PT  - JOURNAL ARTICLE
AU  - Naveen Sablani
AU  - Maryam Mumtaz Hasan
AU  - Ashik Shrestha
AU  - Jeffrey Farkas
TI  - Delayed neurological deficits after endovascular placement of a pipeline embolisation device: clinical manifestation and treatment
AID  - 10.1136/bcr-2016-216580
DP  - 2018 Mar 24
TA  - BMJ Case Reports
PG  - bcr-2016-216580
VI  - 2018
4099  - http://casereports.bmj.com/content/2018/bcr-2016-216580.short
4100  - http://casereports.bmj.com/content/2018/bcr-2016-216580.full
AB  - Endovascular treatment has been the mainstay of therapy for repair of both ruptured and unruptured cerebral aneurysms. Flow diverter devices offer a new option for the treatment of complex aneurysms that were previously not amenable to coiling. Procedural adverse effects include intracranial haemorrhage and ischaemic stroke, which usually occur on the same day. Delayed complications are rare. We report a case of a patient who underwent placement of a pipeline embolisation device and developed delayed neurological deficits, which were thought to be an inflammatory reaction to the hydrophilic coating used in guidewires and microcatheters. Our patient was treated with a course of steroids, with improvement of her neurological deficits and resolution of MRI findings. As the use of flow diverter devices has increased, variable and delayed complications of such therapy are increasingly being reported in the literature.