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논문 기본 정보

자료유형
학술저널
저자정보
Seo, Dongwook (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) Lee, Si Un (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) Oh, Chang Wan (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) Kwon, O-Ki (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) Ban, Seung Pil (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) Kim, Tackeun (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) Byoun, Hyoung Soo (Department of Neurosurgery, Chungnam National University Hospital) Kim, Young Deok (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) Lee, Yongjae (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National Unive) Won, Yu Deok Bang, Jae Seung
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제62권 제6호
발행연도
2019.1
수록면
649 - 660 (12page)

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Objective : To analyze the angiographic features and clinical course, including treatment outcomes and the natural course, of fusiform middle cerebral artery aneurysms (FMCAAs) according to their location, size, and configuration. Methods : We reviewed the literature on adult cases of FMCAAs published from 1980 to 2018; from 25 papers, 112 FMCAA cases, for which the location, size, and configuration could be identified, were included in this study. Additionally, 33 FMCAA cases in our hospital were included, from which 16 were assigned to the observation group. Thus, a total of 145 adult FMCAA cases were included. We classified the FMCAAs according to their location (l-type 1, beginning from prebifurcation; l-type 2, beginning from bifurcation; l-type 3, beginning from postbifurcation), size (small, <10 mm; large, ${\geq}10mm$; giant, ${\geq}25mm$), and configuration (c-type 1, classic dissecting aneurysm; c-type 2, segmental ectasia; c-type 3, dolichoectatic dissecting aneurysm). Results : The c-type 3 was more commonly diagnosed with ischemic symptoms (31.8%) than hemorrhage (13.6%), while 40.9% were found accidentally. In contrast, c-type 2 was more commonly diagnosed with hemorrhagic symptoms (14.9%) than ischemic symptoms (10.6%), and 72.3% were accidentally discovered. According to location, ischemic symptoms and hemorrhage were the most frequent symptoms in l-type 1 (28.6%) and l-type 3 (34.6%), respectively. Most of l-type 2 FMCAAs were found incidentally (68.4%). Based on the size of FMCAAs, only 11.1% of small aneurysms were found to be hemorrhagic, while 18.9% and 26.0% of large and giant aneurysms were hemorrhagic, respectively. Although four aneurysms of the 16 FMCAAs in the observation group increased in size and one aneurysm decreased in size during the observation period, no rupture was seen in any case and there were no significant predictors of aneurysm enlargement. Of 104 FMCAAs treated, 14 cases (13.5%) were aggravated than before surgery and all the aggravated cases were l-type 1. Conclusion : While ischemic symptoms occurred more frequently in l-type 1 and c-type 3, hemorrhagic rather than ischemic symptoms occurred more frequently in l-type 3 and c-type 2. In case of l-type 1 FMCAAs, more caution is required in determining the treatment due to the relatively high complication rate.
#Aneurysm, Dissecting #Fusiform aneurysm #Middle cerebral artery #Natural history

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참고문헌 (40)

참고문헌 신청
Alturki AY / 2018 / Sequential coilingassisted deployment of flow diverter for treatment of fusiform middle cerebral artery aneurysms / Oper Neurosurg (Hagerstown) 15:E13~E18 google schola Al-Yamany M / 1998 / Giant fusiform aneurysm of the middle cerebral artery: successful Hunterian ligation without distal bypass / Br J Neurosurg 12:572~575 google schola Anson JA / 1996 / Characteristics and surgical treatment of dolichoectatic and fusiform aneurysms / J Neurosurg 84:185~193 google schola Borzone M / 1993 / Giant fusiform aneurysm in middle cerebral artery branches: a report of two cases and a review of the literature / Acta Neurochir (Wien) 125:184~187 google schola Cohen MM / 1980 / Embolization from a fusiform middle cerebral artery aneurysm / Stroke 11:158~161 google schola

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