2018 年 12 巻 8 号 p. 398-403
Objective: We report a case of spinal cord infarction that developed after successful coil embolization of a recurrent basilar bifurcation aneurysm. This complication has been rarely reported in the literature, but may cause severe sequelae following the endovascular embolization.
Case Presentation: During a follow-up examination 6 years after balloon-assisted coil embolization by bilateral vertebral artery (VA) approach to treat an unruptured basilar bifurcation aneurysm, recanalization was noted in a 78-year-old patient. There had been no complications after the original surgery and the postoperative course was uneventful. We planned retreatment by stent-assisted coil embolization via the left VA approach. Immediately after the surgery was successfully completed, severe left-sided hemiparesis appeared, but there were no discernible intracranial ischemic lesions causing the symptom. Cervical MRI revealed an infarction on the left side of the cervical spinal cord between the first and fourth cervical vertebrae. At 6 months’ follow-up, she was able to walk with minimal assistance.
Conclusions: The spinal cord infarction seemed to have been caused by wedging of the guiding catheter, which had not occurred during initial treatment. When performing endovascular treatment for posterior circulation disease, wedging of the guiding catheter should be avoided.
