Completely Thrombosed Aneurysms of the Posterior Cerebral Artery: A Comprehensive Review.

摘要: Background  Completely thrombosed aneurysms of the posterior cerebral artery (CTPCAAs) are rare lesions with different characteristics and clinical behavior when compared other intracranial aneurysms. Objective  To describe analyze main features CTPCAAs. Material Methods  Fifteen CTPCAAs were studied (14 literature cases plus one illustrative case). Clinical, radiologic, pathologic, therapeutic data obtained analyzed. Results  CTPCAAs large (mean: 2.43 cm), located proximally (80% at P1–P2 segments), show a slight predominance fusiform appearance. Posterior (PCA) occlusion ensued after aneurysm complete thrombosis in 73% patients (11/15). However, only 33% developed PCA territory stroke, due to rich distal arterial collateral network. Three mutually exclusive presentations observed: subarachnoid hemorrhage (SAH) ( n  = 3), “stroke-like” syndrome  = 7), “tumor-like”  = 4). One case was incidental. treatments performed: conservative endovascular  = 1), surgery  = 7). CTPCAA exclusion goal surgery. Neural structures decompression also sought tumor-like cases. elimination as potential bleeding source target stroke-like General outcome among good (73% scored Glasgow Outcome Scale 4–5/Modified Rankin 0–2). Conclusions characterized by young age presentation, male predominance, proximal location on PCA, tendency cause occlusion. The PCAA presentation depends mechanism thrombosis. SAH harbor less organized thrombus than CTPCAAs, which makes more prone hemorrhagic/ischemic complications. Thus may indicate evolution management varied according patient's condition risk evaluation for future complications derived from aneurysm. Clinical surveillance surgical removal most frequent treatment options performed. Surgery focused neural and/or bleeding.