Natural history and clinical outcomes in patients with complex intracranial aneurysms: a review of 115 bypass cases and 22 nonsurgical cases
| Autor: | Fangjun Liu, Yuming Sun, Jie Zhang, Zhongqing Zhou, Yongli Zhang, Hai Qian, Long Wang, Xiang'en Shi |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Conservative Treatment Neurosurgical Procedures 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine Modified Rankin Scale medicine Humans Child Stroke Aged Retrospective Studies Cerebral Revascularization business.industry Headache Intracranial Aneurysm General Medicine Vascular surgery Middle Aged medicine.disease Survival Analysis Surgery Natural history Treatment Outcome Bypass surgery Female Neurology (clinical) Neurosurgery Presentation (obstetrics) Headaches medicine.symptom business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Neurosurgical review. 43(6) |
| ISSN: | 1437-2320 |
| Popis: | The purpose of this study was to evaluate the natural history of patients with these heterogeneous aneurysms to provide guidance for their treatment. This retrospective analysis was performed at a single institution and included 137 patients with complex intracranial aneurysms who underwent a natural history evaluation. Among the 115 patients who underwent bypass surgery, stroke (n = 39, 33.9%) was the most common clinical symptom followed by progressively severe headaches (n = 25, 21.7%). Of the 104 patients with follow-up information, 87 (83.7%) returned to a normal life within a mean follow-up of 4.17 ± 2.09 years. Ten deaths (9.6%) occurred after a mean of 1.3 ± 0.9 years. Among the 22 patients who selected nonsurgical treatment, mass effect (n = 9, 40.9%) was the most common clinical presentation, and 14 deaths (63.6%) occurred after a mean of 3.3 ± 2.5 years. The modified Rankin scale (mRS) scores of 5 survivors (5/22, 22.7%) progressed from 0-2 at initial presentation to 3-4. Bypass surgical treatment for these aneurysms appears to be effective and can achieve good clinical outcomes without additional limitations related to individual aneurysms despite the impact of recent endovascular techniques on vascular surgery. |
| Databáze: | OpenAIRE |
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