Iatrogenic intracranial pseudoaneurysms: Neuroradiological and therapeutical considerations, including endovascular options

E. F M Ciceri, C. Regna-Gladin, A. Erbetta, L. Chiapparini, S. Nappini, M. Savoiardo, F. Di Meco

Research output: Contribution to journalArticle

Abstract

Intracranial pseudoaneurysms represent a potentially fatal complication of intracranial surgery. Our purpose is to describe their neuroradiological characteristics, prognostic features and possible treatment. Eight cases of postsurgical intracranial pseudoaneurysms have been observed at our institution since 1988. Four were observed following transsphenoidal (TS) surgery and four after pterional craniotomies. Two types of iatrogenic pseudoaneurysms were observed: "fusiform", probably due to weakening of the adventitia during surgical peeling of the tumour from the artery (three cases) and "saccular", occurring after a more focal or complete laceration of the vessel (five cases), more often after TS surgery. A thorough preoperative neuroradiological examination may identify anatomical conditions at risk for development of this severe complication. Postoperative neuroradiological follow-up is mandatory in cases in which unusual bleeding has occurred during the perioperative period, but absence of bleeding does not exclude the possible devel opment of a pseudoaneurysm. Endovascular treatment of pseudoaneurysms represents a safe and durable procedure, specifically in those cases in which damage to the carotid siphon occurred during TS surgery.

Original languageEnglish
Pages (from-to)317-322
Number of pages6
JournalNeurological Sciences
Volume27
Issue number5
DOIs
Publication statusPublished - Nov 2006

Keywords

  • Angiography
  • Embolisation
  • Intracranial iatrogenic pseudoaneurysm
  • Transsphenoidal surgery

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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