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Non-atherosclerotic fusiform cerebral aneurysms
J Max Findlay1, Chunhai Hao, Derek Emery
1Division of Neurosurgery, University of Alberta, Edmonton, Canada.
Summary
A subset of fusiform cerebral aneurysms, distinct from atherosclerotic types, present with thin walls and a risk of rupture. Treatments like proximal occlusion or wrapping are used for these unique brain aneurysms.
Area of Science:
- Neurology
- Vascular Surgery
- Neurosurgery
Background:
- Fusiform cerebral aneurysms are typically broad, atherosclerosis-related dilatations.
- A subset of these aneurysms presents atypically, differing from common descriptions.
Purpose of the Study:
- To identify and characterize a distinct subset of fusiform cerebral aneurysms.
- To understand their morphology, location, and treatment outcomes.
Main Methods:
- Retrospective review of 472 intracranial aneurysms over 11 years.
- Identification of 11 patients with discrete fusiform aneurysms unrelated to atherosclerosis or systemic disease.
Main Results:
- Aneurysms were often in the posterior circulation, partly thin-walled, and varied in size.
- Nine aneurysms were in the posterior circulation; two in the carotid artery.
- Treatments included proximal occlusion (1 death, 1 mild disability) and wrapping, with good recoveries.
Conclusions:
- A distinct subset of fusiform cerebral aneurysms exists, unrelated to atherosclerosis or connective tissue disease.
- These aneurysms can be thin-walled, occur in the vertebrobasilar system, and pose a rupture risk.
- Treatment options differ from saccular aneurysms, involving proximal occlusion or wrapping.