative symptoms such as headache and fever after unruptured aneurysmal coil embolization, however, they have not paid much attention because symptoms almost always resolve spontaneously within a few days. Since the concept of this syndrome has not been standardized, we named it postcoiling syndrome (PCS). In this short review, we reviewed the criteria, risk factors, mechanisms, significance, and treatment of PCS based on a few pieces of literature. Almost all literature has regarded that some kind of bioactive reaction might be involved in PCS. Preliminary data showed the possibility of inhibition of PCS by histamine-2 receptor antagonists. PCS also might have the potential of more predictive maker than previously reported risk factors for recurrence after aneurysm coil embolization. Further investigation is needed in the future, including the accumulation of cases, unification of concepts, and mid-to-long-term follow-up.

Keywords: Endovascular cerebral aneurysmal coil embolization; fever; gastrointestinal symptoms; headache; inflammatory reaction; postcoiling syndrome; postembolization syndrome.

Figure 1

Comparison of PCS criteria scores between the two groups as shown in the boxplots, with significantly lower scores in the famotidine group. ^#P < 0.05 compared with the nonfamotidine group. PCS: Postcoiling syndrome