The Clinical Spectrum of Unruptured Intracranial Aneurysms

Raps, Eric C.; Rogers, John; Galetta, Steven; Solomon, Robert A.; Lennihan, Laura; Klebanoff, Louise M.; Fink, Matthew E.

doi:10.1001/archneur.1993.00540030031010

Cited by 186 publications

(120 citation statements)

References 28 publications

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“…Thrombosis in giant aneurysms is associated with surrounding brain edema and increased mass effect. 6,13,14) Therefore, steroids may have a role in the management of thrombosed giant aneurysms. 5) Intracavernous ICA aneurysms can be treated by aneurysm clipping via a direct surgical approach to the cavernous sinus or by occlusion of the proximal ICA.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Thrombosis of Intracavernous Internal Carotid Artery Aneurysm and Parent Artery Occlusion in Patients With Positive Balloon Test Occlusion. Two Case Reports.

Kurokawa

Kuroshima

Yoshida

et al. 2001

Neurol. Med. Chir.(Tokyo)

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Two patients with giant intracavernous internal carotid artery (ICA) aneurysms were intolerant to balloon test occlusion of the ICA, and later developed spontaneous thrombosis of the aneurysm and the parent ICA without ischemic sequelae. Case 1: A 60-year-old female with a giant right intracavernous ICA aneurysm presented with right abducens nerve paresis. An unsuccessful extracranial-tointracranial bypass graft operation was complicated by transient postoperative ophthalmoplegia. The patient did not tolerate balloon test occlusion of the right ICA after attempted bypass surgery, and was treated conservatively. The patient presented with acute onset of headache 3 years later. Case 2: A 50-year-old female with a giant right intracavernous ICA aneurysm presented with right abducens nerve paresis. The patient was managed conservatively after a positive balloon test occlusion of the right ICA. The patient suffered transient hypopituitarism and acute onset of headache 2 years later. Spontaneous thrombosis of the aneurysms and occlusion of the parent ICA were found in both patients. Neither had major hemispheric infarcts, but the first patient had asymptomatic infarcts, which were presumed to be thromboembolic in nature. Patients with intracavernous ICA aneurysms who have positive balloon test occlusions appear to develop tolerance to spontaneous and gradual occlusion of the ICA without significant sequelae. However, these patients have an increased risk of developing embolic infarctions. The role for anticoagulation and repeat hemodynamic tests remains unclear.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Thrombosis of Intracavernous Internal Carotid Artery Aneurysm and Parent Artery Occlusion in Patients With Positive Balloon Test Occlusion. Two Case Reports.

Kurokawa

Kuroshima

Yoshida

et al. 2001

Neurol. Med. Chir.(Tokyo)

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“…Unruptured CAAs most often remain asymptomatic, but they may manifest themselves through headache, which is reported by up to one fifth of patients with unruptured CAAs [2] and has no specific features in its onset, character or location [2][3][4][5]. In these cases focal symptoms, or signs, or seizures may accompany headache [5].…”

Section: Discussionmentioning

confidence: 99%

Headache attributed to unruptured saccular aneurysm, mimicking hemicrania continua

et al. 2005

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“…101) The mechanism for acute headache from unruptured cerebral aneurysms is most probably local thrombosis of aneurysms or local inflammation of the meninges. 77) Headache associated with the dura of the cavernous sinus or other skull base regions often improves after surgical treatment. 15,76) Coil embolization in 10 patients with large internal carotid artery aneurysms with headache or cranial nerve signs resulted in headache disappearing in all patients although Symptomatic Unruptured Cerebral Aneurysms aneurysm volume was larger than that before surgery due to the coil embolization; the improved headache may be due to reduced transmitted pulsations.…”

Section: Headache and Unruptured Cerebral Aneurysmsmentioning

confidence: 99%

“…75,77,100) Analysis of 269 cases of unruptured aneurysms found 9 cases (3.3%) of infarction due to migrated thrombus from the aneurysm 75) ; four were MCA aneurysms, three were IC aneurysms, and one each of posterior cerebral artery aneurysm and vertebral artery aneurysm. The sizes ranged from 5 to 45 mm (average 12.5 mm).…”

Section: Unruptured Cerebral Aneurysms Causing Cerebral Infarctionmentioning

confidence: 99%

Symptomatic Unruptured Cerebral Aneurysms: Features and Surgical Outcome

Date

2010

Neurol. Med. Chir.(Tokyo)

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Development of less invasive imaging studies, such as magnetic resonance angiography, has increased the chances that unruptured cerebral aneurysms are found. The rupture risk of``symptomatic'' aneurysms is higher than for``asymptomatic'' aneurysms; so``symptomatic'' aneurysms are more often surgically treated. Many reviews examine``asymptomatic'' unruptured cerebral aneurysms, but few evaluate``symptomatic'' aneurysms. The author has treated many patients with symptomatic unruptured cerebral aneurysms and found that improved cranial nerve signs can be expected if the surgical treatment is performed before the symptoms become irreversible; the critical period is approximately 3 months. It is important to suppress the pulsation of the aneurysms compressing the cranial nerves; both a clipping procedure and endovascular coiling are effective. Cranial nerve signs are more commonly the symptoms of unruptured cerebral aneurysms, but large to giant aneurysms can also be the causes of hemiparesis, hydrocephalus, epilepsy, or even cerebral infarction. This review summarizes the features and surgical outcome of symptomatic unruptured cerebral aneurysms.

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The Clinical Spectrum of Unruptured Intracranial Aneurysms

Cited by 186 publications

References 28 publications

Spontaneous Thrombosis of Intracavernous Internal Carotid Artery Aneurysm and Parent Artery Occlusion in Patients With Positive Balloon Test Occlusion. Two Case Reports.

Spontaneous Thrombosis of Intracavernous Internal Carotid Artery Aneurysm and Parent Artery Occlusion in Patients With Positive Balloon Test Occlusion. Two Case Reports.

Headache attributed to unruptured saccular aneurysm, mimicking hemicrania continua

Symptomatic Unruptured Cerebral Aneurysms: Features and Surgical Outcome

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