title: Treatment of ruptured intracranial dissecting aneurysms in Hong Kong.
abstract: BACKGROUND
  Data suggests that hemorrhagic presentations occur in 20% of internal carotid artery dissections and 50% of vertebral artery dissections. A Finnish study has reported favorable outcomes in only 32% of patients. We aimed to review the epidemiology and management outcomes in a Chinese population.
  
  
  METHODS
  We reviewed the aneurysmal subarachnoid hemorrhage registry of patients who presented with intracranial dissecting aneurysms at a neurosurgical center in Hong Kong over a five-year period.
  
  
  RESULTS
  A total of 23 patients with intracranial dissecting aneurysms were identified, accounting for 8% of all spontaneous subarachnoid hemorrhage patients. Forty-eight percent of the patients identified were treated by main trunk occlusion and 39% were treated by embolization or stent-assisted embolization or stent alone. Thirteen percent were managed by craniotomy and trapping or wrapping. Favorable outcomes at six months were achieved in 67%.
  
  
  CONCLUSIONS
  Patients with intracranial dissecting aneurysms account for a significant proportion of the cases of spontaneous subarachnoid hemorrhage in our population. Carefully selected endovascular and microsurgical treatments can lead to management outcomes similar to patients with saccular aneurysms.
authors.affiliation: Division of Neurosurgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: George Kwok Chu
authors.initials: GK
authors.lastname: Wong
authors.forename: Hoi Bun
authors.initials: HB
authors.lastname: Tang
authors.forename: Wai Sang
authors.initials: WS
authors.lastname: Poon
authors.forename: Simon Chun Ho
authors.initials: SC
authors.lastname: Yu