Reappraisal of the causes of spontaneous epidural hematomas: A case after stent-assisted coiling for ruptured posterior communicating artery aneurysm

Abstract We presented a rare case of delayed spontaneous epidural hematoma (EDH) occurring as a complication of stent assisted coiling of a ruptured intracranial aneurysm. We reported a 60-year-old woman with diagnosed ruptured aneurismal subarachnoid hemorrhage with large wide-necked aneurysm of the left posterior communicating artery. After stent assisted coil embolization, dual-antiplatelet therapy was administered. On the 11th day after coiling, she suffered from decreased mentality and dysarthria. Follow-up brain CT scan revealed a large extradural hematoma on the left frontal area which required an emergency hematoma removal. The present report emphasizes the fact that lumbar drainage procedure with anticoagulant, after stent assisted coil embolization, can cause life threatening hemorrhagic complications and requires immediate diagnosis and treatment.