Neurological Sciences

, Volume 27, Issue 5, pp 317–322

Iatrogenic intracranial pseudoaneurysms: neuroradiological and therapeutical considerations, including endovascular options

Authors

    • Department of Diagnostic and Interventional NeuroradiologyIstituto Nazionale Neurologico “C. Besta”
    • Department of NeuroradiologyIstituto Nazionale Neurologico “Carlo Besta”
  • C. Regna-Gladin
    • Department of NeuroradiologyIstituto Nazionale Neurologico “Carlo Besta”
  • A. Erbetta
    • Department of NeuroradiologyIstituto Nazionale Neurologico “Carlo Besta”
  • L. Chiapparini
    • Department of NeuroradiologyIstituto Nazionale Neurologico “Carlo Besta”
  • S. Nappini
    • Department of NeuroradiologyIstituto Nazionale Neurologico “Carlo Besta”
  • M. Savoiardo
    • Department of NeuroradiologyIstituto Nazionale Neurologico “Carlo Besta”
  • F. Di Meco
    • Department of NeurosurgeryIstituto Nazionale Neurologico “Carlo Besta”
ORIGINAL

DOI: 10.1007/s10072-006-0703-y

Cite this article as:
Ciceri, E.F.M., Regna-Gladin, C., Erbetta, A. et al. Neurol Sci (2006) 27: 317. doi:10.1007/s10072-006-0703-y

Abstract

Intracranial pseudoaneurysms represent a potentially fatal complication of intracranial surgery. Our purpose is to describe their neuroradiological characteristics, prognostic features and possible treatment. Eight cases of postsurgical intracranial pseudoaneurysms have been observed at our institution since 1988. Four were observed following transsphenoidal (TS) surgery and four after pterional craniotomies. Two types of iatrogenic pseudoaneurysms were observed: “fusiform”, probably due to weakening of the adventitia during surgical peeling of the tumour from the artery (three cases) and “saccular”, occurring after a more focal or complete laceration of the vessel (five cases), more often after TS surgery. A thorough preoperative neuroradiological examination may identify anatomical conditions at risk for development of this severe complication. Postoperative neuroradiological follow-up is mandatory in cases in which unusual bleeding has occurred during the perioperative period, but absence of bleeding does not exclude the possible devel opment of a pseudoaneurysm. Endovascular treatment of pseudoaneurysms represents a safe and durable procedure, specifically in those cases in which damage to the carotid siphon occurred during TS surgery.

Key words

Angiography Embolisation Intracranial iatrogenic pseudoaneurysm Transsphenoidal surgery

Copyright information

© Springer-Verlag Italia 2006