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World Neurosurg. 2019 Jul;127:165-175. doi: 10.1016/j.wneu.2019.03.275. Epub 2019 Apr 4.

Intracranial Mirror Aneurysm: Epidemiology, Rupture Risk, New Imaging, Controversies, and Treatment Strategies.

Author information

1
Qingdao University, Qingdao, China.
2
Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao, China.
3
Wuhan University, Wuhan, China.
4
Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.
5
Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, China.
6
Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao, China. Electronic address: fengyugongqdu@163.com.

Abstract

There are some controversies about the surgical treatment strategy of mirror aneurysms. Whether to choose 1-stage or 2-stage surgery, bilateral or unilateral craniotomy, or surgical or interventional treatment are the main points in dispute. In this review, the different surgery strategies faced by patients are discussed. Different surgical methods are adopted based on the patient's individual state and the location and size of the aneurysm. A new imaging method is introduced using 3D Slicer, which clearly recognizes the relationship among aneurysm, brain tissue, skull, and nerve. The 3D Slicer can help surgeons undertake adequate preoperative preparation. In addition, we also introduce some ruptured factors (e.g., age, gender, hypertension, morphologic, and hemodynamic) concerning mirror aneurysm. Systematic discussion of the controversies and methods in surgical treatment of mirror aneurysms may provide new perspectives in future research for the prevention and treatment of mirror aneurysms.

KEYWORDS:

3D Slicer; Management; Mirror aneurysms; Rupture

PMID:
30954748
DOI:
10.1016/j.wneu.2019.03.275

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