The angiographic and clinical outcomes of intracranial aneurysms following irradiation in patients with nasopharyngeal carcinoma: A 13-year experience and literature review

Journal of Neuroradiology. Journal De Neuroradiologie
Siang Hua Victor ChanKar Ming Leung

Abstract

Intracranial aneurysms are a known but rare complication of radiotherapy (RT). We reviewed the angiographic and clinical outcomes of intracranial aneurysms following RT in patients with nasopharyngeal carcinoma (NPC), a malignancy endemic in Hong Kong. The clinical, angiographic and laboratory data was collected for nine NPC patients harboring fifteen intracranial aneurysms following RT, diagnosed between 1st January 2000 and 31st December 2012. The median age at aneurysm diagnosis was 56 years with a male predilection (67%). The median latent period to diagnosis was nine years (0.3-30). Eight patients (89%) presented with aneurysmal subarachnoid hemorrhage. Nine aneurysms were located at the anterior circulation, and 14 were saccular in morphology. Of the treated aneurysms, eight underwent endovascular intervention and two were surgically clipped. Within a year, 50% of the treated aneurysms had recurred. Poor neurological outcome was noted. At two-year follow-up, the median score for modified Rankin score and Glasgow Outcome score was 5 and 2 respectively. The two-year mortality rate of patients with treated ruptured intracranial aneurysms was 50%. Compared to previous studies, our irradiated NPC patients had higher mortality ...Continue Reading

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