Treatment for Recurrent Cerebral Aneurysm.
- Author:
Joung Soo PARK
1
;
Man Bin YIM
;
IL Man KIM
;
Chang Young LEE
;
Eun Ik SON
;
Dong Won KIM
Author Information
1. Department of Neurosurgery, Brain Research Institute, Keimyung University School of Medicine, Daegu, Korea.
- Publication Type:Original Article
- Keywords:
Cerebral aneurysm;
Recurrence;
Three dimensional computed tomographic angiography;
Subarachnoid hemorrhage;
Coil embolization;
Clipping
- MeSH:
Aneurysm;
Angiography;
Arteries;
Embolization, Therapeutic;
Endovascular Procedures;
Follow-Up Studies;
Headache Disorders;
Humans;
Intracranial Aneurysm*;
Recurrence;
Subarachnoid Hemorrhage
- From:Journal of Korean Neurosurgical Society
2003;33(5):472-476
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: The aim of this study is to make a management strategy for the patients with recurrent cerebral aneurysm after surgery. METHODS: Over a 19-year period, 1, 546 patients were treated for a ruptured intracranial aneurysm surgically. Twenty-six of these patients(1.7%) were subsequently treated for regrowing aneurysm(8) or de novo aneurysm formation(26). Among them, twenty-three individuals who presented with recurrent subarachnoid hemorrhage underwent conventional angiography to detect the aneurysm recurrence. Three-dimensional computed tomographic angiography was performed in the remaining three patients who complained chronic headache. The mean age at the first surgery was 48.6 years. An interval ranging from 1 to 192 months(mean, 76.1 months) since the original treatment. RESULTS: Total 34 recurrent aneurysms in 26 patients were treated by microsurgical clipping(29 cases), wrapping(1 case), and endovascular coiling(4 cases) as a second procedure. A satisfactory outcomes were achieved in twenty-one patients(80.8%) during a mean 69.5 months follow-up period. The most common site of the recurrence was the internal carotid-posterior communicating artery. Patients with de novo aneurysms are frequently hypertensive(61.1%) and younger in age(55.6%). CONCLUSION: The treatment of recurrent cerebral aneurysm could be performed effectively using direct operations and/or endovascular procedures.
