Intracranieel aneurysma

[:nl]

Intracraniële aneurysmata zijn ballonvormige uitstulpingen van een slagader die in de meeste gevallen te wijten zijn aan aangeboren zwaktes van de vaatwand.
Deze letsels kunnen worden gezien op speciale angiografische sequenties op CT of MRI. Voor een gedetailleerde evaluatie van de anatomie en de behandelingsmogelijkheden wordt een conventionele katheter angiografie (IADSA) uitgevoerd.
Aneurysmata produceren meestal geen symptomen en worden ontdekt als ze scheuren en hierdoor een subarachnoïdale bloeding veroorzaken. Ze kunnen echter ook “incidenteel” (bij toeval) worden ontdekt. Dit betekent dat een CT- of MRI werd gedaan voor een ander doel en het aneurysma werd waargenomen bij toeval. Wanneer een aneurysma wordt ontdekt als een incidentele bevinding dienen de risico’s van behandeling met die van de verwachte spontane loop te worden afgewogen.
In het Universitair Ziekenhuis Brussel hebben we alle behandelingsmogelijkheden voor intracraniële aneurysmata beschikbaar: Microchirurgische clipping en endovasculaire embolisatie. De optimale behandeling voor de patiënt wordt besproken op onze multidisciplinaire neurovasculaire tussen de neurochirurg en de interventionele neuroradioloog.
Microchirurgische clipping impliceert het maken van een kleine opening in de schedel (craniotomie) onder de microscoop en het uitschakelen van het aneurysma uit de circulatie door het plaatsen van een titanium clip. (BEELD).
Endovasculaire embolisatie wordt eveneens uitgevoerd onder algemene verdoving, hierbij wordt een katheter in de liesslagader ingebracht en onder controle met beeldvorming tot in hoofd gebracht. Vervolgens wordt het aneurysma gevuld met platina spiraaltjes.

[:en]

Intracranial aneurysms are balloon-like localized bulges of an artery that develop in the majority of cases due to congenital weakness of the vascular wall.

These lesions can be seen on special angiographic sequences in CT or MRI. For detailed evaluation of anatomy and treatment options a conventional catheter angiography is performed.

Aneurysms usually produce no symptoms and are discovered if they rupture and cause subarachnoid hemorrhage or they are detected “incidentally”. This means that a CT or MRI was done for another purpose and the aneurysm was seen by chance. If an aneurysm is discovered as an incidental finding, the risks of treatment compared with those of the expected spontaneous course must be weighed.

In the Universitair Ziekenhuis Brussels we have both available treatment options for intracranial aneurysms: Microsurgical clipping and endovascular coil embolization. The optimal treatment for the patient is discussed on our Neurovascular board meetings for incidental aneurysms and by direct communication between Neurosurgeon and interventional Neuroradiologist in the emergency case of ruptured aneurysms.

Microsurgical clipping means opening of the skull (craniotomy) under the microscope and excluding the aneurysm from the circulation by placing a titanium clip on its basis (BEELD).

Coil embolization is also performed under general anesthesia. A catheter is inserted into the femoral artery and advanced under fluoroscopic control into the head. Subsequently, the aneurysm is filled with platinum coils.

[:fr]

Intracranial aneurysms are balloon-like localized bulges of an artery that develop in the majority of cases due to congenital weakness of the vascular wall.

These lesions can be seen on special angiographic sequences in CT or MRI. For detailed evaluation of anatomy and treatment options a conventional catheter angiography is performed.

Aneurysms usually produce no symptoms and are discovered if they rupture and cause subarachnoid hemorrhage or they are detected “incidentally”. This means that a CT or MRI was done for another purpose and the aneurysm was seen by chance. If an aneurysm is discovered as an incidental finding, the risks of treatment compared with those of the expected spontaneous course must be weighed.

In the Universitair Ziekenhuis Brussels we have both available treatment options for intracranial aneurysms: Microsurgical clipping and endovascular coil embolization. The optimal treatment for the patient is discussed on our Neurovascular board meetings for incidental aneurysms and by direct communication between Neurosurgeon and interventional Neuroradiologist in the emergency case of ruptured aneurysms.

Microsurgical clipping means opening of the skull (craniotomy) under the microscope and excluding the aneurysm from the circulation by placing a titanium clip on its basis (BEELD).

Coil embolization is also performed under general anesthesia. A catheter is inserted into the femoral artery and advanced under fluoroscopic control into the head. Subsequently, the aneurysm is filled with platinum coils.

[:de]

Intracranial aneurysms are balloon-like localized bulges of an artery that develop in the majority of cases due to congenital weakness of the vascular wall.

These lesions can be seen on special angiographic sequences in CT or MRI. For detailed evaluation of anatomy and treatment options a conventional catheter angiography is performed.

Aneurysms usually produce no symptoms and are discovered if they rupture and cause subarachnoid hemorrhage or they are detected “incidentally”. This means that a CT or MRI was done for another purpose and the aneurysm was seen by chance. If an aneurysm is discovered as an incidental finding, the risks of treatment compared with those of the expected spontaneous course must be weighed.

In the Universitair Ziekenhuis Brussels we have both available treatment options for intracranial aneurysms: Microsurgical clipping and endovascular coil embolization. The optimal treatment for the patient is discussed on our Neurovascular board meetings for incidental aneurysms and by direct communication between Neurosurgeon and interventional Neuroradiologist in the emergency case of ruptured aneurysms.

Microsurgical clipping means opening of the skull (craniotomy) under the microscope and excluding the aneurysm from the circulation by placing a titanium clip on its basis (BEELD).

Coil embolization is also performed under general anesthesia. A catheter is inserted into the femoral artery and advanced under fluoroscopic control into the head. Subsequently, the aneurysm is filled with platinum coils.

[:]