Jamshidi AM, Soldozy S, Elarjani T, Burks JD, Luther E, Starke RM. Fusiform Dilatation of the Internal Carotid Artery in Childhood-Onset Craniopharyngioma- A Systematic Review.
World Neurosurg 2021;
162:77-84. [PMID:
34555575 DOI:
10.1016/j.wneu.2021.09.058]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE
Patients with fusiform dilation of the internal carotid artery (FDCA) following pediatric craniopharyngioma resection typically have a benign clinical course. We sought to review the neurosurgical literature for FDCA outcomes after resection of these tumors.
METHODS
Using PubMed, Web of Science, and Cochrane databases we identified surgical series or case reports reporting incidences of FDCA following craniopharyngioma resection. Inclusion criteria included FDCA outcomes reported specifically after craniopharyngioma resection, with at least 6 months of follow-up data.
RESULTS
Our literature search yielded 12 full-text articles. This resulted in a total of 799 patients (376, 52.3% males). The weighted mean follow-up was 74.8 (9-140) months. The majority of tumors were found to be suprasellar (62.1%), with traditional microsurgery being more commonly employed than endoscopic endonasal surgery (80.9% versus 19.1%). Gross total resection was achieved in 42.6% of cases. A total of 55 aneurysms were reported, most commonly occurring at the terminal internal carotid artery (ICA) (66.7%) . Aneurysmal progression on follow-up occurred in 10 (18.5%) cases, with no reports of rupture. A total of 10 (18.2%) of aneurysms were treated with clipping, endovascular, or bypass techniques.
CONCLUSIONS
FDCA is a rare complication following pediatric craniopharyngioma resection. The exact cause is unclear, and factors related to tumor invasiveness, size, location, and differences in surgical approach all may contribute to FDCA development. The majority of patients who go on to develop FDCA follow an innocuous course on follow-up, with no reports of rupture in the present literature. For this reason, patients rarely require surgical or endovascular intervention for these lesions, and conservative management is favored.
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