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Reliability of Bony Landmarks to Predict Intradural Location of Paraclinoid Aneurysms

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Abstract

Purpose

When dealing with paraclinoid carotid aneurysms, the distinction between intradural and extradural location is a major component for decision-making as only intradural aneurysms carry a risk of subarachnoid hemorrhage (SAH). The aim of this study was to test the accuracy and reliability of computed tomography (CT) bony landmarks for the distinction between intradural and extradural paraclinoid aneurysms.

Methods

All patients referred to this institution for a single paraclinoid aneurysm were retrospectively identified. The study included only the patients who presented with diffuse SAH, thus proving the intradural location of the aneurysm. The preoperative images were assessed by two physicians in order to locate the aneurysms using the tuberculum sellae (TS) and the optic strut (OS) landmarks.

Results

A total of 15 patients were included in the study. There were 4 cases (27%) of disagreement with the OS bony landmark and no cases of disagreement with the TS landmark. No aneurysm was consensually considered as extradural by both readers with both bony landmarks; however, five aneurysms (33%) were considered to be extradural by at least one of the physicians with at least one of the two bony landmarks.

Conclusion

The results of the study showed several disagreements when using the OS landmark. More importantly, several aneurysms were considered as extradural with at least one of these two CT bony landmarks, even though they were all associated with an SAH. More reliable and accurate landmarks are warranted.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Neurosurgery Department, Rothschild Foundation Hospital, 75019, Paris, France

    Etienne Lefevre, Caroline Apra & Dorian Chauvet

  2. Interventional Neuroradiology Department, Rothschild Foundation Hospital, 75019, Paris, France

    Etienne Lefevre, Salomao Faroj Chodraui-Filho, Stanislas Smajda, Michel Piotin & Robert Fahed

Authors
  1. Etienne Lefevre
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  2. Caroline Apra
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  3. Salomao Faroj Chodraui-Filho
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  4. Dorian Chauvet
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  5. Stanislas Smajda
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  6. Michel Piotin
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  7. Robert Fahed
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Corresponding author

Correspondence to Etienne Lefevre.

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Conflict of interest

E. Lefevre ORCID0000-0002-3055-996X, C. Apra, S.F. Chodraui-Filho, D. Chauvet, S. Smajda, M. Piotin and R. Fahed report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Additional information

The corresponding author (EL) has full access to all the data in the study and has final responsibility for the decision to submit for publication.

The manuscript has not been submitted elsewhere or published elsewhere in whole or in part.

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Lefevre, E., Apra, C., Chodraui-Filho, S.F. et al. Reliability of Bony Landmarks to Predict Intradural Location of Paraclinoid Aneurysms. Clin Neuroradiol 30, 843–848 (2020). https://doi.org/10.1007/s00062-020-00896-0

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  • DOI: https://doi.org/10.1007/s00062-020-00896-0

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