Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Predicting Factors Affecting Clinical Outcomes for Saccular Aneurysms of Posterior Inferior Cerebellar Artery with Subarachnoid Hemorrhage

  • Hong, Young-Ho (Department of Neurosurgery, Cerebro-Vascular Center, Bongseng Memorial Hospital) ;
  • Kim, Chang-Hyun (Department of Neurosurgery, Cerebro-Vascular Center, Dong-Rae Bongseng Hospital) ;
  • Che, Gil-Sung (Department of Neurosurgery, Cerebro-Vascular Center, Bongseng Memorial Hospital) ;
  • Lee, Sang-Hoon (Department of Neurosurgery, Cerebro-Vascular Center, Dong-Rae Bongseng Hospital) ;
  • Ghang, Chang-Gu (Department of Neurosurgery, Cerebro-Vascular Center, Bongseng Memorial Hospital) ;
  • Choi, Yu-Seok (Department of Neurosurgery, Cerebro-Vascular Center, Dong-Rae Bongseng Hospital)
  • Received : 2011.03.31
  • Accepted : 2011.10.13
  • Published : 2011.10.28
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : The aim of this study is to investigate the clinical outcomes of surgery and coiling and analyze the predicting factors affecting the clinical outcomes of ruptured posterior inferior cerebellar artery (PICA) aneurysms. Methods : During the last 15 years, 20 consecutive patients with ruptured PICA aneurysms were treated and these patients were included in this study. The Fisher's exact test was used for the statistical significance of Glasgow Outcome Scale (GOS) according to initial Hunt-Hess (H-H) grade, treatment modalities, and the presence of acute hydrocephalus. Results : Eleven (55%) and nine (45%) patients were treated with surgical clipping and endovascular treatment, respectively. Among 20 patients, thirteen (65.0%) patients had good outcomes (GOS 4 or 5). There was the statistical significance between initial poor H-H grade, the presence of acute hydrocephalus and poor GOS. Conclusion : In our study, we suggest that initial H-H grade and the presence of acute hydrocephalus may affect the clinical outcome rather than treatment modalities in the ruptured PICA aneurysms.

Keywords

References

  1. Akar ZC, Dujovny M, Slavin KV, Gomez-Tortosa E, Ausman JI : Microsurgical anatomy of the intracranial part of the vertebral artery. Neurol Res 16 : 171-180, 1994 https://doi.org/10.1080/01616412.1994.11740221
  2. Al-khayat H, Al-Khayat H, Beshay J, Manner D, White J : Vertebral artery-posteroinferior cerebellar artery aneurysms : clinical and lower cranial nerve outcomes in 52 patients. Neurosurgery 56 : 2-10; discussion 11, 2005 https://doi.org/10.1097/00006123-200501001-00002
  3. Coert BA, Chang SD, Do HM, Marks MP, Steinberg GK : Surgical and endovascular management of symptomatic posterior circulation fusiform aneurysms. J Neurosurg 106 : 855-865, 2007 https://doi.org/10.3171/jns.2007.106.5.855
  4. D'Ambrosio AL, Kreiter KT, Bush CA, Sciacca RR, Mayer SA, Solomon RA, et al. : Far lateral suboccipital approach for the treatment of proximal posteroinferior cerebellar artery aneurysms : surgical results and long-term outcome. Neurosurgery 55 : 39-50; discussion 50-54, 2004 https://doi.org/10.1227/01.NEU.0000126874.08468.89
  5. Dinichert A, Rufenacht DA, Tribolet N : Dissecting aneurysms of the posterior inferior cerebellar artery : report of four cases and review of the literature. J Clin Neurosci 7 : 515-520, 2000 https://doi.org/10.1054/jocn.2000.0757
  6. Guglielmi G, Vinuela F, Duckwiler G, Dion J, Lylyk P, Berenstein A, et al. : Endovascular treatment of posterior circulation aneurysms by electrothrombosis using electrically detachable coils. J Neurosurg 77 : 515-524, 1992 https://doi.org/10.3171/jns.1992.77.4.0515
  7. Horowitz M, Kopitnik T, Landreneau F, Krummerman J, Batjer HH, Thomas G, et al. : Posteroinferior cerebellar artery aneurysms : surgical results for 38 patients. Neurosurgery 43 : 1026-1032, 1998 https://doi.org/10.1097/00006123-199811000-00012
  8. Hudgins RJ, Day AL, Quisling RG, Rhoton AL Jr, Sypert GW, Garcia-Bengochea F : Aneurysms of the posterior inferior cerebellar artery. A clinical and anatomical analysis. J Neurosurg 58 : 381-387, 1983 https://doi.org/10.3171/jns.1983.58.3.0381
  9. Hunt WE, Hess RM : Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 28 : 14-20, 1968 https://doi.org/10.3171/jns.1968.28.1.0014
  10. Kallmes DF, Lanzino G, Dix JE, Dion JE, Do H, Woodcock RJ, et al. : Patterns of hemorrhage with ruptured posterior inferior cerebellar artery aneurysms : CT findings in 44 cases. AJR Am J Roentgenol 169 : 1169-1171, 1997 https://doi.org/10.2214/ajr.169.4.9308484
  11. Lewis SB, Chang DJ, Peace DA, Lafrentz PJ, Day AL : Distal posterior inferior cerebellar artery aneurysms : clinical features and management. J Neurosurg 97 : 756-766, 2002 https://doi.org/10.3171/jns.2002.97.4.0756
  12. Lister JR, Rhoton AL Jr, Matsushima T, Peace DA : Microsurgical anatomy of the posterior inferior cerebellar artery. Neurosurgery 10 : 170-199, 1982 https://doi.org/10.1227/00006123-198202000-00004
  13. Mericle RA, Reig AS, Burry MV, Eskioglu E, Firment CS, Santra S : Endovascular surgery for proximal posterior inferior cerebellar artery aneurysms : an analysis of Glasgow Outcome Score by Hunt-Hess grades. Neurosurgery 58 : 619-625; discussion 619-625, 2006 https://doi.org/10.1227/01.NEU.0000204127.81249.28
  14. Mukonoweshuro W, Laitt RD, Hughes DG : Endovascular treatment of PICA aneurysms. Neuroradiology 45 : 188-192, 2003 https://doi.org/10.1007/s00234-002-0913-9
  15. Ogilvy CS, Hoh BL, Singer RJ, Putman CM : Clinical and radiographic outcome in the management of posterior circulation aneurysms by use of direct surgical or endovascular techniques. Neurosurgery 51 : 14-21; discussion 21-22, 2002 https://doi.org/10.1097/00006123-200207000-00003

Cited by

  1. Risk Factors Affecting Clinical Outcome of Ruptured Vertebrobasilar Saccular Aneurysms vol.14, pp.3, 2012, https://doi.org/10.7461/jcen.2012.14.3.175
  2. Safety and efficacy of treatment strategies for posterior inferior cerebellar artery aneurysms: a systematic review and meta-analysis vol.158, pp.12, 2011, https://doi.org/10.1007/s00701-016-2965-3
  3. Acute-phase Endovascular Treatment of a Ruptured Basilar Artery Trunk Aneurysm vol.45, pp.5, 2011, https://doi.org/10.2335/scs.45.362
  4. A Case of Ruptured Distal Posterior Inferior Cerebellar Artery Aneurysm Treated with Intra-aneurysmal Coil Embolization vol.12, pp.3, 2018, https://doi.org/10.5797/jnet.cr.2017-0019
  5. Incidence and Risk Factors for Dysphagia Following Non-traumatic Subarachnoid Hemorrhage: A Retrospective Cohort Study vol.34, pp.2, 2011, https://doi.org/10.1007/s00455-018-9934-3
  6. Clipping versus coiling in posterior circulation intracranial aneurysms: a meta-analysis vol.5, pp.None, 2019, https://doi.org/10.1186/s41016-019-0163-x
  7. Endovascular Treatment of Distal Posterior Inferior Cerebellar Artery Aneurysm: : Case Report vol.70, pp.3, 2011, https://doi.org/10.2974/kmj.70.249