"Misery Collaterals" as Poor Angiographic Findings - Definition, Classification, and Practical Application - = "Misery Collaterals" as Poor Angiographic Findings - Definition, Classification, and Practical Application -

다국어 초록 (Multilingual Abstract)

Objective : Unique Internal carotid artery angiographic findings have been found especially in very poor grade aneurysmal subarachnoid hemorrhage[SAH] patients before and during the endovascular coiling. The author investigates their patterns and classifies them into lour subtypes. Methods : Among Hunt&Hess grade IV, V SAH patients, the author could gather eight patients who showed abnormal intracranial circulation in cerebral catheter-based angiography. Results : The author introduces new term 'misery collaterals' first and has classified them into four types with the case illustrations. Type 1 is the worst condition defined as almost no intracranial circulation. Type 2 is the condition of little intracranial circulation with contrast filling just only at vessels of brain base, type 3 is of no or little cortical circulation with contrast filling at bilateral large vessels of brain base through circle of Willis channel and type 4 is of visible bilateral cortical circulation but delayed intracranial circulation time. The prognosis of these eight patients showed misery collaterals were disappointed. Conclusion : These finding can be used as the supportive information in deciding a management plan in poor grade SAH patients.

참고문헌 (Reference)

1 "The critical first minutes after subarachnoid hem-orrhage" 22 : 654-661, 1988

2 "Rupturedintracranial aneurysms:Acute endovascular treatment with electrolyti-cally detachable coils-a prospective randomized study" 211 : 325-336, 1999

3 "Risk of cerebral angiography in patientswith subarachnoid hemorrhage, cerebral aneurysm, and arteriovenousmalformation : a meta-analysis" 30 : 317-320, 1999

4 "Outcomeafter endovascular treatment of Hunt and Hess grade IV or V aneurysms:comparison of anterior versus posterior circulation" 30 : 2617-2622, 1999

5 "Low rate of complicationsof cerebral angiography in routine clinical practice" 57 : 2012-2014, 2001

6 "Indications for ca-theter based angiography of the cerebrovasculature" 16 : 241-248, 2005

7 "Impact of earlyendovascular aneurysmal occlusion on outcome of patients in poor gradeafter subarachnoid hemorrhage : a prospective, consecutive study" 9 : 648-652, 2002

8 "Endovascular treatment of Hunt and Hess grade IV and V aneurysms" 23 : 953-957, 2002

9 "Development of collaterals in the cerebral circulation" 28 : 183-189, 1991

10 "Comparative study of treatment results between surgicalneck clipping and endovascular coiling on the ruptured middle cerebralartery aneurysms" 35 : 178-182, 2004

11 "Collateral config-uration of the circle of Willis:transcranial color coded duplex ultrason-ography and comparison with postmortem anatomy" 31 : 1346-1351, 2000

12 "Collateral circulation" 34 : 2279-2284, 2003

13 "Assessmentof the collateral circulation of the circle of Willis:three dimensional time-of-flight MR angiography compared with transcranial color coded duplexsonography" 24 : 456-462, 2003

14 "Angiography in brain death" 7 : 25-28, 1974

15 "Angiographic assessment of cerebralcirculation time for outcome prediction in patients with subarachnoidhemorrhage" 62 : 115-120, 2004

16 "Aneurysmalsubarachnoid hemorrhage in patients with Hunt and Hess grade 4 or 5:treatment using the Guglielmi detachable coil system" 40 : September2006

17 "Anatomical studies of the circle ofWillis in normal brain" 81 : 409-418, 1959