Basilar artery trunk saccular aneurysms: morphological characteristics and management.
The purpose of this retrospective study was to report the morphological characteristics and results of surgical and endovascular treatment of basilar artery (BA) trunk saccular aneurysms. Twenty-two patients with 22 BA trunk saccular aneurysms underwent surgery including endovascular intervention. In this series, BA trunk aneurysms showed characteristic features such as so-called lateral aneurysm (41%), multiple aneurysms (32%), including two de novo aneurysms, and various vascular anomalies. Eleven craniotomies for neck clipping were performed for 11 ruptured aneurysms. However, in one of these cases, we abandoned neck clipping, because of concern for neck tearing, and embolized it later. Five ruptured and five unruptured aneurysms were successfully treated by endovascular surgery. Another one incompletely embolized aneurysm had grown to a huge size, and the patient underwent a Hunterian ligation with a flow reconstruction. The unusually high incidence of various associated vascular anomalies suggests that focal wall weakness must be based on the mechanism of aneurysm initiation. Most patients presented with subarachnoid hemorrhage. The pretreatment neurological state was predictive for clinical outcome. And, clinical outcomes in this series were not affected by the choice of treatment. However, considering that three of 11 surgical cases needed subsequent treatment, endovascular surgery should be considered as a first choice.
Higa
Takashi
T
Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. thiga@nij.twmu.ac.jp
Ujiie
Hiroshi
H
Kato
Koichi
K
Kamiyama
Hiroyasu
H
Hori
Tomokatsu
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000601:surgery; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D020767:Intracranial Thrombosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012086:Reoperation; D012189:Retrospective Studies; D055815:Young Adult
J Neurosurg. 1997 Sep;87(3):374-80
9285601
Neurosurgery. 1996 May;38(5):948-53; discussion 953-4
8727820
J Neurosurg. 2006 Jun;104(6):965-8
16776342
J Neurosurg. 1990 Aug;73(2):165-73
2366072
Neurosurgery. 1993 Dec;33(6):981-5
8134011
J Neurosurg. 1998 Jul;89(1):81-6
9647176
No Shinkei Geka. 1994 Oct;22(10):911-24
7969757
Neurosurgery. 1999 Apr;44(4):697-702; discussion 702-4
10201293
Stroke. 1984 Sep-Oct;15(5):846-50
6474536
Radiology. 1973 Oct;109(1):79-82
4783132
Neurosurgery. 1999 Jun;44(6):1225-34; discussion 1234-6
10371621
Neurol Med Chir (Tokyo). 1998 Dec;38(12):826-34; discussion 834-5
10063356
Neurosurgery. 1979 May;4(5):422-6
460570
Neurosurgery. 1996 Jan;38(1):83-92; discussion 92-4
8747955
J Neurosurg. 1999 Sep;91(3):396-401
10470813
J Neurosurg. 1994 Feb;80(2):230-6
8283261
Neurosurgery. 2000 Jun;46(6):1294-8; discussion 1298-300
10834634
Neurosurgery. 1993 Aug;33(2):244-50; discussion 250-1
8367046
J Neurosurg. 1997 Dec;87(6):836-42
9384392
J Neurosurg. 1997 Oct;87(4):544-54
9322845
J Neurosurg. 1988 Sep;69(3):461-6
3404245
AJNR Am J Neuroradiol. 2007 Oct;28(9):1747-51
17885235
Surg Neurol. 1976 Aug;6(2):83-91
951657
J Neurosurg. 1992 Apr;76(4):588-99
1545251
J Neurosurg. 1999 Oct;91(4):538-46
10507372
J Neurosurg. 1985 Dec;63(6):857-61
4056899
Surg Neurol. 1993 Oct;40(4):339-46
8211647
Stroke. 2000 Jan;31(1):100-10
10625723
J Neurosurg. 2001 Oct;95(4):624-32
11596957
J Neurosurg. 1968 Oct;29(4):436-46
4880820
Stroke. 1972 May-Jun;3(3):255-67
5034974
Neuroradiology. 1997 Mar;39(3):185-9
9106290
Surg Neurol. 1985 Aug;24(2):173-80
4012574
J Neurosurg. 1996 Sep;85(3):373-9
8751618
Acta Neurochir (Wien). 1999;141(4):359-66; discussion 366-7
10352745
J Neurosurg. 1994 Apr;80(4):643-9
8151342
Neurosurgery. 1997 Sep;41(3):513-20; discussion 520-1
9310966
Clin Neurosurg. 1974;21:79-89
4608645
Neurosurgery. 1986 Jun;18(6):701-7
3736796
J Neurosurg. 1987 Apr;66(4):500-5
3559716
J Neurosurg. 1997 Aug;87(2):141-62
9254076
J Neurosurg. 1986 Oct;65(4):439-50
3760951
Surg Neurol. 1980 Jul;14(1):59-66
7414487
AJNR Am J Neuroradiol. 1987 Mar-Apr;8(2):233-6
3105281
Clin Neurosurg. 1979;26:96-144
544141
J Neurosurg. 1987 Jan;66(1):30-4
3783256
J Neurosurg. 1997 Mar;86(3):475-82
9046305
J Neurosurg. 1993 Aug;79(2):161-73
8331396
J Neurosurg. 1990 Jul;73(1):18-36
2191090
J Neurosurg. 1996 Feb;84(2):185-93
8592220
J Neurosurg. 1972 Dec;37(6):666-77
4654696