Treatment Strategies for Intracranial Mirror Aneurysms

• Published in: World neurosurgery 2017-04, Vol.100, p.450-458
• Main Authors: Wang, Wen-Xin, MD, PhD, Xue, Zhe, MD, Li, Lin, MD, Wu, Chen, MD, PhD, Zhang, Yan-Yang, MD, Lou, Xin, MD, PhD, Ma, Lin, MD, PhD, Sun, Zheng-Hui, MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Embolization, Therapeutic - methods; Female; Follow-Up Studies; Humans; Interventional therapy; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - therapy; Male; Microsurgery; Middle Aged; Mirror aneurysms; Neurosurgery; Neurosurgical Procedures - methods; Retrospective Studies; Subarachnoid hemorrhage; Treatment Outcome; Young Adult
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2017.01.049

Abstract Objective Intracranial mirror aneurysms are clinically rare and uncommonly reported in the literature. Therefore, the present study evaluated a series of mirror aneurysm cases with respect to the clinical features of the patients and the treatment strategies that were used. Methods This study retrospectively reviewed and systematically analyzed the clinical features, imaging data, treatment methods, and treatment outcomes of 68 cases of mirror aneurysms (a total of 70 pairs) that were admitted to our department between November 2007 and May 2016. Results The patient population included 24 males and 44 females, with a mean age of 52 years. The mirror aneurysms were primarily located in posterior communicating artery and middle cerebral artery and 65 of the aneurysms were large or giant (≧10 mm). Of the 68 patients, 28 were treated by the clipping or embolization of all aneurysms in one stage, 16 were treated in two stages, 16 were treated by treating part of the aneurysms, and 8 were observed. The modified Rankin Scale scores (mRS) of the 60 patients that were treated indicated that 52 had a good recovery (mRS ≦ 2; 86.7%), and one patient was dead. Conclusions Treatment strategies for mirror aneurysms should be individually determined according to the location, size, and morphology of the aneurysm, as well as the clinical manifestations of each patient. Furthermore, the responsible ruptured aneurysm should be given treatment priority, while the contralateral unruptured aneurysm should be observed or treated in either one or two stages.