Abstract
We report two cases of delayed leukoencephalopathy after cerebral endovascular treatment. Case 1 was a man in his 50s who underwent thrombectomy and stent placement for acute occlusion of the left middle cerebral artery (MCA) M1 segment. Three weeks later, he presented with headache and aphasia, and diffusion-weighted imaging (DWI) revealed extensive vasogenic edema in the left MCA territory. Contrast-enhanced magnetic resonance imaging (MRI) showed granular and nodular enhancement within the edema. Case 2 was a man in his 70s who underwent carotid artery stent placement (CAS) for left internal carotid artery (ICA) occlusion. One week later, he developed altered consciousness, and DWI revealed patchy vasogenic edema in the distal perfusion area of the catheter-induced vessel. Unfortunately, since the patient had chronic renal disease, contrast-enhanced MRI was not performed. In both cases, significant improvements in symptoms and imaging findings were observed with steroid treatment. Although definitive diagnosis was not established through biopsy, based on the findings and clinical course, we considered these cases to be delayed leukoencephalopathy due to type IV allergy associated with foreign material embolism.
