Document Detail


Treatment of ruptured lenticulostriate artery aneurysms.
MedLine Citation:
PMID:  18590430     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Lenticulostriate artery (LSA) aneurysms are rarely reported in the literature, making management decisions challenging. Conservative, endovascular, and surgical treatments have been described primarily through case reports and reports of individual authors' experiences. The purpose of this study is to report neurological outcomes in a single-institution experience of ruptured lenticulostriate aneurysms treated surgically. METHODS: The authors have conducted a retrospective review of all cases involving patients with ruptured LSA aneurysms who presented to the Mt. Sinai Hospital neurosurgical service between September 2001 and January 2007. RESULTS: Over 5.4 years, the authors treated 6 patients with 7 LSA aneurysms-6 ruptured and 1 unruptured. The Hunt and Hess grade on admission ranged from I to IV, with subarachnoid hemorrhage in 5 of the 6 patients. Catheter angiography confirmed the presence of the aneurysms, and all patients underwent a pterional craniotomy and clipping or resection of the aneurysm, performed by a single surgeon. Associated risk factors in our series of patients included hypertension, cocaine abuse, and intracranial occlusive disease suggestive of moyamoya disease. Two types of LSA aneurysms were identified. The mean size of the 6 ruptured aneurysms was 3.2 mm. The LSA was preserved in 3 of 6 patients, but LSA preservation did not correlate with development of a postoperative infarct, clinically or radiologically. In patients with ruptured aneurysms, the mean modified Rankin Scale score at discharge was 1.7. The 3 patients in whom the LSA was sacrificed had good outcomes, suggesting that loss of the artery is clinically well tolerated. CONCLUSIONS: This case series demonstrates that surgical treatment of ruptured LSA aneurysms can be an appropriate, effective, and safe therapy.
Authors:
Chirag D Gandhi; Ronit Gilad; Aman B Patel; Abilash Haridas; Joshua B Bederson
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  109     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-01     Completed Date:  2008-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  28-37     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey 07101, USA. gandhich@umdnj.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, Dissecting / complications,  diagnosis*,  surgery*
Basal Ganglia Cerebrovascular Disease / complications,  diagnosis*,  surgery*
Cohort Studies
Craniotomy
Female
Hemostatic Techniques
Humans
Intracranial Aneurysm / complications,  diagnosis*,  surgery*
Male
Middle Aged
Retrospective Studies
Subarachnoid Hemorrhage / diagnosis,  etiology,  therapy
Treatment Outcome

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


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