Asymptomatic Familial Cerebral Aneurysms

Kojima, Masayasu; Nagasawa, S

doi:10.1227/00006123-199906000-00138

Cited by 14 publications

(22 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is known that 1-8 % of the population harbor a cerebral aneurysm and the annual incidence of ruptured aneurysm is 4-10 patients for each 100,000 individuals 23 . In a recent study, Kojima et al 24 reported a 7% (5.6% for men; 8.5% for women) prevalence of aneurysm among 8 680 participants undergoing MR angiography. The prevalence was different between groups of patients with (10.5%) or without (6.8%) family history of aneurysm, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence was different between groups of patients with (10.5%) or without (6.8%) family history of aneurysm, respectively. The prevalence was much higher (42.1%) in first-or second-degree relatives when there was familiar history of subarachnoid hemorrhage (SAH) 24 .…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study 34 , 1,345 CTs of neurological and neurosurgical patients with no previous history of paranasal sinusitis were analyzed. In seventy-five of these patients, CT showed evidence of inflammatory changes, involving maxillary (57), ethmoid (46), sphenoid (24), and frontal (17) sinus.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Computed tomography scan of the head in patients with migraine or tension-type headache

Valênça

Valença

Menezes³

2002

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

-A retrospective study was performed in order to evaluate the frequency of abnormalities found by computed tomography (CT) scan of the head in 78 patients with migraine or tension-type headache. In the present study CT scan was normal in 61.5% of the patients with migraine or tension-type headache. A number of abnormalities were encountered in more than one third of the patients studied, including inflammatory sinus disease (19.2%), cysticercosis (3.9%), unruptuted cerebral aneurysm (2.6%), basilar impression (2.6%), intracranial lipoma (2.6%), arachnoid cyst (2.6%), empty sella (2.6%), intracranial neoplasm (2.6%), and others (2.6%). None of these lesions were symptomatic or responsible by the headache picture, therefore, considered incidental findings. In conclusion, the fortuitous encounter of some abnormalities on CT scan of the head is often higher than what we could predict in patients suffering migraine or tension-type headache. We briefly discuss clinical, epidemiologic, and practical management of some of the abnormalities detected by CT scan as well as the indication to request a neuroimaging investigation.KEY WORDS: headache, migraine, tension-type, CT scan, basilar impression, cysticercosis. T T T T Tomografia computadorizada do crânio em pacientes com migrânea ou cefaléia tensional omografia computadorizada do crânio em pacientes com migrânea ou cefaléia tensional omografia computadorizada do crânio em pacientes com migrânea ou cefaléia tensional omografia computadorizada do crânio em pacientes com migrânea ou cefaléia tensional omografia computadorizada do crânio em pacientes com migrânea ou cefaléia tensional RESUMO -Um estudo retrospectivo foi realizado visando avaliar a frequência de anormalidades encontradas durante a realização de estudo por tomografia computadorizada (TC) em 78 pacientes com migrânea ou cefaléia do tipo tensional. A TC foi normal em 61,5% dos pacientes examinados. Em um terço dos pacientes estudados foram detectadas anormalidades, como doença inflamatória dos seios paranasais (19,2%), cisticercose (3,9%), aneurisma cerebral não-roto (2,6%), impressão basilar (2,6%), lipoma intracraniano (2,6%), cisto aracnoideo (2,6%), sela vazia (2,6%), neoplasia intracraniana (2,6%) e outras afecções (2,6%). Nenhuma destas lesões era sintomática (achado incidental). Concluindo, o encontro fortuito de algumas anormalidades na TC é frequentemente mais elevado do que se prediz em pacientes com cefaléia primária. Nós discutimos brevemente alguns aspectos clínicos, epidemiológicos e da conduta terapêutica-cirúrgica sobre algumas das anomalias diagnosticadas pela TC. Também levantamos, ou questionamos, aspectos éticos que determinam o limite entre o direito do paciente e o direito do médico em afirmar que um indivíduo com dor de cabeça não é portador de lesão intracraniana, baseado na história clínica e no exame físico do paciente.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Computed tomography scan of the head in patients with migraine or tension-type headache

Valênça

Valença

Menezes³

2002

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…23) Autopsy studies have reported an overall prevalence between 0.1% and 9.9% (mean frequency 5%). 24,27,32,33,41) Angiographic studies report a prevalence between 0.2% and 15%. 24,27,32,41) In Japan, using MR angiography as part of thè`b rain screening program,'' unruptured-asymptomatic intracranial aneurysms are found in more than 2% of the patients.…”

Section: Resultsmentioning

confidence: 99%

Treatment Strategy for Patients with Unruptured Intracranial Aneurysms.

Zuccarello

2001

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

The increased sensitivity of neuroimaging techniques has enabled the more frequent diagnosis of unruptured aneurysms. Because the most devastating complication of an unruptured aneurysm is subarachnoid hemorrhage, it has been considered desirable to treat these aneurysms before they rupture. However, the optimal treatment strategy for patients with unruptured aneurysms remains controversial. The management decision requires knowledge of the natural history and an accurate assessment of the risks related to various treatment options. On December 10, 1998 the New England Journal of Medicine published an article by the International Study of Unruptured Intracranial Aneurysms Investigators. The study retrospectively assessed the natural history of unruptured aneurysms in 1449 patients; in addition, treatment-related mortality and morbidity were examined in a prospective cohort of 1172 patients. The major finding was that the rate of rupture for aneurysms smaller than 10 mm in diameter in patients with no history of subarachnoid hemorrhage was 0.05% per year, and that the mortality and morbidity associated with surgery greatly exceeded the risk of rupture in such patients. This report has generated tremendous controversy in the treatment of unruptured aneurysms and has influenced our decision making. The results of this study are critically analyzed and potential flaws presented. To develop recommendations for treatment, the literature was reviewed. The conclusion of this search is that there is insufficient evidence to recommend a standard of management. Therapeutic guidelines are provided, particularly for patients with small incidental aneurysms and no history of subarachnoid hemorrhage.

show abstract

“…1) Asymptomatic aneurysms are more likely to rupture in patients with than in those without a family history of aneurysmal SAH. 6) Cigarette smoking is an important factor determining risk for subsequent aneurysm rupture. 5) Our patient had the following risk factors for rupture of a concomitant unruptured aneurysm: large, multilobed aneurysm, hypertension, family history of aneurysmal SAH, and smoking.…”

Section: Discussionmentioning

confidence: 99%

Rupture of a Concomitant Unruptured Cerebral Aneurysm Within 2 Weeks of Surgical Repair of a Ruptured Cerebral Aneurysm -Case Report-

Sato

Kakino

Ogasawara

et al. 2008

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A 53-year-old man presented with subarachnoid hemorrhage (SAH) in the left sylvian fissure. Preoperative computed tomography angiography revealed symmetrical aneurysms located at the bifurcations of the right and left middle cerebral arteries (MCAs). The left MCA aneurysm responsible for the SAH was clipped. The patient received post-surgical volume expansion treatment that did not induce hypertension. His systolic blood pressure ranged from 170 to 225 mmHg between the day of the first surgery and the 11th postoperative day. The postoperative course was uneventful until the 11th postoperative day when the patient suffered another SAH in the right sylvian fissure. The right MCA aneurysm was responsible for the second SAH and was clipped. The patient had multiple risk factors for rupture of concomitant unruptured aneurysm including a large, multilobed aneurysm, hypertension, smoking, and a family history of aneurysmal SAH. The present case suggests that all aneurysms should be simultaneously treated using endovascular coil embolization or several craniotomies if the patient has multiple risk factors.

show abstract

Asymptomatic Familial Cerebral Aneurysms

Cited by 14 publications

References 3 publications

Computed tomography scan of the head in patients with migraine or tension-type headache

Computed tomography scan of the head in patients with migraine or tension-type headache

Treatment Strategy for Patients with Unruptured Intracranial Aneurysms.

Rupture of a Concomitant Unruptured Cerebral Aneurysm Within 2 Weeks of Surgical Repair of a Ruptured Cerebral Aneurysm -Case Report-

Contact Info

Product

Resources

About