Document Detail


Clinical presentation and management of giant anterior communicating artery region aneurysms.
MedLine Citation:
PMID:  10659014     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The authors reviewed their 20-year experience with giant anterior communicating artery aneurysms to correlate aneurysm size with clinical presentation and to analyze treatment methods. METHODS: In 18 patients, visual and cognitive impairment were quantitated and clinical outcome was categorized according to the Rankin scale. Statistical analysis was performed using Fisher's exact test. CONCLUSIONS: At least 3.5 cm of aneurysm mass effect was required to produce dementia in the patient (p = 0.0004). Dementia was usually caused by direct brain compression by the aneurysm rather than by hydrocephalus. Optic apparatus compression occurred with smaller aneurysms (2.7-3.2 cm) when they pointed inferiorly. Aneurysm neck clipping was possible in half of the cases. Special techniques, including temporary clipping, evacuation of intraluminal thrombus, tandem and/or fenestrated clipping, and clip reconstruction were often required. Occlusion of or injury to the anterior cerebral artery (ACA) was the main cause of poor outcome or death. Proximal ACA occlusion, even of dominant A1 segments with small or no contralateral A1 artery, was an effective treatment alternative and was well tolerated as a result of excellent leptomeningeal collateral circulation.
Authors:
S P Lownie; C G Drake; S J Peerless; G G Ferguson; D M Pelz
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  92     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-02-14     Completed Date:  2000-02-14     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  267-77     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Neurological Sciences (Neurosurgery), University of Western Ontario, London, Ontario, Canada. lownies@lhsc.on.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anterior Cerebral Artery / surgery
Cause of Death
Cerebral Angiography
Child
Female
Humans
Intracranial Aneurysm / diagnosis,  mortality,  surgery*
Male
Middle Aged
Neurologic Examination
Surgical Instruments
Survival Rate
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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