Response to letter “Bias in determining factors associated with early seizures after surgery of unruptured intracranial aneurysms.”

2019 ◽  
Vol 181 ◽  
pp. 67
Author(s):  
Goji Fushihara ◽  
Tomoya Kamide ◽  
Tatsuki Kimura ◽  
Ririko Takeda ◽  
Toshiki Ikeda ◽  
...  
2019 ◽  
Vol 178 ◽  
pp. 93-96 ◽  
Author(s):  
Goji Fushihara ◽  
Tomoya Kamide ◽  
Tatsuki Kimura ◽  
Ririko Takeda ◽  
Toshiki Ikeda ◽  
...  

Cephalalgia ◽  
2011 ◽  
Vol 31 (10) ◽  
pp. 1082-1089 ◽  
Author(s):  
Todd J Schwedt ◽  
Robert W Gereau ◽  
Karen Frey ◽  
Evan D Kharasch

Objective: To analyze headache patterns prior to and following treatment of unruptured intracranial aneurysms and identify factors associated with different headache outcomes. Methods: A prospective observational study of patients being treated for unruptured intracranial aneurysms. Headache patterns were established prior to aneurysm treatment and for 6 months following treatment. Factors associated with different headache outcomes were investigated. Results: In all patients ( n = 44), 90-day headache frequency decreased from an average of 31 days prior to aneurysm treatment to 17 days following treatment ( p < 0.001). In patients with active pretreatment headaches ( n = 28), 90-day headache frequency decreased from 49 days to 26 days ( p = 0.002). Headache frequency was reduced in 68% of patients, while 9% of patients had new or worsened headaches following aneurysm treatment. Pretreatment migraine, more severe pretreatment headaches, higher pretreatment trait anxiety, and stent-assisted aneurysm coiling were associated with a lack of headache improvement. Conclusions: The majority of patients with headaches at the time of aneurysm treatment had reductions in headache frequency during the 6 months following treatment. Potential risk factors for poor headache outcomes were identified but need to be studied further.


Stroke ◽  
2015 ◽  
Vol 46 (11) ◽  
pp. 3093-3098 ◽  
Author(s):  
Hyun Goo Kang ◽  
Bum Joon Kim ◽  
Jisung Lee ◽  
Mi-Jung Kim ◽  
Dong-Wha Kang ◽  
...  

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Aichi Chien ◽  
Feng Liang ◽  
James Sayre ◽  
Noriko Salamon ◽  
Pablo Villablanca ◽  
...  

Introduction: The International Study on Unruptured Intracranial Aneurysms suggests that small (<7mm), asymptomatic, unruptured intracranial aneurysms (UIA) in patients with no history of subarachnoid hemorrhage (SAH) should be managed conservatively. Recent research has independently shown considerable variation in the rupture risk of small UIA. As enlargement may indicate increased risk of rupture, the factors related to UIA growth may also influence rupture risk. Information about small UIA growth is limited and heterogeneous due to limited follow-up data. Hypothesis: Growth factors for small UIA vary between subset groups. Methods: A retrospective study was performed based on a total of 508 patients diagnosed with UIA from 2005-2010 in our center. 235 patients with asymptomatic, small UIA and no history of SAH were monitored with high resolution 3D CTA. Patient medical history and aneurysm characteristics (size, growth, location and multiplicity) were analyzed. Multiple logistic regression analysis and the Hosmer-Lemeshow statistic were used to identify the factors associated with growth. The Student’s t-test was applied to compare the aneurysm growth rate between subset groups. Results: A total of 319 UIA were included with follow-up durations of 29.2 20.0 months. 42 UIA increased in size during the follow-up. 5 UIA grew to become ≥ 7 mm (within 38.2±18.3 months). A trend of higher growth rates was found in single aneurysms than in multiple aneurysms (P=0.07). History of stroke was the only factor associated with single aneurysm growth (P=0.03). The number of aneurysms (P=0.014), aneurysms located within the posterior circulation (P=0.023), and patient history of transient ischemic attack (P=0.032) were related to multiple aneurysm growth. Conclusion: We found that multiple small aneurysms were more likely to grow, especially those at posterior circulation. Although single aneurysms have a lower risk of growth, a trend of higher growth rates was found.


2019 ◽  
Author(s):  
Khodayar Goshtasbi ◽  
Ronald Sahyouni ◽  
Alice Wang ◽  
Edward Choi ◽  
Gilbert Cadena ◽  
...  

2019 ◽  
Vol 24 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Daniel-Alexandre Bisson ◽  
Peter Dirks ◽  
Afsaneh Amirabadi ◽  
Manohar M. Shroff ◽  
Timo Krings ◽  
...  

OBJECTIVEThere are little data in the literature on the characteristics and natural history of unruptured intracranial aneurysms in children. The authors analyzed their experience with unruptured intracranial aneurysms in the pediatric population at their tertiary care pediatric institution over the last 18 years. The first objective was to assess the imaging characteristics and natural history of these aneurysms in order to help guide management strategies in the future. A second objective was to evaluate the frequency of an underlying condition when an incidental intracranial aneurysm was detected in a child.METHODSThe authors conducted a Research Ethics Board–approved retrospective review of incidental intracranial aneurysms in patients younger than 18 years of age who had been treated at their institution in the period from 1998 to 2016. Clinical (age, sex, syndrome) and radiological (aneurysm location, type, size, thrombus, mass effect) data were recorded. Follow-up imaging was assessed for temporal changes.RESULTSSixty intracranial aneurysms occurred in 51 patients (36 males, 15 females) with a mean age of 10.5 ± 0.5 years (range 9 months–17 years). Forty-five patients (88.2%) had a single aneurysm, while 2 and 3 aneurysms were found in 3 patients each (5.8%). Syndromic association was found in 22 patients (43.1%), most frequently sickle cell disease (10/22 [45.5%]). Aneurysms were saccular in 43 cases (71.7%; mean size 5.0 ± 5.7 mm) and fusiform in the remaining 17 (28.3%; mean size 6.5 ± 2.7 mm). Thirty-one aneurysms (51.7%) arose from the internal carotid artery (right/left 1.4), most commonly in the cavernous segment (10/31 [32.3%]). Mean size change over the entire follow-up of 109 patient-years was a decrease of 0.6 ± 4.2 mm (range −30.0 to +4.0 mm, rate −0.12 ± 9.9 mm/yr). Interval growth (2.0 ± 1.0 mm) was seen in 8 aneurysms (13.3%; 4 saccular, 4 fusiform). An interval decrease in size (8.3 ± 10.7 mm) was seen in 6 aneurysms (10%). There was an inverse relationship between aneurysm size and growth rate (r = −0.82, p < 0.00001). One aneurysm was treated endovascularly with internal carotid artery sacrifice.CONCLUSIONSUnruptured pediatric intracranial aneurysms are most frequently single but can occur in multiples in a syndromic setting. None of the cases from the study period showed clinical or imaging signs of rupture. Growth over time, although unusual and slow, can occur in a proportion of these patients, who should be identified for short-term imaging surveillance.


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