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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 24:1237-1239, June-July 2003
© 2003 American Society of Neuroradiology

Case Report
INTERVENTIONAL

Acute Vasogenic Edema Induced by Thrombosis of a Giant Intracranial Aneurysm: A Cause of Pseudostroke after Therapeutic Occlusion of the Parent Vessel

Dima Hammoud^a, Philippe Gailloud^a, Alessandro Olivi^b and Kieran J. Murphy^a

^a Department of Interventional Neuroradiology, the Johns Hopkins Medical Institutions, Baltimore, MD
^b Cerebrovascular Surgery, the Johns Hopkins Medical Institutions, Baltimore, MD

Address reprint requests to Philippe Gailloud, MD, Interventional Neuroradiology, Department of Radiology and Radiological Sciences, the Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287

Summary: A 16-year-old male adolescent presenting with acute retro-orbital pain underwent emergent internal carotid occlusion for a giant cavernous aneurysm. Three weeks later, the patient complained of headache and right hemiparesis, which suggested an acute stroke. CT and MR imaging revealed vasogenic brain edema without infarct. The symptoms rapidly resolved with steroid therapy. Follow-up CT showed resolution of the edema. The imaging characteristics, clinical implications, and etiology of vasogenic edema occurring after thrombosis of a giant intracranial aneurysm are discussed.