Endovascular management of residual intracranial aneurysm after neurosurgical clipping: a case report

Abstract

Introduction and importance: Endovascular coiling can be used to treat residual intracranial aneurysms with prior neurosurgical clipping in aneurysmal subarachnoid haemorrhage. Aneurysmal subarachnoid haemorrhage is a rare subtype of stroke which can be life-threatening. Case presentation: The authors herein report a case of successful management by endovascular coiling of residual intracranial aneurysm post-surgical clipping in a 60-year-old male who was previously diagnosed as diffuse subarachnoid haemorrhage (SAH) Fisher grade 4. On examination, he had a Glasgow Coma Scale 14/15 with verbal confusion present and was hypertensive. Clinical discussion: Aneurysmal subarachnoid haemorrhage is a rare and serious type of stroke and may result in dependency. Endovascular coiling can be used to treat residual intracranial aneurysms with prior neurosurgical clipping. It further helps in decreasing dependency and mortality. Conclusion: Endovascular coiling is a good treatment option for patients who have undergone neurosurgical clipping as their prior surgical attempt in aneurysmal subarachnoid haemorrhage. An endovascular approach may further lead to a better prognosis.