Document Detail


Peripheral intracranial aneurysms: management challenges in 60 consecutive cases.
MedLine Citation:
PMID:  18928355     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The authors report the management and outcomes of 55 patients with 60 intracranial aneurysms arising distal to the major branch points of the circle of Willis and vertebrobasilar system. METHODS: Between July 1997 and December 2006, the authors' neurovascular service treated 2021 intracranial aneurysms in 1850 patients. The database was reviewed retrospectively to identify peripherally located intracranial aneurysms. Aneurysms that were mycotic and aneurysms that were associated with either an arteriovenous malformation or an atrial myxoma were excluded from review. RESULTS: The authors encountered 60 peripheral intracranial aneurysms in 55 patients. There were 42 small, 7 large, and 11 giant lesions. Forty-one (68%) were unruptured, and 19 (32%) had bled. Fifty-three aneurysms were treated surgically by using direct clip reconstruction in 26, trapping or proximal occlusion with distal revascularization in 21, excision with end-to-end anastomosis in 3, and circumferential wrap/clip reconstruction in 3. Coils were used to treat 6 aneurysms, and 1 was treated by endovascular parent artery occlusion. Overall, 49 patients had good outcomes, 4 were left with new neurological deficits, and 2 died. CONCLUSIONS: Peripherally situated intracranial aneurysms are rare lesions that present unique management challenges. Despite the fact that in the authors' experience these lesions were rarely treatable with simple clipping of the aneurysm neck or endovascular coil occlusion, preservation of the parent artery was possible in most cases, and the majority of patients had a good outcome.
Authors:
Eric S Nussbaum; Michael T Madison; James K Goddard; Jeffrey P Lassig; Leslie A Nussbaum
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  110     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-02-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  7-13     Citation Subset:  AIM; IM    
Affiliation:
National Brain Aneurysm Center, St. Joseph's Hospital, St. Paul, Minnesota, USA. lnussbaum@comcast.net
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cerebral Angiography
Cerebral Revascularization
Child
Child, Preschool
Circle of Willis / radiography,  surgery*
Female
Humans
Intracranial Aneurysm / radiography,  surgery*
Male
Middle Aged
Monitoring, Intraoperative
Neurosurgical Procedures*
Postoperative Complications / etiology,  therapy
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome
Ventriculoperitoneal Shunt

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


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