Rzadkie tętniaki wewnątrzczaszkowe – blood blister-like aneurysms. Opis siedmiu przypadków leczonych chirurgicznie
Blood blister-like aneurysms (BBA) are rare aneurysms arising mainly from the anterior wall of the internal carotid artery (ICA) its supraclinoid segment (C6). The aneurism BBA usually forms a as small, consisting only of adventiva, bulge of the artery wall. Often these aneurysms lack aneurysmal neck, which is typical for saccular ones. All of those factors result in susceptibility to rupture causing subarachnoid haemorrhage (SAH) and difficulty in diagnosing and treatment.
The presented case series sums up the treatment of seven BBA cases operated in the Neurosurgery Department of Medical University of Gdansk between 1997 and 2012. All described patients were admitted due to SAH and all underwent surgery. The aneurysms were treated by means of neck clipping technique, applied with or without covering it by a muscular muff or a piece of gauze (wrapping). One case was treated by wrapping only.
Most of treated BBA cases were middle aged women. The results of treatment were unsuccessful in the majority of patients (6/7; 85.7%), three of them died, the other three became disabled and one patient was discharged in a good condition.
The outcome after surgical treatment of BBA is poor. Morphological distinctiveness of these aneurysms significantly complicates their efficient securing. Uneventful prognosis can be achieved in younger patients, with lower scores in Hunt-Hess or Fisher scale.
Adres: dr med. Tomasz Szmuda
Katedra i Klinika Neurochirurgii GUMed
ul. Debinki 7, Gdańsk