Correlation of Magnetic Resonance Imaging and Histological Findings in a Large Basilar Tip Aneurysm After Coil Embolization <b>—Case Report—</b>

Jun-ichirou ASAI; Ryuta SUZUKI; Tsukasa FUJIMOTO; Takayasu MIYO; Goro NAGASHIMA; Hiromu HOKAKU; Atsuko TAKEI; Chi-Wei CHANG; Akira KURATA

doi:10.2176/nmc.40.519

Case Reports

Correlation of Magnetic Resonance Imaging and Histological Findings in a Large Basilar Tip Aneurysm After Coil Embolization

—Case Report—

Jun-ichirou ASAI, Ryuta SUZUKI, Tsukasa FUJIMOTO, Takayasu MIYO, Goro NAGASHIMA, Hiromu HOKAKU, Atsuko TAKEI, Chi-Wei CHANG, Akira KURATA

Author information

Jun-ichirou ASAI
Department of Neurosurgery, Fujigaoka Hospital, Showa University
Ryuta SUZUKI
Department of Neurosurgery, Fujigaoka Hospital, Showa University
Tsukasa FUJIMOTO
Department of Neurosurgery, Fujigaoka Hospital, Showa University
Takayasu MIYO
Department of Neurosurgery, Fujigaoka Hospital, Showa University
Goro NAGASHIMA
Department of Neurosurgery, Fujigaoka Hospital, Showa University
Hiromu HOKAKU
Department of Neurosurgery, Fujigaoka Hospital, Showa University
Atsuko TAKEI
Department of Neurosurgery, Fujigaoka Hospital, Showa University
Chi-Wei CHANG
Department of Neurosurgery, Fujigaoka Hospital, Showa University
Akira KURATA
Department of Neurosurgery, School of Medicine, Kitazato University

Keywords: cerebral aneurysm, coils, embolization, histological finding, interventional instrument, magnetic resonance imaging

JOURNAL OPEN ACCESS

2000 Volume 40 Issue 10 Pages 519-523

DOI https://doi.org/10.2176/nmc.40.519

Details

Abstract

A 73-year-old female with a large basilar tip aneurysm underwent endovascular coil embolization with interlocking detachable coils (IDCs). The patient subsequently died of pneumonia 25 days after the embolization, and the aneurysm specimen was obtained at autopsy. Histological examination showed that the intraaneurysmal structure consisted of three layers. The outer layer was mildly organized thrombus surrounding the coils, the middle layer was disorganized clot, and the inner layer consisted of fresh blood clot. Gradient-echo magnetic resonance (MR) imaging taken before death had demonstrated a central region of high intensity and a peripheral low intensity region corresponding to the inner and middle-outer layers of the aneurysm, respectively. Intraaneurysmal placement of IDCs leads to the formation of a clot surrounding the coils. However, clot formation may be inadequate where the packing of the IDCs is incomplete. Comparison of the MR imaging and histological findings in this case show that gradient-echo MR imaging can assess thrombus and residual blood flow within the aneurysm.

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