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Are blood blister-like aneurysms a specific type of dissection? A comparative study of blood blister-like aneurysms and ruptured mizutani type 4 vertebral artery dissections.

Authors
 Sook Young Sim  ;  Joonho Chung  ;  Yong Sam Shin 
Citation
 Journal of Korean Neurosurgical Society, Vol.56(5) : 395-399, 2014 
Journal Title
 Journal of Korean Neurosurgical Society 
ISSN
 2005-3711 
Issue Date
2014
Keywords
Aneurysm ; Dissection ; Internal carotid artery ; Subarachnoid hemorrhage ; Vertebral artery
Abstract
OBJECTIVE: Blood blister-like aneurysms (BBAs) resemble arterial dissections. The purpose of this study was to investigate the relationship between these two disease entities and highlight commonalities and distinct features. METHODS: Among 871 consecutive patients with aneurysmal subarachnoid hemorrhage, 11 BBAs of internal carotid artery and seven vertebral artery dissections (VADs) with a short segmental eccentric dilatation (Mizutani type 4), which is morphologically similar to a BBA, were selected. The following clinical factors were studied in each group : age, gender, risk factors, Hunt and Hess grade (HHG), Fisher grade (FG), vasospasms, hydrocephalus, perioperative rebleeding rate, and treatment outcome. RESULTS: The mean age was 47.9 years in the BBAs group and 46.4 years in the type 4 VADs group. All the BBA patients were female, whereas there was a slight male predominance in the type 4 VAD group (male : female ratio of 4 : 3). In the BBA and type 4 VAD groups that underwent less aggressive treatment to save the parent artery, 29% (n=2/7) and 66.6% (n=2/3), respectively, eventually required retreatment. Perioperative rebleeding occurred in 72.7% (n=8) and 28.6% (n=2) of patients in the BBA and type 4 VAD groups, respectively. There was no statistical difference in the other clinical factors in both groups, except for the male dominancy in the type 4 VAD group (p=0.011). CONCLUSION: BBAs and ruptured type 4 VADs have a similar morphological appearance but there is a distinct clinical feature in gender and perioperative rebleeding rates. Complete isolation of an aneurysm from the parent artery might be the most important discipline for the treatment of these diseases.
Files in This Item:
T201405564.pdf Download
DOI
10.3340/jkns.2014.56.5.395
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Chung, Joon Ho(정준호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138752
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