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Fifty-four symptomatic patients were identified.Group 1(n=19;mean aneurysm diameter,2.1 cm)had acute symptoms;ischemia(n=7),headache(n=7),seizure(n= 3),and cranial neuropathy(n=2).Group 2(n=35;mean aneurysm diameter,2.2 cm) had chronic symptoms attributed to mass effect:headache(n=18),visual loss (n=10),pyramidal tract dysfunction(n=4),and facial pain(n=3).Group 3(n=57; mean aneurysm diamter,1.1 cm)had asymptomatic aneurysms.Acute severe headache,comparable to subarachnoid hemorrhage headache,but without nuchal rigidity,was associated with the folowing mechanisms:aneurysm thrombosis, localized meningeal inflammation,and unexplained.Unruptured aneurysms may be misdiagnosed as optic neuritis or migraine,or serve as a nidus for cerebral thromboembolic events.Internal carotid artery and posterior circulation aneurysms were more likely to cause focal symptoms from mass effect than were anterior cerebral artery and middle cerebral artery aneurysms.Weeks to years may elapse before diagnosis.The absence of subarachniod blood does not exclude an aneurysm as a cause for acute or chronic neuro-logic symptoms. |
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aneurysm
aneurysm,asymptomatic
aneurysm,intracranial
aneurysm,unruptured
headache
headache,severe
misdiagnosis
neurologic symptoms
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