Growth and Rupture Mechanism of Partially Thrombosed Aneurysms
| Autor: | Carlos E. Baccin, Peter C. Reinacher, W. Y. Zhao, Carlo Gandolfo, Pierre Lasjaunias, Marcus H. T. Reinges, Timo Krings, H. Alvarez, Augustin Ozanne |
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| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry fungi food and beverages Lumen (anatomy) Original Articles Digital subtraction angiography medicine.disease 030218 nuclear medicine & medical imaging Surgery 03 medical and health sciences 0302 clinical medicine Aneurysm Arterial aneurysms cardiovascular system medicine Intramural hemorrhage cardiovascular diseases Thrombus T2 weighted business 030217 neurology & neurosurgery Acute hemorrhage |
| Zdroj: | Interventional Neuroradiology. 13:117-126 |
| ISSN: | 2385-2011 1591-0199 |
| DOI: | 10.1177/159101990701300201 |
| Popis: | Within the group of giant and large aneurysms the subgroup of the so-called “partially thrombosed” aneurysms can be differentiated according to clinical and neuroimaging findings. The present study was carried out to determine the site of bleeding of these aneurysms and what implications concerning their pathomechanism can be drawn from these findings. Twenty patients aged two to 77 (mean 44) years who exhibited a partially thrombosed aneurysm that had recently bled were included. Images (MRI including T1 pre- and postcontrast and T2 weighted images in multiple planes, CT and digital subtraction angiography) and patients' charts were reviewed. MRI showed an onion-skin appearance of the thrombus in 19 patients, rim enhancement of the aneurysm wall (either partial or complete) in 17, and a perifocal edema in 16 patients. The acute hemorrhage was typically crescent-shaped and located at the periphery of the aneurysm, distant from the perfused lumen of the aneurysm within the thrombosed part of the aneurysm. The current denomination “partially thrombosed” intracranial arterial aneurysms leads to the presumption that thrombus is present endoluminal whereas in fact the site of hemorrhage is within the vessel wall. A more accurate nomination would, therefore, be “aneurysms with intra mural hemorrhage”. The enhancing wall and the edematous reaction of the adjacent brain parenchyma might be a sign for an inflammatory pathomechanism which is reinforced by histological and pathophysiological studies. This disease should be regarded as a clinical entity separate from saccular or non-thrombosed giant or large aneurysms. |
| Databáze: | OpenAIRE |
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