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Growth-mechanism of giant intracranial aneurysms; demonstration by CT and MR imaging

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Summary

In four cases of giant intracranial aneurysm, CT demonstrated a hyperdense open-, or closed-ring structure at the periphery of the aneurysm. Surgery in two of the cases demonstrated that this peripheral hyperdensity represents fresh clot inside the wall of the thrombosed mass. An analogy is established between giant intracranial aneurysms, chronic subdural hematomas and growing encapsulated intracerebral hematomas. The common feature of the three entities is slow growth by recurrent hemorrhages into the lesion. It is proven that growth of chronic subdural hematomas and of growing encapsulated hematomas is related to recurrent hemorrhage from capillaries sprouting within the membrane of the lesion. The highly vascularized membranous wall of a giant intracranial aneurysm seems to behave like the membrane of a chronic subdural hematoma. It is suggested that the giant intracranial aneurysm grows by recurrent hemorrhage into its wall and behaves like growing encapsulated hematomas.

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References

  1. Aoki N, Mizuguchi K (1984) Chronic encapsulated intracerebellar hematoma in infancy: Case report. Neurosurgery 14: 594–597

    Google Scholar 

  2. Aoki N, Mizuguchi K (1986) Expanding intracerebellar hematoma: A possible clinicopathological entity. Neurosurgery 18: 94–96

    Google Scholar 

  3. Artmann H, Vonofakos D, Müller H, Grau H (1984) Neuroradiologic and neuropathologic findings with growing giant intracranial aneurysm. Surg Neurol 21: 391–401

    Google Scholar 

  4. Crawford T (1959) Some observations on the pathogenesis and natural history of intracranial aneurysms. J Neurol Neurosurg Psychiatry 22: 259–266

    Google Scholar 

  5. Du Boulay GH (1965) Some observations on the natural history of intracranial aneurysms. Br J Radiol 38: 721–757

    Google Scholar 

  6. Ferguson GG (1972) Physical factors in the initiation, growth, and rupture of human intracranial saccular aneurysms. J Neurosurg 37: 666–677

    Google Scholar 

  7. Friede RL, Schachenmayr W (1978) The origin of subdural neomembranes. Am J Pathol 92: 69–84

    Google Scholar 

  8. Hirsch LF, Spector HS, Bogdanoff BM (1981) Chronic encapsulated intracerebral hematoma. Neurosurgery 9: 169–172

    Google Scholar 

  9. Jain KK (1963) Mechanism of rupture of intracranial saccular aneurysms. Surgery 54: 347–350

    Google Scholar 

  10. Pinto RS, Kricheff II, Butler AR, Murali R (1979) Correlation of computed tomographic, angiographic and neuropathological changes in giant cerebral aneurysms. Radiology 132: 85–92

    Google Scholar 

  11. Reid JD, Kommareddi S, Lankerani M, Park MD (1980) Chronic expanding hematomas. A clinicopathologic entity. J Am Med Assoc 244: 2441–2442

    Google Scholar 

  12. Sarwar M, Batnitzky S, Schechter MM (1976) Tumorous aneurysms. Neuroradiology 12: 79–97

    Google Scholar 

  13. Sarwar M, Batnitzky S, Schechter MM, Liebeskind A, Zimmer AE (1976) Growing intracranial aneurysms. Radiology 120: 603–607

    Google Scholar 

  14. Sato S, Suzuki J (1975) Ultrastructural observations of the capsule of chronic subdural hematoma in various clinical stages. J Neurosurg 43: 569–578

    Google Scholar 

  15. Schubiger O, Valavanis A, Hayek J (1980) Computed tomography in cerebral aneurysms with special emphasis on giant intracranial aneurysms. J Comput Assist Tomogr 4: 24–32

    Google Scholar 

  16. Suzuki J, Ohara H (1978) Clinicopathological study of cerebral aneurysms. Origin, rupture, repair, and growth. J Neurosurg 48: 505–514

    Google Scholar 

  17. Terada T, Okuno T, Moriwaki H, Nakai E, Komai N (1985) Chronic encapsulated intracerebral hematoma during infancy: Case report. Neurosurgery 16: 833–835

    Google Scholar 

  18. Yamashima T, Yamamoto S, Friede R (1983) The role of endothelial gap junctions in the enlargement of chronic subdural hematomas. J Neurosurg 59: 298–303

    Google Scholar 

  19. Yasargil MG (1984) Microneurosurgery, vol II. Clinical considerations. Surgery of the intracranial aneurysms and results. Thieme, Stuttgart New York

    Google Scholar 

Download references

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Schubiger, O., Valavanis, A. & Wichmann, W. Growth-mechanism of giant intracranial aneurysms; demonstration by CT and MR imaging. Neuroradiology 29, 266–271 (1987). https://doi.org/10.1007/BF00451765

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