Journal of Korean Society of Geriatric Neurosurgery 2018;14(1):34-40.
Published online June 30, 2018.
The Clinical Implication of Internal Carotid Artery Calcification in the Ruptured Supraclinoid Internal Carotid Artery Aneurysms
Hah Yong Mun1 , Ki-Su Park3 , Taek-Kyun Nam1 , Yong-Sook Park1 , Jeong-Taik Kwon1 , Woong Jae Lee2 , Jun Soo Byun2
Departments of 1Neurosurgery and 2Radiology Chung-Ang University College of Medicine, Seoul,3Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
Abstract
Objective
The clinical significance of internal carotid artery calcification (ICAC) in intracranial aneurysms remains unknown. The Purpose of this study was to investigate the clinical implication of ICAC in ruptured supraclinoid internal carotid artery (ICA) aneurysms in terms of clinical, aneurysmal characteristics and surgical limitation.
Methods
Between 2005 and 2016, 73 out of 122 patients with ruptured supraclinoid ICA aneurysms who underwent surgery were enrolled. They were categorized into no ICAC (0 point), mild ICAC (1 and 2 points), and severe ICAC (3 and 4 points) groups according to ICAC scores on the basis of computed tomography.
Results
Severity of ICAC by group was correlated with older age (p<0.001) and hypertension (p=0.014). Based on an initial brain CT, patients with severe ICAC showed the lowest modified Fisher scale (p=0.021). And, they showed better neurologic status at admission according to the Glasgow Coma Scale (p=0.008) and Hunt and Hess scale (p=0.048), and also revealed better discharge performance status according to the modified Rankin scale (p=0.032). Additionally, 7 out of 8 patients with severe ICAC (87.5%) showed the failures of temporary clip application (p<0.001). However, there was no statistical significance among three groups in terms of aneurysmal characteristics.
Conclusion
Severe ICAC might have a possible relationship with clinical presentations and a surgical limitation in ruptured supraclinoid ICA aneurysms, but further studies should be considered to investigate any positive correlation between ICAC and aneurysm characteristics.
Key Words: Internal carotid artery, Calcification, Ruptured aneurysm, Surgery


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