Multiple cerebral fusiform aneurysms involving the posterior and anterior circulation including the anterior cerebral artery: a case report

Das, Sumit; Vályi-Nagy, Tibor

doi:10.5114/fn.2017.66716

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…The pathogenesis of IFCAs is unknown, and the common proposed causes are dissection in youth and atherosclerosis in elderly individuals (10,(14)(15)(16)(17). IFCAs are progressive lesions that often start with internal elastic lamina fragmentation and progress due to intramural hemorrhage (14,18).…”

Section: Pathological Processmentioning

confidence: 99%

Intracranial Fusiform and Circumferential Aneurysms of the Main Trunk: Therapeutic Dilemmas and Prospects

et al. 2021

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Intracranial fusiform and circumferential aneurysms (IFCAs), especially those located on the main trunk, are uncommon and difficult to manage. Currently, literature focused on IFCAs on the main trunk of cerebral arteries is lacking. The treatment of IFCAs is still under debate. Therefore, in this review, we further explore the treatment of this complicated entity. In addition, we also present some interesting cases. Based on the literature review and our experience, we found that IFCAs are often located in the vertebrobasilar system and that ruptured or large symptomatic IFCAs are associated with increased mortality and higher rebleeding rates. The treatment strategies for IFCAs can be classified as deconstructive and reconstructive methods via open surgery and/or endovascular treatment (EVT). Currently, EVT is a popular method and the main therapeutic choice. In particular, flow diversion has revolutionized the treatment of IFCAs. Parent artery occlusion (PAO) with or without revascularization may still be considered a suitable choice. Complex IFCAs that cannot be resolved by EVT can also be treated via open surgery with or without extracranial–intracranial bypass. Targeted embolization for the weak points of IFCAs is a temporary or palliative choice that is rarely used. In summary, despite complications, both surgical treatment and EVT are effective options for appropriately selected cases. Due to the development of endovascular implants, EVT will have better prospects in the future.

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Section: Pathological Processmentioning

confidence: 99%

Intracranial Fusiform and Circumferential Aneurysms of the Main Trunk: Therapeutic Dilemmas and Prospects

et al. 2021

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“…However, up to 47% of ruptured sIAs presenting with subarachnoid haemorrhage are < 5 mm in size [12]. In addition, subarachnoid haemorrhage is associated with a high fatality rate [2,6,19]. Nevertheless, the only available preventive methods utilize invasive procedures with a combined morbidity and mortality rate reaching 10.1% [1].…”

Section: Introductionmentioning

confidence: 99%

Impact of inflammation-related degenerative changes on the wall strength of unruptured intracranial aneurysms: a pilot study

Lombarski¹,

Kunert²,

Tarka³

et al. 2022

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Introduction: Saccular intracranial aneurysm (sIA) rupture is a serious cerebrovascular event associated with inflammatory destructive processes leading to gradual weakening of the sIA wall. The aim of the present study was to identify the morphological and histological determinants for low wall strength in unruptured sIAs harvested from autopsy subjects. Material and methods: A total of eight single unruptured sIAs were identified and excised with adjacent cerebral arteries during 8 of 184 postmortem examinations. The dome morphology was assessed for each sIA at a constant pressure of 100 mmHg. Then, after 5 preconditioning cycles which assured muscle fibre relaxation, sIA specimens were subjected to gradually increasing intraluminal pressure at a rate of 20 mmHg/s until rupture of the sIA or cerebral artery was achieved. Micro-structural degenerative changes and inflammatory cell infiltration within the sIA wall were quantitatively analysed after pressurization of the sIA specimens. The microscopic analysis of the slides stained with histological methods (HE, Mallory trichrome, Masson trichrome, orcein) and immunohistochemical methods (LCA, CD3, CD68) was performed. Results: The wall of the sIA ruptured in three specimens, while in the other cases, rupture occurred at the arterial wall. The mean maximal dome size was significantly larger in sIAs with low wall strength, that is, in sIAs that ruptured during pressurization, than in sIAs with high wall strength (6.46 mm vs. 2.43 mm, p = 0.034). Moreover, a significantly higher average percentage of wall hyalinization in sIAs that ruptured than in sIAs that did not rupture was observed (30% vs. 0%, p = 0.006). In contrast, the degree of inflammatory cell infiltration did not differ between the wall strength categories. Conclusions: Our results support the observations that larger sIAs may be at a higher risk of rupture. Histological analysis revealed that hyalinization corresponds to the weakened regions of the wall of unruptured sIAs.

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Fusiform aneurysms of anterior cerebral artery: center experience and systematic literature review

Conte,

Cagil,

Lanzino

et al. 2023

Neurosurg Rev

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Multiple cerebral fusiform aneurysms involving the posterior and anterior circulation including the anterior cerebral artery: a case report

Abstract: A b s t r a c t

Cited by 4 publications

References 11 publications

Intracranial Fusiform and Circumferential Aneurysms of the Main Trunk: Therapeutic Dilemmas and Prospects

Intracranial Fusiform and Circumferential Aneurysms of the Main Trunk: Therapeutic Dilemmas and Prospects

Impact of inflammation-related degenerative changes on the wall strength of unruptured intracranial aneurysms: a pilot study

Fusiform aneurysms of anterior cerebral artery: center experience and systematic literature review

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