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Quantifying unruptured giant intracranial aneurysms by measuring diameter and volume—a comparative analysis of 69 cases

  • Clinical Article - Vascular
  • Published:
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Abstract

Background

Intracranial aneurysms (IA) are usually quantified according to their largest diameter. However, volumetry has recently been increasingly conducted as well, especially in giant intracranial aneurysms (GIAs). Since so far the true value of GIA volumetry is unknown, we designed a trial to examine correlations between GIA diameter and volume with special focus on clinical implications.

Methods

Magnetic resonance imaging of 69 unruptured GIAs in 66 patients was retrospectively evaluated. The largest diameter and volume were measured. Also, potential associations to the patients’ clinical conditions were examined.

Results

Comparing GIA sizes of our patient cohort produced different results depending on whether GIA diameter or volume was measured. Measuring the diameter identified posterior circulation GIAs as the largest ones (39.2 mm, IQR 37.3–48.3), while measuring the volume found GIAs of the MCA to be the largest ones (12.3 cm3, IQR 7.2–27.8). A correlation of GIA diameter and volume was only found in anterior circulation GIAs, which were predominantly saccular in shape, but not in those of the posterior circulation, of which most were fusiform. Neither GIA diameter nor GIA volume but only GIA location was associated with neurological deficits.

Conclusion

Diameter and volume measurements are not interchangeable modes of GIA quantification. Our data suggest that the idea of distinguishing different sizes of GIA may be clinically less relevant than examining their location, shape or mass effect.

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Acknowledgments

The Giant Intracranial Aneurysm Registry is funded by the Center for Stroke Research-Berlin. The grant number is “CS-2009-12”

Clinical Trial Registration-URL:

http://www.clinicaltrials.gov. Unique identifier: NCT02066493.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Charité-Universitaetsmedizin Berlin, Campus Virchow Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Germany

    Julius Dengler, Nicolai Maldaner & Peter Vajkoczy

  2. Service de Neurochirurgie, Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Geneva, Switzerland

    Philippe Bijlenga

  3. Department of Neurosurgery, University Hospital of Zurich, Zurich, Switzerland

    Jan-Karl Burkhardt

  4. Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany

    Alexander Graewe

  5. Department of Neurosurgery, University of Greifswald, Greifswald, Germany

    Susanne Guhl

  6. Department of Neurosurgery, Hannover Medical School, Hannover, Germany

    Makoto Nakamura

  7. Department of Neurosurgery, BG Hospital Bergmannstrost, Halle, Germany

    Christian Hohaus

  8. Department of Neurosurgery and Interventional Neuroradiology, Donau-Isar-Klinikum Deggendorf, Deggendorf, Germany

    Adisa Kursumovic

  9. Department of Neurosurgery, University Medical Center, Hamburg Eppendorf, Hamburg, Germany

    Nils Ole Schmidt

  10. Department of Neurosurgery, University of Regensburg, Regensburg, Germany

    Karl-Michael Schebesch

  11. Department of Neurosurgery, Technical University of Munich, Munich, Germany

    Maria Wostrack

  12. Department of Neurosurgery, Georg August University Goettingen, Goettingen, Germany

    Dorothee Mielke

Authors
  1. Julius Dengler
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  2. Nicolai Maldaner
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  3. Philippe Bijlenga
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  4. Jan-Karl Burkhardt
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  5. Alexander Graewe
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  6. Susanne Guhl
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  7. Makoto Nakamura
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  8. Christian Hohaus
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  9. Adisa Kursumovic
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  10. Nils Ole Schmidt
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  11. Karl-Michael Schebesch
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  12. Maria Wostrack
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  13. Peter Vajkoczy
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  14. Dorothee Mielke
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Consortia

on behalf of the Giant Intracranial Aneurysm Study Group

Corresponding author

Correspondence to Julius Dengler.

Additional information

Comment

This is a concise report on analyses of 2D diametric and volumetric measurement of intracranial giant aneurysms and their correlation with patients’ symptoms. Although this study does not alter in any way or shape the clinical management of those complex aneurysms, it shows the discrepancy between size and volume in posterior circulation giant aneurysms (most likely due to more fusiform shape) and the fact that location but not the size or volume is the only indicator of symptomatic aneurysms in this population.

Amir Dehdashti

NY,USA

No parts of this project have been presented anywhere before.

The Giant Aneurysm Study Group (November 2014)

The Giant Aneurysm Study Group (November 2014)

Vajkoczy P, Uebelacker A, Maldaner N, Dengler J

Department of Neurosurgery, Charité – Universitaetsmedizin Berlin

Endres M

Department of Neurology, Charité – Universitaetsmedizin Berlin

Bohner G, Wiener E, Bauknecht HC

Department of Neuroradiology, Charité – Universitaetsmedizin Berlin

Heuschmann PU, Malzahn U

Institute of Clinical Epidemiology and Biometry, University of Würzburg

Glaesker S, Zentner J, Van Velthoven V

Department of Neurosurgery, University Hospital Freiburg, Germany

Guhl S, Schroeder HWS

Department of Neurosurgery, University of Greifswald, Germany

Strowitzki M

Department of Neurosurgery, Trauma Center Murnau, Murnau, Germany

Etminan N, Haengghi D, Eicker S, Turowski B

Department of Neurosurgery, University of Düsseldorf, Germany

Schebesch KM, Brawanski A

Department of Neurosurgery, University of Regensburg, Germany

Wrede K, Sure U

Department of Neurosurgery, University of Essen, Germany

Schmidt NO, Regelsberger J, Westphal M

Department of Neurosurgery, University Medical Center, Hamburg Eppendorf, Germany

Mielke D, Rohde V

Department of Neurosurgery, Georg-August-University Goettingen, Germany

Hosch H, Moskopp D

Department of Neurosurgery Vivantes-Klinikum im Friedrichshain, Berlin, Germany

Joedicke A

Department of Neurosurgery Vivantes-Klinikum Neukoelln, Berlin, Germany

Hohaus C, Meisel HJ

Department of Neurosurgery, BG-Clinic Bergmannstrost, Halle, Germany.

Wostrack M, Meyer B, Lehmberg J

Department of Neurosurgery, Technical University of Munich, Germany

Musahl C, Hopf N

Department of Neurosurgery, Klinikum Stuttgart, Stuttgart, Germany

Winkler G, Spetzger U

Department of Neurosurgery, Klinikum Karlsruhe, Germany

Graewe A, Meier U

Department of Neurosurgery, Unfallkrankenhaus Berlin, Germany

Hong B, Nakamura M, Krauss J

Department of Neurosurgery, Hannover Medical School, Hannover, Germany

Grote A, Simon M, Schramm J

Department of Neurosurgery, University Hospital Bonn, Bonn, Germany

Kursumovic A, Rath SA

Department of Neurosurgery and Interventional Neuroradiology, Donau-Isar-Klinikum,

Deggendorf, Germany

Walter J, Kalff R

Department of Neurosurgery, Friedrich-Schiller-University, Jena, Germany

Marbacher S, Fathi A, Fandino J

Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland,

Familiari P, Raco A

Department of Neurosurgery, University of Rome “Sapienza”, Rome, Italy

Bijlenga P, Schaller K

Service de Neurochirurgie, Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland

Gruber A, Wang WT, Knosp E

Department of Neurosurgery, Medical University Vienna, Vienna, Austria

Hoffmann KT, Boxhammer E

Department of Neuroradiology, University of Leipzig, Leipzig, Germany

Rüfenacht DA

Department of Neuroradiology, Klinik Hirslanden, Zurich, Switzerland

Boccardi E, Piano M

Department of Neuroradiology, Ospedale Niguarda Ca’ Granda, Milano, Italy

Niemelä M, Nurminen V, Lehecka M, Hernesniemi J

Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland

Burkhardt JK, Bozinov O, Regli L

Department of Neurosurgery, University Hospital of Zurich, Switzerland

Shekhtman OD, Eliava SS

Burdenko Neurosurgical Institute, Russian Academy of Medical Sciences, Moscow, Russia

Kato N, Irie K, Nishimura K, Kaku S, Arakawa H, Yuki I, Ishibashi T, Murayama Y

Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan

Fiss I, Kombos T

Department of Spine Surgery and Neurosurgery, Helios Klinikum Hildesheim, Hildesheim, Germany

van der Zwan A, van Doormaal TP

Department of Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands

Cognard C, Gawlitza M

Department of Neuroradiology, Toulouse University Hospital, Toulouse, France

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Dengler, J., Maldaner, N., Bijlenga, P. et al. Quantifying unruptured giant intracranial aneurysms by measuring diameter and volume—a comparative analysis of 69 cases. Acta Neurochir 157, 361–368 (2015). https://doi.org/10.1007/s00701-014-2292-5

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  • DOI: https://doi.org/10.1007/s00701-014-2292-5

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