دورية أكاديمية
Cerebral aneurysms with intrasellar extension: a systematic review of clinical, anatomical, and treatment characteristics.
| العنوان: | Cerebral aneurysms with intrasellar extension: a systematic review of clinical, anatomical, and treatment characteristics. |
|---|---|
| المؤلفون: | Hanak BW; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Zada G, Nayar VV, Thiex R, Du R, Day AL, Laws ER |
| المصدر: | Journal of neurosurgery [J Neurosurg] 2012 Jan; Vol. 116 (1), pp. 164-78. Date of Electronic Publication: 2011 Nov 04. |
| نوع المنشور: | Journal Article; Review; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Association of Neurological Surgeons Country of Publication: United States NLM ID: 0253357 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1933-0693 (Electronic) Linking ISSN: 00223085 NLM ISO Abbreviation: J Neurosurg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Charlottesville, VA : American Association of Neurological Surgeons Original Publication: Chicago [etc.] |
| مواضيع طبية MeSH: | Intracranial Aneurysm/*surgery , Pituitary Gland/*surgery , Sella Turcica/*surgery, Humans ; Intracranial Aneurysm/pathology ; Pituitary Gland/pathology ; Sella Turcica/pathology |
| مستخلص: | Object: Intrasellar aneurysms are rare lesions that often mimic pituitary tumors, potentially resulting in catastrophic outcomes if they are not appropriately recognized. The authors aimed to characterize the clinical and anatomical details of this poorly defined entity in the modern era of neuroimaging and open/endovascular neurosurgery. Methods: A PubMed literature review was conducted to identify all studies reporting noniatrogenic aneurysms with intrasellar extension, as confirmed by CT or MR imaging and angiography. Clinical, anatomical, and treatment characteristics were analyzed. Results: Thirty-one studies reporting 40 cases of intrasellar aneurysms were identified. Six patients (15%) presented with aneurysmal rupture. Patients with unruptured aneurysms presented with the following signs and symptoms: headache (61%), visual field cuts/decreased visual acuity (61%), endocrinopathy (57%), symptomatic hyponatremia (21%), and cranial nerve paresis (other than optic nerve) (18%). The most common endocrine abnormalities were hyperprolactinemia and hypogonadism. Eight aneurysms (20%) were diagnosed in conjunction with a pituitary adenoma. Aneurysms could be categorized into 2 primary anatomical groups as follows: 1) cavernous/clinoid segment internal carotid artery (ICA) (infradiaphragmatic) aneurysms with medial extension into the sella; and 2) suprasellar (supradiaphragmatic) aneurysms originating from the ophthalmic segment of the ICA or from the anterior communicating artery, with inferomedial extension into the sella. The mean diameters of infradiaphragmatic and supradiaphragmatic aneurysms were 14.5 and 21.8 mm, respectively. Infradiaphragmatic aneurysms were much more likely to present with endocrinopathy, whereas supradiaphragmatic ones presented more commonly with visual disturbances. Aneurysms with infradiaphragmatic growth were generally treated using either endovascular techniques or surgical trapping and bypass, while supradiaphragmatic aneurysms were more often treated by surgical clipping. Conclusions: Aneurysms with intrasellar extension typically present due to mass effect on surrounding structures, and they can be classified as infradiaphragmatic cavernous or clinoid segment ICA aneurysms, or supradiaphragmatic ophthalmic ICA or anterior communicating artery aneurysms. Varying approaches exist for treating these complex aneurysms, and intervention strategies depend substantially on the anatomical subtype. |
| تواريخ الأحداث: | Date Created: 20111108 Date Completed: 20120221 Latest Revision: 20220408 |
| رمز التحديث: | 20231215 |
| DOI: | 10.3171/2011.9.JNS11380 |
| PMID: | 22054212 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1933-0693 |
|---|---|
| DOI: | 10.3171/2011.9.JNS11380 |