Description
A woman aged 66 years with a history of diplopia, headaches and left Cranial Nerve 3 palsy was found to have a 2 cm left paraclinoid internal carotid artery aneurysm. She was started on aspirin and clopidogrel and underwent flow diversion treatment with Pipeline (Covidien Neurovascular, Irvine, California, USA) embolisation of the aneurysm. Intraoperative neurophysiological monitoring via EEG and somatosensory evoked potentials was performed. After the procedure, she was found to have a large right scalp haematoma extending to the right orbit anteriorly and the back of the head posteriorly. Despite manual compression, the periorbital swelling continued to increase in the intensive care unit such that she was not able to open the right eye. A routine postprocedural MRI and MRA of the brain with gadolinium was performed to assess the aneurysm; of note, the study also demonstrated a large right scalp haematoma with contrast enhancement around the...
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