Conservative Management and Natural History of Ruptured Basilar Perforator Artery Aneurysms: Two Cases and Literature Review.
Aneurysm
Basilar perforator artery
Conservative management
Observation
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
25
01
2020
revised:
06
03
2020
accepted:
06
03
2020
pubmed:
21
3
2020
medline:
18
7
2020
entrez:
21
3
2020
Statut:
ppublish
Résumé
Basilar perforator aneurysms are rare causes of subarachnoid hemorrhage and their natural history is poorly characterized. Although various treatment strategies have been reported, conservative management is an option that has been associated with a high likelihood of spontaneous resolution. Here we present 2 cases of subarachnoid hemorrhage, 1 diffuse and the other perimesencephalic, due to small ruptured basilar perforator artery aneurysms. These aneurysms were only identified after repeat angiography. Conservative management with serial imaging was pursued. Both patients did well clinically and repeat imaging demonstrated spontaneous resolution of the ruptured aneurysms. We also provide a literature review of ruptured basilar perforator aneurysms, showing a ~10% re-rupture rate within the early post-rupture period but otherwise a high rate of spontaneous resolution. Although basilar perforator aneurysms can re-rupture, there is also a high likelihood of spontaneous resolution. Given the challenges of treatment, conservative management is an option that can be considered.
Sections du résumé
BACKGROUND
Basilar perforator aneurysms are rare causes of subarachnoid hemorrhage and their natural history is poorly characterized. Although various treatment strategies have been reported, conservative management is an option that has been associated with a high likelihood of spontaneous resolution.
CASE DESCRIPTION
Here we present 2 cases of subarachnoid hemorrhage, 1 diffuse and the other perimesencephalic, due to small ruptured basilar perforator artery aneurysms. These aneurysms were only identified after repeat angiography. Conservative management with serial imaging was pursued. Both patients did well clinically and repeat imaging demonstrated spontaneous resolution of the ruptured aneurysms. We also provide a literature review of ruptured basilar perforator aneurysms, showing a ~10% re-rupture rate within the early post-rupture period but otherwise a high rate of spontaneous resolution.
CONCLUSIONS
Although basilar perforator aneurysms can re-rupture, there is also a high likelihood of spontaneous resolution. Given the challenges of treatment, conservative management is an option that can be considered.
Identifiants
pubmed: 32194275
pii: S1878-8750(20)30510-6
doi: 10.1016/j.wneu.2020.03.042
pii:
doi:
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
218-222Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.