title: Revascularization for anterior cerebral artery dissecting aneurysms--three case reports.
abstract: We describe three rare cases of dissecting aneurysms in the anterior cerebral artery (ACA) treated by surgical reconstruction, and reviewed 79 previously reported cases with the ACA dissecting aneurysm. We found that 35 (77.8%) of 45 patients with ischemic event and 15 (40.5%) of 37 patients with hemorrhagic event were treated conservatively, with 11.4% (4/35 cases) and 13.3% (2/15) risk of bleeding and rebleeding, respectively. Furthermore, half of these patients died. The other 32 patients were treated surgically, and their outcome was favorable, especially after surgical reconstruction. Simultaneous treatment of both hemorrhagic and ischemic events is essential. We recommend early treatment with revascularization for patients with ACA dissection that has hemorrhaged and for patients presenting with signs of clinical deterioration with ischemic event.
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan. srg2017@ndmc.ac.jp
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Uozumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Katoh
authors.forename: Nobusuke
authors.initials: N
authors.lastname: Tsuzuki
authors.forename: Terushige
authors.initials: T
authors.lastname: Toyooka
authors.forename: Takahito
authors.initials: T
authors.lastname: Miyazawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nawashiro
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shima
mesh_terms: D000328:Adult; D000368:Aged; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002533:Cerebral Angiography; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D055502:Secondary Prevention; D020521:Stroke / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*