Case Studies| Volume 25, ISSUE 3, e25-e27, March 2016

A Case of Unexpected Symptomatic Vasospasm after Clipping Surgery for an Unruptured Intracranial Aneurysm

      Delayed symptomatic vasospasm after clipping surgery for unruptured aneurysm is rarely reported. We report a case of a 62-year-old woman who presented with symptomatic vasospasm 11 days after clipping surgery for an unruptured aneurysm. We could not predict the existence of vasospasm until ischemic symptoms developed. We retrospectively found mild vasospasm in the computed tomography angiogram taken 8 days after the operation. The patient complained of a prolonged unexpected headache 1 week after the operation. We should recognize prolonged unexpected headache as a warning sign of vasospasm.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Stroke and Cerebrovascular Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Raynor R.B.
        • Messer H.D.
        Severe vasospasm with an unruptured aneurysm: case report.
        Neurosurgery. 1980; 6: 92-95
        • Paolini S.
        • Kanaan Y.
        • Wagenbach A.
        • et al.
        Cerebral vasospasm in patients with unruptured intracranial aneurysms.
        Acta Neurochir (Wien). 2005; 147 (discussion 8): 1181-1188
        • Rabb C.H.
        • Tang G.
        • Chin L.S.
        • et al.
        A statistical analysis of factors related to symptomatic cerebral vasospasm.
        Acta Neurochir (Wien). 1994; 127: 27-31
        • Findlay J.M.
        • Macdonald R.L.
        • Weir B.K.A.
        • et al.
        Surgical manipulation of primate cerebral arteries in established vasospasm.
        J Neurosurg. 1991; 75: 425-432
        • Grande A.
        • Grewal S.
        • Tackla R.
        • et al.
        Life-threatening allergic vasculitis after clipping an unruptured aneurysm: case report, weighing the risk of nickel allergy.
        Surg Neurol Int. 2014; 5: S161-S164
        • Sakellariou V.I.
        • Atsali E.
        • Starantzis K.
        • et al.
        Postoperative spinal infection mimicking systemic vasculitis with titanium-spinal implants.
        Scoliosis. 2011; 6: 20
        • Edvinsson L.
        • Juul R.
        • Jansen I.
        Perivascular neuropeptides (NPY, VIP, CGRP and SP) in human brain vessels after subarachnoid haemorrhage.
        Acta Neurol Scand. 1994; 90: 324-330
        • Buki A.
        • Horvath Z.
        • Kallo I.
        • et al.
        Peptidergic innervation of human cerebral blood vessels and saccular aneurysms.
        Acta Neuropathol. 1999; 98: 383-388
        • Nozaki K.
        • Uemura Y.
        • Okamoto S.
        • et al.
        Origins and distribution of cerebrovascular nerve fibers showing calcitonin gene-related peptide-like immunoreactivity in the major cerebral artery of the dog.
        J Comp Neurol. 1990; 297: 219-226
        • Arienta C.
        • Balbi S.
        • Caroli M.
        • et al.
        Depletion of calcitonin gene-related peptide in perivascular nerves during acute phase of posthemorrhagic vasospasm in the rabbit.
        Brain Res Bull. 1991; 27: 605-609