Pol J Radiol. 2010 Oct;75(4):24-9.
MR spectroscopy in patients after surgical clipping and endovascular embolisation of intracranial aneurysms.
Polish journal of radiology
Eugeniusz Tarasów, Jan Kochanowicz, Joanna Brzozowska, Zenon Mariak, Jerzy Walecki
Affiliations
Affiliations
- Radiology Department, Medical University of Bialystok, Bialystok, Poland.
PMID: 22802800
PMCID: PMC3389888
Abstract
BACKGROUND: In MR spectroscopy, we evaluated cerebral metabolic changes in patients 2-4 years after clipping or endovascular therapy of intracranial aneurysms. MATERIAL/METODHS: A prospective study was conducted in 36 patients after SAH, treated surgically (n=23) or by endovascular embolisation (n=13). Control group consisted of 20 healthy volunteers. The clinical evaluation was based on the Glasgow Coma Scale, Hunt and Hess grade, and Glasgow Outcome Scale. MR spectroscopy was performed with 1.5T system with PRESS sequence, at echo time of 35 ms, in frontal lobes unchanged in MR examination. Ratios of N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI) and glutamine/glutamate complex (Glx) to creatine were assessed.
RESULTS: Only a slight, statistically insignificant reduction of NAA/Cr and an insignificant increase of mI/Cr were noted; other metabolite ratios were close to the ones in the control group. Similar results were obtained in patients after surgical clipping and after endovascular therapy. Only in patients with aneurysms of anterior communicating artery complex (AcoA), the NAA/Cr ratio showed a significant reduction as compared to that of non-AcoA patients and of the control group. No significant changes of metabolite ratios were found in patients with internal carotid artery (ICA) and middle cerebral artery (MCA) aneurysms, with regard to aneurysm lateralisation.
CONCLUSIONS: Surgical clipping and endovascular embolisation of ICA, MCA and posterior circulatory aneurysms do not induce changes in metabolite concentration in frontal lobes assessed in MR spectroscopy. In patients with AcoA aneurysms, 2-4 years after obliteration, there were found persistent metabolic changes in unchanged brain tissue of the frontal lobes, corresponding to neuronal damage (dysfunction).
Keywords: MR spectroscopy; clipping; embolisation; intracranial aneurysms
References
- Neurosurgery. 2009 Mar;64(3):412-20; discussion 421-2 - PubMed
- Lancet. 1999 Nov 6;354(9190):1594-7 - PubMed
- Stroke. 2005 Jan;36(1):142-3 - PubMed
- Brain. 2000 Feb;123 ( Pt 2):205-21 - PubMed
- Stroke. 2009 Jan;40(1):129-33 - PubMed
- No Shinkei Geka. 2000 Aug;28(8):691-8 - PubMed
- Lancet. 1975 Mar 1;1(7905):480-4 - PubMed
- J Neurosurg. 2009 Jan;110(1):19-29 - PubMed
- Surg Neurol. 1999 Feb;51(2):132-8; discussion 138-9 - PubMed
- Acta Neurochir (Wien). 2003 Oct;145(10):867-72; discussion 872 - PubMed
- J Neurosurg. 2002 Sep;97(3):531-6 - PubMed
- Neurosurgery. 2006 Apr;58(4):612-8; discussion 612-8 - PubMed
- Zentralbl Neurochir. 2007 Nov;68(4):169-75 - PubMed
- J Neurol Neurosurg Psychiatry. 1998 Jan;64(1):98-103 - PubMed
- Lancet. 1974 Jul 13;2(7872):81-4 - PubMed
- J Neurosurg. 1968 Jan;28(1):14-20 - PubMed
- Surg Neurol. 2003 Apr;59(4):269-75; discussion 275-6 - PubMed
- Proc Natl Acad Sci U S A. 1994 Mar 1;91(5):1903-7 - PubMed
- Neurosurgery. 2006 Aug;59(2):319-25; discussion 319-25 - PubMed
- Lancet. 2002 Oct 26;360(9342):1267-74 - PubMed
- J Neurosurg. 2003 Feb;98(2):319-25 - PubMed
- Acta Neurochir (Wien). 2006 Aug;148(8):821-30; discussion 830 - PubMed
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