Etiology and Pathogenesis of Intracranial Berry Aneurysms

Stehbens, William E.

doi:10.1007/978-1-4612-5437-9_12

Cited by 23 publications

(10 citation statements)

References 159 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While, if the aneurysm had entirely thick walls, prophylactic surgery for such patients might be judged contra-indicated. As Stehbens indicated that mural thickness is not always related to the propensity for rupture and some additional change or stress in the wall seems to initiate the tearing and bleeding, the true mechanism underlying the eventual rupture of aneurysms is still unsolved [14][15][16]. However, it is at best conceivable that the rupture will most probably occur at the most fragile point of the aneurysmal wall.…”

Section: Discussionmentioning

confidence: 92%

Types of unruptured cerebral aneurysms reviewed from operation video-recordings

1996

View full text Add to dashboard Cite

To estimate the proportion of unruptured cerebral aneurysms with thin-walled sac, we have analyzed the operative findings of 78 incidental cerebral aneurysms found in 51 consecutive surgical cases by reviewing of intra-operative videotape recordings. Among 78 unruptured aneurysms, 23 (30%) were evaluated as thick-walled aneurysms (Type A), 39 (50%) with partially thin-walled sac (Type B) and 16 (20%) with entirely thin wall sacs (Type C). The mean size of Type A aneurysms was 10.4 mm (ranging from 3 to 22 mm), in Type B it was 9.8 mm (ranging 4 to 25 mm) and in Type C it was 4.4 mm (between 2-12 mm). Approximately two-thirds of Type C aneurysms were 4 mm in size or smaller, and Type C aneurysms were significantly smaller than Type A aneurysms. In summary, this preliminary study has provided two original data. 1) About 70% of incidental unruptured aneurysms have a partially or entirely thin-walled sac. 2) Many of the small aneurysms have an entirely thin sac. Assuming that thin-walled aneurysms are at a high risk of subsequent rupture, the surgical intervention for incidental unruptured aneurysms may be recommended irrespective of their size if the surgical risk is considered low.

show abstract

Section: Discussionmentioning

confidence: 92%

Types of unruptured cerebral aneurysms reviewed from operation video-recordings

1996

View full text Add to dashboard Cite

show abstract

“…Earlier hypotheses suggested that the appearance of aneurysms is exclusively due to congenital abnormalities, but scientific findings suggest that hemodynamic and degenerative factors can contribute to aneurysm development 6. It is now generally accepted that an aneurysm is an acquired lesion, resulting from a complicated interplay of anatomical, hemodynamic, and degenerative factors.…”

Section: Discussionmentioning

confidence: 99%

Association between Internal Carotid Artery Morphometry and Posterior Communicating Artery Aneurysm

Kim

Kang

2007

Yonsei Med J

View full text Add to dashboard Cite

PurposeThe goal of this study was to directly measure the association between the internal carotid artery (ICA) morphometry and the presence of ICA-posterior communicating artery (PCOM) aneurysm.Materials and MethodsThe authors intraoperatively measured the length of the supraclinoid ICA because it is impossible to radiologically determine the exact location of the anterior clinoid process. We used an image analyzer with a CT angiogram to measure the angle between the skull midline and the terminal segment of the ICA (ICA angle), as well as the diameter of the ICA. The lengths and diameters of the supraclinoid ICA and the ICA angle were compared among PCOM aneurysms, anterior communicating artery (ACOM) aneurysms, and middle cerebral artery (MCA) bifurcation aneurysms (n = 27 each). Additionally, the lengths and the diameters of M1 and A1 were compared for each aneurysm.ResultsThe lengths of the supraclinoid ICA were 11.9 ± 2.3mm. The lengths of the supraclinoid ICA in patients with ICA-PCOM aneurysms (9.7 ± 2.8mm) were shorter than those of patients with ACOM aneurysms (13.8 ± 2.2mm, Student's t-test, p < 0.001) and with MCA bifurcation aneurysms (12.2 ± 1.9 mm, Student's t-test, p < 0.001). The diameters of the supraclinoid ICA and A1 in patients with ACOM aneurysms were larger than those in patients with MCA bifurcation aneurysms (Student's t-test, p < 0.05). There were no significant differences in the lengths of M1 and A1, ICA angle, or diameter of M1 for each aneurysm.ConclusionThese results suggest that the relatively shorter length of the supraclinoid ICA may be a novel risk factor for the development of ICA-PCOM aneurysm with higher hemodynamic stress.

show abstract

“…The same is valid for aneurysmatic dilation of the cortical veins when the fistula is located on the cortex. This venous dilation should be distinguished from arterial berry aneurysms, which can occur on the arteries feeding a cerebral AVM [11]. The histological examination of the "aneurysmal sac," done in our case 2, revealed a pure venous structure.…”

Section: Discussionmentioning

confidence: 96%

“…The fistula may occur between a single artery and a single vein, or it may have multiple afferent-efferent anastomoses. They may result in an aneurysm-like, saccular, or varicose dilation of the venous portion most proximal to the fistula [8,11,15]. The most frequently reported examples are direct anastomosis of the posterior circulation arteries with the galenic system.…”

Section: Discussionmentioning

confidence: 99%