Case of the Week – Motor Vehicle Collision Patient gets Neurointerventional Surgery

This case features a 49-year old female motor vehicle collision patient who presented to the emergency department. While asymptomatic initially, later in her hospital stay she developed facial numbness that prompted a CT of her facial bones and CT angiography of her head and neck.

Our diagnostic neuroradiologist found an incidental, unruptured left internal carotid artery (ICA) terminus 10-mm multilobulated, multichambered aneurysm with a 5.5 mm neck. He recommended a neurointerventional consultation.

Dr. Jimmy Ghostine, MD FRCPC and our neurointerventional advanced practice provider, Robert Cordo, MSN, APRN, AGACNP-BC, FNP-C, assessed the patient and determined that a surgical intervention was warranted during this hospitalization given the aneurysm’s location, morphology, and size. A diagnostic cerebral angiogram was performed by Dr. Ghostine to better characterize the aneurysm allowing for a customized care plan to be developed. After discussing the findings with the patient and her trauma surgeon, Dr. Ghostine performed a successful Y-stent assisted reconstruction of the ICA terminus and coil embolization of the multilobulated aneurysm.

Our patient remains neurologically intact post discharge. Our neurointerventional surgery team will follow-up at 6-, 12-, and 18-months for long-term results.