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  • 1
    ISSN: 1432-1920
    Keywords: Key words Aneurysm ; intracranial ; Haemorrhage ; subarachnoid ; Aneurysm ; de novo ; Risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Although aneurysms are widely considered to be of congenital origin there is still debate as to whether some at least might be formed de novo during life. A review of all 49 reported cases plus one previously unpublished case reveals common clinical features and might aid in the management of this group of patients. Statistical analysis of all 50 cases of de novo aneurysms discloses a more frequent history of smoking (P = 0.0007) and arterial hypertension (P = 0.0026) than in a control cohort. Patients with de novo aneurysms are younger (P 〈 0.0001); the proportion with multiple aneurysms was 28 %. Of de novo aneurysms 44 % became symptomatic 3–6 years after the first subarachnoid haemorrhage (SAH), and the interval was significantly shorter in hypertensive patients. We suggest that young patients with a history of SAH and arterial hypertension and nicotine abuse should therefore be considered for conventional angiography after a 5-year interval. MRA might not be useful due to clip artefacts from even nonferromagnetic clips. Close control of blood pressure is essential in these patients.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Aneurysma ; vertebrobasilär ; Embolisation ; Operation ; Key words Aneurysm ; vertebrobasilar ; Embolization ; Surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: Evaluation of clinical and morphological results in 44 consecutive patients with 45 aneurysms of the posterior circulation. Methods: Retrospective analysis of patient charts and angiograms of all vertebrobasilar aneurysms diagnosed in our department between 10/95 and 08/99. All aneurysms were treated. Results: 36/44 pts had a hemorrhage. Hunt/Hess (HH) gradings were as follows: HH1 in 10, HH2 in 6, HH3 in 9, HH4 in 10 cases, and HH5 in 1 case. 38 pts with 39 aneurysms were treated exclusively in the endovascular way, 3 pts with 3 aneurysms were operated on. 3 patients had to be operated upon following insufficient endovascular treatment. Endovascular treatment resulted in 63% total and 27% subtotal occlusions, results being stable in 85%. For our pts as a whole, the grading according to the Glasgow Outcome Scale (GOS) was GOS1 in 4, GOS3 in 8, GOS4 in 7, and GOS5 in 25 cases. Conclusion: Despite a less favourable clinical status of pts pre-treatment, the results of our interdisciplinary concept compare favourably with those of other surgical or interventional groups.
    Notes: Zusammenfassung Fragestellung: Klinische und morphologische Ergebnisse der endovaskulären Behandlung bei 44 konsekutiven Patienten mit 45 Aneurysmen der hinteren Zirkulation. Methodik: Retrospektive Auswertung der Krankenblätter und Angiogramme aller von 10/95 bis 08/99 diagnostizierten vertebrobasilären Aneurysmen. Alle Aneurysmen wurden behandelt. Ergebnisse: Bei 36/44 Patienten lag eine Blutung vor. Die Graduierung entsprach in 10 Fällen HH1 nach Hunt/Hess (HH), in 6 Fällen HH2, in 9 Fällen HH3, in 10 Fällen HH4 und in 1 Fall HH5. 38 Patienten mit 39 Aneurysmen wurden ausschließlich endovaskulär, 3 Patienten mit 3 Aneurysmen ausschließlich operativ behandelt. 3 Patienten mit 3 Aneurysmen mußten wegen unbefriedigender endovaskulärer Behandlung anschließend operiert werden. Endovaskulär konnten 63% der Aneurysmen total, weitere 27% subtotal ausgeschaltet werden, in 85% war das Behandlungsergebnis stabil. Für die gesamte Patientengruppe entsprach die Graduierung nach der Glasgow Outcome Skala (GOS) in 4 Fällen GOS1, in 8 GOS3, in 7 GOS4 und in 25 Fällen GOS5. Schlußfolgerungen: Trotz eines schlechteren klinischen Ausgangszustands der Patienten vor Behandlung sind die Ergebnisse unseres interdisziplinären Konzepts vergleichbar mit denen operativer oder interventioneller Arbeitsgruppen.
    Type of Medium: Electronic Resource
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