Psychological Wellbeing of Elders as a Function of Religious Involvement, Spirituality and Personal Meaning in Life

Abstract

PURPOSE: Blood Blister-Like (BBL) Aneurysms of the supraclinoid Internal Carotid Artery (ICA) are rare and extremely dangerous lesions. According to pathological studies, these aneurysms seem to be dissecting in origin. The purpose of our study was to analyze the angiographic findings treatment and outcome in these lesions. METHODS: 14 patients presenting with subarachnoid hemorrhage due to a BBL aneurysm were included in the study. There were 12 women and 2 men ranging in age from 20 to 67 years (mean age: 41.5 ys.). Eight patients were treated by endovascular approach (coiling in 1 patient, ballon-assisted coiling in 3, stenting/coiling in 4), 4 patients were treated by surgery and in 2 patients the endovascular treatment was performed after failure of surgery. In 3 patients, repeated angiog- raphies showed changes of the aneurysm morphology. RESULTS: Good clinical and anatomic results were obtained in 6 patients (endovascular treatment in 4 and surgical in 2). Good clinical outcome was observed in 2 patients despite residual lesion. Mild/ poor clinical outcome in 3 patients. Three patients died. In 2 patients, angiography after treatment (1 endovascular /1 surgical) showed progression of dissecting phenomena. CONCLUSION: The optimum treatment of BBL aneurysms is still not known. Despite different therapeutic strategies, these lesions are often associated with high morbidity and mortality rates. Limitations of the endovascular treatment, including stenting and parent artery occlusion, are also due to acute hemorrhagic presentation. Better understanding and careful analysis of these lesions is needed in order to improve clinical and angiographic results.