Tuberothalamic Artery Infarctions following Coil Embolization of Ruptured Posterior Communicating Artery Aneurysms with Posterior Communicating Artery Sacrifice

被引:33
作者
Endo, H. [1 ,2 ]
Sato, K. [2 ]
Kondo, R.
Matsumoto, Y.
Takahashi, A. [3 ]
Tominaga, T. [2 ]
机构
[1] Kohnan Hosp, Dept Neuroendovasc Therapy, Taihaku Ku, Sendai, Miyagi 9828523, Japan
[2] Tohoku Univ, Dept Neurosurg, Grad Sch Med, Sendai, Miyagi 980, Japan
[3] Tohoku Univ, Grad Sch Med, Dept Neuroendovasc Therapy, Sendai, Miyagi 980, Japan
关键词
INTRACRANIAL ANEURYSMS; MICROSURGICAL ANATOMY; FETAL VARIANT; EVENTS; CIRCLE;
D O I
10.3174/ajnr.A2828
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND AND PURPOSE: Ischemic complications after coil embolization of the PcomA aneurysms are not thoroughly understood, especially in cases in which the PcomA is sacrificed. Our purpose was to examine the preoperative angiographic features and pattern of postoperative cerebral infarctions exhibited by patients who underwent embolization of ruptured PcomA aneurysms with PcomA sacrifice. MATERIALS AND METHODS: A retrospective review identified 14 patients with ruptured PcomA aneurysms who underwent embolization of the aneurysms in combination with PcomA sacrifice. Preoperative angiographic data, including the Allcock test, postoperative DWI, and neurologic status, were examined. RESULTS: Elimination of the aneurysm was complete in all cases. Postoperative DWI indicated 7 cases with infarctions (infarction group) and 7 cases without infarctions (noninfarction group). All patients in the infarction group developed infarctions in the vicinity of the tuberothalamic artery. In all 14 cases, a preoperative Allcock test demonstrated a retrograde filing of the PcomA through the P1 segment. The incidence of negative visualizations of the P1 segment on vertebral angiograms was significantly higher in the infarction group (100%) than in the noninfarction group (0%; P = .00058). The mean PcomA diameters, PcomA/P1 ratios, and aneurysm sizes observed in the infarction group were significantly greater than those in the noninfarction group (P < .05, P < .01, and P < .02, respectively). Tuberothalamic artery infarction caused hemiparesis and memory disturbance, which were associated with unfavorable outcomes. CONCLUSIONS: After the coil occlusion of ruptured PcomA aneurysms with PcomA sacrifice, tuberothalamic artery infarctions tended to occur in cases exhibiting negative visualization of the P1 segment, even when collateral flow was observed with the Allcock test.
引用
收藏
页码:500 / 506
页数:7
相关论文
共 25 条
[1]   Cognitive and Functional Outcome After Aneurysmal Subarachnoid Hemorrhage [J].
Al-Khindi, Timour ;
Macdonald, R. Loch ;
Schweizer, Tom A. .
STROKE, 2010, 41 (08) :E519-E536
[2]   THE SYNDROME OF UNILATERAL TUBEROTHALAMIC ARTERY TERRITORY INFARCTION [J].
BOGOUSSLAVSKY, J ;
REGLI, F ;
ASSAL, G .
STROKE, 1986, 17 (03) :434-441
[3]   Postprocedure ischemic events after treatment of intracranial aneurysms with Guglielmi detachable coils [J].
Derdeyn, CP ;
Cross, DT ;
Moran, CJ ;
Brown, GW ;
Pilgram, TK ;
Diringer, MN ;
Grubb, RL ;
Rich, KM ;
Chicoine, MR ;
Dacey, RG .
JOURNAL OF NEUROSURGERY, 2002, 96 (05) :837-843
[4]  
Foix C, 1925, REV NEUROL, V32, P705
[5]   The microsurgical anatomy of the premamillary artery [J].
Gibo, H ;
Marinkovic, S ;
Brigante, L .
JOURNAL OF CLINICAL NEUROSCIENCE, 2001, 8 (03) :256-260
[6]   Cognitive dysfunction following thalamic stroke: a study of 16 cases and review of the literature [J].
Karussis, D ;
Leker, RR ;
Abramsky, O .
JOURNAL OF THE NEUROLOGICAL SCIENCES, 2000, 172 (01) :25-29
[7]  
Kato S., 1991, RONEN SEISHIN IGAKU, V2, P1339
[8]   Dividing the posterior communicating artery in approaches to the interpeduncular fossa: Technical aspects and safety [J].
Krayenbuehl, Niklaus ;
Krisht, Ali F. .
NEUROSURGERY, 2007, 61 (05) :392-396
[9]   Prediction of Functional Outcome in Acute Cerebral Hemorrhage Using Diffusion Tensor Imaging at 3T: A Prospective Study [J].
Kusano, Y. ;
Seguchi, T. ;
Horiuchi, T. ;
Kakizawa, Y. ;
Kobayashi, T. ;
Tanaka, Y. ;
Seguchi, K. ;
Hongo, K. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2009, 30 (08) :1561-1565
[10]   Endovascular Treatment of Wide-Neck Intracranial Aneurysms Using a Microcatheter Protective Technique: Results and Outcomes in 75 Aneurysms [J].
Lee, J. Y. ;
Seo, J. H. ;
Cho, Y. D. ;
Kang, H-S. ;
Han, M. H. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2011, 32 (05) :917-922