Recanalisation of cerebral artery aneurysms treated endovascularly — a midterm follow-up

Endovascular methods of aneurysm treatment, as an alternative to neurosurgical clipping, have proved a welcome opportunity to treat patients with unruptured aneurysms or those disqualified from neurosurgical intervention. This paper presents our own experience of endovascular treatment of cerebral aneurysms in 107 patients. It includes clinical and technical data from the perioperative period and a 12-month radiological follow-up of 78 patients. Method. Our retrospective evaluation covered patients with intracranial aneurysms treated endovascularly. The following were analysed: age, sex, neurological symptoms, and familial burden of intracranial aneurysm. Multivariate analysis was performed to determine independent factors of recanalisation of the cerebral aneurysm 12 months after embolisation. Results. The data of 107 patients at a mean age of 61 years [57.09 ± 14.27] treated with embolisation was analysed. The indication for intervention in 16 patients was subarachnoid haemorrhage; in the remaining 91 cases, aneurysms were revealed during diagnostic procedures for different symptoms or during imaging examinations. The intracranial segment of the internal carotid artery and the anterior communicating artery were the most common locations for aneurysms. After embolisation, subarachnoid haemorrhage occurred in one patient, ischaemic stroke in two patients, and one patient died because of acute circulatory insufficiency. The functional status of 94 patients on the day of discharge from the department (on days 4-21) was very good. 78 patients completed a 12-month follow-up period. In 11 of those, a follow-up MR angiography revealed recanalisation 12 months after the intervention. Except for one patient reporting vertigo, aneurysm recanalisation procedures were asymptomatic. The only independent risk factor for recanalisation was the size of aneurysm > 10 mm; OR 3.0; CI [1.15–7.83] p = 0.0255. Conclusions. Embolisation of cerebral aneurysms is a safe method with few perioperative complications, and most of these are mild and transient.The size of the aneurysm during qualification for embolisation is a risk factor for recanalisation in the subsequent 12 months. Recanalisation of embolised cerebral aneurysms concerns less than 20% of patients in a one-year follow-up and is most often asymptomatic

Obstetric and neonatal outcomes in women with epilepsy in Poland — a two-centre study

Aim of the study. To report pregnancy, delivery and perinatal outcomes in women with epilepsy seen in university clinics in Poland. Clinical rationale for the study. Women with epilepsy are reported to be at increased risk of adverse pregnancy and foetal outcomes.Materials and methods. The following data was collected in 171 pregnant women seen in two university epilepsy clinics: epilepsy characteristics and treatment, seizure frequency, pregnancy outcomes, perinatal outcomes, and feeding method.Results. The mean age of patients at the time of delivery was 28.8 years, and most women were nulliparous. Almost 80% of patients were on monotherapy and the majority were prescribed antiepileptic drugs with low teratogenic potential. 53.8% of patients were seizure-free during pregnancy. Half of the cohort delivered by caesarean section and the majority delivered in term. Nearly all newborns scored > 7 Apgar points. Major congenital malformation was diagnosed in only one foetus. Any adverse pregnancy/neonatal outcome was found in 13% of patients. Two thirds of women reported breastfeeding at any time.Conclusions and clinical implications. Almost 90% of women continued antiepileptic therapy during pregnancy. 46% of patients had epileptic seizures during pregnancy. Any adverse pregnancy/neonatal outcome was found in 13% of women with epilepsy. The majority of patients delivered healthy babies. Further studies are needed to find risk factors for adverse pregnancy/neonatal outcomes in women with epilepsy in Poland