Symptomatic Cerebral Vasospasm After Clipping of an Unruptured Intracranial Aneurysm: A Case Report and Literature Review

Symptomatic cerebral vasospasm after clipping of unruptured intracranial aneurysms (UIA) is extremely rare. Furthermore, its pathophysiology and risk factors are poorly understood. Delayed diagnosis and treatment can lead to severe neurological deficits. We report the case of a 53-year-old woman who developed delayed symptomatic cerebral vasospasm seven days after clipping of an unruptured left middle cerebral artery (MCA) aneurysm. The patient presented with right-sided hemiparesis and motor aphasia. Digital subtraction angiography revealed vasospasms from the M1 to M2 segments. Treatment with intra-arterial fasudil injection and continuous intravenous fasudil with ozagrel sodium resulted in complete neurological recovery. Cerebral vasospasm after UIA clipping is uncommon and may be overlooked, thereby resulting in serious sequelae.