Abstract
Background:
Perianeurysmal edema occurring after endovascular treatment for cerebral aneurysms is uncommon compared to surgical clipping. The clinical aspects and the exact explanation is poorly understood.
Methods:
We searched PubMed, Google Scholar, Web of Science. We used the following keywords “endovascular management of cerebral aneurysms” “perianeurysmal cerebral edema”, perianeurysmal cerebral edema after endovascular treatment endovascular treatment” “intracranial aneurysms with perianeurysmal edema” “vessel wall enhancement after endovascular therapy”. For each case, demographic, clinicopathological, therapeutic and follow-up data were gathered and analyzed.
Results:
Perianeurysmal edema after endovascular treatment has a clear female predilection, with a male: female ratio of (12 (25%):29 (60.41%)). The average time from EVT to the onset of edema ranged from one day to about eight years. The aneurysm dimension ranged from 6.8 to 25 mm as the largest size reported. Most patients were asymptomatic 18(37.5 %), and headache was the presenting symptom in 10 patients (20.8%). Aneurysmal wall enhancement was reported in (16 (33.3 %)) patients with perianeurysmal edema. About 12 patients (25%) developed post EVT hydrocephalus. The most common coil used was the platinum type 31 (64.58%). Most of the patients were treated expectantly with follow up 17 (35.41 %), while steroids were used only in 14 (29.16%) patients. Most of the patients have their edema resolved 29 (60.41%) or stable 9 (37.5%).
Conclusion:
There is growing evidence supporting the incidence of post embolization inflammatory reactions involving the vessel wall and the surrounding parenchyma, however, the exact clinical perspectives and the predisposing factors are not fully uncovered. This analysis highlights the possible presentations, and short term outcome of patients presenting with perianeurysmal edema after endovascular management of cerebral aneurysms.