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Acta Neurochirurgica

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Open Access 01-12-2024 | Aneurysm | Original Article

Stability of infundibular dilatations: a single center follow-up study and systematic review of the literature

Authors: Jeremias Tarkiainen, Liisa Pyysalo, Tero Hinkka, Juha-Pekka Pienimäki, Antti Ronkainen, Juhana Frösen

Published in: Acta Neurochirurgica | Issue 1/2024

Abstract

Purpose

Although infundibular dilatations (IDs) have been thought to be benign anatomical variants, case reports suggest that they can grow and rupture. The aim of this study was to determine whether IDs have a tendency to grow or rupture.

Methods

The study population was collected from the Tampere University Hospital (TAUH) Aneurysm Database. The presence of IDs was screened from the medical records and imaging studies of 356 intracranial aneurysm patients left to follow-up from 2005 to 2020. The imaging studies were reviewed to confirm the IDs, and their clinical course. Finally, we performed a systematic review of published cases of ID leading to aneurysmatic rupture from PubMed.

Results

We found 97 typical IDs in 83 patients and 9 preaneurysmal lesions resembling ID in 9 patients. Out of the typical cone-shaped IDs, none grew or ruptured in a total follow-up of 409 patient-years. One preaneurysmal lesion ruptured during a follow-up: this lesion had components of both infundibular dilatation and aneurysm at the beginning of follow-up. In the systematic literature search, we found 20 cases of aneurysmatic SAHs originating from an ID. Of those, only 7 had imaging available prerupture. All 7 IDs were typically cone-shaped, but a branching vessel originating from the apex of ID was only seen in 4/7.

Conclusion

Typical infundibular dilatations seem to be benign anatomical variants that are stable and, thus, do not need prophylactic treatment or imaging follow-up. Likely, the SAHs reported from IDs were actually caused by misdiagnosed preaneurysmal lesions.

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Title: Stability of infundibular dilatations: a single center follow-up study and systematic review of the literature
Authors: Jeremias Tarkiainen
Liisa Pyysalo
Tero Hinkka
Juha-Pekka Pienimäki
Antti Ronkainen
Juhana Frösen
Publication date: 01-12-2024
Publisher: Springer Vienna
Keywords: Aneurysm
Aneurysm
Subarachnoid Hemorrhage
Subarachnoid Hemorrhage
Published in: Acta Neurochirurgica / Issue 1/2024
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-024-05890-w

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Springer Medicine

Stability of infundibular dilatations: a single center follow-up study and systematic review of the literature

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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