Diagnosis of a displacement of Guglielmi detachable coils by transcranial color-coded sonography.

n recent years, intracranial aneurysms that cause subarachnoid hemorrhage have been treated by an endovascular approach. The use of endovascular Guglielmi detachable coils (GDCs) has improved the radiologic and neurologic outcome of these patients, reaching results similar to those of craniotomy.1 This technique implies certain risks that are decreasing because of the development of new delivery systems and softer GDCs and the increasing experience of neuroradiologists.2 Displacement of coils is not an uncommon complication after endovascular embolization of cerebral aneurysms.3 Transcranial color-coded sonography (TCCS) is a noninvasive reliable bedside technique that allows an anatomic and hemodynamic follow up after embolization of aneurysms.4,5 We report the case of a patient in which a displacement of the coil occurred after GDC treatment of a cerebral aneurysm. A segment of the coil invaded the cerebral vessel, causing a partial blockage of blood flow. This complication was correctly diagnosed by TCCS, permitting a posterior endovascular solution.