Nickel Induced Delayed White Matter Lesions after Stent-assisted Coil Embolization for Intracranial Aneurysm

Abstract

Delayed onset multiple white matter lesions is a rare pathology that has been reported in patients after endovascular coiling of cerebral aneurysms. This pathology was reportedly caused by nickel allergies or foreign body embolization of polyvinylpyrrolidone. Here, we report a case of white matter lesions in a patient which was diagnosed as a nickel allergy based on a positive reaction to the skin patch test. Steroid therapy improved symptoms and magnetic resonance imaging findings immediately. Clinical differential diagnosis of delayed multiple white matter lesions is difficult. Although biopsy is useful for obtaining a diagnosis, a skin patch test can also be helpful.