Clinical Study on Recurrent Intracranial Aneurysms

The authors report 11 cases who underwent reoperations upon for recurrent aneurysms. The initial operations were performed on average 10.1 years earlier for subarachnoid hemorrhage (SAH). The patients’ mean age at the first surgery was 39.7 years. The locations were 9 internal carotid (IC)-posterior communicating artery (PC) and 2 anterior communicating artery (A-com) aneurysms. A residual aneurysmal neck after the first operation was observed in 3 of 10 cases confirmed by postoperative angiography. The primitive-type PC artery was seen in 8 of 9 recurrent IC-PC aneurysms. The recurrent manifestations were SAH in 9 cases. Clipping operations were conducted in 10 and ligation of the IC artery together with extracranial-intracranial bypass in 1 large IC-PC aneurysm. The present study demonstrated two risk factors for aneurysm recurrence, namely, young age and IC-PC aneurysms with a primitive-type PC. Furthermore, direct operation for recurrent aneurysm is often embarassing due to adhesions to the surrounding tissue as a sequela of the previous operation, hence understanding of the anatomical correlation between the old clip and the recurrent portion is important.

[1]  A. Molyneux,et al.  Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding. , 1999, Journal of neurosurgery.

[2]  T. Kirino,et al.  Risk of recurrent subarachnoid hemorrhage after complete obliteration of cerebral aneurysms. , 1998, Stroke.

[3]  A. Yamaura,et al.  A Retrospective Study on Recurrent or New Intracranial Aneurysms after Neck Clipping , 1996 .

[4]  R F Spetzler,et al.  Revascularization and aneurysm surgery: current techniques, indications, and outcome. , 1996, Neurosurgery.

[5]  S. Giannotta,et al.  Reoperative management of intracranial aneurysms. , 1995, Journal of neurosurgery.

[6]  T. Sakaki,et al.  Recurrence of ICA-PCoA aneurysms after neck clipping. , 1994, Journal of neurosurgery.

[7]  A. Fox,et al.  Regrowth of aneurysm sacs from residual neck following aneurysm clipping. , 1989, Journal of neurosurgery.

[8]  T. Kayama,et al.  The Incidence of Rebleeding After Surgical Treatment of Ruptured Aneurysms , 1987 .

[9]  C. Lindquist,et al.  Natural history of postoperative aneurysm rests. , 1987, Journal of neurosurgery.

[10]  M. Suzuki,et al.  Recurrence of cerebral aneurysm after initial neck clipping. , 1982, Neurosurgery.

[11]  P. B. Wollschlaeger,et al.  Experience and result with postmortem cerebral angiography performed as routine procedure of the autopsy. , 1967, The American journal of roentgenology, radium therapy, and nuclear medicine.

[12]  H. Locksley,et al.  Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. , 1966, Journal of neurosurgery.

[13]  H. Locksley.  Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. Based on 6368 cases in the cooperative study. , 1966, Journal of neurosurgery.