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Strategies in the Treatment of Distal Cerebellar Aneurysms: Report of a Series of 11 Patients.
MedLine Citation:
PMID:  22585564     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background Distal cerebellar artery aneurysms are rare entities and treatment modalities technically challenging. In recent years, new therapeutic options have emerged through microsurgical and endovascular means.Objective Based on a series of 11 cases, we describe combined interdisciplinary treatment strategies and report the outcome in a midterm follow-up interval of 12 months.Methods Collection of clinical case data during acute phase and follow-up including standardized angiographic control intervals during follow-up and assessment of the outcome.Results 7 of 11 reported cases had flow-related aneurysms based on an underlying arteriovenous malformation (AVM) or dural arteriovenous fistula (DAVF); we found multiple aneurysms in four cases. All patients with flow-related aneurysms presented with subarachnoid hemorrhage (SAH). Only one of four patients in this series without an underlying AVM or DAVF presented with SAH that was attributable to a distal cerebellar aneurysm. In one case, we observed a de novo formation of two flow-associated distal aneurysms (10 years interval). Two patients were treated conservatively, five patients were treated endovascularly, one patient was treated surgically and three patients were treated with combined methods. 9 of 11 patients with initial SAH had a good outcome.Conclusions Distal cerebellar aneurysms associated with AVM or DAVF are rare but characterized by a high risk of hemorrhage. The present series indicates that an experienced interdisciplinary team and the combination of available techniques may lead to a reduction of complications and to a better outcome.
Authors:
Ali Harati; Anastasios Mpotsaris; Frauke Lohmann; Christian Loehr; Werner Weber; Maximilian J A Puchner
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-14
Journal Detail:
Title:  Journal of neurological surgery. Part A, Central European neurosurgery     Volume:  -     ISSN:  2193-6323     ISO Abbreviation:  J Neurol Surg A Cent Eur Neurosurg     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101580767     Medline TA:  J Neurol Surg A Cent Eur Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Affiliation:
Department of Neurosurgery, Klinikum Vest, Recklinghausen, Germany.
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