Endovascular coil transfixing a cranial nerve five years after embolisation.

After endovascular coiling, several authors have reported refilling of the aneurysm, appearance of a mass effect, coils protruding into the parent artery, migration of coils into parent artery or through aneurysm wall, and compression of the parent artery by coil impaction. This is the first report of an endovascular coil transfixing a cranial nerve. We present a 59 year old man who presented with a symptomatic bilobulated aneurysm of the right internal carotid artery. The aneurysm was embolised by endovascular coiling. Angiographic follow up showed occlusion of the aneurysm. Five years later, the patient complained of progressive diplopia with ptosis. Follow-up angiography showed renewed filling of the aneurysm at its neck. The aneurysm was clipped surgically. At operation, a coil mass effect was noted and one coil penetrated the fibres of the right oculomotor nerve.

Acute paraplegia revealing an intraspinal neurenteric cyst in a child.

The authors report a case of intraspinal neurenteric cyst in a 22-month-old child, who presented with acute paraplegia following a vesicourethrogram. Despite 8 days' delay in surgical decompression, he made a complete neurological recovery. Neurenteric cysts are rare congenital lesions of the spinal canal lined with an epithelium of endodermal origin. They are usually located at the cervicothoracic junction and present with progressive mild to moderate signs of myelopathy. This is a unique case in regard both to its clinical presentation and to the excellent outcome after 8 days of complete paraplegia.