gms | German Medical Science

60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit den Benelux-Ländern und Bulgarien

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

24. - 27.05.2009, Münster

Primary epileptogenic unruptured intracranial aneurysms – incidence and treatment implications

Meeting Abstract

Suche in Medline nach

  • D. Hänggi - Neurochirugische Klinik, Heinrich-Heine-Universität Düsseldorf
  • P. Winkler - Neurochirurgische Klinik, Ludwig-Maximilian-Universität, München
  • H.-J. Steiger - Neurochirugische Klinik, Heinrich-Heine-Universität Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP13-05

DOI: 10.3205/09dgnc391, URN: urn:nbn:de:0183-09dgnc3918

Veröffentlicht: 20. Mai 2009

© 2009 Hänggi et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Seizures as initial manifestation of unruptured intracranial aneurysms are rare. It is unclear whether seizures forebode a risk of subsequent rupture and how these aneurysms are best treated to control epilepsy.

Methods: Out of a series of 85 unruptured aneurysms in patients without previous subarachnoid hemorrhage, 7 patients exclusively presented with epileptic seizures. In 3 of them a highly situated internal carotid artery aneurysm was diagnosed that was buried in the parahippocampal gyrus. In 2 patients middle cerebral artery aneurysms likewise created a conflict with the medial temporal lobe adjacent to the parahippocampal gyrus. An anterior communicating and a pericallosal artery aneurysm were diagnosed in 2 further patients. Initially, the 2 MCA aneurysms were incompletely occluded with GDC coils, without an effect on the aneurysm. In all but one patient the aneurysm was finally clipped and completely removed.

Results: Intraoperatively there were no signs of hemorrhage but of cortical gliosis around the dome of the aneurysm, which was also removed surgically. Freedom from seizures without medication resulted in all cases after microsurgical operation.

Conclusions: Seizures as a presenting symptom of unruptured intracranial aneurysms are rare. Seemingly there exists a preponderance of aneurysms anatomically related to the temporomesial region. Elimination of the aneurysm and of perifocal gliosis promises cure of the epilepsy.