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Journal of Cerebrovascular and Endovascular Neurosurgery

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https://www.readbyqxmd.com/read/28184353/spontaneous-regression-of-aneurysm-remnant-after-incomplete-surgical-clipping-in-a-patient-with-ruptured-cerebral-aneurysm
#1
Hyo Sub Jun, JunHyong Ahn, Joon Ho Song, In Bok Chang
Cases of spontaneous regression of cerebral aneurysm remnant after incomplete surgical clipping have been rarely reported. This paper reports the regression of an aneurysm remnant after incomplete surgical clipping during postsurgical follow-up. A 50-year-old male presented with subarachnoid hemorrhage because of rupture of an anterior communicating artery aneurysm. An emergency clipping of the aneurysm was performed. A cerebral angiography, which was performed two weeks postoperatively, revealed an aneurysm remnant...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28184352/spontaneous-aggressive-conversion-of-venous-drainage-pattern-in-dural-arteriovenous-fistula-treated-with-onyx-embolization
#2
Yeongu Chung, Seok Keun Choi, Sung Ho Lee, Eui Jong Kim
We report a case of dural arteriovenous fistula (DAVF) that showed spontaneous conversion of venous drainage pattern from Borden type II to type III within a four month period of follow-up. Upon admission, the patient presented with aggravated neurologic status and newly developed seizure. After admission, endovascular embolization was performed through the middle meningeal artery with Onyx®. Complete obliteration of dural arteriovenous shunt was confirmed by angiography, and the patient's clinical symptoms improved...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28184351/spontaneous-absorption-of-cerebral-air-embolus-developed-accidentally-during-an-intra-arterial-procedure
#3
Tae Ki Yang
Cerebral arterial air embolism (CAAE), although infrequent, is a complication that can occur at any time during an invasive medical procedure. We experienced two cases of CAAE during cerebral angiography accidentally. The author reports the two cases of CAAE wherein air emboli dissolved spontaneously and immediately under normal atmospheric pressure, not under therapeutic hyperbaric environment. One of the cases shows entire dissolution of the air embolus on the moving image. This report shows that arterial air embolus can be absorbed spontaneously, and air embolus size is one of the factors that influence air embolus dissolution besides hyperbaric oxygen condition...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28184350/severe-cerebral-vasospasm-in-patients-with-hyperthyroidism
#4
Hyuk-Jin Oh, Seok-Mann Yoon, Jae-Sang Oh, Jai-Joon Shim, Hack-Gun Bae
Cerebral vasospasm associated with hyperthyroidism has not been reported to cause cerebral infarction. The case reported here is therefore the first of cerebral infarction co-existing with severe vasospasm and hyperthyroidism. A 30-year-old woman was transferred to our hospital in a stuporous state with right hemiparesis. At first, she complained of headache and dizziness. However, she had no neurological deficits or radiological abnormalities. She was diagnosed with hyperthyroidism 2 months ago, but she had discontinued the antithyroid medication herself three days ago...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28184349/serpentine-cavernous-aneurysm-presented-with-visual-symptoms-improved-by-endovascular-coil-trapping
#5
Myeong-Jin Oh, Dong-Seong Shin, Rady Se, Bum-Tae Kim
This report describes a case of a serpentine fusiform aneurysm of the internal carotid artery in a patient who presented with visual disturbances. The serpentine aneurysm was treated successfully by coil trapping and occlusion of the parent artery, accompanied by balloon dilation. Nine months post-operatively, the patient's visual acuity had improved considerably.
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28184348/refractory-spontaneous-chronic-subdural-hematoma-a-rare-presentation-of-an-intracranial-arteriovenous-fistula
#6
El Kim
The author has encountered a 67-year-old man with dural arteriovenous fistula (AVF) presenting as a non-traumatic chronic subdural hematoma (CSDH). This previously healthy patient was hospitalized due to progressive headache with subacute onset. He underwent burr-hole surgery twice for evacuating the left CSDH that was thickest at the posterior temporal area. The operative procedure and finding was not extraordinary, but subdural hematoma slowly progressed for days following the revision surgery. After investigation by super-selective external carotid angiography, a dural AVF found near the transverse-sigmoid sinus was diagnosed...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28184347/intra-arterial-thrombolysis-for-central-retinal-artery-occlusion-after-the-coil-embolization-of-paraclinoid-aneurysm
#7
Minwook Yoo, Sung-Chul Jin, Hae Yu Kim, Byeong-Sam Choi
The most common complication of coil embolization for cerebral aneurysms is thrombo-embolic stroke; in rare cases, these strokes, can present with central retinal artery occlusion. At our institution, a 53-year-old woman underwent stent-assisted coiling of the aneurysm. The patient's vision was improved immediately after intra-arterial thrombolysis and had further improved 8 months later. This report describes our experience of a rare case of central retinal artery occlusion after coil embolization that was successfully treated by intra-arterial thrombolysis...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28184346/the-interference-phenomenon-of-microcatheters-in-the-jailing-treatment-for-internal-carotid-artery-side-wall-aneurysms-with-an-open-cell-stent-system
#8
Minwook Yoo, Sung-Chul Jin, Seung-Hwan Kim, Byeong-Sam Choi, Hae Yu Kim, SungJun Lee, Sung Tae Kim, Hae Woong Jeong
OBJECTIVE: Excelsior XT-27 (Stryker Neurovascular, Fremont, CA, USA) or Rebar 27 (eV3 Covidien, Irvine, CA, USA) microcatheters have recently been used to overcome the limitations of the Renegade Hi-Flo microcatheter such as interference between two microcatheters (one for stent delivery and the other for cerebral aneurysm coiling) during the jailing technique. We evaluated differences and influential factors related to the interference phenomenon according to these two microcatheters group...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28184345/y-configuration-stent-assisted-coil-embolization-for-wide-necked-intracranial-bifurcation-aneurysms
#9
Kwangho Lee, Hyun Park, Insung Park, Sukh Que Park, O-Ki Kwon, Jongwoo Han
OBJECTIVE: The objective of this study was to determine the efficiency and safety of Y configuration stent-assisted coiling with double-closed stents for wide-necked intracranial aneurysms located at arterial bifurcations thorough analysis of a multicenter case series. MATERIALS AND METHODS: A retrospective chart review was done on 10 patients who underwent endovascular treatment of wide-necked intracranial aneurysms with Y-configuration stent-assisted coil embolization in three centers from August 2011 to March 2014...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847782/traumatic-pseudoaneurysm-related-to-calcified-nodules-of-cerebral-convexity-dura-mater-in-an-american-college-football-player
#10
Yoo Sung Jeon, Jong Gon Lee, Young Il Chun, Joon Cho, Woo Jin Choe
Repeated concussion is common among football players; however, these minor blunt head trauma rarely result in serious complications. We report a case of a young college football player who presented acute subdural hematoma, cerebral edema, and seizure due to pseudoaneurysm rupture. The pseudoaneurysm, located at the cortical branch of the middle cerebral artery, was speculated to be formed by dural calcification and adhesion with the underlying brain, possibly due to repeated concussions. Following successful excision of the pseudoaneurysm and control of brain swelling, the patient recovered without sequelae and was discharged after a short while...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847781/subdural-hematoma-without-subarachnoid-hemorrhage-caused-by-the-rupture-of-middle-cerebral-artery-aneurysm
#11
Jinsol Han, Dong-Jun Lim, Sang-Dae Kim, Sung-Kon Ha, Seung-Hwan Lee, Se-Hoon Kim
Pure subdural hematomas caused by a ruptured intracranial aneurysm are extremely rare. We describe the case of a 42-year-old woman who presented with headache without evidence of head trauma. Magnetic resonance angiography and conventional cerebral angiography revealed a ruptured aneurysm at the right middle cerebral artery bifurcation. The patient underwent surgical treatment and had a good outcome without any neurological deficit. The mechanisms and clinical characteristics of this condition are discussed...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847780/recurrent-carotid-cavernous-fistula-originating-from-a-giant-cerebral-aneurysm-after-placement-of-a-covered-stent
#12
Jung Wook Baek, Sung Tae Kim, Young Seo Lee, Young-Gyun Jeong, Hae Woong Jeong, Jin Wook Baek, Jung Hwa Seo
We report the case of a recurrent carotid cavernous fistula (CCF) originating from a giant cerebral aneurysm (GCA) after placement of a covered stent. A 47-year-old woman presented with sudden onset of severe headache, and left-sided exophthalmos and ptosis. Cerebral angiography revealed a CCF caused by rupture of a GCA in the cavernous segment of the left internal carotid artery. Two covered stents were placed at the neck of the aneurysm. The neurological symptoms improved at first, but were aggravated in the 6 months following the treatment...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847779/pure-subdural-hemorrhage-caused-by-internal-carotid-artery-dorsal-wall-aneurysm-rupture
#13
Young Woon Lee, Taek Min Nam, Jong Soo Kim, Seung Chyul Hong, Je Young Yeon
A 37-year-old woman was admitted to our hospital with altered mentality. The patient was diagnosed an internal carotid artery (ICA) dorsal wall aneurysm leading to acute subdural hemorrhage (SDH) without occurring subarachnoid hemorrhage and/or internal parenchymal hemorrhage. An aneurysmal neck clipping and hematoma evacuation were performed at once. A pure SDH by ruptured aneurysm is unusual, but it is important to consider it if a SDH patient has no other medical history.
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847778/pseudoaneurysm-formation-after-repetitive-suction-thrombectomy-using-a-penumbra-suction-catheter
#14
Eun-Oh Jeong, Hyon-Jo Kwon, Seung-Won Choi, Hyeon-Song Koh
With the recent advent of suction catheters, the use of manual aspiration thrombectomy (MAT) for patients with acute ischemic stroke with large vessel occlusion has increased. Although contrast leakage and subarachnoid hemorrhage have been reported during MAT procedures, pseudoaneurysm formation due to vessel injury by suction catheters has not been. We discuss the case of a 60-year-old woman who presented to our emergency room with dysarthria and left-sided weakness. She underwent suction thrombectomy 5 times for acute middle cerebral artery occlusion and significant contrast leakage occurred during the procedure...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847777/onyx-embolization-of-intracranial-pial-arteriovenous-fistula
#15
Hae-Min Kim, Jae-Hoon Cho, Ki-Hong Kim
Intracranial pial arteriovenous fistulas (AVFs) are rare cerebrovascular lesions consisting of one or more arterial connections to a single venous channel without an intervening nidus. Because of the location and high flow dynamics of these lesions, neurosurgeons may have a difficulty deciding between endovascular treatment and open surgical treatment. We report on a patient who underwent endovascular treatment with liquid embolic agent. A 50-year-old man with a decreased mental state and a tonic seizure event was brought to our hospital...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847776/multiple-spontaneous-intracerebral-hematoma-without-presenting-risk-factors
#16
Sangman Park, Eun-Kyung Park, Ju-Seong Kim, Kyu-Won Shim
The incidence of intracerebral hemorrhage in those aged 45-84 years is 0.3-0.5%. In people over 80 years of age, this incidence increases 25-fold compared with that of the total population. The most common causes of spontaneous intracerebral hemorrhage in the younger population are vascular malformation, aneurysm, and overuse of drugs. In contrast, common causes in the elderly include hypertension, tumors, and coagulation disorders. Here, we present a case involving a 72-year-old male patient who, without any of these predisposing conditions, was admitted to the hospital with spontaneous intracerebral hemorrhage and showed signs of multifocal intracerebral hemorrhage during his stay...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847775/incomplete-clipping-resulting-from-scissoring-of-the-clip-blades-during-treatment-of-a-large-atheromatous-aneurysm
#17
Jin Seong Kim, Seung Hwan Lee, Hak Cheol Ko, Hee Sup Shin, Jun Seok Koh
The cerebral aneurysm 'clip scissoring' phenomenon resulting from clip blade twisting is an unpredictable surgical complication. Additionally, incomplete clipping resulting from the presence of an atherosclerotic wall in the neck of the aneurysm can also cause unforeseen problems. Here, the authors present an unusual case of incomplete clipping of a large, atheromatous aneurysm resulting from clip scissoring, which was treated with additional endovascular coiling.
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847774/fusiform-superior-cerebellar-artery-aneurysm-treated-with-endovascular-treatment
#18
Joon Bok Jeon, Se-Yang Oh, Dong-Keun Hyun, Yu Shik Shim
An aneurysm of the distal superior cerebellar artery (SCA) is a highly rare disease. Fusiform aneurysms of the distal SCA are particularly challenging to treat. Clipping, trapping with or without bypass using microsurgery or endovascular treatment (EVT) were used to treat this condition. We describe the case of fusiform distal SCA aneurysms treated successfully with endovascular coiling with a 3-month follow-up. A 39 year-old male was presented with subarachnoid hemorrhage (SAH) and a 15 mm fusiform aneurysm of the ambient segment of the left distal SCA...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847773/evaluation-and-treatment-of-the-acute-cerebral-infarction-with-convexal-subarachnoid-hemorrhage
#19
Min Hyung Lee, Sang Uk Kim, Dong Hoon Lee, Young Il Kim, Chul Bum Cho, Seung Ho Yang, Il Sup Kim, Jae Taek Hong, Jae Hoon Sung, Sang Won Lee
Non-traumatic convexal subarachnoid hemorrhage (CSAH) is a comparatively infrequent with various vascular and nonvascular causes, it rarely occurs concomitant to acute ischemic stroke. We report a case of a 59-year-old woman, visited emergency room with right side subjective weakness spontaneously. Magnetic resonance diffusion-weighted images revealed an acute infarction of anterior cerebral arterial territory. Computed tomographic angiography showed a left frontal CSAH without any vascular lesions. And other laboratory studies were non-specific...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847772/endovascular-treatment-of-giant-serpentine-aneurysm-of-the-middle-cerebral-artery
#20
Young Ha Jeong, Jong Yeon Kim, Youn Moo Koo, Jong Wook Choi, Kum Whang, Chul Hu, Sung Min Cho
Giant serpentine aneurysms are uncommon types of aneurysmal disease and have angiographically authentic features. We report a case of a 44-year-old male with headache and seizure. He presented a giant serpentine aneurysm arising from the middle cerebral artery (MCA). It was a large intracranial aneurysm thrombosed as a mass-like lesion while it maintained its outflow drainage into the distal MCA branches. The balloon occlusion test (BOT) was performed to test the tolerance of temporary collateral circulation...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
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