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Spontaneous dissecting aneurysm of the intracranial vertebral artery: Management strategies

DC FieldValueLanguage
dc.contributor.author김동익-
dc.contributor.author김용배-
dc.contributor.author이재환-
dc.contributor.author정진영-
dc.contributor.author허승곤-
dc.date.accessioned2014-12-21T17:23:06Z-
dc.date.available2014-12-21T17:23:06Z-
dc.date.issued2007-
dc.identifier.issn0513-5796-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/97488-
dc.description.abstractPURPOSE: Pathogenesis and treatment of spontaneous dissecting aneurysm of the intracranial vertebral artery (VA) remain controversial. This study was designed to provide management strategies and to improve management outcome in patients with these aneurysms. MATERIALS AND METHODS: Among a total of 1,990 patients treated for intracranial aneurysms from February 1992 to June 2005, 28 patients (1.4%) were treated either by surgery (8 patients) or neurointervention (20 patients) for spontaneous dissecting aneurysms of the intracranial VA. Twenty-two patients had ruptured aneurysms. We analyzed indications of surgery or neurointervention for each case, and assessed the management outcome at a 6-month follow-up. RESULTS: For selection of therapeutic options, patients were initially evaluated as possible candidates for neurointervention using the following criteria: 1) poor clinical grade; 2) advanced age; 3) medical illness; 4) unruptured aneurysm; 5) equal or larger opposite VA; 6) anticipated surgical difficulty due to a deep location of the VA-posterior inferior cerebellar artery (PICA) junction. Surgery was considered for patients with: 1) high-risk aneurysms (large or irregular shaped); 2) smaller opposite VA; 3) failed neurointervention; or 4) dissection involving the PICA. Management outcomes were favorable in 25 patients (89.3%). Causes of unfavorable outcome in the remaining 3 patients were the initial insult in 2 patients, and medical complications in one patient. CONCLUSION: Ruptured aneurysms must be treated to prevent rebleeding. For unruptured aneurysms, follow-up angiography would be necessary to detect growth of the aneurysm. Treatment modality should be selected according to the clinical characteristics of each patient and close collaboration between neurosurgeons and neurointerventionists is essential.-
dc.description.statementOfResponsibilityopen-
dc.format.extent425~432-
dc.relation.isPartOfYonsei Medical Journal-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleSpontaneous dissecting aneurysm of the intracranial vertebral artery: Management strategies-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Radiation Oncology (방사선종양학)-
dc.contributor.googleauthorJae Whan Lee-
dc.contributor.googleauthorJin Young Jung-
dc.contributor.googleauthorKyu Chang Lee-
dc.contributor.googleauthorDong Ik Kim-
dc.contributor.googleauthorSeung Kon Huh-
dc.contributor.googleauthorYong Bae Kim-
dc.identifier.doi10.3349/ymj.2007.48.3.425-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA00408-
dc.contributor.localIdA03088-
dc.contributor.localIdA04356-
dc.contributor.localIdA00743-
dc.relation.journalcodeJ02813-
dc.contributor.alternativeNameKim, Dong Ik-
dc.contributor.alternativeNameKim, Yong Bae-
dc.contributor.alternativeNameLee, Jae Whan-
dc.contributor.alternativeNameJung, Jin Young-
dc.contributor.alternativeNameHuh, Seung Kon-
dc.contributor.affiliatedAuthorKim, Dong Ik-
dc.contributor.affiliatedAuthorLee, Jae Whan-
dc.contributor.affiliatedAuthorHuh, Seung Kon-
dc.rights.accessRightsfree-
dc.citation.volume48-
dc.citation.number3-
dc.citation.startPage425-
dc.citation.endPage432-
dc.identifier.bibliographicCitationYonsei Medical Journal, Vol.48(3) : 425-432, 2007-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers

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