Abstract
OBJECTIVEDuring the microsurgical clipping of known aneurysms, angiographically occult (AO) aneurysms are sometimes found and treated simultaneously to prevent their growth and protect the patient from future rupture or reoperation. The authors analyzed the incidence, treatment, and outcomes associated with AO aneurysms to determine whether limited surgical exploration around the known aneurysm was safe and justified given the known limitations of diagnostic angiography.METHODSAn AO aneurysm was defined as a saccular aneurysm detected using the operative microscope during dissection of a known aneurysm, and not detected on preoperative catheter angiography. A prospective database was retrospectively reviewed to identify patients with AO aneurysms treated microsurgically over a 20-year period.RESULTSOne hundred fifteen AO aneurysms (4.0%) were identified during 2867 distinct craniotomies for aneurysm clipping. The most common locations for AO aneurysms were the middle cerebral artery (60 aneurysms, 54.1%) and the anterior cerebral artery (20 aneurysms, 18.0%). Fifty-six AO aneurysms (50.5%) were located on the same artery as the known saccular aneurysm. Most AO aneurysms (95.5%) were clipped and there was no attributed morbidity...Continue Reading
References
Jan 1, 1997·Acta neurochirurgica·H KarasawaH Kin
Dec 29, 1998·The New England Journal of Medicine·UNKNOWN International Study of Unruptured Intracranial Aneurysms Investigators
Sep 2, 1999·Journal of Neurosurgery·C A DavidS Partovi
Jun 29, 2001·Neurological Research·J InamasuT Kawase
Jul 8, 2005·Brain : a Journal of Neurology·M J H WermerUNKNOWN ASTRA Study Group
Aug 26, 2006·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Jin Young JungKyu Chang Lee
Oct 12, 2007·AJNR. American Journal of Neuroradiology·M RomijnC B Majoie
May 25, 2011·Neurosurgical Review·Marco FontanellaAlessandro Ducati
Jun 7, 2011·Neurosurgical Review·Michaël BruneauBoris Lubicz
May 15, 2012·Academic Radiology·Siong Chuong WongKhairul Azmi Abd Kadir
Dec 12, 2012·World Neurosurgery·Gustavo PradillaRafael J Tamargo
Apr 20, 2013·AJNR. American Journal of Neuroradiology·H MengA Siddiqui
Aug 21, 2014·Surgical Neurology International·Rajan KumarSanjay Behari
Nov 11, 2015·BMJ : British Medical Journal·Charlotte J J van AschUNKNOWN DIAGRAM Investigators
Apr 30, 2016·Journal of Neurosurgery·Mason A BrownAaron A Cohen-Gadol
Nov 4, 2016·Nature Reviews. Neurology·Nima Etminan, Gabriel J Rinkel
Feb 16, 2017·Neurosurgery·Lucas R PhilippGustavo Pradilla
Dec 16, 2017·Journal of Neurosurgery·Ethan A WinklerMichael T Lawton