TY - JOUR
T1 - Perianeurysmal edema in giant intracranial aneurysms in relation to aneurysm location, size, and partial thrombosis
AU - Dengler, Julius
AU - Maldaner, Nicolai
AU - Bijlenga, Philippe
AU - Burkhardt, Jan-Karl
AU - Graewe, Alexander
AU - Guhl, Susanne
AU - Hong, Bujung
AU - Hohaus, Christian
AU - Kursumovic, Adisa
AU - Mielke, Dorothee
AU - Schebesch, Karl-Michael
AU - Wostrack, Maria
AU - Rufenacht, Daniel
AU - Vajkoczy, Peter
AU - Schmidt, Nils Ole
AU - Giant Intracranial Aneurysm Study Group
AU - Gläsker, Sven
PY - 2015/8
Y1 - 2015/8
N2 - OBJECT: The underlying mechanisms causing intracranial perianeurysmal edema (PAE) are still poorly understood. Since PAE is most frequently observed in giant intracranial aneurysms (GIAs), the authors designed a study to examine the occurrence of PAE in relation to the location, size, and partial thrombosis (PT) of GIAs along with the clinical impact of PAE.METHODS: Magnetic resonance imaging data for patients with a diagnosis of unruptured GIA from the international multicenter Giant Intracranial Aneurysm Registry were retrospectively analyzed with regard to location and size of the GIA, PAE volume, and the presence of PT. The occurrence of PAE was correlated to clinical findings.RESULTS: Imaging data for 69 GIAs were eligible for inclusion in this study. Perianeurysmal edema was observed in 33.3% of all cases, with the highest frequency in GIAs of the middle cerebral artery (MCA; 68.8%) and the lowest frequency in GIAs of the cavernous internal carotid artery (ICA; 0.0%). Independent predictors of PAE formation were GIA volume (OR 1.13, p = 0.02) and the occurrence of PT (OR 9.84, p = 0.04). Giant intracranial aneurysm location did not predict PAE occurrence. Giant aneurysms with PAE were larger than GIAs without PAE (p < 0.01), and GIA volume correlated with PAE volume (rs = 0.51, p = 0.01). Perianeurysmal edema had no influence on the modified Rankin Scale score (p = 0.30 or the occurrence of aphasia (p = 0.61) or hemiparesis (p = 0.82).CONCLUSIONS: Perianeurysmal edema was associated with GIA size and the presence of PT. As no PAE was observed in cavernous ICA aneurysms, even though they exerted mass effect on the brain and also displayed PT, the dura mater may serve as a barrier protecting the brain from PAE formation.
AB - OBJECT: The underlying mechanisms causing intracranial perianeurysmal edema (PAE) are still poorly understood. Since PAE is most frequently observed in giant intracranial aneurysms (GIAs), the authors designed a study to examine the occurrence of PAE in relation to the location, size, and partial thrombosis (PT) of GIAs along with the clinical impact of PAE.METHODS: Magnetic resonance imaging data for patients with a diagnosis of unruptured GIA from the international multicenter Giant Intracranial Aneurysm Registry were retrospectively analyzed with regard to location and size of the GIA, PAE volume, and the presence of PT. The occurrence of PAE was correlated to clinical findings.RESULTS: Imaging data for 69 GIAs were eligible for inclusion in this study. Perianeurysmal edema was observed in 33.3% of all cases, with the highest frequency in GIAs of the middle cerebral artery (MCA; 68.8%) and the lowest frequency in GIAs of the cavernous internal carotid artery (ICA; 0.0%). Independent predictors of PAE formation were GIA volume (OR 1.13, p = 0.02) and the occurrence of PT (OR 9.84, p = 0.04). Giant intracranial aneurysm location did not predict PAE occurrence. Giant aneurysms with PAE were larger than GIAs without PAE (p < 0.01), and GIA volume correlated with PAE volume (rs = 0.51, p = 0.01). Perianeurysmal edema had no influence on the modified Rankin Scale score (p = 0.30 or the occurrence of aphasia (p = 0.61) or hemiparesis (p = 0.82).CONCLUSIONS: Perianeurysmal edema was associated with GIA size and the presence of PT. As no PAE was observed in cavernous ICA aneurysms, even though they exerted mass effect on the brain and also displayed PT, the dura mater may serve as a barrier protecting the brain from PAE formation.
KW - Adult
KW - Aged
KW - Brain Edema
KW - Female
KW - Humans
KW - Intracranial Aneurysm
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Thrombosis
KW - Research Support, Non-U.S. Gov't
U2 - 10.3171/2014.10.JNS141560
DO - 10.3171/2014.10.JNS141560
M3 - Article
C2 - 25884259
VL - 123
SP - 446
EP - 452
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
SN - 0022-3085
IS - 2
ER -