Endovascular Surgery for Proximal Posterior Inferior Cerebellar Artery Aneurysms: An Analysis of Glasgow Outcome Score by Hunt-Hess Grades

Mericle, Robert A.; Reig, Adam S.; Burry, Matthew V; Eskioglu, Eric; Firment, Christopher S; Santra, Swadeshmukul

doi:10.1227/01.neu.0000204127.81249.28

Cited by 68 publications

(47 citation statements)

References 21 publications

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“…Clinical and angiographic results were reported to be favorable. [9][10][11][12] In this study, procedural mortality was 4.6% (2 of 46, patients 25 and 29). Both patients were in very poor clinical condition after acute SAH and died several days and 2 months respectively after coiling complicated by rupture.…”

Section: Discussionmentioning

confidence: 49%

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Posterior Inferior Cerebellar Artery Aneurysms: Incidence, Clinical Presentation, and Outcome of Endovascular Treatment

Peluso¹,

Rooij²,

Sluzewski³

et al. 2007

AJNR Am J Neuroradiol

114

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Section: Discussionmentioning

confidence: 49%

“…[1][2][3][4][5][6][7][8] Although endovascular treatment of intracranial aneurysms is increasingly used as an alternative to surgery, endovascular results of PICA aneurysms are not well established. [9][10][11][12] In this study, we report our experience with endovascular treatment of 47 proximal PICA aneurysms in 46 patients.…”

mentioning

confidence: 99%

Posterior Inferior Cerebellar Artery Aneurysms: Incidence, Clinical Presentation, and Outcome of Endovascular Treatment

Peluso¹,

Rooij²,

Sluzewski³

et al. 2007

AJNR Am J Neuroradiol

114

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show abstract

“…PICA aneurysms are more prevalent in female than in male, and 80% or more of such cases have been reported to occur in the anterior medullary segment 2,4,11,13) . Also, according to the side, the left VA is under more hemodynamic stress than the right VA because it is larger and carries more blood than the right VA does.…”

Section: Discussionmentioning

confidence: 99%

“…It was reported that of the 52 patients who underwent surgery via LSOC, LCNP 10) . It was reported that EVD was performed prior to treatment of PICA aneurysm rupture using endovascular coiling in all patients 13) . Tweleve (60%) of 20 patients had acute hydrocephalus at the initial presentation.…”

Section: Clinical Outcomes Of Surgical Clippingmentioning

confidence: 99%

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Predicting Factors Affecting Clinical Outcomes for Saccular Aneurysms of Posterior Inferior Cerebellar Artery with Subarachnoid Hemorrhage

Hong

Kim

Che

et al. 2011

J Korean Neurosurg Soc

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study that analyzed the predicting factors of clinical outcome 13) . We experienced 20 patients for PICA aneurysms with subarachnoid hemorrhage (SAH). And so, we investigated the clinical outcomes after surgery and endovascular treatment and tried to find the predicting factors affecting the outcomes for ruptured PICA aneurysms. MATERIALS AND METHODS Patient populationsBetween April 1996 and December 2010, 1960 intracranial aneurysms were treated at our institution. Among them, we retrospectively reviewed 20 patients of PICA aneurysms with SAH, of which there were 18 females and 2 males with a mean age of 55.9 (range 42-86 years). In our study, all aneurysms were included except fusiform and dissecting aneurysms. Among them, eleven cases were treated with surgical clipping and 9 cases were treated with endovascular treatment. Patients' data include age, sex, side and location of aneurysm, initial HuntHess (H-H) grade, procedure-related complications, follow-up duration, and Glasgow Outcome Scale (GOS) at last follow-up visit. According to GOS, we categorized the two groups into good (GOS 4 and 5) and poor (GOS 1-3) for the statistical anal- INTRODUCTIONIn view of location, posterior inferior cerebellar artery (PICA) aneurysms are reported to most frequently occur in the region where PICA originates in the vertebral artery (VA) 8,12) . When surgical clipping is performed, there are some risks of neurological complications because of the intimate anatomical relationships of the proximal PICA to the brain stem and lower cranial nerves 2,4,11) . Because of difficulty in general anesthesia due to poor general condition, recent advancement in endovascular surgery, and difficulties related with surgery, endovascular treatment is being used as a primary or alternative method for treating these aneurysms 3,6) . For ruptured or unruptured PICA aneurysms, in our knowledge, many authors 2,4,7,8,14,15) reported the clinical outcomes of surgery or endovascular treatment, but there was only one Results : Eleven (55%) and nine (45%) patients were treated with surgical clipping and endovascular treatment, respectively. Among 20 patients, thirteen (65.0%) patients had good outcomes (GOS 4 or 5). There was the statistical significance between initial poor H-H grade, the presence of acute hydrocephalus and poor GOS. Conclusion : In our study, we suggest that initial H-H grade and the presence of acute hydrocephalus may affect the clinical outcome rather than treatment modalities in the ruptured PICA aneurysms.

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Serum soluble lectin‐like oxidized low‐density lipoprotein receptor‐1 as a biomarker of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

Lin

Dai

et al. 2020

Brain and Behavior

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Objective: Delayed cerebral ischemia (DCI) greatly contributes to the high morbidity and mortality of aneurysmal subarachnoid hemorrhage (aSAH) patients. Expression of lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) was substantially raised in the basilar arterial wall of SAH rabbits. We attempted to ascertain the relationship between serum soluble LOX-1 (sLOX-1) levels and the occurrence of DCI after aSAH. Materials and methods:We enrolled 125 aSAH patients and 125 healthy controls.Serum sLOX-1 levels were quantified using commercial enzyme-linked immunosorbent assay kit. The relationship between sLOX-1 levels and DCI was analyzed utilizing the multivariate logistic regression analysis.Results: Serum sLOX-1 levels were significantly higher in stroke patients than in controls (median: 1,450.2 vs. 445.7 pg/ml, p < .001). Serum sLOX-1 levels were highly correlated with World Federation of Neurological Surgeons (WFNS) scores, Hunt-Hess scores, and modified Fisher scores (r = .574, .625, and .569, respectively). Fortytwo patients (33.6%) experienced DCI. Serum sLOX-1 > 1,450.2 pg/ml, WFNS scores and modified Fisher scores were the independent predictors of DCI. Under receiver operating characteristic curve, serum sLOX-1 levels exhibited a significant discriminatory capability (area under curve 0.825, 95% confidence interval 0.747-0.887). The predictive power of serum sLOX-1 levels was similar to those of WFNS scores and modified Fisher grade (both p > .05). Moreover, serum sLOX-1 levels significantly improved their predictive capability (both p < .05).Conclusions: Serum soluble LOX-1, in positive association with hemorrhagic severity, appears to have the potential to become a promising predictor of DCI after aSAH. K E Y W O R D Saneurysmal subarachnoid hemorrhage, delayed cerebral ischemia, lectin-like oxidized lowdensity lipoprotein receptor-1, severity

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Endovascular Surgery for Proximal Posterior Inferior Cerebellar Artery Aneurysms: An Analysis of Glasgow Outcome Score by Hunt-Hess Grades

Cited by 68 publications

References 21 publications

Posterior Inferior Cerebellar Artery Aneurysms: Incidence, Clinical Presentation, and Outcome of Endovascular Treatment

Posterior Inferior Cerebellar Artery Aneurysms: Incidence, Clinical Presentation, and Outcome of Endovascular Treatment

Predicting Factors Affecting Clinical Outcomes for Saccular Aneurysms of Posterior Inferior Cerebellar Artery with Subarachnoid Hemorrhage

Serum soluble lectin‐like oxidized low‐density lipoprotein receptor‐1 as a biomarker of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

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