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Figures
- Fig 1.
Different patterns of cortical and sulcal hyperintensity on gadolinium-enhanced FLAIR in different patients. A and B, A 49-year-old woman with a postcoiling unruptured anterior communicating artery aneurysm via a right internal carotid artery approach. A, Postcoiling gadolinium-enhanced FLAIR shows CSHF along the right anterior cerebral artery territory (white arrows). B, Two-month follow-up Gd-FLAIR shows no residual abnormality. C and D, A 64-year-old woman postcoiling of a left paraclinoid ICA aneurysm via a left ICA approach. C, Postcoiling Gd-FLAIR shows CSHF along the left middle cerebral artery territory (white arrows) and left ACA territory (white arrowhead). D, Two-month follow-up Gd-FLAIR shows resolution of the abnormality. E and F, A 61-year-old woman with a postcoiling basilar tip artery aneurysm via a left vertebral artery approach. E, Postprocedural Gd-FLAIR shows CSHF along the left cerebellar fissures (white arrow). F, Two-month follow-up Gd-FLAIR shows no residual abnormality.
- Fig 2.
A, Right internal carotid artery angiographic approach for coiling of a right ophthalmic ICA aneurysm (black arrowhead) in a 71-year-old woman using 7.78 mL/kg of iodinated contrast volume and a procedural time of 4 hours. Note the presence of fetal origin of the right posterior cerebral artery (black arrow). B, Gadolinium-enhanced FLAIR performed at 12 hours after endovascular coiling shows cortical and sulcal hyperintensity along the right middle cerebral artery territory (white arrows) and the right PCA territory (white arrowheads). C, Corresponding DWI shows no diffusion restriction. D, A follow-up unenhanced CT scan obtained on the same date shows no evidence of subarachnoid hemorrhage. E, Two-month follow-up Gd-FLAIR shows no residual abnormality.
Tables
Patient data No. 58 Age (mean) (range) (yr) 57.17 ± 10.94 (33–78) Sex (No.) (%) Female, 40 (69%) Endovascular coiling aneurysms (No.) 62 Target aneurysm locations (N = 62) AComA (No.) (%) 10 (16.13) Right ICA (No.) (%) 12 (19.35) Left ICA (No.) (%) 8 (12.9) Right PcomA (No.) (%) 4 (6.45) Right MCA (No.) (%) 7 (11.29) Left MCA (No.) (%) 2 (3.22) BA (No.) (%) 17 (27.42) Left VA (No.) (%) 1 (1.61) Left PCA (No.) (%) 1 (1.61) Endovascular coiling techniques (N = 62) Routine coiling (No.) (%) 23 (37.1%) Balloon-assisted coiling (No.) (%) 29 (46.77%) Stent-assisted coiling (No.) (%) 6 (9.68%) Pipeline flow diverter and coiling (No.) (%) 3 (4.8%) Balloon- and stent-assisted coiling (No.) (%) 1 (1.61%) No. of coils (median) (range) 5 (1–32) Note:—AcomA indicates anterior communicating artery; PcomA, posterior communicating artery; BA, basilar artery.
Factors Findings Negative for CSHF (n = 30) Findings Positive for CSHF (n = 32) Total (N = 62) P Value Contrast volume (mean) (mL) 453.33 ± 156.98 431.25 ± 161.52 441.93 ± 158.42 .588 Contrast volume per weight (mean) (mL/kg) 6.53 ± 2.39 6.15 ± 2.56 6.33 ± 2.46 .556 Duration of endovascular coiling procedure (median) (IQR) (hr) 1.39 (0.95–2.20) 2.21 (1.63–3.26) 1.89 (1.26–2.66) .001 Time from coiling to MRI (median) (IQR) (hr) 16.16 (11.99–22.51) 16.08 (10.03–22.61) 16.16 (11.56–22.125) .871 No. of angiographic runs (median) (IQR) 13 (10–17) 18 (12–22) 14 (12–20) .019 DWI grading (No.) (%) 0 9 13 22 (35.5%) .68 I 13 12 25 (40.3%) II 8 7 15 (20.2%)
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