XXXX and management options in the endovascular era.

@entity1 @entity510 @entity6128 @entity439 @entity397 @entity2849 @entity438
UNASSIGNED: @entity6128 (ACA) @entity2849 are a challenge to manage. Difficult diagnosis, delayed presentation and catastrophic outcomes contribute to the overall prognosis of traumatic @entity438 . Clipping or coiling of the @entity439 and/or parent vessel occlusion are the treatment options. However, surgery and coiling both may be difficult due to limited access and the need for parent vessel preservation. Rarely, these @entity439 must be managed conservatively. We present four @entity1 with @entity438 admitted to our center in the last 10months. Three @entity1 had @entity2849 of the distal ACA and one had an @entity439 arising from a cortical branch of the ACA. Their clinical presentations and management, along with outcomes, are discussed as well as the dilemmas associated with them. Three @entity1 were managed by clipping and coiling while one was managed conservatively. The diagnosis was made relatively early in three @entity1 while delayed @entity510 led to diagnosis in the fourth. Although the overall prognosis remains grim, with high mortality and morbidity rates, both microsurgical and interventional management of these @entity439 may be useful, if detected early before @entity397 . Expectant management and surveillance may be required in a select group of @entity1 .
