State-of-Art Surgical Treatment of Dissecting Anterior Circulation Intracranial Aneurysms.
Intracranial dissecting aneurysms (IDAs) are an important cause of subarachnoid hemorrhage, stroke, or compression of intracranial structures. Since the availability of endovascular treatment and the advantage of intraprocedural anticoagulation, an endovascular strategy has become the mainstay of their therapy. But in some cases selective aneurysm obliteration by the endovascular approach is impossible or associated with an unacceptable risk of morbidity. This is particularly true when the IDA is a blood blister-like aneurysm or when dissection affects peripheral branches of the internal carotid artery. The literature dealing with surgical treatment of IDAs in the anterior circulation is heterogeneous, and formulation of general recommendations concerning the surgical strategy remains difficult. The aim of this study was to conduct a systematic review of the current knowledge on incidence, pathogenesis, clinical presentation, and diagnostic procedures with a special emphasis on the surgical treatment of intracranial dissections of anterior circulation.
Department of Neurosurgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.
Vladimir
V
Balik
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan.
Yasuhiro
Y
Yamada
Department of Neurosurgery, Andhra Medical College, Maharanipeta, Visakhapatnam, India.
Sandeep
S
Talari
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan.
Yamashiro
Y
Kei
Department of Neurosurgery, Sogo Shinkawabashi Hospital, Kawasaki-city, Japan.
Hirotoshi
H
Sano
Department of Surgery, Hospital of Slovak Railways, Kosice, Slovakia.
Igor
I
Sulla
Department of Neurosurgery, Fuchu Keijinkai Hospital, Tokyo, Japan.
Daisuke
D
Suyama
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan.
Tukasa
T
Kawase
Normal Pressure Hydrocephalus Center, Chiba Kashiwa Tanaka Hospital, Kashiwa city, Japan.
Kiyoshi
K
Takagi
Department of Neurosurgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan.
Katsumi
K
Takizawa
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan.
Yoko
Y
Kato
D000784:Aortic Dissection / Q000601:surgery*; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D016896:Treatment Outcome