The efficacy of endosaccular aneurysm occlusion in alleviating neurological deficits produced by mass effect.

Published

Journal Article

Endovascular obliteration of intracranial aneurysms with preservation of the parent artery (endosaccular occlusion) has been advocated for patients who fail or are excluded from surgical clipping and cannot undergo Hunterian ligation therapy. To clarify the effect that endosaccular occlusion has on the presenting neurological signs, 26 patients with aneurysms and symptoms related to mass effect who underwent this therapy were followed for a mean of 60 months. Only patients with objective neurological deficits who had not suffered a hemorrhage were included in this series. Response to therapy was classified into one of three groups: "resolved," if the patient had complete resolution of presenting signs; "improved," if significant and sustained improvement was recorded in the neurological examinations, and "unchanged," if no change was observed. Thirteen patients (50%) were classified as resolved, 11 (42.3%) as improved, and two (7.7%) as unchanged. A comparison of patients classified as resolved with those who were improved revealed that the former group had less wall calcification (30% vs. 60%) and a shorter duration of symptoms. Patients with neurological sign resolution (62%) were more likely to have totally occluded aneurysms on late follow-up arteriograms than those who had improvement (28%) or were unchanged (0%). This study suggests that endosaccular embolization therapy can improve or alleviate presenting neurological signs unrelated to hemorrhage or distal embolization in the majority of cases.

Full Text

Duke Authors

Cited Authors

  • Halbach, VV; Higashida, RT; Dowd, CF; Barnwell, SL; Fraser, KW; Smith, TP; Teitelbaum, GP; Hieshima, GB

Published Date

  • April 1, 1994

Published In

Volume / Issue

  • 80 / 4

Start / End Page

  • 659 - 666

PubMed ID

  • 8151344

Pubmed Central ID

  • 8151344

International Standard Serial Number (ISSN)

  • 0022-3085

Digital Object Identifier (DOI)

  • 10.3171/jns.1994.80.4.0659

Language

  • eng

Conference Location

  • United States