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Aladawi M, Elfil M, Najdawi ZR, Ghaith H, Sayles H, Thorell W, Hawkes MA. Aneurysmal Subdural Hematoma: A Systematic Review. Neurocrit Care 2024:10.1007/s12028-024-01938-y. [PMID: 38332336 DOI: 10.1007/s12028-024-01938-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 01/03/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Aneurysmal subdural hematoma (aSDH) is a rare complication of aneurysm rupture, affecting between 0.5 and 7.9% of patients with aneurysmal subarachnoid hemorrhage (aSAH). The clinical presentation, course, and outcomes of these patients are largely unknown. OBJECTIVE This study aims to systematically review the literature to evaluate the demographics, clinical presentation, aneurysm location, treatment options, and outcomes of patients with aSDH with and without aSAH. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we conducted a systematic review of three databases (PubMed, EMBASE, and Google Scholar). From identified reports, we extracted data on patients' demographics, clinical presentation, imaging findings, surgical interventions, and clinical outcomes. We compared clinical outcomes, need for surgical treatment, and aneurysm location between patients with aSDH with and without concurrent aSAH using χ2 and Fisher's exact tests. We used simple and multivariable logistic regression models to further examine the association between the presence of aSAH and surgical treatment with clinical outcomes. RESULTS We identified 112 articles with a total of 270 patients (70% women, mean age 52.8 [± 15.5] years). The most common aneurysm locations were the middle cerebral artery, followed by the posterior communicating artery, and the internal carotid artery. Patients with isolated aSDH fully recovered more frequently than those with concomitant aSAH (38% vs. 6%). The presence of aSAH increased the odds of unfavorable outcome (odds ratio [OR] 2.68, 95% confidence interval [CI] 1.34-5.37). Surgical treatment was inversely associated with unfavorable outcome in the univariable (OR 0.48, 95% CI 0.28-0.84) but not in the multivariable analysis (OR 0.76, 95% CI 0.35-1.66). CONCLUSION aSDH occurs infrequently. Simultaneous presence of both aSDH and aSAH from an aneurysmal source is associated with poor outcomes. Surgical treatment is associated with lower rates of unfavorable outcomes including death and severe disability.
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Affiliation(s)
- Mohammad Aladawi
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Mohamed Elfil
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Zaid R Najdawi
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Hazem Ghaith
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Harlan Sayles
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - William Thorell
- Department of Neurosurgery, University of Nebraska Medical Center, Omaha, NE, USA
| | - Maximiliano A Hawkes
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA.
- Department of Neurology, Mayo Clinic, 200 1st ST SW, Rochester, MN, 55905, USA.
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Kosyrkova AV, Gavrilov AG, Eliava SS, Kravchuk AD. [Giant thrombosed aneurysm of the pericallosal artery: clinical observation, literature review]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2019; 83:74-81. [PMID: 31577272 DOI: 10.17116/neiro20198304174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Are characterized by Distal giant aneurysms of the anterior cerebral artery are an extremely rare pathology. There are less than 40 cases of this disease described in literature. OBJECTIVE The aim of the article is to present the clinical observation of a successfully treated giant aneurysm of the pericallosal artery in a 58-year-old man, and also analyze the publications on distal cerebral aneurysms. MATERIAL AND METHODS The data of a patient hospitalized with a suspected tumor of the left brain hemisphere spreading to the left lateral ventricle is presented. Repeated MRI suggests a giant subtotal thrombotic aneurysm of the left perical artery, which was confirmed by SCT angiography. The patient underwent aneurysm treping-cliping with dissection of the aneurysm sac. In the analysis of the literature it was shown that the frequency of perical artery aneurysms varies from 5.3-6.0%, and giant aneurysms of this localization are extremely rare and occur in 1-4.5% of all perical artery aneurysms. Unlike distal anterior cerebral artery aneurysms of small and medium size, giant aneurysms are characterized by pseudotumorrhagic symptoms, which causes diagnostic difficulties. CONCLUSION It is necessary to remember about the diagnostic difficulties caused by the pseudotumorrhosis of the giant aneurysms of the pericallosal artery and the frequent negative angiography data due to total thrombosis of the aneurysmal sac. The gold standard is microsurgical clipping with excision of the aneurysmal sac. The prognosis for this group of patients is favorable.
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Torné R, Rodríguez-Hernández A, Romero-Chala F, Arikan F, Vilalta J, Sahuquillo J. Prognosis of patients in coma after acute subdural hematoma due to ruptured intracranial aneurysm. J Clin Neurosci 2016; 26:126-9. [DOI: 10.1016/j.jocn.2015.06.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/21/2015] [Accepted: 06/14/2015] [Indexed: 11/29/2022]
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Ibrahim TF, Hafez A, Andrade-Barazarte H, Raj R, Niemela M, Lehto H, Numminen J, Jarvelainen J, Hernesniemi J. De novo giant A2 aneurysm following anterior communicating artery occlusion. Surg Neurol Int 2015; 6:S560-5. [PMID: 26664872 PMCID: PMC4653326 DOI: 10.4103/2152-7806.168074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 08/23/2015] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND De novo intracranial aneurysms are reported to occur with varying incidence after intracranial aneurysm treatment. They are purported to be observed, however, with increased incidence after Hunterian ligation; particularly in cases of carotid artery occlusion for giant or complex aneurysms deemed unclippable. CASE DESCRIPTION We report a case of right-sided de novo giant A2 aneurysm 6 years after an anterior communicating artery (ACoA) aneurysm clipping. We believe this de novo aneurysm developed in part due to patient-specific risk factors but also a significant change in cerebral hemodynamics. The ACoA became occluded after surgery that likely altered the cerebral hemodynamics and contributed to the de novo aneurysm. We believe this to be the first reported case of a giant de novo aneurysm in this location. Following parent vessel occlusion (mostly of the carotid artery), there are no reports of any de novo aneurysms in the pericallosal arteries let alone a giant one. The patient had a dominant right A1 and the sudden increase in A2 blood flow likely resulted in increased wall shear stress, particularly in the medial wall of the A2 where the aneurysm occurred 2 mm distal to the A1-2 junction. CONCLUSION ACoA preservation is a key element of aneurysm surgery in this location. Suspected occlusion of this vessel may warrant closer radiographic follow-up in patients with other risk factors for aneurysm development.
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Affiliation(s)
- Tarik F Ibrahim
- Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland, USA ; Department of Neurosurgery, Loyola University Medical Center, Maywood, IL, USA
| | - Ahmad Hafez
- Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland, USA
| | | | - Rahul Raj
- Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland, USA
| | - Mika Niemela
- Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland, USA
| | - Hanna Lehto
- Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland, USA
| | - Jussi Numminen
- Department of Neuroradiology, Helsinki University Hospital, Helsinki, Finland, USA
| | - Juha Jarvelainen
- Department of Neuroradiology, Helsinki University Hospital, Helsinki, Finland, USA
| | - Juha Hernesniemi
- Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland, USA
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Biesbroek JM, Rinkel GJ, Algra A, van der Sprenkel JWB. Risk Factors for Acute Subdural Hematoma From Intracranial Aneurysm Rupture. Neurosurgery 2012; 71:264-8; discussion 268-9. [DOI: 10.1227/neu.0b013e318256c27d] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
An acute subdural hematoma (aSDH) is a rare complication of aneurysmal subarachnoid hemorrhage (SAH) and is associated with poor clinical condition on admission and poor outcome. Risk factors for the development of an aSDH from aneurysmal rupture are unknown and may help our understanding of how an aSDH develops.
OBJECTIVE:
To identify risk factors for the development of an aSDH from intracranial aneurysm rupture.
METHODS:
Patients were selected from our prospectively collected single-center SAH database. From all 1757 patients fulfilling prespecified inclusion criteria, 63 had an aSDH. We assessed sex, age, smoking, hypertension, history of SAH, sentinel headache, location of the ruptured aneurysm, and intracerebral hemorrhage (ICH) as risk factors for an aSDH. Univariable and multivariable risk ratios with corresponding 95% confidence intervals (CIs) were calculated for characteristics with Poisson regression.
RESULTS:
Multivariable risk ratios were 1.021 (95% CI: 1.001-1.042) for each year increase in age, 2.3 (95% CI: 1.3-3.8) for posterior communicating artery aneurysms, 3.0 (95% CI: 1.5-6.0) for sentinel headache, and 5.2 (95% CI: 3.1-8.9) for ICH. None of the 95 patients (0%; 95% CI: 0%-3.8%) with a ruptured vertebrobasilar aneurysm had an aSDH, which was statistically significantly lower than at other sites (P = .02 for basilar aneurysm; P = .04 for vertebral aneurysm). None of the other studied characteristics had a statistically significant association with an aSDH.
CONCLUSION:
Increasing age, sentinel headache, ICH, and aneurysms at the posterior communicating artery are independent risk factors for an aSDH. Patients with a basilar or vertebral aneurysm have a low risk of an aSDH.
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Affiliation(s)
- J. Matthijs Biesbroek
- Utrecht Stroke Center, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Gabriel J.E. Rinkel
- Utrecht Stroke Center, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ale Algra
- Utrecht Stroke Center, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jan Willem Berkelbach van der Sprenkel
- Utrecht Stroke Center, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
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Matsushima K, Kawashima M, Suzuyama K, Takase Y, Takao T, Matsushima T. Thrombosed giant aneurysm of the distal anterior cerebral artery treated with aneurysm resection and proximal pericallosal artery-callosomarginal artery end-to-end anastomosis: Case report and review of the literature. Surg Neurol Int 2011; 2:135. [PMID: 22059130 PMCID: PMC3205492 DOI: 10.4103/2152-7806.85608] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 08/04/2011] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Giant distal anterior cerebral artery (DACA) aneurysms are extremely rare, with only 32 cases reported in the literature. Most giant DACA aneurysms have features that make standard neck clipping difficult, and bypass surgery is sometimes required, although this surgery was performed in only three reported cases. This report presents the fourth case treated with bypass surgery. CASE DESCRIPTION A 69-year-old female presented with an unruptured thrombosed giant DACA aneurysm. She underwent wrapping operation 7 years before, but radiological imaging revealed enlargement of the aneurysm at the left pericallosal artery (PerA)-callosomarginal artery (CMA) junction. Before operation, three different strategies were considered for bypass surgery in case the neck could not be clipped. Aneurysm resection and left proximal PerA-CMA end-to-end anastomosis were successfully performed under intraoperative digital subtraction angiography (DSA) and motor-evoked potential (MEP) monitoring. CONCLUSION Most DACA aneurysms are located at the PerA-CMA junction. In some cases, adequate retrograde flow to the distal PerA from the posterior or middle cerebral artery can be expected, making distal PerA reconstruction unnecessary. Moreover, when the distal PerA is cut, proximal PerA-CMA end-to-end anastomosis can be easily performed because of reduced tension in both vessels. We therefore conclude that this strategy should be utilized for treating such patients. We also presented here the effectiveness of intraoperative modalities, such as intraoperative DSA and MEP monitoring, for performing a safe operation.
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Affiliation(s)
- Ken Matsushima
- Department of Neurosurgery, Saga University, Saga, Japan
| | | | - Kenji Suzuyama
- Department of Neurosurgery, Saga University, Saga, Japan
| | | | - Tetsuro Takao
- Department of Neurosurgery, Saga University, Saga, Japan
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Marbacher S, Fandino J, Lukes A. Acute subdural hematoma from ruptured cerebral aneurysm. Acta Neurochir (Wien) 2010; 152:501-7. [PMID: 19855924 DOI: 10.1007/s00701-009-0521-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2009] [Accepted: 09/09/2009] [Indexed: 11/29/2022]
Abstract
PURPOSE The combination of ruptured aneurysms with acute subdural hematomas (aSDHs) is a rare presentation. Patients with aSDH associated with aneurysmal bleeding represent a subgroup within the spectrum of aneurysmatic hemorrhage. We summarize the clinical characteristics, diagnostic evaluation, and management of a series of cases presenting with aSDH associated with aneurysmal subarachnoid hemorrhage (SAH). METHODS Medical records and surgical reports of 743 consecutive patients admitted to our institution with SAH from January 1995 to December 2007 were screened to detect cases of associated aSDH. Admission evaluations included the Glasgow Coma Scale (GCS) and the subarachnoid grade of the World Federation of Neurosurgical Societies (WFNS). Radiological assessment included computer tomography (CT) scan, CT angiography (CTA), and digital subtraction angiography (DSA). The presence and volume of SAH, intracerebral hemorrhage (ICH), and aSDH were documented. Outcome was measured in terms of Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) at 4-8 months. RESULTS A total of seven cases (0.9%) presenting with aSDH (mean width: 11.2 mm +/- 4.8 mm, range: 5-20 mm) attributable to SAH were documented. Three of these patients were admitted with a suspicion of trauma. Five patients presented with WFNS grade 5, one patient with WFNS grade 3, and one patient with WFNS grade 1. All patients underwent evacuation of the aSDH. In four patients, surgical obliteration of the aneurysm was achieved in the same procedure. Two patients underwent delayed occlusion of the aneurysm: one by coiling and one by clipping. Three of the seven patients recovered completely from their neurological deficits (GOS 5, mRS 0-1), three recovered with mild disability (GOS 4, mRS 2-3), and one died within 8 h after the decompressive procedure. CONCLUSIONS The incidence of aSDH associated with SAH is low. Most of the patients with aSDH due to a ruptured aneurysm present in exceptionally poor neurological condition. Nevertheless, rapid surgical treatment of the hematoma and aneurysm obliteration can lead to a favorable outcome. Routine CTA should be performed in all patients presenting with an aSDH associated with SAH and no clear history of trauma.
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MESH Headings
- Adult
- Aged
- Angiography, Digital Subtraction
- Comorbidity
- Embolization, Therapeutic/instrumentation
- Embolization, Therapeutic/methods
- Emergency Medical Services/methods
- Female
- Glasgow Coma Scale
- Hematoma, Subdural, Acute/diagnostic imaging
- Hematoma, Subdural, Acute/epidemiology
- Hematoma, Subdural, Acute/pathology
- Humans
- Incidence
- Intracranial Aneurysm/diagnostic imaging
- Intracranial Aneurysm/epidemiology
- Intracranial Aneurysm/pathology
- Male
- Middle Aged
- Neurosurgical Procedures/instrumentation
- Neurosurgical Procedures/methods
- Outcome Assessment, Health Care/methods
- Predictive Value of Tests
- Prognosis
- Prosthesis Implantation/methods
- Retrospective Studies
- Severity of Illness Index
- Surgical Instruments
- Tomography, X-Ray Computed
- Treatment Outcome
- Vascular Surgical Procedures/instrumentation
- Vascular Surgical Procedures/methods
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Affiliation(s)
- Serge Marbacher
- Department of Neurosurgery, Inselspital, University of Bern, 3010 Bern, Switzerland.
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Lehecka M, Dashti R, Lehto H, Kivisaari R, Niemelä M, Hernesniemi J. Distal Anterior Cerebral Artery Aneurysms. SURGICAL MANAGEMENT OF CEREBROVASCULAR DISEASE 2010; 107:15-26. [DOI: 10.1007/978-3-211-99373-6_3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Gelfenbeyn M, Natarajan SK, Sekhar LN. Large distal anterior cerebral artery aneurysm treated with resection and interposition graft: case report. Neurosurgery 2009; 64:E1008-9; discussion E1009. [PMID: 19404124 DOI: 10.1227/01.neu.0000339119.92564.29] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Distal anterior cerebral artery (DACA) aneurysms are rare, representing only 2% to 6.7% of all intracranial aneurysms. Most of them are small. Large and giant aneurysms are even rarer in this location. Only 26 giant pericallosal (PC) aneurysms have been reported thus far. Various surgical techniques have been used to treat these aneurysms, including direct aneurysm neck clipping, aneurysm trapping, proximal occlusion of the anterior cerebral artery, or a combination of clipping with coiling or a bypass procedure. The report presents an unusual case of a complex DACA aneurysm managed by resection and interposition arterial graft. CLINICAL PRESENTATION A 69-year-old woman presented with acute onset of a severe headache. A digital subtraction angiogram showed a partially thrombosed, complex broad-necked A2-A3 junction aneurysm involving the origin of PC and callosomarginal vessels with a probability of a dissection of the DACA. The left PC artery was significantly narrowed. Because of the complex neck and involvement of the origin of PC and callosomarginal arteries, endovascular treatment was not possible, and microsurgical treatment was planned. TECHNIQUE A large, partially thrombosed, and fusiform anterior cerebral artery A2-A3 aneurysm, with evidence of previous bleeding, was found and treated with resection and a short interposition graft using a segment of the superficial temporal artery. CONCLUSION Surgical treatment of a large DACA aneurysm may be difficult due to a complex neck and the involvement of the branch vessels. Resection and interposition grafting and A3-A3 or A4-A4 anastomoses are treatment options for such patients.
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Affiliation(s)
- Mikhail Gelfenbeyn
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
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Pandey A, Rosenwasser RH, Veznedaroglu E. Management of distal anterior cerebral artery aneurysms: a single institution retrospective analysis (1997-2005). Neurosurgery 2008; 61:909-16; discussion 916-7. [PMID: 18091267 DOI: 10.1227/01.neu.0000303186.26684.81] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Our goal was to assess the clinical and angiographic outcomes among patients undergoing treatment for distal anterior cerebral artery aneurysms at the Jefferson Hospital for Neuroscience (1997-2005). METHODS Forty-one patients (1.5% of all aneurysms treated) with distal anterior cerebral artery aneurysms had undergone treatment. The clinical and angiographic outcomes of these patients were studied retrospectively using chart reviews, operative reports, and angiographic reports. The mean clinical and angiographic follow-up periods were 16 months (range, 3-74 mo) and 16.5 months (range, 6-81 mo), respectively. RESULTS Twenty-eight (68%) patients had undergone endovascular embolization (22 women, six men; mean age, 58.2 yr), whereas 13 (32%) had undergone microsurgery for clip ligation (six men, seven women; mean age, 47.4 yr). Within the coiled group, 50% of the patients belonged in the Hunt and Hess (HH) III and IV groups, whereas 46.2% of the patients in the clipped group were elective patients (HH Grade 0). The mean aneurysmal sizes among the clipped and coiled groups were 4.9 and 5.5 mm, respectively. Among the clipped patient population, 100% of the patients had successful clip ligation as evidenced by intraoperative cerebral angiography, there was a 0% recurrence rate among the two patients who have had long-term follow-up, 0% recurrent subarachnoid hemorrhage, and 92% patients achieved a modified Glasgow Outcome Scale score of I to II. Among the coiled patient population, there was an 89% rate of successful embolization, 18% recurrence rate, 0% recurrent subarachnoid hemorrhage, and 64% achieved a modified Glasgow Outcome Scale score of I to II. None of the patients had clinically symptomatic vasospasm. A strong correlation existed between having a ventriculostomy and requiring a shunt in patients with HH Grade IV compared with patients in HH Grades I through III. CONCLUSION In our analysis, clinical outcomes were better in the clipped group; however, the differences are not statistically significant (P = 0.3675) and are explained by the selection bias. Statistically significant predictors of outcomes were age (<60 yr), size of the aneurysm (>5 mm), absence of ventriculostomy, and presenting HH grade.
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Affiliation(s)
- Aditya Pandey
- Department of Neurosurgery, Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania 19107, USA
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Park DH, Chung YG, Shin IY, Lee JB, Suh JK, Lee HK. Thrombosed giant aneurysm of the pericallosal artery with inconclusive findings of multiple neuroimaging studies. Neurol Med Chir (Tokyo) 2008; 48:26-9. [PMID: 18219189 DOI: 10.2176/nmc.48.26] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 65-year-old woman presented with a thrombosed giant pericallosal artery aneurysm manifesting as headache and memory loss that developed over a 2-year period. Computed tomography (CT), magnetic resonance (MR) imaging, and conventional and CT angiography could not establish the differential diagnosis. Open craniotomy revealed the mass as thrombosed giant aneurysm from the pericallosal artery. Direct clipping with thrombectomy was performed successfully with an uneventful postoperative course. Thrombosed giant aneurysm of the distal anterior cerebral artery should be considered in the differential diagnosis of an unusual mass in the mid-frontal area, particularly in the presence of inconclusive angiographic and MR imaging findings.
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Affiliation(s)
- Dong-Hyuk Park
- Department of Neurosurgery, Korea University, College of Medicine, Seoul, ROK
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12
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Yuen CM, Kuo YL, Ho JT, Liao JJ. Rapid regrowth of a successfully coiled traumatic pericallosal aneurysm. J Clin Neurosci 2007; 14:1215-9. [PMID: 17656097 DOI: 10.1016/j.jocn.2006.04.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2006] [Revised: 04/11/2006] [Accepted: 04/16/2006] [Indexed: 11/20/2022]
Abstract
Regrowth of an intracranial aneurysm is a known complication of endovascular coiling. We report a patient with a traumatic pericallosal aneurysm which was initially treated successfully with endovascular coiling. Six-month follow-up angiography showed aneurysm regrowth with migration of the coils. To our knowledge, recurrence of a coiled pericallosal aneurysm of traumatic etiology has not been previously reported. Endovascular coiling may not be the best primary treatment for traumatic pericallosal artery aneurysms.
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Affiliation(s)
- Chun-Man Yuen
- Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan Hospital, 123, Ta-pei Road, Niaosung Hsiang, Kaohsiung Hsien, Taiwan
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