PT  - JOURNAL ARTICLE
AU  - Ikemura, A.
AU  - Ishibashi, T.
AU  - Otani, K.
AU  - Yuki, I.
AU  - Kodama, T.
AU  - Kan, I.
AU  - Kato, N.
AU  - Murayama, Y.
TI  - Delayed Leukoencephalopathy: A Rare Complication after Coiling of Cerebral Aneurysms
AID  - 10.3174/ajnr.A6386
DP  - 2020 Feb 01
TA  - American Journal of Neuroradiology
PG  - 286--292
VI  - 41
IP  - 2
4099  - http://www.ajnr.org/content/41/2/286.short
4100  - http://www.ajnr.org/content/41/2/286.full
SO  - Am. J. Neuroradiol.2020 Feb 01; 41
AB  - BACKGROUND AND PURPOSE: Delayed leukoencephalopathy is a rare complication that occurs after endovascular coiling of cerebral aneurysms. We aimed to describe a clinical picture of delayed leukoencephalopathy and explore potential associations with procedural characteristics.MATERIALS AND METHODS: We considered endovascular coiling procedures for cerebral aneurysms performed between January 2006 and December 2017 in our institution with follow-up MRIs. We used logistic regression models to estimate the ORs of delayed leukoencephalopathy for each procedural characteristic.RESULTS: We reviewed 1754 endovascular coiling procedures of 1594 aneurysms. Sixteen of 1722 (0.9%) procedures demonstrated delayed leukoencephalopathy on follow-up FLAIR MR imaging examinations after a median period of 71.5 days (interquartile range, 30–101 days) in the form of high-signal changes in the white matter at locations remote from the coil mass. Seven patients had headaches or hemiparesis, and 9 patients were asymptomatic. All imaging-associated changes improved subsequently. We found indications suggesting an association between delayed leukoencephalopathy and the number of microcatheters used per procedure (P = .009), along with indications suggesting that these procedures required larger median volumes of contrast medium (225 versus 175 mL, OR = 5.5, P = .008) as well as a longer median fluoroscopy duration (123.6 versus 99.3 minutes, OR = 3.0, P = .06). Our data did not suggest that delayed leukoencephalopathy was associated with the number of coils (P = .57), microguidewires (P = .35), and guiding systems (P = .57).CONCLUSIONS: Delayed leukoencephalopathy after coiling of cerebral aneurysms may have multiple etiologies such as foreign body emboli, contrast-induced encephalopathy, or hypersensitivity reaction to foreign bodies.DLdelayed leukoencephalopathy