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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Ruptured middle cerebral artery aneurysms and the different bleeding patterns – influence of the sylvian fissure anatomy and geometric vascular parameters

Rupturierte Aneurysmen der A. cerebri media und die unterschiedlichen Blutungsmuster – Einfluss der anatomischen Varaitionen der Sylvischen Fissur und geometrische vaskuläre Parameter

Meeting Abstract

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  • Ali Siblini - Nordstadt Klinikum, Neurochirurgie, Hannover, Deutschland
  • Belal Neyazi - Nordstadt Klinikum, Neurochirurgie, Hannover, Deutschland
  • Roman Frantsev - Universitätsklinik Essen, Essen, Deutschland
  • Neriman Özkan - Universitätsklinik Essen, Essen, Deutschland
  • I. Erol Sandalcioglu - Nordstadt Klinikum, Neurochirurgie, Hannover, Deutschland
  • Ulrich Sure - Universitätsklinik Essen, Essen, Deutschland
  • presenting/speaker Homajoun Maslehaty - Nordstadt Klinikum, Neurochirurgie, Hannover, Deutschland; Universitätsklinik Essen, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP132

doi: 10.3205/19dgnc468, urn:nbn:de:0183-19dgnc4686

Veröffentlicht: 8. Mai 2019

© 2019 Siblini et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: The aim of the study was to analyze the association of the morphological variations of the Sylvian fissure (SF) and vascular parameters on occurrence of different bleeding patterns in patients with ruptured middle cerebral artery (MCA) aneurysms.

Methods: The data of consecutive 202 patients with ruptured MCA aneurysm of two centers were included for analysis. The patients were divided into three groups: Group 1 with subarachnoid hemorrhage (SAH), Group 2 with accompanying intracerebral hemorrhage (ICH) and Group 3 with intrasylvian hemorrhage (ISH). The SF was divided into five types according to the previously described classification. The vascular parameters, which were analyzed in the study, were aneurysm size, localization, presence of a daughter aneurysm, shape and angulation of the aneurysm sac. SPSS 24.0 for Windows was used for statistical analysis.

Results: A total of 202 patients (141 female, 61 male, mean age 52.4 y) were included in this study. 67 patients (33.2%) had a SAH (Group 1), 122 (60.4%) presented with accompanying ICH (Group 2) and n=13 patients (6.4%) with ISH (Group 3). Statistical analysis showed a significant association of narrow and twisted SF types 4 and 5 (p<0.0001) and temporal angulation of the aneurysm (p=0.030) for occurrence of ICH. All other vascular parameters showed no significant association for any kind of hemorrhage.

Conclusion: Our results allow the conclusion that the complex SF types 4 and 5, as well as and the temporal angulation of the aneurysm sac are the main predictive factors for occurrence of ICH in ruptured MCA aneurysms.