Hallazgo incidental de aneursimas cerebrales


Hallazgo incidental de aneurisma intracraneal/ Incidental Findings AND Intracranial Aneurysm

Aneurisma Intracraneal || Hallazgos incidentales en la RNM

En un hecho relativamente frecuente y plantea una serie de incertidumbres acerca de cual es el planteamiento adecuado: No intervenir y realizar o no seguimiento con pruebas de imagen, intervenir segun determinadas características, la edad del paciente, la presencvia de tabaquismo u otras comorbilidades.. Recientemente se ha publicado el siguiente artículo que sigue clarificando el tema, ya que desde los datos publicados en 2003 en el International Study of Unruptured Intracranial Aneurysms (ISUIA) sabemos que el riesgo de ruptura de los aneurismas intracraneales no rotos menores de 7 mm es muy bajo

Risk Profile of Intracranial Aneurysms Rupture Rate Is Not Constant After Formation Koji Sato, MD; Yuhei Yoshimoto, MD. Stroke. 2011 Oct 6. [Epub ahead of print]

el aneurisma que se va a romper lo hará pronto mientras que el que no sangre pronto ya no lo hará.

El dilema de los aneurismas cerebrales no rotos. Entrada del Blog Neurobsesión del Dr. Sergio Calleja

Análisis del estudio ISUIA. Como se señala en los comentarios del neuroradiólogo aunque tienen menos riesgo de ruptura en los seguimientos, el hecho es que la mayoría de los que se rompen y provocan una hemorragia subaracnoidea son menosres de 4 mm.

Stroke. 2008 Sep;39(9):2497-504. Epub 2008 Jul 10. Immediate clinical outcome of patients harboring unruptured intracranial aneurysms treated by endovascular approach: results of the ATENA study.

Estudio patrocinado por la Sociedad Francesa de Neurorradiología en centros franceses y canadienses. Seiscientos cuarenta y nueve pacientes con un total de 1.100 aneurismas de 27 centros de Canadá tratados de forma prospectiva y consecutiva por embolización endovascular. El tratamiento endovascular falló en 32 aneurismas (4,3%). Eventos adversos, con o sin modificación clínica se encontraron en el 15,4% de los pacientes e incluyeron complicaciones tromboembólicas (7,1% por procedimiento), rotura intraoperatoria (2,6% por procedimiento), y problemas relacionados con el dispositivo (2,9% por procedimiento). Los eventos adversos asociados con déficit neurológico transitorio o permanente o la muerte se encuentra en el 5,4% de los casos. La morbilidad de 1 mes y las tasas de mortalidad fueron de 1,7% y 1,4%, respectivamente.

Bibliografia

 



Aneurismas incidentales en el contexto de hemorragias subaracnoideas perimesencefalicas.
Radiologia. 2014 Jan-Feb; 56(1): 76-9. Rojas Jimenez, A; Martinez Cueto, P; Vila Nieto, O; Vazquez Fernandez, E;

Oclusion terapeutica de la arteria carotida interna.
Revista espanola de anestesiologia y reanimacion. 2004 Nov; 51(9): 560-2. Torres Machi, M L; Partida Figuerola, C; Hussein Gonzalez, Z; Medina Ramirez, C; Ojeda Betancor, N; Rodriguez Perez, A; Otermin, E;


Bibliografia en Ingles

 



Y-stent-assisted coil embolization of anterior circulation aneurysms using two Solitaire AB devices: a single center experience.
Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. 2012 Jun; 18(2): 158-63. Martinez-Galdamez, M; Saura, P; Saura, J; Martinez, A; De Campos, J M; Perez, A;

Safety of intravenous thrombolysis in acute ischemic stroke patients with saccular intracranial aneurysms.
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2013 Jul; 22(5): 639-43. Mittal, Manoj K; Seet, Raymond C S; Zhang, Yi; Brown, Robert D Jr; Rabinstein, Alejandro A;

Clinical presentation of cerebral aneurysms.
Eur J Radiol. 2013 Oct;82(10):1618-22. doi: 10.1016/j.ejrad.2012.11.019. Epub 2012 Dec 10. Cianfoni A., Pravata E., De B., Tschuor C.S., Bonaldi G.

Anterior cerebral artery dissecting aneurysm associated with untreated craniopharyngioma.
British journal of neurosurgery. 2013 Feb; 27(1): 102-4. Takeuchi, Satoru; Wada, Kojiro; Sakakibara, Fumihiro; Nawashiro, Hiroshi; Mori, Kentaro;

Small (< 10-mm) incidentally found intracranial aneurysms, Part 1: reasons for detection, demographics, location, and risk factors in 212 consecutive patients.
Neurosurgical focus. 2011 Dec; 31(6): E3. Loumiotis, Ioannis; Wagenbach, Anne; Brown, Robert D Jr; Lanzino, Giuseppe;

Prevalence of unruptured intracranial aneurysm on MR angiography.
Korean journal of radiology : official journal of the Korean Radiological Society. 2011 Sep-Oct; 12(5): 547-53. Jeon, Tae Yeon; Jeon, Pyoung; Kim, Keon Ha;

De novo aneurysm on the posterior cerebral artery: a case report and literature review.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet. 2012 Dec; 95(12): 1613-8. Chankaew, Ekawut; Sitthinamsuwan, Bunpot; Srirabheebhat, Prajak; Aurboonyawat, Thaweesak; Nunta-aree, Sarun;

Incidental aneurysms in temporal lobe epilepsy surgery: report of three cases and a review of the literature.
British journal of neurosurgery. 2012 Feb; 26(1): 69-74. Lad, Shivanand P; Shannon, Larry; Byrne, Richard W;

Small (< 10-mm) incidentally found intracranial aneurysms, Part 2: treatment recommendations, natural history, complications, and short-term outcome in 212 consecutive patients.
Neurosurgical focus. 2011 Dec; 31(6): E4. Loumiotis, Ioannis; Brown, Robert D Jr; Vine, Roanna; Cloft, Harry J; Kallmes, David F; Lanzino, Giuseppe;

Management of incidentally discovered intracranial vascular abnormalities.
Neurosurgical focus. 2011 Dec; 31(6): E1. Chalouhi, Nohra; Dumont, Aaron S; Randazzo, Ciro; Tjoumakaris, Stavropoula; Gonzalez, L Fernando; Rosenwasser, Robert; Jabbour, Pascal;

Incidental findings on cranial imaging in nonagenarians.
Neurosurgical focus. 2011 Dec; 31(6): E11. Al-Holou, Wajd N; Khan, Adam; Wilson, Thomas J; Stetler, William R Jr; Shah, Gaurang V; Maher, Cormac O;

Intravenous rt-PA is not associated with increased risk of hemorrhage in patients with intracranial aneurysms.
Neurocritical care. 2012 Oct; 17(2): 199-203. Sheth, Kevin N; Shah, Nikeith; Morovati, Tanya; Hermann, Lisa D; Cronin, Carolyn A;

Long-term follow-up of incidental intracranial aneurysms in patients with acute ischemic stroke.
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2013 May; 22(4): 329-33. Oh, Yoon-Sang; Shon, Young-Min; Kim, Beum Saeng; Cho, A-Hyun;

Intracranial hypotension with multiple complications: an unusual case report.
Case reports in neurological medicine. 2013; 2013913465. Ade, Swetha; Moonis, Majaz;

Association of Intracranial Aneurysms with Meningiomas, Pituitary Adenomas, and Gliomas: Review of Possible Interrelationships.
ISRN neurology. 2013; 2013383425. Spitler, Kevin; Drazin, Doniel; Hanna, George; Patel, Ashish; Chu, Ray;

Incidental findings on brain Magnetic Resonance Imaging in long-term survivors of breast cancer treated with adjuvant chemotherapy.
European journal of cancer (Oxford, England : 1990). 2011 Nov; 47(17): 2531-6. Koppelmans, Vincent; Schagen, Sanne B; Poels, Marielle M F; Boogerd, Willem; Seynaeve, Caroline; van der Lugt, Aad; Breteler, Monique M B;

Incidental Superior Hypophygeal Artery Aneurysm Embedded within Pituitary Adenoma.
Journal of Korean Neurosurgical Society. 2013 Sep; 54(3): 250-2. Choi, Hong-Seok; Kim, Min-Su; Jung, Young-Jin; Kim, Oh-Lyong;

Small incidentally found aneurysms.
Neurosurgical focus. 2011 Dec; 31(6): E2; discussion E2. Solomon, Robert A;

Persistence of the otic artery with neurological sequelae: case report.
Surgical and radiologic anatomy : SRA. 2012 Mar; 34(2): 191-3. Tubbs, R Shane; Mortazavi, Martin M; Denardo, Andrew J; Cohen-Gadol, Aaron A;

Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies.
Lancet neurology. 2014 Jan; 13(1): 59-66. Greving, Jacoba P; Wermer, Marieke J H; Brown, Robert D Jr; Morita, Akio; Juvela, Seppo; Yonekura, Masahiro; Ishibashi, Toshihiro; Torner, James C; Nakayama, Takeo; Rinkel, Gabriel J E; Algra, Ale;


 

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