[Minor leak in intracranial aneurysms].
To study the clinical features of aneurysm with a minor leak, 68 aneurysmal cases were divided into Group A (53 cases which showed a major rupture after a minor leak) and Group B (15 cases which only showed a minor leak). Most patients with a minor leak complain of a thunderclap type headache, which is usually located in the occipital area, or which seem to involve the whole brain. It is also associated with nausea and vomiting. Patients with a minor leak from an internal carotid artery aneurysm had ipsilateral, hemicranial or periorbital pain. Half of the patients initially saw a physician, but only in 4 cases (7.5%) was the correct diagnosis made. Fifteen patients in Group B were diagnosed by lumbar puncture or CT scanning and were operated on without mortality. CT scanning produced negative result in 33% of patients in Group B but lumbar puncture was always positive. A minor leak prior to major aneurysmal rupture, if unrecognized, is associated with a high mortality rate. CT scanning is unreliable in diagnosing a minor leak, so lumbar puncture is the examination of choice, even if CT scanning is negative.
Fujita
K
K
Department of Neurosurgery, Kobe University School of Medicine.
Rinn
X P
XP
Shirakuni
T
T
Tamaki
N
N
Matsumoto
S
S
D005260:Female; D006261:Headache; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008297:Male; D011379:Prognosis; D012422:Rupture, Spontaneous; D013129:Spinal Puncture; D014057:Tomography, X-Ray Computed