Spontaneous regression of intracranial aneurysm following remote ruptured aneurysm treatment with pipeline stent assisted coiling

BMJ Case Rep. 2015 Aug 13:2015:bcr2015011931. doi: 10.1136/bcr-2015-011931.

Abstract

Spontaneous aneurysm regression is a rare phenomenon. We present the interesting case of a 54-year-old woman who was admitted with a Hunt/Hess grade IV, Fisher grade III subarachnoid hemorrhage and multiple intracranial aneurysms. She was treated with coiling of the largest paraclinoid aneurysm and placement of a flow diverting pipeline embolization device that covered all internal carotid artery (ICA) aneurysms. A follow-up angiogram at 6 months showed remodeling of the ICA with complete obliteration of all treated aneurysms. A distant, untreated, right frontal M2 aneurysm regressed spontaneously, after the flow was diverted away from it with the stent. The literature is reviewed, and potential pathophysiological mechanisms leading to aneurysm regression are discussed.

Keywords: Aneurysm; Angiography; Coil; Flow Diverter; Subarachnoid.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, Ruptured / pathology
  • Aneurysm, Ruptured / therapy*
  • Cerebral Angiography
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Intracranial Aneurysm / pathology
  • Intracranial Aneurysm / therapy*
  • Middle Aged
  • Stents
  • Subarachnoid Hemorrhage / pathology
  • Subarachnoid Hemorrhage / therapy*