• World Neurosurg · Mar 2019

    Review

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

    • Andrew S Griffin, Oppong Marvin Darkwah MD Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA., and Erik F Hauck.
    • Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA. Electronic address: Andrew.s.griffin@duke.edu.
    • World Neurosurg. 2019 Mar 1; 123: 188-192.

    BackgroundInfundibular 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).MethodsWe reviewed all reported cases of infundibular dilations and SAH in the world literature and present an illustrative case.ResultsMost infundibula in the context of SAH were associated with an aneurysm either on or near an infundibulum. However, there have been 7 reports in which 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.ConclusionsThe 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.Copyright © 2018 Elsevier Inc. All rights reserved.

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