Infundibular dilations and subarachnoid hemorrhage - to treat or not to treat?

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Infundibular dilations and subarachnoid hemorrhage - to treat or not to treat?

World Neurosurg. 2018 Dec 18;:

Authors: Griffin AS, Oppong MD, Hauck EF

Abstract
BACKGROUND: Infundibular dilations are funnel-shaped widenings at the origin of a cerebral artery, most commonly the posterior communicating artery. Controversy exists as to whether an infundibulum represents a normal anatomic variant or a lesion with the potential for rupture and subarachnoid hemorrhage (SAH).
METHODS: We reviewed all reported cases of infundibular dilations and SAH in the world literature and present an illustrative case.
RESULTS: Most infundibula in the context of SAH were associated with an aneurysm either on or near an infundibulum. However, there have been 7 reports where the infundibulum could have been the primary site of rupture and no associated aneurysm was identified. Close review reveals significant limitations of those 7 reports.
CONCLUSION: The literature and our own experience do not support the treatment of infundibula, even in SAH patients. Treatment should be directed toward an associated aneurysm, not the infundibulum.

PMID: 30576822 [PubMed - as supplied by publisher]

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