Distal anterior cerebral artery aneurysms

Sousa, Atos Alves de; Dantas, Fernando Luíz Rolemberg; Cardoso, Gervásio Teles Carvalho de; Costa, Bruno Silva

doi:10.1016/s0090-3019(99)00066-x

Cited by 124 publications

(131 citation statements)

References 26 publications

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“…Furthermore, ruptured DACA aneurysms have a high incidence of accompanying IPH. 3,5,8,[11][12][13]15,18,[20][21][22]25,26,31,32) Those characteristics were thought to be unfavorable for endovascular therapy. 10) Although surgical clipping is considered as the primary treatment, it is difficult when comparing with other anterior circulation aneurysms because of the narrow operative field, protection of bridge veins, and interhemispheric adhesions.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Efficacy of Endovascular Therapy for Ruptured Distal Anterior Cerebral Artery Aneurysms

Oishi

Nonaka

Yamamoto

et al. 2013

Neurol. Med. Chir.(Tokyo)

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Surgical clipping has been the primary treatment option for ruptured distal anterior cerebral artery (DACA) aneurysms. Therefore, the literature on endovascular therapy is sparse. The present study investigated the feasibility and efficacy of endovascular therapy for ruptured DACA aneurysms in 31 patients, 26 females and 5 males (mean age 63.2 ± 12.6 years). Mean aneurysm size and neck width were 4.8 ± 2.3 mm and 2.2 ± 0.7 mm, respectively. The Hunt and Hess (H/H) grades just prior to the treatment were scored as H/H grades 1-3 in 20 patients and H/H grades 4-5 in 11 patients. Fifteen patients had an intraparenchymal hematoma (IPH) surrounding the ruptured aneurysm on the initial computed tomography. Overall, 22 patients had a modified Rankin scale (mRS) score of 0-2 and 9 had a mRS score of 3-6 at discharge. H/H grade was closely related to the clinical outcomes, whereas the presence of IPH was not. Overall immediate angiographic outcomes were complete occlusion in 15, residual neck in 11, and residual aneurysm in 5. The overall recurrence rate was 35.3%. Complications including posttreatment rebleeding occurred in 5 patients. Symptomatic vasospasm occurred in 1 of the 18 patients with H/H grades 1-3. Endovascular therapy of ruptured DACA aneurysms is feasible and effective. However, the risks of recurrence and posttreatment bleeding remain to be resolved.

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Section: Discussionmentioning

confidence: 99%

Feasibility and Efficacy of Endovascular Therapy for Ruptured Distal Anterior Cerebral Artery Aneurysms

Oishi

Nonaka

Yamamoto

et al. 2013

Neurol. Med. Chir.(Tokyo)

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“…10) Only a few cases of large and giant distal ACA aneurysms have been reported. 2,7,8) Distal ACA aneurysm tends to rupture before any mass effect manifests. 7,8) In one series, 67% of the ruptured distal ACA aneurysms were less than 5 mm in diameter.…”

Section: Discussionmentioning

confidence: 99%

“…2) Two stage surgery at two different sessions has been recommended for multiple aneurysms to reduce the mortality. 2) However, one stage surgery is also suggested, 13) with which we agree.…”

Section: Discussionmentioning

confidence: 99%

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Distal Anterior Cerebral Artery Mirror Aneurysms and Middle Cerebral Artery Aneurysms-Case Report-

Dinç

İplikçioğlu

Bikmaz

et al. 2006

Neurol. Med. Chir.(Tokyo)

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Fig. 1 Cranial axial T 1 -weighted magnetic resonance image revealing a mass lesion with surrounding cerebral edema in the left frontal lobe and probable aneurysm formation in the interhemispheric space. AbstractA 52-year-old woman presented with bilateral distal anterior cerebral artery (ACA) mirror aneurysms, in addition to two right middle cerebral artery (MCA) aneurysms. The left distal ACA and right MCA aneurysms were clipped through right interhemispheric and right pterional craniotomies. The right distal ACA aneurysm was thrombosed. Distal ACA aneurysms tend to be multiple, but mirror aneurysms are rare, especially in the absence of congenital vascular anomaly. Single stage unilateral craniotomy is recommended for surgical treatment.

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“…Symptomatic vasospasm represents the most important cause of morbidity in patients surviving SAH and affects up to 30% of patients presenting with SAH caused by ruptured aneurysms in the anterior circulation (6,8,17). In our series, only two patients developed clinically significant vasospasm, both with Fisher grade III SAH on CT scans.…”

Section: Clinical Outcomementioning

confidence: 99%

Single center experience and technical nuances in the treatment of distal anterior cerebral artery aneurysms

Gherasim¹,

Gyorki²,

Bălaşa³

2017

Romanian Neurosurgery

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Objective: This study presents the experience of one neurosurgical center in the treatment of 18 consecutive patients with distal anterior cerebral artery (DACA) aneurysms during a 10 years period. Our aim was to compare treatment outcomes of these lesions with intracranial aneurysms in general, and to present technical nuances in surgical treatment. Methods: We analyzed the clinical and radiological data of 18 patients treated between 2005 and 2015. All patients were treated surgically using the microscope. No patients were lost to follow-up. We compared treatment and outcome of ruptured DACA aneurysms (n 18) with all consecutive ruptured aneurysms treated in our clinic during the same period (n 446). Results: DACA aneurysms accounted for 4% of all intracranial aneurysms. They were smaller (median, 5,5 versus 9 mm) We found only one case with associated aneurysms (5,5%). DACA aneurysms presented more often with intracerebral hematomas (39% versus 26%) than ruptured aneurysms in general. Their microsurgical treatment showed the same complication rates (treatment morbidity, 15%) as for other ruptured aneurysms in literature. Their mortality rate was lower (11% versus 24%). Conclusion: Despite their specific anatomic features, and particular surgical technique, with modern treatment methods, ruptured DACA aneurysms have the same favorable outcome and lower mortality as ruptured aneurysms in general.

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Distal anterior cerebral artery aneurysms

Cited by 124 publications

References 26 publications

Feasibility and Efficacy of Endovascular Therapy for Ruptured Distal Anterior Cerebral Artery Aneurysms

Feasibility and Efficacy of Endovascular Therapy for Ruptured Distal Anterior Cerebral Artery Aneurysms

Distal Anterior Cerebral Artery Mirror Aneurysms and Middle Cerebral Artery Aneurysms-Case Report-

Single center experience and technical nuances in the treatment of distal anterior cerebral artery aneurysms

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