Are Blood Blister-Like Aneurysms a Specific Type of Dissection? A Comparative Study of Blood Blister-Like Aneurysms and Ruptured Mizutani Type 4 Vertebral Artery Dissections.
10.3340/jkns.2014.56.5.395
- Author:
Sook Young SIM
1
;
Joonho CHUNG
;
Yong Sam SHIN
Author Information
1. Department of Neurosurgery, Inje University Seoul Paik Hospital, Seoul, Korea.
- Publication Type:Comparative Study ; Original Article
- Keywords:
Aneurysm;
Dissection;
Internal carotid artery;
Subarachnoid hemorrhage;
Vertebral artery
- MeSH:
Aneurysm*;
Arteries;
Carotid Artery, Internal;
Dilatation;
Female;
Humans;
Hydrocephalus;
Male;
Parents;
Retreatment;
Risk Factors;
Subarachnoid Hemorrhage;
Treatment Outcome;
Vertebral Artery;
Vertebral Artery Dissection*
- From:Journal of Korean Neurosurgical Society
2014;56(5):395-399
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Blood blister-like aneurysms (BBAs) resemble arterial dissections. The purpose of this study was to investigate the relationship between these two disease entities and highlight commonalities and distinct features. METHODS: Among 871 consecutive patients with aneurysmal subarachnoid hemorrhage, 11 BBAs of internal carotid artery and seven vertebral artery dissections (VADs) with a short segmental eccentric dilatation (Mizutani type 4), which is morphologically similar to a BBA, were selected. The following clinical factors were studied in each group : age, gender, risk factors, Hunt and Hess grade (HHG), Fisher grade (FG), vasospasms, hydrocephalus, perioperative rebleeding rate, and treatment outcome. RESULTS: The mean age was 47.9 years in the BBAs group and 46.4 years in the type 4 VADs group. All the BBA patients were female, whereas there was a slight male predominance in the type 4 VAD group (male : female ratio of 4 : 3). In the BBA and type 4 VAD groups that underwent less aggressive treatment to save the parent artery, 29% (n=2/7) and 66.6% (n=2/3), respectively, eventually required retreatment. Perioperative rebleeding occurred in 72.7% (n=8) and 28.6% (n=2) of patients in the BBA and type 4 VAD groups, respectively. There was no statistical difference in the other clinical factors in both groups, except for the male dominancy in the type 4 VAD group (p=0.011). CONCLUSION: BBAs and ruptured type 4 VADs have a similar morphological appearance but there is a distinct clinical feature in gender and perioperative rebleeding rates. Complete isolation of an aneurysm from the parent artery might be the most important discipline for the treatment of these diseases.
