PT  - JOURNAL ARTICLE
AU  - Brisman, J.L.
AU  - Jilani, M.
AU  - McKinney, J.S.
TI  - Contrast Enhancement Hyperdensity After Endovascular Coiling of Intracranial Aneurysms
AID  - 10.3174/ajnr.A0844
DP  - 2008 Mar 01
TA  - American Journal of Neuroradiology
PG  - 588--593
VI  - 29
IP  - 3
4099  - http://www.ajnr.org/content/29/3/588.short
4100  - http://www.ajnr.org/content/29/3/588.full
SO  - Am. J. Neuroradiol.2008 Mar 01; 29
AB  - BACKGROUND AND PURPOSE: Endovascular coil embolization is used increasingly to treat cerebral aneurysms. The purpose of our study was to quantify the incidence of CT-detectable abnormalities after aneurysm coiling and map the radiographic and clinical progression.MATERIALS AND METHODS: We reviewed the radiographic and clinical sequelae of 30 consecutive patients with aneurysms who underwent endosaccular coiling followed by head CT scans. Patients with CT abnormalities received follow-up scans at 4 to 6 hours and 20 to 25 hours. Contrast enhancement was defined as CT hyperdensities with progressive resolution over 25 hours and a Hounsfield unit (HU) of less than 70. The incidence of CT abnormalities was recorded and correlated with amount of contrast used, use of antiplatelet agents, procedure time, and clinical sequelae.RESULTS: Seven patients (23%) had new hyperdensities on CT scan. Four showed gyral hyperattenuation; 1 showed basal ganglia hyperattenuation, and 2 showed a combination of these patterns. All were asymptomatic and were consistent with contrast enhancement, with complete resolution in 5 of 7 and partial resolution in 2 of 7 by 20 to 25 hours. Antithrombotic or antiplatelet medication was continued in all cases. The amount of contrast used (P = .014) and the use of antiplatelet medication (P = .029) were statistically correlated with the presence of hyperattenuation after aneurysm coiling, whereas the length of the procedure was not (P = .162).CONCLUSION: Contrast enhancement, unlike contrast extravasation, is a fairly common and clinically benign finding after aneurysm coiling. The enhancement resolves by 25 hours in most cases, regardless of the continuation of antithrombotic or antiplatelet therapy.