Growth of giant intracranial aneurysms: An aneurysmal wall disorder?

Ferracci, François-Xavier; Gilard, Vianney; Cébula, H.; Magné, Nicolas; Lejeune, Jean‐Paul; Langlois, Olivier; Proust, F.

doi:10.1016/j.neuchi.2017.01.001

Cited by 6 publications

(4 citation statements)

References 49 publications

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“…Our literature search could not locate any report of a giant anterior circulation aneurysm in which the ipsilateral ICA was occluded. Although aneurysm growth has been recorded on several occasions, a radiologically demonstrated growth of aneurysm size within a 3-month observation period is relatively uncommon 3 and has never been recorded in the literature. Since the aneurysm had rapidly grown in size, any form of conservative treatment was no longer a viable option.…”

Section: Discussionmentioning

confidence: 96%

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“Flow Reversal” and Cure in a Case of Giant Intracranial Aneurysm: A Case Report

Shah

Vutha

Doshi

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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We describe the case of an 11-year-old girl having a giant anterior circulation aneurysm. The ipsilateral internal carotid artery was entirely blocked and the aneurysm was supplied by posterior circulation. Following a high-flow bypass that connected the external carotid artery to the middle cerebral artery, the giant aneurysm thrombosed spontaneously. We discuss several relatively rare and unique features of the case.

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Section: Discussionmentioning

confidence: 96%

“…Such growth of aneurysm in a short observation period is only rarely reported. [1][2][3] High-flow bypass from the external carotid artery to the middle cerebral artery (MCA) resulted in spontaneous occlusion of the aneurysm. Presence of a giant aneurysm in a child with complete blockage of the ipsilateral ICA is a rare observation.…”

Section: Introductionmentioning

confidence: 99%

“Flow Reversal” and Cure in a Case of Giant Intracranial Aneurysm: A Case Report

Shah

Vutha

Doshi

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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“…The presence of bone remodelling around the aneurysm indicates that this aneurysm has gradually increased in size over a period. Various factors have been previously attributed to the growth of giant aneurysms [ 1 , 3 , 6 , 13 , 14 ]. These include wall shear stress resulting in endothelial dysfunction from haemodynamic stress, layering of fresh thrombus formation over chronic thrombosis from recurrent haemorrhage and neoangiogenesis from the vasa vasorum of the intracranial vessels.…”

Section: Discussionmentioning

confidence: 99%

Giant aneurysm arising from a cortical middle cerebral artery branch presenting as an extra-axial tumour: a case report

Jain

Paschalis

Das

et al. 2023

Journal of Surgical Case Reports

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The size and anatomical complexity make giant intracranial aneurysms challenging surgical lesions. There is limited literature available for those arising from distal branches. The cases that have been reported in the literature have all presented with symptoms from a rupture leading to an intracranial haemorrhage. In this case report, the authors present a case of a giant aneurysm arising from a cortical branch of the middle cerebral artery presenting as an extra-axial tumour. A 76-year-old gentleman presented with a 2-day history of subjective left arm numbness. Imaging revealed a large conical right-sided parietal lesion. Intraoperatively, it was found that the lesion was being supplied by a single vascular pedicle. Histology was consistent with an aneurysm. In this case, that patient did not have any evidence of a rupture unlike all reported cases of cortical giant aneurysms. This case highlights the myriad location and presentation of giant intracranial aneurysms.

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“…Yasui et al reported similar findings of numerous clefts in old thrombus near the wall of the distal aneurysmal neck that seemed to connect the parent artery lumen with the most peripheral fresh hemorrhage ( 17 ). Ferracci et al also reported that parent arterial inflow rather than VV may be the cause of IMH and that shear stress on the edge of the aneurysm neck or at the vessel dissection point might drive dissection, leading to recurrent intramural hemorrhage ( 18 ). Furthermore, inflammation is involved in thrombus organization, vessel dissection, and neovascularization ( 12 , 19 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of reconstructive endovascular treatment of vertebrobasilar dissecting aneurysms with intramural hematoma

Zhang

Peng²,

Zhou³

et al. 2022

Front. Neurol.

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BackgroundVertebrobasilar dissecting aneurysms (VBDAs) with an intramural hematoma (IMH) usually cause symptoms because of mass effect and grow in size over time. Clinical outcomes are generally poor.ObjectiveThis study aimed to examine outcomes of reconstructive endovascular treatment (EVT) in patients with VBDAs with IMH. Safety and effectiveness were compared between flow diverters (FDs) and conventional stents.MethodsWe retrospectively analyzed the clinical and radiological data of 36 VBDAs with IMH in 36 patients who underwent EVT with either FDs or conventional stents from January 2012 to December 2020 at our institution.ResultsAmong the 36 study patients, 20 were treated with FDs and 16 with conventional stents. Incidence of procedure-related complications did not significantly differ between the two stents. IMH growth occurred after EVT in a significantly higher proportion of conventional stent group aneurysms (zero vs. 31.3% [5/16]; p = 0.012). Among the five aneurysms with IMHs that grew, all recurred. Change in IMH size after EVT was significantly lower in the FD group (−2.7 vs. +8.1%, p = 0.036). However, after the recurrent aneurysms were removed from the conventional stent group, change in IMH size did not significantly differ between the two groups (−2.7 vs. +1.0%, p = 0.332). The proportion of patients who experienced an improvement in mRS score after EVT was significantly higher in the FD group (60 vs. 25%, p = 0.036).ConclusionIMHs in VBDAs stop growing after successful reconstructive EVT. Although both FD and conventional stent treatment are effective, FD treatment may be superior based on clinical outcomes and effect on IMH size.

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Growth of giant intracranial aneurysms: An aneurysmal wall disorder?

Cited by 6 publications

References 49 publications

“Flow Reversal” and Cure in a Case of Giant Intracranial Aneurysm: A Case Report

“Flow Reversal” and Cure in a Case of Giant Intracranial Aneurysm: A Case Report

Giant aneurysm arising from a cortical middle cerebral artery branch presenting as an extra-axial tumour: a case report

Outcomes of reconstructive endovascular treatment of vertebrobasilar dissecting aneurysms with intramural hematoma

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