A case of unruptured cerebral aneurysm treated by intra-aneurysmal embolization during outpatient hemodialysis for chronic renal failure

Takeshi Nakajima, Masayuki Ezura, Akira Takahashi, Takashi Yoshimoto

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

A 70-year-old woman, who had been receiving hemodialysis in a local hospital every other day for 2 years, complained of occasional headaches. Magnetic resonance imaging showed a large middle cerebral artery (MCA) aneurysm. Angiography in the midterm day of hemodialysis demonstrated a large aneurysm on the right MCA bifurcation. Her chronic renal failure made us hesitate to perform craniotomy. Intraaneurysmal Guglielmi detachable coil (GDC) embolization was performed also in the midterm day of hemodialysis. She was admitted to our hospital after hemodialysis on the day before the embolization. The embolization was carried out under local anesthesia and systemic heparinization. The aneurysm was almost completely embolized with five GDCs. She was transferred to the local hospital to receive the next hemodialysis on the day after the embolization. Patients with chronic renal failure are not suitable for neurosurgical therapy because mortality of patients undergoing dialysis is 45-80 %, which is mainly due to disequilibrium syndrome and a hemorrhagic tendency. We propose that some eases like this case should be treated with an intra-vascular neurosurgical technique. In conclusion, this report demonstrates that intra-aneurysmal embolization is less invasive and is a more suitable treatment for patients who are considered to be at high risk for surgery and general anesthesia.

Original languageEnglish
Pages (from-to)255-259
Number of pages5
JournalNeurological Surgery
Volume27
Issue number3
Publication statusPublished - 1999 Mar 1

Keywords

  • Cerebral aneurysm
  • Guglielmi detachable coil
  • Hemodialysis
  • Intra-aneurysmal embolization
  • Intravascular neurosurgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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