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Symptomatic and silent cerebral infarction following surgical clipping of unruptured intracranial aneurysms: incidence, risk factors, and clinical outcome

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机构: [1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, People’s Republic of China [2]China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China [3]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People’s Republic of China [4]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, People’s Republic of China
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关键词: Unruptured intracranial aneurysm Surgery Cerebral infarction Computed tomography Risk factor

摘要:
Cerebral infarction (CI) associated with clipping of unruptured intracranial aneurysms (UIAs) has not been completely studied. The role of individual and operative characteristics is not known, and the risk of silent CI has not been well described. To determine the incidence, risk factors, and clinical outcome of postoperative CI, we retrospectively analyzed 388 consecutive patients undergoing clipping of UIAs between January 2012 and December 2015. We reviewed the pre- and postoperative computed tomography (CT) images of each patient. Postoperative CI was defined as a new parenchymal hypodensity in the vascular territory of treated artery. Patient-specific, aneurysm-specific, and operative variables were analyzed as potential risk factors. Functional outcome at discharge was assessed with the modified Rankin Scale (mRS). Postoperative CI was found in 49 (12.6%) patients, 29 of whom manifested neurological deficits. The incidences of symptomatic stroke and silent CI were 7.5 and 5.2%, respectively. Multivariate analysis showed that larger aneurysm size and history of hypertension were significantly associated with CI. Disability (mRS > 2) rate was 42.9% among patients with CI, which was substantially higher than that among patients without (0.9%). In conclusion, the incidence of CI following clipping of UIAs was not low. Larger aneurysm size and history of hypertension were independent risk factors. Postoperative symptomatic stroke correlated with an extremely high risk of disability. Silent CI was seemingly nondisabling, but the possible cognitive consequence is pending.

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出版当年[2017]版
大类 | 4 区 医学
小类 | 3 区 外科 4 区 临床神经病学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 外科
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出版当年[2016]版:
Q2 SURGERY Q3 CLINICAL NEUROLOGY
最新[2023]版:
Q1 SURGERY Q2 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, People’s Republic of China [2]China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China [3]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People’s Republic of China [4]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, People’s Republic of China
通讯作者:
通讯机构: [1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, People’s Republic of China [2]China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China [3]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People’s Republic of China [4]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, People’s Republic of China
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