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Muslin-induced intracranial vasculopathic stenosis: a report of two cases
Journal article   Open access   Peer reviewed

Muslin-induced intracranial vasculopathic stenosis: a report of two cases

Daniel W Lee, Mandy J Binning, Victoria K Shanmugam, Richard H Schmidt, William T Couldwell, Maximilian Meyer, Thomas Cupps, Andrea Douglas and Kevin McGrail
Clinical neurology and neurosurgery, v 114(1), pp 63-67
01 Jan 2012
DOI: https://doi.org/10.1016/j.clineuro.2011.07.014
PMID: 21937164
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc3655272View
Accepted (AM)Open Access (License Unspecified),  Open

Abstract

Adult Angioplasty Bandages - adverse effects C-Reactive Protein - metabolism Carotid Stenosis - etiology Cerebral Angiography Cerebral Arterial Diseases - etiology Cerebral Arteries - surgery Cerebral Arteries - transplantation Constriction, Pathologic Craniotomy Female Headache - etiology Humans Intracranial Aneurysm - complications Intracranial Aneurysm - surgery Ischemic Attack, Transient - etiology Magnetic Resonance Imaging Neurosurgical Procedures - adverse effects Postoperative Complications - etiology Subarachnoid Hemorrhage - surgery Tissue Adhesives - adverse effects
Muslin wrapping is a commonly utilized alternative technique in the treatment of aneurysms that are not amenable to direct clipping. In this case report, we describe two patients from different institutions who both required aneurysm wrapping with gauze/muslin for aneurysm reinforcement. Both patients developed an inflammatory foreign body response to muslin visible on MRI that resulted in a vasculitic stenosis. The onset of TIAs was at 6 months and 1 month postoperatively, respectively. The stenoses rapidly progressed to near occlusion despite antiplatelet therapy, and in one case, an aggressive corticosteroid regimen. One patient eventually developed leptomeningeal collateral flow that allowed tolerance of the stenosis, while the other patient required microsurgical bypass. These cases reports are the first to our knowledge that describe the adverse effects of muslin wrapping without adhesive reinforcement, as well as one of few reports to include follow-up angiographic imaging.

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7 Record Views
7 citations in Web of Science
9 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Surgery
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