title: Posterior Cerebral Artery Aneurysms: Treatment and Outcome Analysis in 121 Patients.
abstract: OBJECTIVE
  Aneurysms of the posterior cerebral artery (PCA) are uncommon. Because of their low incidence, only 5 series with more than 30 patient cases have been reported. The treatment of PCA aneurysms is challenging because of the high frequency of fusiform aneurysms and closeness to important neuroanatomic structures.
  
  
  METHODS
  A total of 121 patients with 135 PCA aneurysms were reviewed. The clinical and radiologic data, treatment strategies, and 1-year outcomes were analyzed. Patients with giant aneurysms, associated aneurysms, and aneurysms on arteriovenous malformation-feeding PCAs were considered as complex cases. Outcomes were categorized into 3 groups: good (modified Rankin Scale [mRS], score 0-1), moderate (mRS score, 2-4), and poor (mRS score, 5-6).
  
  
  RESULTS
  There were 52 ruptured (39%) and 83 unruptured (61%) PCA aneurysms in 121 patients, with the following distribution: P1 (n = 53), P1/2 (n = 39), P2 (n = 28), and P3 (n = 15). The incidence of fusiform PCA aneurysms was high (24%). Microsurgical treatment was applied to 63 aneurysms and endovascular treatment to 19 aneurysms; 55 aneurysms were treated conservatively. The following treatment results were achieved: for patients with unruptured PCA aneurysms, n = 19; 12 good outcomes, 63%; 6 moderate, 31%; 1 poor, 1%; for patients with ruptured PCA aneurysms, n = 27; 10 good, 37%; 9 moderate, 33%; 8 poor, 30%; and for patients with complex neurovascular diseases and PCA aneurysms, n = 96; 42 good, 43%; 40 moderate, 42%; 14 poor, 15%.
  
  
  CONCLUSIONS
  Aneurysms of the PCA are infrequent and often associated with other vascular diseases. Microsurgery and endovascular treatment are effective for the occlusion of PCA aneurysms. The preservation or reconstruction of the parent vessel is crucial for favorable treatment outcomes.
authors.affiliation: Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland; Department of Neurosurgery, Stroke Center, Bergmannstrost Hospital, Halle, Germany. Electronic address: fgoehre@gmail.com.
authors.forename: Felix
authors.initials: F
authors.lastname: Goehre
authors.affiliation: Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Behnam Rezai
authors.initials: BR
authors.lastname: Jahromi
authors.affiliation: Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Martin
authors.initials: M
authors.lastname: Lehecka
authors.affiliation: Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Lehto
authors.affiliation: Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Riku
authors.initials: R
authors.lastname: Kivisaari
authors.affiliation: Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Hugo
authors.initials: H
authors.lastname: Andrade-Barazarte
authors.affiliation: Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Tarik F
authors.initials: TF
authors.lastname: Ibrahim
authors.affiliation: Department of Neurological Surgery, Hospital Univalle, Cochabamba-Cercado, Bolivia.
authors.forename: Richard Gonzalo
authors.initials: RG
authors.lastname: Párraga
authors.affiliation: Department of Neurosurgery, Stroke Center, Bergmannstrost Hospital, Halle, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Ludtka
authors.affiliation: Department of Neurosurgery, Stroke Center, Bergmannstrost Hospital, Halle, Germany.
authors.forename: Hans Jörg
authors.initials: HJ
authors.lastname: Meisel
authors.affiliation: Department of Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Koivisto
authors.affiliation: Department of Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Mikael
authors.initials: M
authors.lastname: von Und Zu Fraunberg
authors.affiliation: Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Niemelä
authors.affiliation: Department of Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Juha E
authors.initials: JE
authors.lastname: Jääskeläinen
authors.affiliation: Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Juha A
authors.initials: JA
authors.lastname: Hernesniemi
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Aneurysm; Outcome; Posterior Cerebral Artery; Treatment