| Management-related morbidity and mortality in unselected aneurysms of the basilar trunk and vertebrobasilar junction. | |
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MedLine Citation:
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PMID: 11437287 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTS: To analyze the management-related morbidity and mortality in unselected aneurysms of the basilar trunk and vertebrobasilar junction. The secondary objective was to investigate the factors associated with favourable or unfavourable surgical outcome in order to define subgroups for surgical and endovascular treatment. METHODS: 24 consecutive patients with aneurysms of the basilar trunk and vertebrobasilar junction were included in this study. They comprised 2.7% of all aneurysms treated during the study period between 1990 and 1997. 22 patients presented with acute subarachnoid hemorrhage (SAH) and 2 patients with symptoms of brainstem compresssion. All patients were managed using a standard protocol including surgery at the earliest possible moment, aggressive tripe-H therapy in patients with symptomatic vasospasm and mandatory follow-up angiography. 23 patients underwent surgical clipping and one patient endovascular coiling of the aneurysm. 12 patients had an excellent outcome. 6 patients had a good outcome, resulting in a total of satisfactory outcomes in 18 patients (75%). 4 patients (17%) had moderate to severe deficits. Two patients died (8%). Both patients had fusiform basilar trunk aneurysms. Good or excellent outcome was observed in 7 of 8 patients with aneurysms of the vertebrobasilar junction, 13 of 14 patients with moderate or minor SAH or without SAH (Fisher grade 0 to 2) and all patients with small sized aneurysm (n = 6). Factors mostly associated with poor outcome or death after surgical treatment were aneurysm location at the basilar trunk, large aneurysm size or fusiforme aneurysm type and severe SAH. CONCLUSIONS: Location, aneurysm size and the severity of SAH may help to predict the subgroup which highly benefits from surgical clipping of these rare vascular lesions. |
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Authors:
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V Seifert; A Raabe; D Stolke |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Acta neurochirurgica Volume: 143 ISSN: 0001-6268 ISO Abbreviation: Acta Neurochir (Wien) Publication Date: 2001 |
Date Detail:
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Created Date: 2001-07-04 Completed Date: 2001-12-04 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0151000 Medline TA: Acta Neurochir (Wien) Country: Austria |
Other Details:
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Languages: eng Pagination: 343-8; discussion 348-9 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Johann Wolfgang Goethe University, Frankfurt/Main, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aneurysm, Ruptured / mortality*, radiography, therapy* Basilar Artery / radiography, surgery* Cerebral Angiography Embolization, Therapeutic* Female Humans Intracranial Aneurysm / mortality*, radiography, therapy* Male Middle Aged Morbidity Patient Selection Severity of Illness Index Subarachnoid Hemorrhage / mortality*, radiography, therapy* Surgical Instruments Treatment Outcome Vertebral Artery / radiography, surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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