Document Detail


Endovascular treatment of posterior cerebral artery aneurysms.
MedLine Citation:
PMID:  16484397     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The purpose of this study was to report the incidence, clinical presentation, endovascular treatment, and outcome of aneurysms of the posterior cerebral artery (PCA). PATIENTS AND METHODS: Among 1880 aneurysms treated between January 1995 and January 2005, 22 aneurysms (1.2%) in 22 patients were located on the PCA. Ten patients presented with subarachnoid hemorrhage (SAH) from the PCA aneurysm: 2 of these patients had additional visual field deficits and 2 had additional occulomotor palsy. One patient presented with acute occulomotor palsy only. Eleven PCA aneurysms were unruptured: 9 were additional to another ruptured aneurysm and 2 were incidentally discovered. Three aneurysms were >15 mm and the other 19 aneurysms were < or = 8 mm. Eighteen aneurysms were saccular, 2 were fusiform, one was dissecting, and one was mycotic. RESULTS: All aneurysms were successfully treated, 17 with selective occlusion of the aneurysm with coils and 5 with simultaneous occlusion of the aneurysm and parent PCA with coils. There were no complications of treatment. Two patients died of sequelae of SAH shortly after treatment. One patient died 2 months after coiling of an unruptured P1 aneurysm with intramural thrombus of SAH from the same aneurysm. One patient had persistent hemianopsia. In 2 patients with intact visual field in which the parent PCA was occluded, no hemianopsia developed due to sufficient leptomeningeal collateral circulation. CONCLUSION: Aneurysms of the PCA are rare with an incidence in our practice of 1.2% of all types of aneurysms. Clinical presentation is variable with SAH, occulomotor palsy, visual field deficit or a combination. Endovascular treatment with either selective occlusion of the aneurysm or occlusion of the aneurysm together with the parent artery with coils is safe and effective with good clinical results.
Authors:
W J van Rooij; M Sluzewski; G N Beute
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Publication Detail:
Type:  Case Reports    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  27     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-02-17     Completed Date:  2006-04-13     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  300-5     Citation Subset:  IM    
Affiliation:
Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Ruptured / mortality,  radiography,  therapy*
Cerebral Angiography
Embolization, Therapeutic*
Female
Follow-Up Studies
Glasgow Outcome Scale
Hemianopsia / etiology,  mortality,  radiography
Humans
Incidental Findings
Intracranial Aneurysm / mortality,  radiography,  therapy*
Male
Middle Aged
Prognosis
Subarachnoid Hemorrhage / mortality,  radiography,  therapy*
Survival Rate
Tomography, X-Ray Computed
Visual Fields / physiology

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