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Surgical Strategies and outcomes for distal anterior cerebral arteries aneurysms

BACKGROUND: Distal anterior cerebral artery (DACA) aneurysms are rare and their surgical treatment presents some unique difficulties. In this report, we present our experience of cases with DACA aneurysms. MATERIALS AND METHODS: Among 80 patents with cerebral aneurysm operated on in the three-year p...

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Autor principal: Orz, Yasser
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Annals of Cardiac Anaesthesia 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205545/
https://www.ncbi.nlm.nih.gov/pubmed/22059099
http://dx.doi.org/10.4103/1793-5482.85628
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author Orz, Yasser
author_facet Orz, Yasser
author_sort Orz, Yasser
collection PubMed
description BACKGROUND: Distal anterior cerebral artery (DACA) aneurysms are rare and their surgical treatment presents some unique difficulties. In this report, we present our experience of cases with DACA aneurysms. MATERIALS AND METHODS: Among 80 patents with cerebral aneurysm operated on in the three-year period, 15 patients (18.75%) had DACA aneurysms, who were studied retrospectively. We analyze the specific clinical and radiological features, surgical strategies and prognostic factors affecting the surgical outcomes of these DACA aneurysms. RESULTS: There were 10 male and 5 female patients harboring 16 DACA aneurysms. All patients presented with subarachnoid hemorrhage, 11 patients (73%) had intracerebral hematoma in their initial CT scan and four of them had associated intraventricular hemorrhage. Thirteen of the ruptured DACA aneurysms (86%) were small in size (less than 7 mm in diameter). Three patients (20%) had other associate aneurysms. In 14 patients (93%), a unilateral interhemispheric approach was used in their treatment, while pterional approach was used in one patient. Eleven patients (73%) had favorable outcomes and only one patient (7%) died. The follow-up data suggested that poor admission grade and initial Intracerebral hematoma (ICH) on brain scan portend an unfavorable prognosis. CONCLUSIONS: DACA aneurysms are usually small even when ruptured, they are usually associated with ICH more frequently than intracranial aneurysms in other locations. They should be aggressively treated even if very small because of their tendency to early rupture.
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spelling pubmed-32055452011-11-06 Surgical Strategies and outcomes for distal anterior cerebral arteries aneurysms Orz, Yasser Asian J Neurosurg Original Article BACKGROUND: Distal anterior cerebral artery (DACA) aneurysms are rare and their surgical treatment presents some unique difficulties. In this report, we present our experience of cases with DACA aneurysms. MATERIALS AND METHODS: Among 80 patents with cerebral aneurysm operated on in the three-year period, 15 patients (18.75%) had DACA aneurysms, who were studied retrospectively. We analyze the specific clinical and radiological features, surgical strategies and prognostic factors affecting the surgical outcomes of these DACA aneurysms. RESULTS: There were 10 male and 5 female patients harboring 16 DACA aneurysms. All patients presented with subarachnoid hemorrhage, 11 patients (73%) had intracerebral hematoma in their initial CT scan and four of them had associated intraventricular hemorrhage. Thirteen of the ruptured DACA aneurysms (86%) were small in size (less than 7 mm in diameter). Three patients (20%) had other associate aneurysms. In 14 patients (93%), a unilateral interhemispheric approach was used in their treatment, while pterional approach was used in one patient. Eleven patients (73%) had favorable outcomes and only one patient (7%) died. The follow-up data suggested that poor admission grade and initial Intracerebral hematoma (ICH) on brain scan portend an unfavorable prognosis. CONCLUSIONS: DACA aneurysms are usually small even when ruptured, they are usually associated with ICH more frequently than intracranial aneurysms in other locations. They should be aggressively treated even if very small because of their tendency to early rupture. Annals of Cardiac Anaesthesia 2011 /pmc/articles/PMC3205545/ /pubmed/22059099 http://dx.doi.org/10.4103/1793-5482.85628 Text en Copyright: © Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Orz, Yasser
Surgical Strategies and outcomes for distal anterior cerebral arteries aneurysms
title Surgical Strategies and outcomes for distal anterior cerebral arteries aneurysms
title_full Surgical Strategies and outcomes for distal anterior cerebral arteries aneurysms
title_fullStr Surgical Strategies and outcomes for distal anterior cerebral arteries aneurysms
title_full_unstemmed Surgical Strategies and outcomes for distal anterior cerebral arteries aneurysms
title_short Surgical Strategies and outcomes for distal anterior cerebral arteries aneurysms
title_sort surgical strategies and outcomes for distal anterior cerebral arteries aneurysms
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205545/
https://www.ncbi.nlm.nih.gov/pubmed/22059099
http://dx.doi.org/10.4103/1793-5482.85628
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