Angiographic Characteristics of the Intracranial Saccular Aneurysms to Predict the Rupture / 대한뇌혈관외과학회지

OBJECTIVE: During the last two decades, detection of unruptured intracranial aneurysms has increased because of the improving diagnostic methods, but the management of unruptured intracranial aneurysm is still controversial. We analyzed the angiographic characteristics to compare ruptured aneurysms with unruptured aneurysms. METHODS: The patients were retrospectively selected for this study based on the availability of angiograms and a clear diagnosis of an unruptured or ruptured aneurysm. One hundred sixty nine patients with 209 aneurysms were included in the study. Sixty-one patients harbored only unruptured lesions, 85 only ruptured lesions and 27 had both ruptured and unruptured lesions. RESULTS: The mean age of all the patients was 55.3 years, and it was 53.34 years for those with ruptured aneurysms. It was found that 42.0% of the ruptured aneurysms were on the anterior communicating artery, compared with 10.3% of the unruptured aneurysms. None of the ophthalmic artery aneurysms were ruptured. The mean dome size, depth and aspect ratio of the ruptured aneurysms, except for the neck size, were significantly larger than that of the unruptured aneurysms, but the mean neck size of the ruptured and unruptured aneurysms showed no significant difference. A daughter sac was present in 7.2% of the unruptured aneurysms and in 17.0% of the ruptured aneurysms. CONCLUSION: We suggest that the morphologic features and location of aneurysms should be considered when making decisions regarding whether to treat unruptured aneurysms.

Endovascular Stent Treatment for Traumatic Common Carotid Artery Dissection with Cerebral Infarction : Case Report and Literature Review / 대한뇌혈관외과학회지

Accurate determination of the true incidence of blunt carotid artery injury is difficult because the patient may be asymptomatic or the condition may be masked by concomitant injuries. We present a case of blunt injury to the right common carotid artery and dissection with acute infarction on right fronto-temporo-parietal area and treated with carotid stent. We review the blunt carotid artery injury rate of occurrence, mechanism, presentation, screening, radiologic diagnosis, management and outcome.

Progressive Visual Loss after Endovascular Coiling Treatment of a Large Paraclinoid Aneurysm / 대한뇌혈관외과학회지

Recently, favorable outcomes have been reported after the endovascular treatment of either ruptured or unruptured paraclinoid aneurysms. The complications specifically related to the endovascular treatment of paraclinoid aneurysms have also been reported in other studies. Visual symptoms related to the mass effects associated with giant paraclinoid aneurysm normally improve after coil embolization. However, these symptoms have also been reported to be exacerbated in some cases. The authors here report an unusual case of progressive visual loss occurring after endovascular coiling treatment in a case of a large paraclinoid aneurysm.