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Joseph D. Burns, MD; Alejandro A. Rabinstein, MD; Harry Cloft, MD, PhD; Giuseppe Lanzino, MD; David J. Daniels, MD, PhD; Eelco F. M. Wijdicks, MD, PhD

Arch Neurol. 2009;66(6):786-788.

Objective  To report the clinical and radiologic findings in a case of transient minimally conscious state after rupture and coiling of a giant basilar aneurysm.

Design  Case report.

Setting  Neuroscience intensive care unit.

Patient  A 44-year-old man who developed a transient minimally conscious state in association with perianeurysmal edema in the rostral brainstem and thalamus after rupture and coiling of a giant basilar artery aneurysm.

Main Outcome Measure  Correlation of clinical and magnetic resonance imaging findings.

Results  A minimally conscious state and bilaterally symmetric vasogenic edema of the rostral brainstem and thalamus developed 2 days after endovascular aneurysm coiling. The clinical and radiologic abnormalities improved significantly and in parallel during the following 4 weeks.

Conclusions  Perianeurysmal vasogenic edema in the brainstem and thalamus can develop after rupture and coiling of a giant basilar artery aneurysm. This process can be transient and can produce dramatic alterations in consciousness that later resolve.

Author Affiliations: Departments of Neurology (Drs Burns, Rabinstein, and Wijdicks), Radiology (Dr Cloft), and Neurosurgery (Drs Lanzino and Daniels), Mayo Clinic College of Medicine, Rochester, Minnesota.

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