J Neurol Surg A Cent Eur Neurosurg 2017; 78(01): 67-77
DOI: 10.1055/s-0036-1588064
Review Article
Georg Thieme Verlag KG Stuttgart · New York

State-of-Art Surgical Treatment of Dissecting Anterior Circulation Intracranial Aneurysms

Vladimir Balik
1  Department of Neurosurgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
,
Yasuhiro Yamada
2  Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan
,
Sandeep Talari
3  Department of Neurosurgery, Andhra Medical College, Maharanipeta, Visakhapatnam, India
,
Yamashiro Kei
2  Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan
,
Hirotoshi Sano
4  Department of Neurosurgery, Sogo Shinkawabashi Hospital, Kawasaki-city, Japan
,
Igor Sulla
5  Department of Surgery, Hospital of Slovak Railways, Kosice, Slovakia
,
Daisuke Suyama
6  Department of Neurosurgery, Fuchu Keijinkai Hospital, Tokyo, Japan
,
Tukasa Kawase
2  Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan
,
Kiyoshi Takagi
7  Normal Pressure Hydrocephalus Center, Chiba Kashiwa Tanaka Hospital, Kashiwa city, Japan
,
Katsumi Takizawa
8  Department of Neurosurgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
,
Yoko Kato
2  Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan
› Author Affiliations
Further Information

Publication History

16 April 2016

06 July 2016

Publication Date:
05 September 2016 (online)

Abstract

Intracranial dissecting aneurysms (IDAs) are an important cause of subarachnoid hemorrhage, stroke, or compression of intracranial structures. Since the availability of endovascular treatment and the advantage of intraprocedural anticoagulation, an endovascular strategy has become the mainstay of their therapy. But in some cases selective aneurysm obliteration by the endovascular approach is impossible or associated with an unacceptable risk of morbidity. This is particularly true when the IDA is a blood blister-like aneurysm or when dissection affects peripheral branches of the internal carotid artery. The literature dealing with surgical treatment of IDAs in the anterior circulation is heterogeneous, and formulation of general recommendations concerning the surgical strategy remains difficult. The aim of this study was to conduct a systematic review of the current knowledge on incidence, pathogenesis, clinical presentation, and diagnostic procedures with a special emphasis on the surgical treatment of intracranial dissections of anterior circulation.