4.3 Article

Coexistence of neurovascular compression syndrome and unruptured cerebral aneurysm

Journal

JOURNAL OF CLINICAL NEUROSCIENCE
Volume 105, Issue -, Pages 22-25

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.jocn.2022.08.021

Keywords

Unruptured cerebral aneurysm; Trigeminal neuralgia; Hemifacial spasm

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This study aimed to investigate the relationship between neurovascular compression syndrome (NVCS) and unruptured cerebral aneurysms (UCAs). The results showed that the prevalence of UCAs in NVCS patients was significantly higher than in the control group. Most UCAs associated with NVCS were small aneurysms and did not rupture during the course of NVCS treatment.
Unruptured cerebral aneurysms (UCAs) are usually asymptomatic and detected incidentally by intracranial examinations. The coexistence of neurovascular compression syndrome (NVCS) and UCAs has not been well described. The aim of this study was to clarify the characteristics of UCAs with the NVCS. A total of 103 cases that underwent microvascular decompression (MVD) for trigeminal neuralgia (TN) or hemifacial spasm (HFS) were assigned to the NVCS group. The prevalence of UCAs in the NVCS group was compared retrospectively to that in 110 control cases (a control group) by neuro-imaging. Overall treatment courses for NVCS and UCAs were investigated in the NVCS group. Sixteen (15.3%; TN 11 cases, HFS 5 cases) of 103 MVD cases had 19 UCAs, a significantly higher prevalence than the 3.6% in the control group. Binomial logistic regression showed that NVCS is a significant factor for predicting the presence of UCAs, with an odds ratio of 4.80. In the NVCS group, 18 UCAs (94.7%) were supratentorial aneurysms, and 17 UCAs (89.5%) were less than 5 mm in size. Nine UCAs were surgically treated with clipping or coiling. Of the surgical cases, 2 UCAs were treated before MVD for NVCS, whereas the other 7 UCAs were treated after MVD. No aneurysms ruptured during the treatment course. The NVCS occurred with UCAs at a significantly higher rate than in the control group. Most UCAs with the NVCS were supratentorial, small aneurysms that did not affect the surgical treatment of NVCS.

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