Minimally conscious state after ruptured giant basilar aneurysm

Arch Neurol. 2009 Jun;66(6):786-8. doi: 10.1001/archneurol.2009.67.

Abstract

Objective: To report the clinical and radiologic findings in a case of transient minimally conscious state after rupture and coiling of a giant basilar aneurysm.

Design: Case report.

Setting: Neuroscience intensive care unit.

Patient: A 44-year-old man who developed a transient minimally conscious state in association with perianeurysmal edema in the rostral brainstem and thalamus after rupture and coiling of a giant basilar artery aneurysm.

Main outcome measure: Correlation of clinical and magnetic resonance imaging findings.

Results: A minimally conscious state and bilaterally symmetric vasogenic edema of the rostral brainstem and thalamus developed 2 days after endovascular aneurysm coiling. The clinical and radiologic abnormalities improved significantly and in parallel during the following 4 weeks.

Conclusions: Perianeurysmal vasogenic edema in the brainstem and thalamus can develop after rupture and coiling of a giant basilar artery aneurysm. This process can be transient and can produce dramatic alterations in consciousness that later resolve.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Brain Edema / etiology*
  • Brain Edema / pathology*
  • Brain Edema / physiopathology
  • Brain Stem / blood supply
  • Brain Stem / pathology
  • Brain Stem / physiopathology
  • Consciousness / physiology
  • Dexamethasone / therapeutic use
  • Embolization, Therapeutic / adverse effects*
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods
  • Humans
  • Intracranial Aneurysm / complications*
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / surgery
  • Magnetic Resonance Imaging
  • Male
  • Oculomotor Nerve Diseases / etiology
  • Oculomotor Nerve Diseases / pathology
  • Oculomotor Nerve Diseases / physiopathology
  • Persistent Vegetative State / etiology*
  • Persistent Vegetative State / pathology*
  • Persistent Vegetative State / physiopathology
  • Postoperative Complications / etiology
  • Postoperative Complications / pathology
  • Postoperative Complications / physiopathology
  • Prostheses and Implants / adverse effects
  • Recovery of Function / drug effects
  • Recovery of Function / physiology
  • Tegmentum Mesencephali / blood supply
  • Tegmentum Mesencephali / pathology
  • Tegmentum Mesencephali / physiopathology
  • Thalamus / blood supply
  • Thalamus / pathology
  • Thalamus / physiopathology
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Dexamethasone