Intracranial aneurysms

Gasparotti, Roberto; Liserre, Roberto

doi:10.1007/s00330-004-2614-8

Cited by 63 publications

(52 citation statements)

References 25 publications

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“…Intracranial aneurysmal daughter blebs [1,2,3,4,5], also known as ‘daughter aneurysm’ [1,6,7,8,9,10], ‘bleb’ [11,12,13,14,15,16,17,18,19], ‘daughter sac’ [20,21,22], ‘bubble’ [6], ‘loculation’ [23,24,25,26], ‘lobulation’ [27,28,29,30,31], ‘secondary loculus’ [24,32], ‘nipple’ [15,33,34,35,36,37,38] or ‘Murphy’s tit’ [39], are focal bulges that are commonly observed on the surface of original aneurysm walls. This type of lesion is distinguished from the pseudoaneurysm outpouching caused by bleeding [40,41].…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Analysis of Intracranial Aneurysms with Daughter Blebs

Zhang

Chen

et al. 2011

Eur Neurol

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Background and Purpose: Intracranial aneurysms with daughter blebs appear to have a higher risk of rupture. Whether hemodynamic factors are involved in this phenomenon is not clear. Methods: 54 patient-specific aneurysms harboring 69 daughter blebs were divided into ruptured and unruptured groups based on their clinical history. Realistic models were retrospectively constructed and analyzed by a computational fluid dynamic method. Results: There were no differences in the aspect ratio and morphology type of the aneurysms, the size of blebs or other common risk factors between the two groups. The wall shear stress (WSS) was significantly lower while the oscillatory shear index (OSI) was higher in the daughter blebs than in the primary aneurysms. Bleb-bearing aneurysms with a rupture history displayed significantly lower WSS in the daughter bleb. Of the daughter blebs, 73.9% were localized to the impingement region of the inflow jet. Conclusion: These observations indicate that low WSS and high OSI in the daughter blebs might be involved in increasing the risk of rupture. The localized striking force caused by inflow jets may contribute to the development of daughter blebs. However, a precise role of hemodynamics in predicting the future rupture of daughter blebs needs further study.

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Section: Introductionmentioning

confidence: 99%

Hemodynamic Analysis of Intracranial Aneurysms with Daughter Blebs

Zhang

Chen

et al. 2011

Eur Neurol

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“…However, several studies have shown that MRA can be inaccurate in the diagnosis of IAs [45][46][47] and can detect only 85 % of aneurysms diagnosed on angiography [48]. The efficacy of both CTA and MRA has been shown to decrease with smaller aneurysm size [42,49,50], with sensitivities dropping to 61 and 38 % for 3 mm aneurysms, respectively [50].…”

Section: Diagnostic Testsmentioning

confidence: 98%

Treatment of Intracranial Aneurysms: Clipping Versus Coiling

Liu

Huang

2015

Curr Cardiol Rep

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Intracranial aneurysms (IAs) have an estimated incidence of up to 10 % and can lead to serious morbidity and mortality. Because of this, the natural history of IAs has been studied extensively, with rupture rates ranging from 0.5 to 7 %, depending on aneurysm characteristics. The spectrum of presentation of IAs ranges from incidental detection to devastating subarachnoid hemorrhage. Although the gold standard imaging technique is intra-arterial digital subtraction angiography, other modalities such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are being increasingly used for screening and treatment planning. Management of these patients depends upon a number of factors including aneurysmal, patient, institutional, and operator factors. The ultimate goal of treating patients with IAs is complete and permanent occlusion of the aneurysm sac in order to eliminate future hemorrhagic risk, while preserving or restoring the patient's neurological function. The most common treatment approaches include microsurgical clipping and endovascular coiling, and multiple studies have compared these two techniques. To date, three large prospective, randomized studies have been done: a study from Finland, International Subarachnoid Aneurysm Trial (ISAT), and the Barrow Ruptured Aneurysm Trial (BRAT). Despite differences in methodology, the results were similar: in patients undergoing coiling, although rates of rebleeding and retreatment are higher, the overall rate of poor outcomes at 12 months was significantly lower. As minimally invasive procedures and devices continue to be refined, endovascular strategies are likely to increase in popularity. However, as long-term outcome studies become available, it is increasingly apparent that they are complementary treatment strategies, with patient selection of critical importance.

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“…Whereas DSA is the gold standard for identifying cerebral aneurysms, CTA is gaining increasing acceptance, thanks to its immediacy and noninvasiveness and a specificity and sensitivity comparable with DSA. CTA also has a significant advantage in that it can be performed immediately following the baseline CT examination, which enables a significant shortening of examination times and the possibility of initiating treatment immediately [10][11][12][13][14][15][16][17][18][19][20][21][22][23].…”

Section: Parole Chiave Angio-tc Multistrato • Aneurisma Cerebralementioning

confidence: 99%

“…Lo studio angiografico cerebrale a sottrazione digitale rappresenta il gold standard per l'evidenziazione degli aneurismi cerebrali; l'ATC viene sempre più utilizzata per l'immediatezza e la non invasività associate a specificità e sensibilità comparabili con la DSA. L'ATC inoltre ha il grande vantaggio di poter essere eseguita in rapida successione all'esame TC di base consentendo di accorciare sensibilmente i tempi e di poter procedere tempestivamente al trattamento [10][11][12][13][14][15][16][17][18][19][20][21][22][23].…”

Section: Parole Chiave Angio-tc Multistrato • Aneurisma Cerebraleunclassified