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Cerebral fusiform aneurysm

Saleem I Abdulrauf, Peter Vuong, Ritesh Patel, Raghu Sampath, Ahmed M Ashour, Lauren M Germany, Jonathon Lebovitz, Colt Brunson, Yuvraj Nijjar, J Kyle Dryden, Maheen Q Khan, Mihaela G Stefan, Evan Wiley, Ryan T Cleary, Connor Reis, Jodi Walsh, Paula Buchanan
OBJECTIVE Risk of ischemia during aneurysm surgery is significantly related to temporary clipping time and final clipping that might incorporate a perforator. In this study, the authors attempted to assess the potential added benefit to patient outcomes of "awake" neurological testing when compared with standard neurophysiological testing performed under general anesthesia. The procedure is performed after the induction of conscious sedation, and for the neurological testing, the patient is fully awake. METHODS The authors conducted an institutional review board-approved prospective study of clipping unruptured intracranial aneurysms (UIAs) in 30 consecutive adult patients who underwent awake clipping...
October 21, 2016: Journal of Neurosurgery
Yoshitaka Tanaka, Yasushi Motoyama, Fumihiko Nishimura, Young-Su Park, Hiroyuki Nakase
BACKGROUND: A spontaneous fusiform aneurysm in the middle cerebral artery (MCA) can present with both ischemic and hemorrhagic symptoms, but the clinical course and prognosis are unclear because of its rarity. CASE DESCRIPTION: An asymptomatic fusiform shape aneurysm was found in a branch of the right middle cerebral artery (MCA) incidentally on a medical check-up in a 51-year-old woman with no medical history. It was followed-up by magnetic resonance imaging every year with no medical treatment...
October 11, 2016: World Neurosurgery
Joseph R Linzey, Julius Griauzde, Zhe Guan, Nicole Bentley, Joseph J Gemmete, Neeraj Chaudhary, B Gregory Thompson, Aditya S Pandey
BACKGROUND: Stent-assisted coiling is commonly used to treat wide-necked and fusiform cerebral aneurysms. We evaluated our institutional experience with stent-assisted coiling of cerebral aneurysms to elucidate potential risk factors for recurrence. METHODS: A retrospective analysis of patients undergoing stent-assisted coiling of cerebral aneurysms from 2005 to 2012 resulted in 122 patients with 122 aneurysms. Demographic, peri-procedural, medical comorbidity, and follow-up data were collected...
October 3, 2016: Journal of Neurointerventional Surgery
Jay Vachhani, Christopher Nickele, Lucas Elijovich, Paul Klimo, Adam S Arthur
Intracranial flow diversion has gained increasing popularity since the approval of the Pipeline Embolization Device (PED). Although it is only approved for use in adult patients, the PED has been used to treat aneurysms in pediatric patients. We present the first reported case of the use of a PED in a pediatric patient to treat an unusual fusiform distal anterior cerebral artery aneurysm. A 12-year-old female presented with new onset seizures and was found to have an incidental distal left anterior cerebral artery aneurysm...
September 29, 2016: World Neurosurgery
Seung Chai Jung, Ho Sung Kim, Choong-Gon Choi, Sang Joon Kim, Sun U Kwon, Dong-Wha Kang, Jong S Kim
PURPOSE: The aim of this article is to present high-resolution magnetic resonance imaging (HR-MRI) findings of chronic stage spontaneous and unruptured intracranial artery dissection (ICAD). MATERIAL AND METHODS: From March 2012 to April 2016 a total of 29 patients (15 male and14 female, age range 37-68 years) with chronic stage spontaneous and unruptured ICAD (vertebral artery 27, posterior inferior cerebellar artery 1 and middle cerebral artery 1) were retrospectively enrolled...
September 27, 2016: Clinical Neuroradiology
Jung Soo Park, Hyo Sung Kwak, Jong Myong Lee
Use of the Pipeline embolization device (PED) has increased based on studies about its safety and effectiveness, and new reports that describe peri- or postprocedural complications are now emerging. We report a rare periprocedural device-related complication that occurred during endovascular treatment with the pipeline embolization device for a dissecting aneurysm on the vertebral artery. A 55-year old woman was admitted due to left medullary infarction, and angiography showed a fusiform dilatation in the left vertebral artery that was suspicious for dissecting aneurysm...
September 2016: Journal of Korean Neurosurgical Society
Eduard Quintana, Pietro Bajona, Hartzell V Schaff, Joseph A Dearani, Richard Daly, Kevin Greason, Alberto Pochettino
Open aortic arch surgery after coronary artery bypass grafting (CABG) is considered a high-risk operation. We reviewed our surgical approach and outcomes to establish the risk profile for this patient population. In methods, from 2000-2014, 650 patients underwent aortic arch surgery with circulatory arrest. Of these, 45 (7%) had previous CABG. Complete medical record was available for review including all preoperative coronary angiograms and detailed management of myocardial protection. In results, the mean interval from previous CABG to aortic arch surgery was 6...
2016: Seminars in Thoracic and Cardiovascular Surgery
Hideaki Matsumura, Noriyuki Kato, Yusuke Fujiwara, Hisayuki Hosoo, Tomosato Yamazaki, Susumu Yasuda, Akira Matsumura
We present a retrospective analysis of endovascular treatments for posterior cerebral artery (PCA) aneurysms and discuss the susceptibility of a fetal-type PCA to vascular insufficiency after parent artery occlusion. Among 1207 aneurysms treated with endovascular therapy between March 1997 and March 2013 in our institution, 10 patients (0.8%) presented PCA aneurysms. The principal strategy was to employ selective coil embolization for the aneurysm. However, in certain cases of fusiform or dissecting aneurysms, we performed parent artery occlusion with coils...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Paulo Henrique Aguiar, Iracema Araújo ESTEVãO, César Cozar Pacheco, Marcos Vinicius Maldaun, Carlos Tadeu Oliveira
AIM: The aim of this retrospective study was to evaluate the follow-up results of patients who received surgical treatment for distal anterior cerebral artery aneurysms (pericallosal artery) and correlate these findings with the literature. MATERIAL AND METHODS: During the period of 2000 to 2013, 19 cases were operated, conducted preoperative angiographic and CT study. To classify the CT findings were used Fisher and World Federation of Neuro Surgeons (WFNS) SAH grading scales...
April 20, 2016: Turkish Neurosurgery
Ashish Kulhari, Sunil Manjila, Gagandeep Singh, Kunal Kumar, Robert W Tarr, Nicholas Bambakidis
The authors present a unique case of intracranial lipoma in the interpeduncular cistern associated with proximal P1 segment fenestration. This patient is a 20-year-old male with extensive psychiatric history and complaints of recent auditory hallucinations. Cranial magnetic resonance imaging (MRI) (T1, T2, and FLAIR) showed a hyperintense lesion in the left aspect of interpeduncular cistern with a prominent flow void within the hyperintense lesion suggestive of a combined vascular-lipomatous lesion. Computed tomography (CT) angiography showed a high-riding large tortuous P1 segment on the left side with proximal fenestration, the ectatic posteromedial limb harboring a fusiform dilated segment...
June 2016: Journal of Vascular and Interventional Neurology
Guilherme Cabral de Andrade, Helvercio P Alves, Valter Clímaco, Eduardo Pereira, Alexandre Lesczynsky, Michel E Frudit
Intracranial circumferential fusiform aneurysms of the posterior circulation involving arterial branches or perforating vessels are difficult to treat. This article shows an endovascular reconstruction technique not yet described, using a telescoping self-expandable stent (LEO+) and flow-diverter device (SILK) at different surgical times. Two patients with circumferential fusiform aneurysm, one being an aneurysm of the segments P2 and P3 of the posterior cerebral artery, diagnosed after a headache, and the other a partially thrombosed aneurysm of the lower basilar artery, diagnosed following ischemia of the brain stem...
October 2016: Interventional Neuroradiology
Guilherme Dabus, Jonathan A Grossberg, C Michael Cawley, Jacques E Dion, Ajit S Puri, Ajay K Wakhloo, Douglas Gonsales, Pedro Aguilar-Salinas, Eric Sauvageau, Italo Linfante, Ricardo A Hanel
BACKGROUND: The off-label use of flow diverters in the treatment of distal aneurysms continues to be debated. OBJECTIVE: To report our multicenter experience in the treatment of complex anterior cerebral artery aneurysms with the Pipeline embolization device (PED). METHODS: The neurointerventional databases of the four participating institutions were retrospectively reviewed for aneurysms treated with PED between October 2011 and January of 2016...
July 5, 2016: Journal of Neurointerventional Surgery
Sayal Parag, Zafar Arif, Rajaraman Chittoor
BACKGROUND: Radiotherapy-related intracranial aneurysms are a recognized but rare phenomenon and often present following rupture leading to subarachnoid hemorrhage. Treatment poses a particular dilemma and both endovascular, and surgical approaches have been used with varied success. We present the case of a radiotherapy-related aneurysm treated conservatively with a favorable outcome. CASE DESCRIPTION: A 37-year-old man was diagnosed with a left temporal lobe mass for which he underwent an uneventful craniotomy and debulking...
2016: Surgical Neurology International
Peng Qi, Daming Wang, Jiachun Liu, Lijun Wang, Jun Lu
OBJECTIVE: To explore the feasibility, safety and efficacy of endovascular reconstructive treatment by multiple overlapping stents with or without coils. METHODS: Totally 17 patients of vertebrobasilar fusiform aneurysms treated by multiple overlapping stents with or without coils between September 2011 and September 2015 in Department of Neurosurgery, Beijing Hospital were retrospectively reviewed. There were 15 male and 2 female patients with mean age of (47±13) years...
May 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Goran Mrak, Kresimir Sasa Duric, Jakob Nemir
BACKGROUND: Ischemic stroke is a well-described but less frequent consequence of ruptured or unruptured intracranial aneurysms. To date, the optimal form of treatment for patients with a thrombosed cerebral aneurysm has not yet been well-defined. CASE DESCRIPTION: Here, we report a case of a 68-year-old female patient presenting with cerebral stroke. Five days poststroke multislice computed tomography (MSCT) and MSCT angiography were performed for the evaluation of clinical deterioration, showing a left M2 middle cerebral artery (MCA) bifurcation aneurysm and subarachnoid hemorrhage...
2016: Surgical Neurology International
Xuanfeng Qin, Feng Xu, Yashengjiang Maimaiti, Yongtao Zheng, Bin Xu, Bing Leng, Gong Chen
OBJECTIVE Aneurysms of the posterior cerebral artery (PCA) are uncommon. To date, a limited number of studies have examined the outcomes of endovascular treatment for PCA aneurysms. The authors' aim in this study is to report their experience with the endovascular treatment of PCA aneurysms. METHODS Between January 2007 and December 2014, 55 patients with 59 PCA aneurysms were treated using the endovascular approach at the authors' institution. Twenty-three patients had 25 saccular aneurysms, and 32 patients had 34 fusiform/dissecting aneurysms...
April 22, 2016: Journal of Neurosurgery
Guillaume Marzolf, Marcela Sabou, Béatrice Lannes, François Cotton, David Meyronet, Damien Galanaud, Jean-Philippe Cottier, Sylvie Grand, Hubert Desal, Julie Kreutz, Maleka Schenck, Nicolas Meyer, Francis Schneider, Jean-Louis Dietemann, Meriam Koob, Raoul Herbrecht, Stéphane Kremer
Cerebral aspergillosis is associated with a significant morbidity and mortality rate. The imaging data present different patterns and no full consensus exists on typical imaging characteristics of the cerebral lesions. We reviewed MRI findings in 21 patients with cerebral aspergillosis and correlated them to the immune status of the patients and to neuropathological findings when tissue was available. The lesions were characterized by their number, topography, and MRI signal. Dissemination to the brain resulted from direct spread from paranasal sinuses in 8 patients, 6 of them being immunocompetent...
2016: PloS One
Felix Goehre, Behnam Rezai Jahromi, Martin Lehecka, Hanna Lehto, Riku Kivisaari, Hugo Andrade-Barazarte, Tarik F Ibrahim, Richard Gonzalo Párraga, Christopher Ludtka, Hans Jörg Meisel, Timo Koivisto, Mikael von Und Zu Fraunberg, Mika Niemelä, Juha E Jääskeläinen, Juha A Hernesniemi
OBJECTIVE: Aneurysms of the posterior cerebral artery (PCA) are uncommon. Because of their low incidence, only 5 series with more than 30 patient cases have been reported. The treatment of PCA aneurysms is challenging because of the high frequency of fusiform aneurysms and closeness to important neuroanatomic structures. METHODS: A total of 121 patients with 135 PCA aneurysms were reviewed. The clinical and radiologic data, treatment strategies, and 1-year outcomes were analyzed...
August 2016: World Neurosurgery
Yasushi Ogasawara, Yoshitaka Kubo, Takahiro Koji, Yuiko Sato, Shunrou Fujiwara, Kuniaki Ogasawara
We describe the case of subarachnoid hemorrhage and cerebral infarction that developed simultaneously and was caused by suspected dissection of the anterior communicating artery. A 65-year-old woman presented with sudden onset of headache and nausea. Head computed tomography(CT)and magnetic resonance imaging revealed subarachnoid hemorrhage in the interhemispheric fissure and a spotty ischemic lesion in the right frontal cortex. Both, CT angiography and angiography with arterial catheterization showed an aneurysmal dilatation of the anterior communicating artery...
March 2016: No Shinkei Geka. Neurological Surgery
Rieko Segawa, Daina Kashiwazaki, Naoki Akioka, Masaki Koh, Naoya Kuwayama, Satoshi Kuroda
We report a case of a fusiform aneurysm in the P2 segment of the posterior cerebral artery treated with stent-assisted coil embolization. A 44-year-old woman presented with an unruptured fusiform aneurysm in the left posterior cerebral artery. Stent-assisted coil embolization was performed using a "down-the-barrel" view to preserve the parent artery. The postoperative course was uneventful, and MRI showed no evidence of cerebral infarct. The patient was discharged 12 days after surgery, with no neurological deficit...
March 2016: No Shinkei Geka. Neurological Surgery
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