Beyin Anevrizmaları ve Tedavisi
Özet
Bu bölüm, intrakraniyal anevrizmaların etyopatogenezi, epidemiyolojisi, histopatolojik özellikleri, sınıflandırılması, klinik prezentasyonu ve güncel tedavi yaklaşımlarını kapsamlı bir şekilde ele almaktadır. İntrakraniyal anevrizmaların büyük kısmının asemptomatik seyrettiği, ancak rüptür durumunda yüksek mortalite ve morbiditeye yol açabilen subaraknoid kanama ile prezente olabildiği vurgulanmaktadır. Anevrizmaların lokalizasyonu, morfolojisi ve boyutunun rüptür riskini belirlemedeki önemi detaylandırılmakta; BT, BT anjiyografi, MR anjiyografi ve dijital substraksiyon anjiyografinin tanısal rolleri açıklanmaktadır. Tedavi bölümünde cerrahi klipleme ve endovasküler yaklaşımlar karşılaştırmalı olarak sunulmakta; koil embolizasyonu, balon ve stent destekli teknikler, akım çevirici cihazlar ve intraanevrizmal akım modifikasyon sistemleri güncel literatür ışığında değerlendirilmektedir. Bölüm, intrakraniyal anevrizmaların hasta bazlı, multidisipliner ve bireyselleştirilmiş tedavi gerektiren dinamik bir patoloji olduğunu ortaya koymaktadır.
Referanslar
EvliyAoğlu Ç. İntrakraniyal Anevrizma Patofizyolojisi ve Genetiği. Türk Nöroşirurji Dergisi. 2012;22:189-96.
Nakagawa T, Hashi K. The incidence and treatment of asymptomatic, unruptured cerebral aneurysms. Journal of neurosurgery. 1994;80(2):217-23.
Ajiboye N, Chalouhi N, Starke RM, Zanaty M, Bell R. Unruptured cerebral aneurysms: evaluation and management. The Scientific World Journal. 2015;2015(1):954954.
Krishna H, Wani A, Behari S, Banerji D, Chhabra D, Jain V. Intracranial aneurysms in patients 18 years of age or under, are they different from aneurysms in adult population? Acta neurochirurgica. 2005;147:469-76.
Ronkainen A, Miettinen H, Karkola K, Papinaho S, Vanninen R, Puranen M, et al. Risk of harboring an unruptured intracranial aneurysm. Stroke. 1998;29(2):359-62.
Rinkel GJ, Djibuti M, Algra A, Van Gijn J. Prevalence and risk of rupture of intracranial aneurysms: a systematic review. Stroke. 1998;29(1):251-6.
Brisman JL, Song JK, Newell DW. Cerebral aneurysms. New England journal of medicine. 2006;355(9):928-39.
Schievink WI. Intracranial aneurysms. New England Journal of Medicine. 1997;336(1):28-40.
Gasser TC. Modeling the structural and mechanical properties of the normal and aneurysmatic aortic wall. Multi-scale Extracellular Matrix Mechanics and Mechanobiology: Springer; 2019. p. 55-82.
Hacein-Bey L, Provenzale JM. Current imaging assessment and treatment of intracranial aneurysms. American Journal of Roentgenology. 2011;196(1):32-44.
Keedy A. An overview of intracranial aneurysms. McGill Journal of Medicine: MJM. 2006;9(2):141.
HASHIMOTO H, SHIN Y, HIRONAKA Y, SAKAKI T. Subarachnoid Hemorrhage from Intracranial Dissecting Aneurysms of the Anterior Circulation—Two Case Reports—. Neurologia medico-chirurgica. 1999;39(6):442-6.
Rennert RC, Santiago-Dieppa DR, Pannell JS, Khalessi AA. Management of Ruptured and Rapidly Progressive Mycotic Cerebral Aneurysms in the setting of unilateral carotid occlusion and endocarditis with valve failure. Journal of Neurological Surgery Reports. 2015;76(02):e222-e6.
Peschillo S, Miscusi M, Caporlingua A, Cannizzaro D, Santoro A, Delfini R, et al. Blister-like aneurysms in atypical locations: a single-center experience and comprehensive literature review. World Neurosurgery. 2015;84(4):1070-9.
Nerva JD, Morton RP, Levitt MR, Osbun JW, Ferreira MJ, Ghodke BV, et al. Pipeline Embolization Device as primary treatment for blister aneurysms and iatrogenic pseudoaneurysms of the internal carotid artery. Journal of neurointerventional surgery. 2015;7(3):210-6.
Yoon JW, Siddiqui AH, Dumont TM, Levy EI, Hopkins LN, Lanzino G, et al. Feasibility and safety of pipeline embolization device in patients with ruptured carotid blister aneurysms. Neurosurgery. 2014;75(4):419-29.
Bojanowski MW, Weil AG, McLaughlin N, Chaalala C, Magro E, Fournier J-Y. Morphological aspects of blister aneurysms and nuances for surgical treatment. Journal of neurosurgery. 2015;123(5):1156-65.
Lee VH, Connolly HM, Brown RD. Central nervous system manifestations of cardiac myxoma. Archives of neurology. 2007;64(8):1115-20.
Broderick JP, Brown Jr RD, Sauerbeck L, Hornung R, Huston III J, Woo D, et al. Greater rupture risk for familial as compared to sporadic unruptured intracranial aneurysms. Stroke. 2009;40(6):1952-7.
Vergouwen MD, Jong-Tjien-Fa AV, Algra A, Rinkel GJ. Time trends in causes of death after aneurysmal subarachnoid hemorrhage: a hospital-based study. Neurology. 2016;86(1):59-63.
Greenberg M. SAH and aneurysms. Handbook of neurosurgery 5th ed New York: Thieme Medical. 2000;803.
Claassen J, Bernardini GL, Kreiter K, Bates J, Du YE, Copeland D, et al. Effect of cisternal and ventricular blood on risk of delayed cerebral ischemia after subarachnoid hemorrhage: the Fisher scale revisited. Stroke. 2001;32(9):2012-20.
Dhar S, Tremmel M, Mocco J, Kim M, Yamamoto J, Siddiqui AH, et al. Morphology parameters for intracranial aneurysm rupture risk assessment. Neurosurgery. 2008;63(2):185-97.
Kang H, Ji W, Qian Z, Li Y, Jiang C, Wu Z, et al. Aneurysm characteristics associated with the rupture risk of intracranial aneurysms: a self-controlled study. PloS one. 2015;10(11):e0142330.
Baker CJ, Ortiz O, Solomon RA. Resolution of focal CT hypodense lesions in patients with Subarachnoid hemorrhage. Surgical neurology. 1993;39(2):158-62.
Suarez JI. Diagnosis and management of subarachnoid hemorrhage. CONTINUUM: Lifelong Learning in Neurology. 2015;21(5):1263-87.
Lantigua H, Ortega-Gutierrez S, Schmidt JM, Lee K, Badjatia N, Agarwal S, et al. Subarachnoid hemorrhage: who dies, and why? Critical care. 2015;19:1-10.
Mckinney AM, Palmer C, Truwit C, Karagulle A, Teksam M. Detection of aneurysms by 64-section multidetector CT angiography in patients acutely suspected of having an intracranial aneurysm and comparison with digital subtraction and 3D rotational angiography. American journal of neuroradiology. 2008;29(3):594-602.
Sames TA, Storrow AB, Finkelstein JA, Magoon MR. Sensitivity of new‐generation computed tomography in subarachnoid hemorrhage. Academic Emergency Medicine. 1996;3(1):16-20.
Metens T, Rio F, Balériaux D, Roger T, David P, Rodesch G. Intracranial aneurysms: detection with gadolinium-enhanced dynamic three-dimensional MR angiography—initial results. Radiology. 2000;216(1):39-46.
Binet E, Angtuaca E. Radiology of intracranial aneurysms. Wilkins RH, New York. 1985:1341-54.
Uysal E, Yanbuloglu B, Ertürk M, Kilinç BM, Basak M. Spiral CT angiography in diagnosis of cerebral aneurysms of cases with acute subarachnoid hemorrhage. Diagnostic and interventional radiology. 2005;11(2):77.
Aburto-Murrieta Y, Marquez-Romero JM, Bonifacio-Delgadillo D, López I, Hernández-Curiel B. Endovascular treatment: balloon angioplasty versus nimodipine intra-arterial for medically refractory cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Vascular and endovascular surgery. 2012;46(6):460-5.
Chyatte D, Fode NC, Sundt TM. Early versus late intracranial aneurysm surgery in subarachnoid hemorrhage. Journal of neurosurgery. 1988;69(3):326-31.
Raaymakers TW, Rinkel GJ, Limburg M, Algra A. Mortality and morbidity of surgery for unruptured intracranial aneurysms: a meta-analysis. Stroke. 1998;29(8):1531-8.
Thornton J, Bashir Q, Aletich VA, Debrun GM, Ausman JI, Charbel FT. What percentage of surgically clipped intracranial aneurysms have residual necks? Neurosurgery. 2000;46(6):1294-300.
David CA, Vishteh AG, Spetzler RF, Lemole M, Lawton MT, Partovi S. Late angiographic follow-up review of surgically treated aneurysms. Journal of neurosurgery. 1999;91(3):396-401.
Brinjikji W, Rabinstein A, Nasr D, Lanzino G, Kallmes D, Cloft HJ. Better outcomes with treatment by coiling relative to clipping of unruptured intracranial aneurysms in the United States, 2001–2008. American Journal of Neuroradiology. 2011;32(6):1071-5.
Molyneux AJ, Kerr RS, Birks J, Ramzi N, Yarnold J, Sneade M, et al. Risk of recurrent subarachnoid haemorrhage, death, or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): long-term follow-up. The Lancet Neurology. 2009;8(5):427-33.
Molyneux A. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. The Lancet. 2002;360(9342):1267-74.
Vinuela GG. Electrothrombosis of saccular aneurysms via endovascular approach. Part 2: Preliminary clinical experience. J Neurosurg. 1991;75:8-14.
Oishi H, Tanoue S, Teranishi K, Hasegawa H, Nonaka S, Magami S, et al. Endovascular parent artery occlusion of proximal posterior cerebral artery aneurysms: a report of two cases. Journal of neurointerventional surgery. 2016;8(6):591-3.
Abrams HL. Abrams' angiography: interventional radiology: Lippincott Williams & Wilkins; 2006.
Moret J, Cognard C, Weill A, Castaings L, Rey A. The “remodelling technique” in the treatment of wide neck intracranial aneurysms: angiographic results and clinical follow-up in 56 cases. Interventional Neuroradiology. 1997;3(1):21-35.
Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms. Stroke. 2001;32(9):1998-2004.
Gemmete JJ, Elias AE, Chaudhary N, Pandey AS. Endovascular methods for the treatment of intracranial cerebral aneurysms. Neuroimaging Clinics. 2013;23(4):563-91.
Walsh KM, Moskowitz SI, Hui FK, Spiotta AM. Multiple overlapping stents as monotherapy in the treatment of ‘blister’pseudoaneurysms arising from the supraclinoid internal carotid artery: a single institution series and review of the literature. Journal of neurointerventional surgery. 2014;6(3):184-94.
Cohen JE, Melamed I, Itshayek E. X-microstenting and transmesh coiling in the management of wide-necked tent-like anterior communicating artery aneurysms. Journal of Clinical Neuroscience. 2014;21(4):664-7.
Lubicz B, Mine B, Collignon L, Brisbois D, Duckwiler G, Strother C. WEB device for endovascular treatment of wide-neck bifurcation aneurysms. American journal of neuroradiology. 2013;34(6):1209-14.
