Multiple intracranial aneurysms: Surgical treatment and outcome

Cervoni, Luigi; Delfini, Roberto; Santoro, Antonio; Cantore, Giampaolo

doi:10.1007/bf01401124

Cited by 22 publications

(7 citation statements)

References 16 publications

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“…Therefore, treatment should be initiated as soon as possible in hemorrhaging patients 19,20. In order to treat bleeding MirAn, the initial treatment should focus primarily on the hemisphere with the bleeding aneurysm 17,21,22. Our findings suggested that the rupture risk was significantly higher for large aneurysms, which is consistent with the findings of previous studies 11,23.…”

Section: Discussionsupporting

confidence: 89%

A comparative study of 43 patients with mirror-like intracranial aneurysms: risk factors, treatment, and prognosis

Wang¹,

Zhang²,

Zhao³

et al. 2014

NDT

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Background and objectiveMirror-like intracranial aneurysms (MirAn) occur symmetrically at the corresponding intracranial arteries and are a subgroup of multiple intracranial aneurysms. The aim of this study was to analyze the risk factors, treatment, and prognosis of MirAn.MethodsWe retrospectively analyzed 43 cases of MirAn diagnosed between January 2000 and December 2009. The control groups comprised patients with non-mirror-like multiple aneurysms (nMirAn) and single aneurysms (SingAn). Sex, age, localization of MirAn, hypertension, diabetes, smoking, and rupture were identified as potential risk factors for MirAn.ResultsThe male to female ratio of the MirAn patients was 1.0:5.1, which was significantly different from that of the nMirAn patients (1.0:1.9, P=0.037) and SingAn patients (1.0:1.3, P<0.001). There was no difference in age (P=0.8741), smoking (P=0.301), diabetes (P=0.267), or hypertension (P=0.874) between the MirAn and nMirAn patients. The aneurysms in 28 MirAn patients (65.1%) involved the internal carotid-posterior communicating arteries; in these patients, the rupture risk was significantly higher for larger aneurysms compared with smaller aneurysms (P<0.05).ConclusionMore women suffered from MirAn than nMirAn or SingAn. The most common MirAn sites were the internal carotid-posterior communicating arteries. Our results suggest that MirAn was not associated with age, smoking, hypertension, or diabetes.

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Section: Discussionsupporting

confidence: 89%

A comparative study of 43 patients with mirror-like intracranial aneurysms: risk factors, treatment, and prognosis

Wang¹,

Zhang²,

Zhao³

et al. 2014

NDT

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“…4,5,26 Surgical clipping of all aneurysms can be performed in one session in 70 to 80% of patients with multiple intracranial aneurysms. 2,5,26,31,38 A unilateral location of multiple intracranial aneurysms in the anterior circulation is more favorable for a one-stage procedure than one involving the bilateral anterior circulation or a combination of anterior and posterior circulation. 25,31,38 The onestage procedure can be performed using a unilateral, a contralateral, or a bilateral surgical approach.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of multiple intracranial aneurysms by using Guglielmi detachable coils

Solander¹,

Ulhôa²,

Viñuela³

et al. 1999

Journal of Neurosurgery

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“…[10][11][12][13] In patients with multiple aneurysms that cannot be clipped in one surgical session, rapid, accurate identification of the ruptured aneurysm is important. 14,15 Inaccurate determination of the site of the ruptured aneurysm may result in clipping of the wrong aneurysm. It has been reported that postoperative re-bleeding is usually due to a misinterpretation of the location of the ruptured aneurysm in the presence of multiple aneurysms.…”

Section: Jssn 2018; 21 (1)mentioning

confidence: 99%

Prediction of aneurysm location based on pattern of bleed on CT scan

Rajbhandari

Sharma

Shilpakar

et al. 2018

J. Soc. Surg. Nepal

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Introduction: Computed tomography (CT) is the ‘gold standard’ for detecting subarachnoid hemorrhage (SAH) and digital subtraction angiography (DSA) for visualizing the vascular pathology. There is some correlation between the pattern (based on Fisher grading) and location of bleed on CT scan and eventual location of cerebral aneurysm(s). Our aim was to assess the correlation between distribution of hemorrhage on the initial CT scan and eventual site of the ruptured aneurysm at our institution. Methods: This retrospective review of prospectively collected data consisted of 50 patients with SAH over 8 months period. CT scan of patients performed within 72 hours after the ictus with suspected SAH were included in the study. Four neurosurgeons, who had at least three years of experience after being qualified, who were blind to the imaging studies, analyzed and scored independently the quantity and distribution of the hemorrhage on CT. Their prediction of the site of the ruptured aneurysm was recorded and this was correlated with the CT angiography (CTA) and/ or DSA findings. Results: Overall accuracy of prediction was 71.6 % (68.2-75%). Parenchymal cerebral hematoma was an excellent predictor for the site of a ruptured aneurysm but was present in only a few cases (16%). The next valid predictor was blood distribution on CT for ruptured anterior communicating artery (ACom) and middle cerebral artery (MCA) aneurysms (89.4% and 85% respectively). Pattern of blood on CT together with CTA/DSA findings was found to be reliable for identifying the ruptured aneurysm in patients with multiple aneurysms in all cases. Conclusion: The quantity and pattern of the blood on CT is a fairly reliable and quick tool for locating a ruptured MCA or ACom aneurysms. It is not, however, reliable for locating other ruptured aneurysms.

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Multiple intracranial aneurysms: Surgical treatment and outcome

Cited by 22 publications

References 16 publications

A comparative study of 43 patients with mirror-like intracranial aneurysms: risk factors, treatment, and prognosis

A comparative study of 43 patients with mirror-like intracranial aneurysms: risk factors, treatment, and prognosis

Endovascular treatment of multiple intracranial aneurysms by using Guglielmi detachable coils

Prediction of aneurysm location based on pattern of bleed on CT scan

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