Cerebral Aneurysms and Subarachnoid Hemorrhage
Though a recognized entity since the days preceding Morgagni in the seventeenth century, a clear understanding of why aneurysms form, grow, and rupture as well as the best strategies for treating unruptured and ruptured aneurysms still eludes the neuroscience community (Prestigiacomo 2006). Recent advances in neurosurgical techniques and neuro-intensive care have resulted in progressive improvement in mortality, morbidity, and functional status following subarachnoid hemorrhage (SAH) secondary to the rupture of a cerebral aneurysm (Heros & Morcos, 2000).
Unlike other causes of stroke, SAH occurs in persons in the prime of their working years, with a mean age of onset between 40 and 60 years (Sethi, Moore, Dervin, Clifton, & MacSweeney, 2000). With an estimated incidence of 37,500 in the United States alone, and a lifetime cost of over $230,000 per individual, spontaneous aneurysmal SAH cost the United States over $5.6 billion in 1990 dollars (Taylor et al., 1996...
KeywordsIntracranial Aneurysm Cerebral Aneurysm Cerebral Vasospasm Blood Flow Restriction Unruptured Aneurysm
- Chalif, D. J., & Weinberg, J. S. (1998) Surgical treatment of aneurysm of the anterior cerebral artery. Neurosurgery Clinicas of North America, 9, 797–821.Google Scholar
- Hoh, B. L., Cheung, A. C., Rabinov, J. D., Pryor, J. C., Carter, B. S., & Ogilvy, C. S. (2004) Results of a prospective protocol of computed tomographic angiography in place of catheter angiography as the only diagnostic and pretreatment planning study for cerebral aneurysms by a combined neurovascular team. Neurosurgery, 54, 1329–1340.PubMedCrossRefGoogle Scholar
- Molyneux, A. J., Kerr, R. S. C., Yu, L-M., Clarke, M., Sneade, J. A., Yarnold, J. A., & Sandercock, P. (2005) International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomized comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet, 366, 809–817.PubMedCrossRefGoogle Scholar
- Mayeux, R. Ottman, R., Tang, M. X., Noboa-Bauza, L., Marder, K., Gurland, B., et al. (1993) Genetic susceptibility and heaed injury as risk factors for Alzheimer’s disease among community-dwelling elserly persons and their first-degree relatives. Annals of Neurology,33, 494–501.PubMedCrossRefGoogle Scholar
- Ogden, J. A., Levin, P. L., & Mee, E. W. (1990) Long-tern neuropsychological and psychological effects of subarachnoid hemorrhage. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 3, 260–274.Google Scholar
- Victor, M., & Ropper, A. H. (2001) Cerebrovascular diseases. In Adams, R. D. & Victor, M., (Eds.), Principles of neurology (pp 821–924). New York: McGraw-Hill.Google Scholar
- Wiebers, D. O., Whisnant, J. P., Huston, J., III., Meissner, I., Brown, R. D. Jr., Piepgras, D. G. et al. (2003) International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet, 362(9378),103–1010.CrossRefGoogle Scholar
- Westerkam, R., Cifu, D. X., & Keyser, L. (1997) Functional outcome after inpatient rehabilitation following aneurismal subarachnoid hemorrhage: A prospective analysis. Top Stroke Rehabilitation, 4, 20–37.Google Scholar