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Perianeurysmal edema in giant intracranial aneurysms in relation to aneurysm location, size, and partial thrombosis.
- Source :
-
Journal of neurosurgery [J Neurosurg] 2015 Aug; Vol. 123 (2), pp. 446-52. Date of Electronic Publication: 2015 Apr 17. - Publication Year :
- 2015
-
Abstract
- Object: The underlying mechanisms causing intracranial perianeurysmal edema (PAE) are still poorly understood. Since PAE is most frequently observed in giant intracranial aneurysms (GIAs), the authors designed a study to examine the occurrence of PAE in relation to the location, size, and partial thrombosis (PT) of GIAs along with the clinical impact of PAE.<br />Methods: Magnetic resonance imaging data for patients with a diagnosis of unruptured GIA from the international multicenter Giant Intracranial Aneurysm Registry were retrospectively analyzed with regard to location and size of the GIA, PAE volume, and the presence of PT. The occurrence of PAE was correlated to clinical findings.<br />Results: Imaging data for 69 GIAs were eligible for inclusion in this study. Perianeurysmal edema was observed in 33.3% of all cases, with the highest frequency in GIAs of the middle cerebral artery (MCA; 68.8%) and the lowest frequency in GIAs of the cavernous internal carotid artery (ICA; 0.0%). Independent predictors of PAE formation were GIA volume (OR 1.13, p = 0.02) and the occurrence of PT (OR 9.84, p = 0.04). Giant intracranial aneurysm location did not predict PAE occurrence. Giant aneurysms with PAE were larger than GIAs without PAE (p < 0.01), and GIA volume correlated with PAE volume (rs = 0.51, p = 0.01). Perianeurysmal edema had no influence on the modified Rankin Scale score (p = 0.30 or the occurrence of aphasia (p = 0.61) or hemiparesis (p = 0.82).<br />Conclusions: Perianeurysmal edema was associated with GIA size and the presence of PT. As no PAE was observed in cavernous ICA aneurysms, even though they exerted mass effect on the brain and also displayed PT, the dura mater may serve as a barrier protecting the brain from PAE formation.
- Subjects :
- Adult
Aged
Brain Edema pathology
Brain Edema surgery
Female
Humans
Intracranial Aneurysm pathology
Intracranial Aneurysm surgery
Magnetic Resonance Imaging
Male
Middle Aged
Retrospective Studies
Thrombosis pathology
Thrombosis surgery
Brain Edema complications
Intracranial Aneurysm complications
Thrombosis complications
Subjects
Details
- Language :
- English
- ISSN :
- 1933-0693
- Volume :
- 123
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 25884259
- Full Text :
- https://doi.org/10.3171/2014.10.JNS141560