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Journal of Cerebrovascular and Endovascular Neurosurgery

Devendra Pal Singh, Soon Chan Kwon, Lijin Huang, Won Joo Lee
Migration of coils during endovascular procedures is a rare, but well-known complication. We are reporting two cases of successfully retrieving migrated coil using detachable intracranial stent. In both of our cases there was distal migration of coil during the intracranial aneurysm coiling procedure. The Solitaire® AB stent (Covidien, Irvine, CA, USA) was used to retrieve those coils. The stent was passed distal to the migrated coil using standard technique. It was then partially deployed and gradually withdrawn along with the entangled coil...
March 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
Travis C Hill, Omar Tanweer, Cheddhi Thomas, John Engler, Maksim Shapiro, Tibor Becske, Paul P Huang
Rupture of isolated posterior spinal artery (PSA) aneurysms is a rare cause of subarachnoid hemorrhage (SAH) that presents unique diagnostic challenges owing to a nuanced clinical presentation. Here, we report on the diagnosis and management of the first known case of an isolated PSA aneurysm in the context of leukocytoclastic vasculitis. A 53-year-old male presented to an outside institution with acute bilateral lower extremity paralysis 9 days after admission for recurrent cellulitis. Early magnetic resonance imaging was read as negative and repeat imaging 15 days after presentation revealed SAH and a compressive spinal subdural hematoma...
March 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
Shigeyuki Sakamoto, Masaaki Shibukawa, Itaru Tani, Shuichi Oki, Kaoru Kurisu
We describe a case of successful open-cell stent deployment across the wide neck of a large middle cerebral artery aneurysm using the stent anchor technique. A microcatheter was looped through the aneurysm and navigated into a distal vessel across the aneurysm neck. Although the loop of the microcatheter in the aneurysm straightened as it was gently withdrawn, the microcatheter again protruded into the aneurysm by open-cell stent navigation. The stent was partially deployed in a vessel distal to the aneurysm neck, withdrawn slowly to straighten the loop of the microcatheter in the aneurysm, and completely deployed across the aneurysm neck...
March 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
Sangwoo Ha, Jaeho Kim, Chong-Gue Kim, Suk Jung Jang
Behçet's disease is an inflammatory disorder involving multiple organs. Its cause is still unknown, but vasculitis is the major pathologic characteristic. The common vascular lesions associated with Behçet's disease are aneurysm formation, arterial or venous occlusive diseases, and varices. Arterial aneurysms mostly occur in large arteries. Intracranial aneurysms hardly occur with Behçet's disease. We would like to present a 41-year-old female patient with Behçet's disease who showed symptoms of severe headache due to subarachnoid hemorrhage...
March 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
Jun Hak Kim, Si-Un Lee, Choonwoong Huh, Chang Wan Oh, Jae Seung Bang, Tackeun Kim
A man visited the emergency room with a headache. Brain computed tomography showed aneurysmal subarachnoid hemorrhage (SAH) and multiple aneurysms. After aneurysm clipping surgery, the patient was discharged. After 5 days, he was admitted to the hospital with skin ulceration and was diagnosed with Behcet syndrome. An angiogram taken 7 weeks after aneurysmal SAH showed intracranial vasospasm. Because inflammation in Behcet syndrome may aggravate intracranial vasospasm, intracranial vasospasm after aneurysmal SAH in Behcet syndrome should be monitored for longer compared to general aneurysmal SAH...
March 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
Si On Kim, Yeon Gu Chung, Yu Sam Won, Myung Ho Rho
For securing large, giant, and wide-neck aneurysms, conventional coil embolization has substantial limitations, such as incomplete occlusion, recanalization, and a high recurrence rate. To overcome these limitations, a novel paradigm was suggested and, as a result, flow-diverting device was developed. The flow-diverting device is an innovative and effective technique to allow securing of large, giant, and wide-neck aneurysms. In numerous studies, the flow-diverting device has shown better outcomes than coil embolization...
March 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
Matthew R Fusco, Mohamed M Salem, Bradley A Gross, Arra S Reddy, Christopher S Ogilvy, Ekkehard M Kasper, Ajith J Thomas
OBJECTIVE: Preoperative endovascular embolization of intracranial tumors is performed to mitigate anticipated intraoperative blood loss. Although the usage of a wide array of embolic agents, particularly polyvinyl alcohol (PVA), has been described for a variety of tumors, literature detailing the efficacy, safety and complication rates for the usage of Onyx is relatively sparse. MATERIALS AND METHODS: We reviewed our single institutional experience with pre-surgical Onyx embolization of extra-axial tumors to evaluate its efficacy and safety and highlight nuances of individualized cases...
March 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
Yuhee Kim, Chan-Jong Yoo, Cheol Wan Park, Myeong Jin Kim, Dae Han Choi, Yeon Jun Kim, Kawngwoo Park
OBJECTIVE: To select a surgical approach for aneurysm clipping by comparing 2 approaches. MATERIALS AND METHODS: 204 patients diagnosed with subarachnoid hemorrhage treated by the same neurosurgeon at a single institution from November 2011 to October 2013, 109 underwent surgical clipping. Among these, 40 patients with Hunt and Hess or Fisher grades 2 or lower were selected. Patients were assigned to Group 1 (supraorbital keyhole approach) or Group 2 (modified supraorbital approach)...
March 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
Dale Ding
No abstract text is available yet for this article.
December 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Won Ho Cho, Hyuk Jin Choi, Kyoung Hyup Nam, Jae Il Lee
Contrast extravasation on computed tomography angiography (CTA) is rare but becoming more common, with increasing use of CTA for various cerebral vascular diseases. We report on two cases of spontaneous subarachnoid hemorrhage (SAH) in which the CTA showed an upper basilar trunk saccular lesion suggesting ruptured aneurysm. However, immediate subsequent digital subtraction angiography (DSA) failed to show a vascular lesion. In one case, repeated follow up DSA was also negative. The patient was treated conservatively and discharged without any neurologic deficit...
December 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Christina Huang Wright, James Wright, Anish Badjatiya, Sunil Manjila, Steven Reed, Robert Geertman
Pseudoaneurysms of the superficial temporal artery are rare and may be treated by manual compression, surgical intervention, coil embolization, or percutaneous thrombin injection. We present a novel technique of local ultrasound guided low-profile coil embolization of the superficial temporal artery with both satisfactory cosmetic and surgical results.
December 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Hae Woong Jeong, Won-Bae Seung
OBJECTIVE: This retrospective study presents our experience with respect to the clinical and angiographic outcomes of patients treated with stent-assisted coil embolization using Solitaire™ AB stents. MATERIALS AND METHODS: From March 2011 to December 2014, 50 patients with 55 wide-necked and/or complex intracranial aneurysms were evaluated. Four patients presented with an acute subarachnoid hemorrhage. Stent deployment was performed with a standard coiling procedure in 49 aneurysms...
December 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Omar Tanweer, Stephen P Kalhorn, Jamaal T Snell, Taylor A Wilson, Bryan A Lieber, Nitin Agarwal, Paul P Huang, Kenneth M Sutin
Intracranial hypotension (IH) can occur following lumbar drainage for clipping of an intracranial aneurysm. We observed 3 cases of IH, which were all successfully treated by epidural blood patch (EBP). Herein, the authors report our cases.
December 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Hae Woong Jeong, Sung-Chul Jin
OBJECTIVE: Based on the use of Nano™ coils, we retrospectively compared the proportion of the coils (≤ 1.5 mm) and packing density in two patient groups with small cerebral aneurysms (< 4 mm diameter) who were treated with or without Nano™ coils. MATERIALS AND METHODS: Between January 2012 and November 2013, in 548 cerebral aneurysms treated by endovascular coiling, 143 patients with 148 small cerebral aneurysms underwent endovascular coiling. After March 2013, coiling with Nano™ coils was performed on 45 small cerebral aneurysms (30...
December 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Gwang-Jin Lee, Ki-Seong Eom, Cheol Lee, Dae-Won Kim, Sung-Don Kang
OBJECTIVE: Unruptured intracranial aneurysms are now being detected with increasing frequency in clinical practice. Results of the largest studies, including those of the International Study of Unruptured Intracranial Aneurysms, indicate that surgical and endovascular treatments are rarely justified in small aneurysms. However, we have encountered several cases of rupture of small and very small aneurysms in our clinical practice. This retrospective study analyzed the incidence and clinical characteristics of very small ruptured aneurysms...
September 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Se Hun Chang, Hee Sup Shin, Seung Hwan Lee, Hak Cheol Koh, Jun Seok Koh
OBJECTIVE: Early rebleeding after coil embolization of ruptured intracranial aneurysms is rare, however serious and fatal results of rebleeding have been reported. We studied the incidence and angiographic and clinical characteristics of rebleeding of ruptured aneurysms occurring in the immediate postoperative period after coil embolization. MATERIALS AND METHODS: We analyzed patients who had aneurysmal subarachnoid hemorrhage and underwent coil embolization. Patients with dissecting aneurysms, blood blister-like aneurysms, fusiform aneurysms, and pseudoaneurysms were excluded...
September 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Gun-Ill Lee, Kyu-Sun Choi, Myung-Hoon Han, Hyoung-Soo Byoun, Hyeong-Joong Yi, Byung-Ro Lee
OBJECTIVE: Terson's syndrome, a complication of visual function, has occasionally been reported in patients with aneurysmal subarachnoid hemorrhage (SAH), however the factors responsible for Terson's syndrome in aneurysmal SAH patients have not yet been fully clarified. In this study, we report on potential risk factors for prediction and diagnosis of Terson's syndrome in the earlier stage of the disease course in patients with aneurysmal SAH. MATERIALS AND METHODS: The authors retrospectively analyzed the data of 322 consecutive patients who suffered from aneurysmal SAH in a single institution between Jan...
September 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Seon Jin Yoon, Jin-Yang Joo, Yong Bae Kim, Chang-Ki Hong, Joonho Chung
OBJECTIVE: Routine use of prophylactic antiepileptic drugs (AED) has been debated. We retrospectively evaluated the effects of prophylactic AED on clinical outcomes in patients with a good clinical grade suffering from aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS AND METHODS: Between September 2012 and December 2014, 84 patients who met the following criteria were included: (1) presence of a ruptured aneurysm; (2) Hunt-Hess grade 1, 2, or 3; and (3) without seizure presentation...
September 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Su Yong Choi, Chan Jong Yoo, Jin Yook Kim, Myeong Jin Kim
The approach to ethmoidal dural arteriovenous fistulas (eDAVFs) is usually via a pterional or a frontal craniotomy. However, the transfrontal sinus is a more direct route to the fistula. The aim of this report is to describe our experience and associated complications occurring as a result of flow diversion in the transfrontal sinus approach for eDAVFs. In this report, we discuss visual field defects occurring after a transfrontal sinus operation. This approach is most direct for surgical treatment of an eDAVF, enabling preservation of neural structures with minimal to no negative effects on the brain...
September 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Won-Hyung Kim, Dong-Jun Lim, Jong-Il Choi, Sung-Kon Ha, Sang-Dae Kim, Se-Hoon Kim
Cerebral cavernous malformations (CMs) are vascular malformations of the central nervous system, which can be detected in the absence of any clinical symptoms. Nodules and cysts with mixed signal intensity and a peripheral hemosiderin rim are considered brain magnetic resonance imaging (MRI) findings typical of CMs. A 48-year-old man was admitted to our hospital because of abnormal MRI findings without significant neurological symptoms. A cyst with an internal fluid-fluid level was found in the left basal ganglia on the initial brain MRI...
September 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
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