| Title: | Outcomes of multidisciplinary treatment for posterior cerebral artery aneurysms |
| Author(s): | Kim YB; Lee JW; Huh SK; Kim BM; Kim DJ; |
| Address: | "Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea" |
| DOI: | 10.1016/j.clineuro.2013.07.004 |
| ISSN/ISBN: | 1872-6968 (Electronic) 0303-8467 (Linking) |
| Abstract: | "OBJECTIVE: Posterior cerebral artery (PCA) aneurysms are rare and often challenging to manage. Since Drake's historical report regarding PCA aneurysms, there has been limited additional information on recent advancements in either microsurgical or endovascular tools. We report a series of 25 consecutive cases and attempt to extrapolate useful information for managing PCA aneurysms. METHODS: A total of 25 cases of PCA aneurysm that were treated either by microsurgical or endovascular methods were selected and retrospectively reviewed. The clinical data, radiographic findings, and outcomes associated with the treatment modality were analysed. RESULTS: The case series included 13 women and 12 men with a mean age of 52 years, ranging from 11 to 75 years. Fourteen aneurysms were ruptured, 7 aneurysms caused a direct mass effect, and the remaining 4 aneurysms were found incidentally. Most aneurysms were located in the P1 through P2A segment of the PCA (19 aneurysms, 76%). Seven aneurysms (28%) were large-giant in size (>20 mm), 4 of which had a thrombosed sac. Microsurgical treatment was the primary treatment in 15 aneurysms, including 9 successful direct clip ligations, 3 aneurysms that were surgically trapped without a bypass, and 2 wrapped aneurysms. One giant thrombosed aneurysm was incompletely clipped; subsequently, the large remnant was coil-embolised. Endovascular coil embolisation was performed for 6 aneurysms, stent-assisted coil embolisation was performed for 2 aneurysms, and 2 aneurysms were treated by endovascular occlusion of the parent artery. Permanent deficits acquired after treatment included limb weakness, palsy of the third cranial nerve, and hemianopsia in 5 cases (20%). There was no mortality. Overall, 22 patients (88%) showed favourable clinical outcomes according to the modified Rankin Scale Score ( |
| Keywords: | "Adolescent Adult Aged Cerebral Angiography Child Embolization, Therapeutic Female Follow-Up Studies Humans Intracranial Aneurysm/surgery/*therapy Magnetic Resonance Angiography Male Microsurgery Middle Aged Neurosurgical Procedures Patient Care Team *Post;" |
| Notes: | "MedlineKim, Yong Bae Lee, Jae Whan Huh, Seung-Kon Kim, Byung Moon Kim, Dong Jun eng Netherlands 2013/08/06 Clin Neurol Neurosurg. 2013 Oct; 115(10):2062-8. doi: 10.1016/j.clineuro.2013.07.004. Epub 2013 Jul 30" |
