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Cerebral Ischemia Complicating Intracranial Aneurysm: A Warning Sign of Imminent Rupture?
Patients harboring nongiant cerebral aneurysms may rarely present with an ischemic infarct distal to the aneurysm. The aim of this case series was to report clinical and radiologic characteristics of these patients, their management, and outcome. We undertook a single-center retrospective analysis o...
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| Published in: | American journal of neuroradiology : AJNR 2011-11, Vol.32 (10), p.1862-1865 |
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| container_end_page | 1865 |
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| container_title | American journal of neuroradiology : AJNR |
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| creator | GUILLON, B DAUMAS-DUPORT, B DELAROCHE, O WARIN-FRESSE, K SEVIN, M HERISSON, F AUFFRAY-CALVIER, E DESAL, H |
| description | Patients harboring nongiant cerebral aneurysms may rarely present with an ischemic infarct distal to the aneurysm. The aim of this case series was to report clinical and radiologic characteristics of these patients, their management, and outcome.
We undertook a single-center retrospective analysis of consecutive patients admitted during an 8-year period with an acute ischemic stroke revealing an unruptured nongiant ( |
| doi_str_mv | 10.3174/ajnr.a2645 |
| format | article |
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We undertook a single-center retrospective analysis of consecutive patients admitted during an 8-year period with an acute ischemic stroke revealing an unruptured nongiant (<25 mm) sacciform intracranial aneurysm. Clinical, radiologic, therapeutic, and follow-up data were analyzed.
Nine patients were included. The mean size of aneurysms was 9.6 ± 6 mm, and 5 were partially or totally thrombosed. Two patients had a fatal SAH within 3 days after stroke-symptom onset, whereas asymptomatic meningeal bleeding was diagnosed or suspected in 2 others. Most of the patients with unthrombosed aneurysms were successfully treated by endovascular coiling in the acute phase. Thrombosed aneurysms were usually treated with antithrombotics, and most recanalized secondarily, requiring endovascular treatment or surgical obliteration. No recurrence of an ischemic event or SAH was observed during the 31 ± 12 months of follow-up (from 4 to 53 months).
In this single-center series, the frequency of early SAH in patients with ischemic stroke distal to an unruptured intracranial aneurysm was high. Acute management should be undertaken with care regarding antithrombotic use, and early endovascular coiling should be considered.</description><identifier>ISSN: 0195-6108</identifier><identifier>EISSN: 1936-959X</identifier><identifier>DOI: 10.3174/ajnr.a2645</identifier><identifier>PMID: 21868623</identifier><identifier>CODEN: AAJNDL</identifier><language>eng</language><publisher>Oak Brook, IL: American Society of Neuroradiology</publisher><subject>Adult ; Adult and adolescent clinical studies ; Aneurysm, Ruptured - diagnostic imaging ; Aneurysm, Ruptured - etiology ; Biological and medical sciences ; Brain ; Brain Ischemia - complications ; Brain Ischemia - diagnostic imaging ; Cerebral Angiography ; Female ; Humans ; Intracranial Aneurysm - complications ; Intracranial Aneurysm - diagnostic imaging ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Mood disorders ; Nervous system ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Risk Factors</subject><ispartof>American journal of neuroradiology : AJNR, 2011-11, Vol.32 (10), p.1862-1865</ispartof><rights>2015 INIST-CNRS</rights><rights>2011 by American Journal of Neuroradiology 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-5a263f82c4f76ce4651c7ba1e65c9a371da4fb55315718a521e7b0dff6e710813</citedby><cites>FETCH-LOGICAL-c505t-5a263f82c4f76ce4651c7ba1e65c9a371da4fb55315718a521e7b0dff6e710813</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7965994/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7965994/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25272635$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21868623$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GUILLON, B</creatorcontrib><creatorcontrib>DAUMAS-DUPORT, B</creatorcontrib><creatorcontrib>DELAROCHE, O</creatorcontrib><creatorcontrib>WARIN-FRESSE, K</creatorcontrib><creatorcontrib>SEVIN, M</creatorcontrib><creatorcontrib>HERISSON, F</creatorcontrib><creatorcontrib>AUFFRAY-CALVIER, E</creatorcontrib><creatorcontrib>DESAL, H</creatorcontrib><title>Cerebral Ischemia Complicating Intracranial Aneurysm: A Warning Sign of Imminent Rupture?</title><title>American journal of neuroradiology : AJNR</title><addtitle>AJNR Am J Neuroradiol</addtitle><description>Patients harboring nongiant cerebral aneurysms may rarely present with an ischemic infarct distal to the aneurysm. The aim of this case series was to report clinical and radiologic characteristics of these patients, their management, and outcome.
We undertook a single-center retrospective analysis of consecutive patients admitted during an 8-year period with an acute ischemic stroke revealing an unruptured nongiant (<25 mm) sacciform intracranial aneurysm. Clinical, radiologic, therapeutic, and follow-up data were analyzed.
Nine patients were included. The mean size of aneurysms was 9.6 ± 6 mm, and 5 were partially or totally thrombosed. Two patients had a fatal SAH within 3 days after stroke-symptom onset, whereas asymptomatic meningeal bleeding was diagnosed or suspected in 2 others. Most of the patients with unthrombosed aneurysms were successfully treated by endovascular coiling in the acute phase. Thrombosed aneurysms were usually treated with antithrombotics, and most recanalized secondarily, requiring endovascular treatment or surgical obliteration. No recurrence of an ischemic event or SAH was observed during the 31 ± 12 months of follow-up (from 4 to 53 months).
In this single-center series, the frequency of early SAH in patients with ischemic stroke distal to an unruptured intracranial aneurysm was high. Acute management should be undertaken with care regarding antithrombotic use, and early endovascular coiling should be considered.</description><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Aneurysm, Ruptured - diagnostic imaging</subject><subject>Aneurysm, Ruptured - etiology</subject><subject>Biological and medical sciences</subject><subject>Brain</subject><subject>Brain Ischemia - complications</subject><subject>Brain Ischemia - diagnostic imaging</subject><subject>Cerebral Angiography</subject><subject>Female</subject><subject>Humans</subject><subject>Intracranial Aneurysm - complications</subject><subject>Intracranial Aneurysm - diagnostic imaging</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Mood disorders</subject><subject>Nervous system</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Risk Factors</subject><issn>0195-6108</issn><issn>1936-959X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNqFkU2LFDEQhoMo7uzqxR8gfRFB6DVJp5KOB2UYVh1YEPxAPYXqTDKbpTs9Jt3C_nvT7LjqyVMd6uHlrXoIecLoecOUeInXMZ0jlwLukRXTjaw16G_3yYoyDbVktD0hpzlfU0pBK_6QnHDWylbyZkW-b1xyXcK-2mZ75YaA1WYcDn2wOIW4r7ZxSmgTxlCQdXRzusnDq2pdfcUUF-BT2Mdq9NV2GEJ0cao-zodpTu7NI_LAY5_d4-M8I1_eXnzevK8vP7zbbtaXtQUKUw2leONbboVX0johgVnVIXMSrMZGsR0K3wE0DBRrEThzqqM776VT5TLWnJHXt7mHuRvczrqlcW8OKQyYbsyIwfy7ieHK7MefRmkJWosS8PwYkMYfs8uTGUK2ru8xunHORjPGpBBa_Z-kgnNQIAv54pa0acw5OX_Xh1GzSDOLNLNepBX46d8X3KG_LRXg2RHAbLH3RYcN-Q8HXJUnQvMLb16gzw</recordid><startdate>20111101</startdate><enddate>20111101</enddate><creator>GUILLON, B</creator><creator>DAUMAS-DUPORT, B</creator><creator>DELAROCHE, O</creator><creator>WARIN-FRESSE, K</creator><creator>SEVIN, M</creator><creator>HERISSON, F</creator><creator>AUFFRAY-CALVIER, E</creator><creator>DESAL, H</creator><general>American Society of Neuroradiology</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope><scope>5PM</scope></search><sort><creationdate>20111101</creationdate><title>Cerebral Ischemia Complicating Intracranial Aneurysm: A Warning Sign of Imminent Rupture?</title><author>GUILLON, B ; DAUMAS-DUPORT, B ; DELAROCHE, O ; WARIN-FRESSE, K ; SEVIN, M ; HERISSON, F ; AUFFRAY-CALVIER, E ; DESAL, H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-5a263f82c4f76ce4651c7ba1e65c9a371da4fb55315718a521e7b0dff6e710813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Aneurysm, Ruptured - diagnostic imaging</topic><topic>Aneurysm, Ruptured - etiology</topic><topic>Biological and medical sciences</topic><topic>Brain</topic><topic>Brain Ischemia - complications</topic><topic>Brain Ischemia - diagnostic imaging</topic><topic>Cerebral Angiography</topic><topic>Female</topic><topic>Humans</topic><topic>Intracranial Aneurysm - complications</topic><topic>Intracranial Aneurysm - diagnostic imaging</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Mood disorders</topic><topic>Nervous system</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GUILLON, B</creatorcontrib><creatorcontrib>DAUMAS-DUPORT, B</creatorcontrib><creatorcontrib>DELAROCHE, O</creatorcontrib><creatorcontrib>WARIN-FRESSE, K</creatorcontrib><creatorcontrib>SEVIN, M</creatorcontrib><creatorcontrib>HERISSON, F</creatorcontrib><creatorcontrib>AUFFRAY-CALVIER, E</creatorcontrib><creatorcontrib>DESAL, H</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of neuroradiology : AJNR</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GUILLON, B</au><au>DAUMAS-DUPORT, B</au><au>DELAROCHE, O</au><au>WARIN-FRESSE, K</au><au>SEVIN, M</au><au>HERISSON, F</au><au>AUFFRAY-CALVIER, E</au><au>DESAL, H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral Ischemia Complicating Intracranial Aneurysm: A Warning Sign of Imminent Rupture?</atitle><jtitle>American journal of neuroradiology : AJNR</jtitle><addtitle>AJNR Am J Neuroradiol</addtitle><date>2011-11-01</date><risdate>2011</risdate><volume>32</volume><issue>10</issue><spage>1862</spage><epage>1865</epage><pages>1862-1865</pages><issn>0195-6108</issn><eissn>1936-959X</eissn><coden>AAJNDL</coden><abstract>Patients harboring nongiant cerebral aneurysms may rarely present with an ischemic infarct distal to the aneurysm. The aim of this case series was to report clinical and radiologic characteristics of these patients, their management, and outcome.
We undertook a single-center retrospective analysis of consecutive patients admitted during an 8-year period with an acute ischemic stroke revealing an unruptured nongiant (<25 mm) sacciform intracranial aneurysm. Clinical, radiologic, therapeutic, and follow-up data were analyzed.
Nine patients were included. The mean size of aneurysms was 9.6 ± 6 mm, and 5 were partially or totally thrombosed. Two patients had a fatal SAH within 3 days after stroke-symptom onset, whereas asymptomatic meningeal bleeding was diagnosed or suspected in 2 others. Most of the patients with unthrombosed aneurysms were successfully treated by endovascular coiling in the acute phase. Thrombosed aneurysms were usually treated with antithrombotics, and most recanalized secondarily, requiring endovascular treatment or surgical obliteration. No recurrence of an ischemic event or SAH was observed during the 31 ± 12 months of follow-up (from 4 to 53 months).
In this single-center series, the frequency of early SAH in patients with ischemic stroke distal to an unruptured intracranial aneurysm was high. Acute management should be undertaken with care regarding antithrombotic use, and early endovascular coiling should be considered.</abstract><cop>Oak Brook, IL</cop><pub>American Society of Neuroradiology</pub><pmid>21868623</pmid><doi>10.3174/ajnr.a2645</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Adult and adolescent clinical studies Aneurysm, Ruptured - diagnostic imaging Aneurysm, Ruptured - etiology Biological and medical sciences Brain Brain Ischemia - complications Brain Ischemia - diagnostic imaging Cerebral Angiography Female Humans Intracranial Aneurysm - complications Intracranial Aneurysm - diagnostic imaging Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Miscellaneous Mood disorders Nervous system Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Radiodiagnosis. Nmr imagery. Nmr spectrometry Risk Factors |
| title | Cerebral Ischemia Complicating Intracranial Aneurysm: A Warning Sign of Imminent Rupture? |
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