The
clinical severity of CBS was classified into three groups:
acute, impending, and threatened (21). Chang et al found
that clinical severity is the significant factor affecting
the hemostatic outcome of endovascular management
and advised making this clinical classification as a guide
for management of CBS (21). The outcomes of most NPC
patients with acute CBS were not satisfied. In this patient,
endovascular treatment achieved immediate oblileration
of ICA pseudoaneurysm. There was good collateral
circulation to the left anterior and left middle cerebral
arteries. Although no procedure-related complication
occurred, this patient remained ventilator dependent from
recurrent stroke and pneumonia. In Mak’s series, 10 out
of 15 patients who received successful endovascular
treatment of ruptured ICA pseudoaneurysm after
irradiation for NPC died within 11months (10). Causes of
death include sepsis, pneumonia, meningitis, myocardial
infarction, and tumor progression