Warning signs prior to rupture of an intracranial aneurysm

Okawara, Shige-Hisa

doi:10.3171/jns.1973.38.5.0575

Cited by 158 publications

(72 citation statements)

References 13 publications

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“…From our results and those of a previous report, 24 the incidence of a warning headache before a major attack was low in elderly patients with SAH. However, the frequency of potential minor leak according to T1-FLAIR mismatch was high in elderly patients with SAH.…”

Section: Minor Leaks In Elderly Patients With Sahsupporting

confidence: 82%

Neuroradiologic Diagnosis of Minor Leak prior to Major SAH: Diagnosis by T1-FLAIR Mismatch

Oda

Shimoda

Hirayama

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:In major SAH, the only method to diagnose a preceding minor leak is to ascertain the presence of a warning headache by interview; however, poor clinical condition and recall bias can cause inaccuracy. We devised a neuroradiologic method to diagnose previous minor leak in patients with SAH and attempted to determine whether warning (sentinel) headaches were associated with minor leaks before major SAH.

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Section: Minor Leaks In Elderly Patients With Sahsupporting

confidence: 82%

Neuroradiologic Diagnosis of Minor Leak prior to Major SAH: Diagnosis by T1-FLAIR Mismatch

Oda

Shimoda

Hirayama

et al. 2015

AJNR Am J Neuroradiol

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“…Although oculomotor nerve palsy caused by PCoA aneurysm has been regarded as a warning sign of SAH, 1,30,46 oculomotor nerve palsy was not related to SAH in the present study.…”

Section: Clinical Characteristicsmentioning

confidence: 51%

Morphological and clinical risk factors for posterior communicating artery aneurysm rupture

Matsukawa¹,

Fujii²,

Akaike

et al. 2014

JNS

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Object Recent studies have shown that posterior circulation aneurysms, specifically posterior communicating artery (PCoA) aneurysms, are more likely to rupture than other aneurysms. To date, few studies have investigated the factors contributing to PCoA aneurysm rupture. The authors aimed to identify morphological and clinical characteristics predisposing to PCoA aneurysm rupture. Methods The authors retrospectively reviewed 134 consecutive patients with PCoA aneurysms managed at their facility between July 2003 and December 2012. The authors divided patients into groups of those with aneurysmal rupture (n = 39) and without aneurysmal rupture (n = 95) and compared morphological and clinical characteristics. Morphological characteristics were mainly evaluated by 3D CT angiography and included diameter of arteries (anterior cerebral artery, middle cerebral artery, and internal carotid artery), size of the aneurysm, dome-to-neck ratio, neck direction of the aneurysmal dome around the PCoA (medial, lateral, superior, inferior, and posterior), aneurysm bleb formation, whether the PCoA was fetal type, and the existence of other intracranial unruptured aneurysm(s). Results Patients with ruptured PCoA aneurysms were significantly younger (a higher proportion were < 60 years of age) and a significantly higher proportion of patients with ruptured PCoA aneurysms showed a lateral direction of the aneurysmal dome around the PCoA, had bleb formation, and the aneurysm was > 7 mm in diameter and/or the dome-to-neck ratio was > 2.0. Multivariate logistic regression analysis showed age < 60 years (OR 4.3, p = 0.011), history of hypertension (OR 5.1, p = 0.008), lateral direction of the aneurysmal dome around the PCoA (OR 6.7, p = 0.0001), and bleb formation (OR 11, p < 0.0001) to be significantly associated with PCoA aneurysm rupture. Conclusions The present results demonstrated that lateral projection of a PCoA aneurysm may be related to rupture.

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“…2,4,6,7,14) Fortunately we were able to treat both aneurysms successfully by endovascular procedures. Detailed neurological evaluation is often difficult in the acute phase of SAH.…”

Section: Discussionmentioning

confidence: 90%