The aim of our study was to report a series of 15 consecutive patients with aneurysms of the proximal segment (A1) of the anterior cerebral artery. In 15 patients with diagnosed A1 aneurysms, representing 2.1% of 720 aneurysm patients treated at a University Clinical Center between October 1999 and August 2012, clinical presentation, neuroradiological findings, surgical treatment methods and outcome were retrospectively analyzed. Mean patient age was 53.06 (range 32 to 75) years. Ten saccular aneurysms were treated with micro neurosurgical approach via standard pterional craniotomy, four fusiform aneurysms with coiling, and one fusiform aneurysm with stent. No patients died during the operation. The mean follow-up period was 32 months (range 5 months to 7 years). Clinical outcomes revealed good recovery in all patients. Despite the general opinion that A1 aneurysms are benign lesions, an increasing number of reports have demonstrated their potential complications. To date, due to the rarity of A1 aneurysms, only a few consecutive series have been reported. Conduct of multicenter studies are required in order to understand clinical features of A1 aneurysms and devise a proper treatment plan.
BACKGROUND: Craniocerebral gunshot wounds (CGW) are the most lethal injuries of the cranium. CGW is mostly secondary to military conflicts but may also be seen in civilian life. These injuries also have severe consequences, such as epilepsy, hydrocephalus, infection and late-term cognitive dysfunctions. The present study aims to present our series of CGW and to discuss the prognostic factors and consequences of these injuries.
METHODS:The data of patients who were treated in our department for CGW between 2011 and 2019 were retrospectively reviewed in this study. The injury type, wounding site, surgical management and outcomes were analyzed. Radiological evaluation was also performed.
RESULTS:Thirty patients were treated with the diagnosis of CGW. All of the patients were male and the mean age was 27.9 years. The frontal lobe was affected in 12 (40%) patients, while temporal lobe in eight, occipital lobe in six, parietal lobe in three, and posterior fossa in one patients. Twenty-three patients underwent surgical treatment, seven patients were treated conservatively. Thirteen (43.3%) patients died despite the treatment.
CONCLUSION:Mortality in CGW is high. Ventricular injuries, bihemispheric or midline injuries, perforating injuries, brain stem injuries and low GCS score at admission are prognostic factors for CGW. Appropriate management is mandatory to obtain a better clinical outcome.
Ce er rr ra ah hi i y ya ak kl la aş şı ım m a aç çı ıs sı ın nd da an n h hi ip po of fi iz ze er r f fo os ss sa a i il le e i il li iş şk ki il li i y ya ap pı ıl la ar rı ın n m mo or rf fo om me et tr ri ik k a an na al li iz zi i M Mo or rp ph ho om me et tr ri ic c A An na al ly ys si is s o of f H Hy yp po op ph hy ys se ea al l F Fo os ss sa a R Re el la at te ed d S St tr ru uc ct tu ur re e; ; i in n T Te er rm ms s o of f S Su ur rg gi ic ca al l A Ap pp pr ro oa ac ch h
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.