Artikel
De novo aneurysms – is a long-term follow-up after treatment of cerebral aneurysms necessary?
De novo-Aneurysmen - ist eine Kontrolle des Langzeitverlaufes nach Behandlung von zerebralen Aneurysmen erforderlich?
Suche in Medline nach
Autoren
Veröffentlicht: | 4. Mai 2005 |
---|
Gliederung
Text
Objective
Once a cerebral aneurysm has been successfully treated and other aneurysms have been excluded, long-term follow-up is rarely performed. This strategy has to be questioned seriously as de novo aneurysms are reported with increasing frequency.
Results
5 out of 238 patients (2.1%) were diagnosed with a de novo aneurysm 2-24 years after treatment of subarachnoid hemorrhage (SAH) in our center since 2000. In two patients incidental aneurysms were found when MRI was indicated for severe headaches, three patients were in good clinical condition after the first treatment and had a second SAH. One of these patients died, one was severely handicapped and the third recovered well.
Reviewing the literature, the incidence of new aneurysms is reported to range from 0.9% and 1.8% per yea, but the rate may be far underestimated as angiography or MRI is not routinely repeated over years. Hypertension and a positive family history are believed to be high risk factors for developing cerebral aneurysms.
The published data underline that cerebral aneurysms have to be understood as a systemic disease of cerebral arteries, where new aneurysms have to be expected over the years. With MR-angiography there is a non-invasive tool that is useful for follow-up.
Conclusions
The often life-threatening course in these patients justify a long-term follow-up, which we think should be performed by non-invasive MR-angiography at two year intervals in order to provide the best treatment for non-ruptured de novo aneurysms.