Abstract:
BACKGROUND:Aneurysms at nonbranching sites in the supraclinoid internal carotid artery (ICA), known as blood blister-like aneurysms (BBAs), are rare entities and differ from saccular aneurysms. In this study, we attempt to describe our clinical experience and the outcome of treatments for BBAs. METHOD:Thirteen of 745 patients with aneurysmal subarachnoid hemorrhage (SAH) who visited our institution between March 2005 and July 2010, and were confirmed to have BBAs at nonbranching sites of the supraclinoid ICA by digital subtraction angiography (DSA) or computed tomography angiography, were followed-up. In these patients, several therapeutic managements were provided depending on their clinical condition. Data analyzed included patient age, sex, World Federation of Neurologic Surgeons (WFNS) scale, time interval from first DSA to second DSA, treatment of aneurysms, and the modified Rankin scale score at follow-up, 6 months after SAH. RESULT:Of these 13 patients, 5 underwent rapid configuration change from blood blister-like aneurysm to saccular-shaped. Different therapeutic managements were provided, including clipping on wrapping material in 2 patients, ICA trapping without extracranial-intracranial (EC-IC) bypass in 3 patients, EC-IC bypass and ICA trapping in 3 patients, transarterial endovascular therapy in 3 patients, direct clipping in 1 patient, and external ventricular drainage in 1 patient. Good clinical outcome was achieved in 4 patients, whereas the other 9 patients had moderate to severe disability due to rebleeding of aneurysms, large cerebral infarction, or severe cerebral vasospasm. CONCLUSIONS:BBAs of the supraclinoid ICA have special neuroradiological and clinicopathological characteristics. Direct clipping or endovascular coil embolization along may not be sufficient and sometimes have undesirable results. ICA trapping or ligation including the lesion segment can be considered an alternative choice if the balloon occlusion test (BOT) is successful. However, if the patient does not tolerate the BOT, EC-IC bypass surgery with ICA ligation or trapping is another option.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Yu-Tse L,Ho-Fai W,Cheng-Chi L,Chu-Mei K,Yi-Chou W,Tao-Chieh Ydoi
10.3109/02688697.2011.631617subject
Has Abstractpub_date
2012-06-01 00:00:00pages
378-82issue
3eissn
0268-8697issn
1360-046Xjournal_volume
26pub_type
杂志文章abstract:BACKGROUND:Maintenance of on-call referrals databases is on the rise in neurosurgical units across the UK and helps provide data to estimate workload. We hypothesize that these databases underestimate the workload and propose the use of the number of telephone calls to the on-call registrar as an easily obtainable and ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2012.743966
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abstract::Intracerebral haemorrhage is a devastating condition lacking effective therapies, with an uncertain role for surgery in many. Early research described an ischaemic penumbra around the haematoma, representing an area of potential therapeutic intervention. This article discusses the evidence for and against the existenc...
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abstract:PURPOSE:In this study, we investigated the effect of local injection of ropivacaine and bupivacaine with magnesium sulfate on postoperative pain in vertebral laminectomy surgery. DESIGN:This randomized double-blind prospective study was conducted among 60 patients aged 18-65 years old with ASA class I and II. METHODS...
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journal_title:British journal of neurosurgery
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abstract::A 39-year-old female moyamoya disease patient underwent a salvage direct bypass surgery involving anastomosis of the superficial temporal artery or STA and middle cerebral artery or MCA. This report describes a rare case of moyamoya disease that was revascularized after the previous indirect bypass surgery failed to r...
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journal_title:British journal of neurosurgery
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doi:10.3109/02688697.2010.508959
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journal_title:British journal of neurosurgery
pub_type: 临床试验,杂志文章
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doi:10.3109/02688698709023777
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