Levodopa-responsive Parkinsonism Caused by Recurrence of Large Basilar-tip Aneurysm after Stent-assisted Coil Embolization: A Case Report

DOI Web Site 参考文献10件
  • NISHIHORI Masahiro
    Department of Neurosurgery, Nagoya University of Graduate School of Medicine, Nagoya, Aichi, Japan
  • IZUMI Takashi
    Department of Neurosurgery, Nagoya University of Graduate School of Medicine, Nagoya, Aichi, Japan
  • TSUKADA Tetsuya
    Department of Neurosurgery, Nagoya University of Graduate School of Medicine, Nagoya, Aichi, Japan
  • ARAKI Yoshio
    Department of Neurosurgery, Nagoya University of Graduate School of Medicine, Nagoya, Aichi, Japan
  • YOKOYAMA Kinya
    Department of Neurosurgery, Nagoya University of Graduate School of Medicine, Nagoya, Aichi, Japan
  • UDA Kenji
    Department of Neurosurgery, Nagoya University of Graduate School of Medicine, Nagoya, Aichi, Japan
  • WAKABAYASHI Toshihiko
    Department of Neurosurgery, Nagoya University of Graduate School of Medicine, Nagoya, Aichi, Japan

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<p>Aneurysms of the large basilar artery (BA) occasionally cause cranial nerve palsy and motor disorder through mass effect. Since 1967, five cases of cerebral aneurysm leading to parkinsonism have been reported. Herein, we describe a rare case of progressive parkinsonism caused by the recurrence of a large aneurysm of the basilar tip after stent-assisted coil embolization. A 66-year-old man visited our hospital with an asymptomatic large aneurysm (maximum diameter, 21 mm) of the BA tip. Magnetic resonance imaging (MRI) revealed no perianeurysmal edema. Coil embolization with a Y-configuration stent with cross-placement was performed. Although thrombus formation occurred and the perforator infarction was complicated, complete occlusion was achieved. Three months later, the patient developed progressive and severe parkinsonism. MRI revealed mild enlargement of the aneurysm and perianeurysmal mesencephalic edema with minor neck recurrence. A trial administration of levodopa and additional stent-assisted coil embolization were performed. Levodopa dramatically improved parkinsonism; thus, the patient’s symptoms were controlled by a continuous levodopa regimen. In a large BA-tip aneurysm patient, moderate regrowth and minor neck recurrence occurred after initial treatment, and chronic compression of the midbrain caused secondary parkinsonism. In such cases, it is important to consider levodopa administration and therapeutic strategies to prevent recurrence or regrowth.</p>

収録刊行物

  • NMC Case Report Journal

    NMC Case Report Journal 8 (1), 107-111, 2021

    一般社団法人 日本脳神経外科学会

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