Intracranial Vertebral Artery Aneurysms : Clinical Features and Outcome of 190 Patients

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Lehto , H , Niemela , M , Kivisaari , R , Laakso , A , Jahromi , B R , Hijazy , F , Andrade-Barazarte , H , Dashti , R & Hernesniemi , J 2015 , ' Intracranial Vertebral Artery Aneurysms : Clinical Features and Outcome of 190 Patients ' , World Neurosurgery , vol. 84 , no. 2 , pp. 380-389 . https://doi.org/10.1016/j.wneu.2015.03.034

Title: Intracranial Vertebral Artery Aneurysms : Clinical Features and Outcome of 190 Patients
Author: Lehto, Hanna; Niemela, Mika; Kivisaari, Riku; Laakso, Aki; Jahromi, Behnam Rezai; Hijazy, Ferzat; Andrade-Barazarte, Hugo; Dashti, Reza; Hernesniemi, Juha
Contributor: University of Helsinki, Neurokirurgian yksikkö
University of Helsinki, Neurokirurgian yksikkö
University of Helsinki, Clinicum
University of Helsinki, Department of Neurosciences
University of Helsinki, Neurokirurgian yksikkö
University of Helsinki, Neurokirurgian yksikkö
University of Helsinki, Clinicum
Date: 2015-08
Language: eng
Number of pages: 10
Belongs to series: World Neurosurgery
ISSN: 1878-8750
URI: http://hdl.handle.net/10138/223810
Abstract: BACKGROUND: Vertebral artery (VA) aneurysms comprise approximately one-third of posterior circulation aneurysms. They are morphologically variable, and located critically close to the cranial nerves and the brainstem. We aim to represent the characteristics of these aneurysms and their treatment, and to analyze the outcome. METHODS: We reviewed retrospectively 9709 patients with intracranial aneurysms. Of these, we included 190 with aneurysms at the VA or VA posterior inferior cerebellar artery junction. The patients were treated in the Department of Neurosurgery, Helsinki, Finland, between 1934 and 2011. RESULTS: The 190 patients had 193 VA aneurysms, among which 131 (68%) were ruptured, The VA aneurysm caused a mass effect in 7 and ischemia in 2 patients. Compared to 4387 patients with a ruptured aneurysm in other locations, those with a VA aneurysm were older, their aneurysms were more often fusiform, and more often caused intraventricular hemorrhages. Among surgically treated aneurysms, clipping was the treatment in 91 (88%) saccular and 11 (50%) fusiform aneurysms. Treatment was endovascular in 13 (9%), and multimodal in 6 (4%) aneurysms, Within a year after aneurysm diagnosis, 53 (28%) patients died. Among the survivors, 104 (93%) returned to an independent or to their previous state of life; only 2 (2%) were unable to return home. CONCLUSIONS: Microsurgery is a feasible treatment for VA aneurysms, although cranial nerve deficits are more common than in endovascular surgery. Despite the challenge of an often severe hemorrhage, of challenging morphology, and risk for laryngeal palsy, most patients surviving the initial stage return to normalcy.
Subject: Cerebral aneurysm
Microneurosurgery
Vertebral artery
INFERIOR CEREBELLAR ARTERY
VERTEBROBASILAR DISSECTING ANEURYSMS
RECURRENT SUBARACHNOID HEMORRHAGE
POSTERIOR CIRCULATION ANEURYSMS
LATERAL SUBOCCIPITAL APPROACH
ENDOVASCULAR TREATMENT
COIL EMBOLIZATION
MANAGEMENT
COMPLEX
SURGERY
3124 Neurology and psychiatry
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