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Cerebral fusiform aneurysm

Adam N Wallace, Jonathan A Grossberg, Josser E Delgado Almandoz, Mudassar Kamran, Anil K Roy, Yasha Kayan, Matthew J Austin, Brian M Howard, Christopher J Moran, C Michael Cawley, DeWitte T Cross, Jacques E Dion, Akash P Kansagra, Joshua W Osbun
BACKGROUND: Flow diversion of posterior cerebral artery (PCA) aneurysms has not been widely reported, possibly owing to concerns regarding parent vessel size and branch vessel coverage. OBJECTIVE: To examine the safety and effectiveness of PCA aneurysm flow diverter treatment. METHODS: Retrospective review of PCA aneurysms treated with the Pipeline Embolization Device (PED; Medtronic Inc, Dublin, Ireland) at 3 neurovascular centers, including periprocedural complications and clinical and angiographic outcomes...
March 8, 2018: Neurosurgery
Jeewaka E Mohotti, Nicole S Carter, Victor Jia Wei Zhang, Leon T Lai, Christopher Xenos, Hamed Asadi, Ronil V Chandra
Intracranial aneurysms in the neonate, presenting in the first 4 weeks of life, are exceedingly rare. They appear to have characteristics, including presentation and location, that vary from those found in adults. The authors present a case of a 28-day-old neonate with a ruptured distal middle cerebral artery (MCA) aneurysm. Initial noninvasive imaging with transfontanelle ultrasound and CT confirmed intraparenchymal and subarachnoid hemorrhage. Contrast-enhanced MRI revealed a 14-mm ruptured fusiform MCA aneurysm that was not identified on time-of-flight magnetic resonance angiography (MRA)...
March 2, 2018: Journal of Neurosurgery. Pediatrics
NiZaMiDingJiang ReXiaTi, ReXiDan AiKeReMu, KaHeErMan KaDeEr, Yan-Dong Fan, Zhao-Hai Feng, Kai Wang, TeWuErBaTi SuErTanNiYa, Tao-Tao Dou, Hai-Qiang Wu, MaiMaiTiLi AiSha, Xiao-Jiang Cheng
OBJECTIVE: To observe the short-term efficacy of Pipeline embolization divice (PED) for the treatment of complex intracranial aneurysms. METHODS: The clinical data of 29 consecutive patients with 32 intracranial aneurysms treated with PED between April 2015 to September 2016 were analyzed retrospectively. There were 3 small aneurysm, 15 large aneurysms, 8 giant aneurysms, 5 fusiform ayneurysms and 1 recidivation. The vessels include 25 anterior circulation and 4 posterior circulation...
2018: Bio-medical Materials and Engineering
Yuichi Ito, Yoshio Araki, Takashi Izumi, Sho Okamoto, Masaaki Kimura, Toshihiko Wakabayashi
BACKGROUND: Oncotic aneurysm is a rare condition with a high mortality rate. Since no consensus has been reached regarding therapeutic strategy for ruptured oncotic aneurysm, treatment remains challenging. CASE DESCRIPTION: A 35-year-old woman developed sudden onset of severe headache. Computed tomography showed subarachnoid hemorrhage and cerebral angiography revealed two fusiform aneurysms in the distal portion of the left middle cerebral artery. Aneurysmectomy with vessel reconstruction using a superficial temporal artery graft was performed to maintain blood flow to the distal middle cerebral artery...
February 15, 2018: World Neurosurgery
Hyo Sung Kwak, Jung Soo Park, Eun Jeong Koh
Herein, we describe a technique for stent-assisted coil embolization with a spring-shaped microcatheter in a patient with an M1 ultrawide-necked circumferential aneurysm in the middle cerebral artery (MCA). A 49-year-old man was referred for treatment of an incidentally detected M1 large-circumference aneurysm on magnetic resonance angiography. Subsequent digital subtraction angiography revealed an 18.2×16.5 mm ultrawide-necked circumferential aneurysm on the distal M1 portion of the left MCA, and we planned stent-assisted coil embolization using a spring-shaped microcatheter...
February 14, 2018: Journal of Neurointerventional Surgery
Jan-Karl Burkhardt, Ethan Winkler, Halima Tabani, Sirin Gandhi, Arnau Benet, Michael T Lawton
No abstract text is available yet for this article.
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
Hyo Sung Kwak, Jung Soo Park, Eun Jeong Koh
Herein, we describe a technique for stent-assisted coil embolization with a spring-shaped microcatheter in a patient with an M1 ultrawide-necked circumferential aneurysm in the middle cerebral artery (MCA). A 49-year-old man was referred for treatment of an incidentally detected M1 large-circumference aneurysm on magnetic resonance angiography. Subsequent digital subtraction angiography revealed an 18.2×16.5 mm ultrawide-necked circumferential aneurysm on the distal M1 portion of the left MCA, and we planned stent-assisted coil embolization using a spring-shaped microcatheter...
January 18, 2018: BMJ Case Reports
David L Penn, Arianna B Lanpher, Jennifer M Klein, Harry P W Kozakewich, Kristopher T Kahle, Edward R Smith, Darren B Orbach
The most common primary cardiac tumor is myxoma, typically originating in the left atrium. Emboli to the central nervous system can cause cerebral infarction or, rarely, seed tumor growth within vessel walls, causing myxomatous aneurysms. Fewer than 60 myxomatous aneurysms have been reported, including 2 cases in children. Here, the authors describe 2 different growing myxomatous aneurysms in a child successfully managed using a combined multidisciplinary approach. A 12-year-old boy developed a sudden headache, diplopia, gait instability, and speech difficulty...
January 5, 2018: Journal of Neurosurgery. Pediatrics
Tyler Scullen, Mansour Mathkour, Joseph Lockwood, Leah Ott, Ricky Medel, Aaron S Dumont, Peter S Amenta
BACKGROUND: Intracranial aneurysms (IA) are the leading cause of non-traumatic subarachnoid hemorrhage and are most commonly associated with the anterior cerebral artery (ACA) and anterior communicating artery complex. We describe the presentation and management of a 27-year-old male with concurrent bilateral A1-2 junction aneurysms and fusiform intraorbital ophthalmic artery (OA) aneurysms. CASE DESCRIPTION: A 27-year-old male with no past medical history presented with three months of headaches...
December 28, 2017: World Neurosurgery
Yutaka Fukushima, Tomohiro Takaki, Shinichiro Yoshino, Katsuyuki Hirakawa, Tooru Inoue
A 71-year-old woman presented with a sudden onset of headache and vomiting. Computed tomography(CT)showed diffuse subarachnoid hemorrhage(SAH)that was more severe on the right side. Three-dimensional CT angiography and right carotid angiography(CAG)demonstrated 2-mm microaneurysms at the middle cerebral artery(MCA)bifurcation and anterior communicating artery, with slight narrowing and dilatation of the M2 inferior trunk. Each microaneurysm was smooth, making it difficult to identify the bleeding source. Thus, surgery was postponed at the acute stage, and further investigation was planned...
December 2017: No Shinkei Geka. Neurological Surgery
Nicolai Maldaner, Jan-Karl Burkhardt, Martin Nikolaus Stienen, Johannes Goldberg, David Bervini, Philippe Bijlenga, Davide Croci, Daniel Zumofen, Donato D'Alonzo, Serge Marbacher, Rodolfo Maduri, Roy Thomas Daniel, Carlo Serra, Giuseppe Esposito, Marian C Neidert, Oliver Bozinov, Luca Regli
BACKGROUND: To determine the neurosurgeon's agreement in aneurysmal subarachnoid haemorrhage (aSAH) management with special emphasis on the rater's level of experience. A secondary aim was to analyse potential aneurysm variables associated with the therapeutic recommendation. METHOD: Basic clinical information and admission computed tomography angiography (CTA) images of 30 consecutive aSAH patients were provided. Twelve neurosurgeons independently evaluated aneurysm characteristics and gave recommendations regarding the emergency management and aneurysm occlusion therapy...
February 2018: Acta Neurochirurgica
Kotaro Oshio, Tetsuya Ikeda, Takashi Matsumori, Daisuke Wakui, Hidemichi Ito, Hiroshi Takasuna, Yuichiro Tanaka
Pure fusiform aneurysms without dissection are considered to have a low risk of rupture. Furthermore, aneurysm wall with atherosclerotic change tends to be less susceptible to rupture. We present a rare case of multiple atherosclerotic fusiform aneurysms associated with repeated subarachnoid hemorrhage(SAH)during a 9-year observation period. A 34-year-old woman was admitted to our hospital because of SAH. SAH with a temporal hematoma due to a fusiform aneurysm of the right middle cerebral artery(MCA)was detected using computed tomography(CT)...
November 2017: No Shinkei Geka. Neurological Surgery
Se Jin Choi, Se-Yang Oh, Yu Shik Shim, Dong Keun Hyun
The premammillary artery (PMA) is a branch of the posterior communicating artery (PCoA). While the PMA is known to originate from the PCoA as demonstrated by most anatomical studies, it originates directly from the internal carotid artery in approximately 1% of patients. Cerebral aneurysms associated with the PMA have rarely been reported. We report an extremely rare case of a ruptured PMA aneurysm that was managed using endovascular treatment.
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
Abdulrahman Y Alturki, Philip G R Schmalz, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND AND IMPORTANCE: Fusiform intracranial aneurysms remain challenging lesions to treat. These aneurysms have historically required bypass procedures or clip remodeling constructs for cure. Recently, endovascular specialists have reported experience with flow diversion for complex fusiform aneurysms of the vertebrobasilar system, with mixed results. Vascular anatomy for anterior circulation fusiform aneurysms may make these lesions more amenable to flow diversion and embolization procedures; however, published experience with these techniques is lacking...
November 11, 2017: Operative Neurosurgery (Hagerstown, Md.)
Mohamed Wael Osman, Krzysztof Kadziolka, Laurent Peirot
BACKGROUND: Posterior cerebral artery aneurysms are uncommon, with an occurrence rate of less than 1% of intracranial aneurysms. They have various shapes, including saccular and fusiform. Dissecting aneurysms may occur in distal posterior cerebral artery and they may affect the whole artery. Endovascular therapy is considered as a safe method of treatment and there are different techniques for endovascular therapy. SUMMARY: Posterior cerebral artery aneurysms are uncommon...
October 2017: Interventional Neurology
Gökce Hatipoglu Majernik, Elvis J Hermann, Christian Hartmann, Peter Raab, Joachim K Krauss
Perforating arteries are thin and long vessels which originate from the main cerebral arteries. Subarachnoidal hemorrhage from a perforator aneurysm is rare. Here, we report on a 70-year-old woman who presented with severe subarachnoid hemorrhage from a fusiform lateral anterior (A1) artery perforator aneurysm. Unexpectedly, digital subtraction angiography was non-diagnostic. MR imaging, however, demonstrated occlusion of the aneurysm secondary to thrombosis. Surgery was performed to remove the associated hematoma, and histopathological examination verified intraaneurysmal thrombosis...
January 2018: World Neurosurgery
Martin M Mortazavi, Tania Hassanzadeh, Kianoush Khalili, Sajid S Suriya, M Asif Taqi, Salman A Fard, R Shane Tubbs
BACKGROUND: Various techniques have been used for wrap-clipping a ruptured, fusiform intracranial aneurysm; however, there is no available literature on use of the falx cerebri for wrap-clipping. We present a review of the literature, with an illustrative case, of a ruptured fusiform pericallosal artery aneurysm firmly attached to the lower edge of the falx cerebri and not amenable to endovascular intervention. METHODS: Although the firm attachment between the inferior falx and the fusiform aneurysm was maintained, a section of the lower thinner part of the falx cerebri firmly attached to the aneurysm was dissected and wrapped around the fusiform aneurysm, and then stabilized with a fenestrated clip...
January 2018: World Neurosurgery
Harminder Singh, Harley Brito da Silva, David C Straus, Mehdi Zeinalizadeh, Laligam N Sekhar
No abstract text is available yet for this article.
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
Martin Winterholler, Roland Coras, Walter Geißdörfer, Rudolf Rammensee, Philipp Gölitz, Christian Bogdan, Roland Lang
Fungal infections of the central nervous system (CNS) frequently occur in immunosuppressed patients. Here, we describe the case of an immunocompetent 64-year-old man who presented with diplopia, right-sided hemiparesis, and a mild headache after cleaning and replacing nesting boxes of wild birds during the preceding months. Lumbar puncture revealed pleocytosis, elevated protein, and lactate levels in the cerebrospinal fluid (CSF). Initial imaging showed ischemia in the left thalamus and an enlargement of the sellar region...
2017: Frontiers in Medicine
Anil Arat, Ergun Daglioglu, Ilkay Akmangit, Ahmet Peker, Murat Arsava, Mehmet Akif Topcuoglu, Deniz Belen
PURPOSE: Bioresorbable vascular scaffolds (BVS) have changed practice patterns in cardiology. These resorbable stents have not yet been utilized in the cerebrovascular circulation. We report the initial experiences with these devices in interventional neuroradiology. METHODS: A retrospective review of clinical presentations, imaging findings and follow-up results of all patients treated using a BVS by our neurovascular team was carried out using hospital electronic charts and the hospital radiographic archive system...
July 26, 2017: Clinical Neuroradiology
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