Intracranial aneurysms with perianeurysmal edema: Long-term outcomes post-endovascular treatment - 03/04/15
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Summary |
Background and purpose |
Perianeurysmal edema is rare and is associated with expansion of intracranial aneurysms despite adequate endovascular treatment. The natural history of this condition is poorly understood. We present a case series of perianeurysmal edema to investigate the incidence, natural history and management of these aneurysms.
Materials and methods |
Retrospective analysis of endovascularly treated aneurysms from January 2001 to December 2012 was performed. Perianeurysmal edema either pre- or post-treatment as detected on MRI was used to identify cases.
Results |
Ten of the 838 patients demonstrated perianeurysmal edema. The median age was 51.5 (interquartile range 48 to 59). Of the 10 subjects, 50% (5/10) were male. Perianeurysmal edema was detected after the initial presentation and treatment in 70% (7/10) of the patients, with one patient developing headache after endovascular coiling, while the remaining 6 were found on routine follow-up imaging. Only 4 of the patients were ever symptomatic in the setting of perianeurysmal edema, with 3 of these patients improved clinically following treatment of the aneurysm. Radiological follow-up showed expanding neck remnants leading to a second endovascular coiling procedure in 50% (5/10) of the patients and a third procedure in 20% (2/10) of the patients to attenuate aneurysm growth.
Conclusion |
Ten of the aneurysms treated with endovascular therapy in our case series demonstrated perianeurysmal edema. They are mostly asymptomatic, with no cases of re-bleeding identified, however perianeurysmal edema is associated with aneurysm re-expansion despite initial endovascular treatment.
Le texte complet de cet article est disponible en PDF.Keywords : Endovascular coiling, Magnetic resonance imaging, Perianeurysmal edema
Abbreviations : MRI, MRS, DSA, CT, Acom, ICA, FVL, PED, Pcom, SAH
Plan
Vol 42 - N° 2
P. 72-79 - avril 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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