Clinical Analysis of Determining the Primary Rupture Site in Multiple Intracranial Aneurysms: Preliminary Report
Journal of Korean Neurosurgical Society
; : 537-542, 2003.
Article
em Ko
| WPRIM
| ID: wpr-212667
Biblioteca responsável:
WPRO
ABSTRACT
OBJECTIVE: Misjudgement of rupture site may result in disastrous postoperative rebleeding from the unclipped but truly ruptured aneurysm. We assess the concordance rate between radiologic findings and operative ones, and then we document the problems in false localization of rupture site in multiple intracranial aneurysms. METHODS: From January 2001 to December 2002, We retrospectively analyzed 14 patients with a total of 32 multiple aneurysms to assess the primary rupture site. The rupture site was determined on the basis of computed tomographic and angiographic findings by neurosurgeons and one neuroradiologist. The operative findings such as healed thrombotic cap, localized clot, and easy collapse before and after clipping of ruptured aneurysms were compared with the predicted radiologic findings. On the other hand, we analyzed the causes in the cases of false localization. RESULTS: The location of ruptured aneurysm was verified at the time of surgery in 10 patients. The concordance rate of localized clot(100%) was higher than laterality of subarachnoid hemorrhage(66.7%) on CT scan, and those of focal vasospasm and nipple formation(100%) were also higher than size(72.7%) or irregularity(83.3%) of aneurysms on angiographic findings. Two of four misjudged patients were expired due to rebleeding from unclipped aneurysms. CONCLUSION: Although most reliable radiologic findings are useful in determination of rupture site, we should also consider less reliable radiologic findings and careful surgical inspection of the target aneurysm. And then early second operation should be performed as soon as possible in cases of misjudgment on initial diagnosis.
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Índice:
WPRIM
Assunto principal:
Ruptura
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Tomografia Computadorizada por Raios X
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Aneurisma Intracraniano
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Estudos Retrospectivos
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Aneurisma Roto
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Diagnóstico
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Mãos
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Aneurisma
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Mamilos
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Limite:
Humans
Idioma:
Ko
Revista:
Journal of Korean Neurosurgical Society
Ano de publicação:
2003
Tipo de documento:
Article