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Ruptured cerebral aneurysm

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https://www.readbyqxmd.com/read/28741219/in-vitro-analysis-of-platelet-function-in-acute-aneurysmal-subarachnoid-haemorrhage
#1
Christian von der Brelie, Alexander Subai, Verena Limperger, Veit Rohde, Astrid Dempfle, Azize Boström
Platelet function might play an essential role in the pathogenesis of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid haemorrhage (SAH). Thus, impaired platelet function and disturbed primary haemostasis induced by intake of acetylsalicylic acid (ASA) might influence the rate of DCI. Primary haemostasis and platelet function can be measured with in vitro diagnosis (platelet function analyser test, PFA 100). The aim of this study is to evaluate the rate of DCI, haemorrhagic complications and the neurological outcome...
July 24, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28740717/hybrid-repair-of-aortic-arch-aneurysms-a-comprehensive-review
#2
REVIEW
Steve Xydas, Christos G Mihos, Roy F Williams, Angelo LaPietra, Maurice Mawad, S Howard Wittels, Orlando Santana
Open total arch replacement (TAR) has become safer with refinements in cerebral protection techniques. The frequent extension of aortic arch aneurysms into the descending thoracic aorta customarily requires a two-staged conventional elephant trunk procedure, carrying relatively high mortality and morbidity risks and high rates of rupture in the interval between the two open surgeries. The technical demands and invasive nature of TAR has therefore precluded many high-risk patients from being surgical candidates for aneurysm repair...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28739616/awakening-with-amantadine-from-a-persistent-vegetative-state-after-subarachnoid-haemorrhage
#3
Sophie Mirabell Lehnerer, Franziska Scheibe, Ralph Buchert, Stefan Kliesch, Andreas Meisel
We report the case of a 36-year-old woman with a subarachnoid haemorrhage (SAH) caused by a rupture of a right-sided middle cerebral artery aneurysm and subsequent malignant infarction of the right hemisphere leading to a persistent vegetative state and severe spastic tetraparesis with recurrent myocloni. Nine months after disease onset, the patient was transferred to our department for diagnostic and therapeutic re-evaluation. The poor clinical condition could not be explained by the brain lesion caused by the SAH or infarction...
July 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28736346/shifting-treatment-paradigms-for-ruptured-aneurysms-from-open-surgery-to-endovascular-therapy-over-25-years
#4
M T Bender, H Wendt, T Monarch, L M Lin, B Jiang, J Huang, A L Coon, R J Tamargo, G P Colby
BACKGROUND: Since the introduction of GDCs in the early 1990s, major clinical studies have supported an increasing role for coil embolization of ruptured aneurysms. We assessed aneurysm location and treatment modality in aneurysmal subarachnoid hemorrhage (aSAH) over the past 25 years. METHODS: A prospective, IRB-approved aneurysm database was screened for patients presenting with aSAH from 1991-2016. Microsurgical and endovascular capabilities were present throughout...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735717/real-time-cineangiography-visualization-of-cerebral-aneurysm-rupture-in-an-awake-patient-anatomic-physiological-and-functional-correlates
#5
Tasha L Welch, Waleed Brinjikji, Guiseppe Lanzino, William L Lanier
Intracranial aneurysms are common and, on a population-based perspective, are a major cause of morbidity and mortality as a result of mass effect or rupture. Cerebral angiography is the primary technique used for the diagnosis of cerebral aneurysms, and the imaging data have additional utility for planning medical, endovascular, or surgical treatments. An extremely rare periprocedural complication of cerebral angiography is rupture of the aneurysm, either as a chance phenomenon or as a result of some physiologic change or mechanical effect...
July 20, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28735438/adenosine-assisted-neurovascular-surgery-initial-case-series-and-review-of-literature
#6
REVIEW
Alaa Al-Mousa, Gahan Bose, Katharine Hunt, Ahmed K Toma
Cerebral aneurysms in complex anatomical locations and intraoperative rupture of aneurysms are challenging for neurosurgeons and anaesthetists alike. Mechanical and non-mechanical methods to reduce blood flow into aneurysms are well-recognised techniques to facilitate aneurysm exclusion from the circulation. Mechanical methods like temporary clipping of parent arteries, carotid artery ligation and endovascular balloon occlusion are commonly used in clinical practice. However, non-mechanical techniques such as rapid ventricular pacing and adenosine-induced cardiac standstill with hypotension are still emerging strategies...
July 22, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28735142/bifurcation-location-and-growth-of-aneurysm-size-are-significantly-associated-with-an-irregular-shape-of-unruptured-intracranial-aneurysms
#7
Xin Feng, Baorui Zhang, Erkang Guo, Luyao Wang, Zenguhi Qian, Peng Liu, Xiaolong Wen, Wenjuan Xu, Chuhan Jiang, Youxiang Li, Zhongxue Wu, Aihua Liu
BACKGROUND AND OBJECTIVE: Previous studies firmly proved that an irregular aneurysmal shape was strongly associated with intracranial aneurysm (IA) rupture, but it is unclear how irregularly shaped intracranial aneurysms (IAs) form. We aimed to identify the factors related to irregular shape of IAs. METHOD: We retrospectively analyzed of consecutive patients evaluated or treated for IA at our institution from June 2015 to July 2016. According to the imaging morphology of aneurysm, the enrolled patients are divided into irregular and regular group...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28733907/multiple-intracranial-aneurysms-a-direct-hemodynamic-comparison-between-ruptured-and-unruptured-vessel-malformations
#8
Philipp Berg, Oliver Beuing
PURPOSE: Despite numerous studies addressing the rupture risk of intracranial aneurysms that have been published, the assessment thereof still remains challenging. Image-based simulations enable a precise prediction of patient-specific blood flow information. However, those approaches normally consider only small segments of the complete cerebral vasculature. METHODS: To test the validity of the consideration of single aneurysms in one computational setup, domains of the complete anterior and posterior circulations with multiple intracranial aneurysms (MIA) were simulated...
July 21, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28733225/microneurosurgical-clip-ligation-of-acutely-ruptured-cerebral-aneurysm-immediately-preceded-by-intentional-subtotal-endovascular-coil-embolization-under-a-single-anesthesia-observations-using-a-deliberate-combined-sequential-treatment-strategy-in-13-cases
#9
Jeffrey E Thomas, Jack C Rose
BACKGROUND: Endovascular coil embolization and craniotomy with clip ligation are the two most commonly used treatments for ruptured cerebral aneurysm. While coiling maintains the advantages of brevity and complete avoidance of brain retraction and manipulation, clipping offers the benefits of decompression of the injured brain and lower aneurysm recurrence rates. A combined, immediately sequential treatment strategy for acutely ruptured cerebral aneurysm that simultaneously maximizes the advantages of both techniques, while minimizing their respective disadvantages, may be a useful paradigm...
July 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28729919/toward-understanding-non-coding-rna-roles-in-intracranial-aneurysms-and-subarachnoid-hemorrhage
#10
Fengzhen Huang, Jiping Yi, Tieqiao Zhou, Xiaoxiang Gong, Hong Jiang, Xiaoxi Yao
Subarachnoid hemorrhage (SAH) is a common and frequently life-threatening cerebrovascular disease, which is mostly related with a ruptured intracranial aneurysm. Its complications include rebleeding, early brain injury, cerebral vasospasm, delayed cerebral ischemia, chronic hydrocephalus, and also non neurological problems. Non-coding RNAs (ncRNAs), comprising of microRNAs (miRNAs), small interfering RNAs (siRNAs) and long non-coding RNAs (lncRNAs), play an important role in intracranial aneurysms and SAH. Here, we review the non-coding RNAs expression profile and their related mechanisms in intracranial aneurysms and SAH...
2017: Translational Neuroscience
https://www.readbyqxmd.com/read/28720746/-a-rare-case-of-ruptured-internal-carotid-posterior-communicating-artery-aneurysm-associated-with-contralateral-delayed-oculomotor-nerve-palsy
#11
Chika Somagawa, Yutaka Fukuda, Shota Yoshimura, Kei Satoh, Takeshi Hiu, Tomonori Ono, Ryujirou Ushijima, Keisuke Toda, Keisuke Tsutsumi
A 55-year-old man presented with difficulty breathing, chest pain, and disturbance of consciousness, and was transferred to our hospital. Initial whole body CT revealed a diffuse subarachnoid hemorrhage(SAH)with severe pulmonary edema that was considered neurogenic in origin. He received controlled ventilation under sedation and conservative care for the SAH. One day after the onset of the SAH, his left pupil suddenly became dilated to 6mm, with no reaction to light. Head CT showed no new bleeding. Subsequent CT angiogram revealed a right internal carotid-posterior communicating artery aneurysm(IC-PC AN)with a posterior-lateral projection; however, no vessel abnormality was observed in the left anterior or posterior circulations...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28720742/-two-cases-of-ruptured-blood-blister-like-aneurysm-treated-with-x-ray-angiography-perfusion-xap-analysis
#12
Shoichi Tani, Hirotoshi Imamura, Katsunori Asai, Kampei Shimizu, Hidemitsu Adachi, So Tokunaga, Takayuki Funatsu, Mikiya Beppu, Keita Suzuki, Hiromasa Adachi, Tomohiro Okuda, Yuichi Matsui, Yasunori Yoshida, Shuhei Kawabata, Ryo Akiyama, Kazufumi Horiuchi, Nobuyuki Sakai
Two cases of ruptured blood blister-like internal carotid artery aneurysms for which low flow bypass was sufficient to attain successful treatment of trapping are reported. In the acute stage of rupture, it is troublesome to perform accurate examinations of tolerance to ischemia like balloon occlusion test(BOT)for estimating the required amount of bypass flow. In our cases, X-ray angiography perfusion(XAP)analysis was introduced, which could be performed in a couple dozen seconds without room-to-room transfer of patients, following the ordinary examination of diagnostic digital subtraction angiography...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28711292/perioperative-stroke-after-cerebral-aneurysm-clipping-risk-factors-and-postoperative-impact
#13
Ahmed I Kashkoush, Brian T Jankowitz, Chris Nguyen, Paul A Gardner, Daniel A Wecht, Robert M Friedlander, Yue-Fang Chang, Miguel Habeych, Donald Crammond, Jeffrey Balzer, Parthasarathy D Thirumala
Stroke is a devastating complication after intracranial aneurysm clipping. Understanding the risk factors that prognosticate perioperative stroke may help to identify patients that would benefit from neuroprotective therapy. This study assesses patient-specific independent predictors of perioperative stroke in relation to surgical aneurysm clipping. Additionally, this study evaluates the postoperative complications of stroke. We performed a retrospective chart review of 437 patients with ruptured and unruptured intracranial aneurysms, which underwent surgical clipping from 2006 to 2013...
July 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28706287/association-of-wall-shear-stress-with-intracranial-aneurysm-rupture-systematic-review-and-meta-analysis
#14
Geng Zhou, Yueqi Zhu, Yanling Yin, Ming Su, Minghua Li
To evaluate the relationship between wall shear stress (WSS) magnitude and cerebral aneurysm rupture and provide new insight into the disparate computational fluid dynamics (CFD) findings concerning the role of WSS in intracranial aneurysm (IA) rupture. A systematic electronic database (PubMed, Medline, Springer, and EBSCO) search was conducted for all accessible published articles up to July 1, 2016, with no restriction on the publication year. Abstracts, full-text manuscripts, and the reference lists of retrieved articles were analyzed...
July 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28698088/microsurgical-repair-of-ruptured-aneurysms-associated-with-moyamoya-pattern-collateral-vessels-of-the-middle-cerebral-artery-a-report-of-two-cases
#15
Min Lang, Nina Z Moore, Alex M Witek, Varun R Kshettry, Mark Bain
BACKGROUND: Patients with Moyamoya or other intracranial steno-occlusive disease are at risk for developing aneurysms associated with flow through collateral vessels. Because these lesions are rare, the optimal management remains unclear. Here, we describe two cases of microsurgical repair of ruptured collateral vessel aneurysms associated with middle cerebral artery (MCA) occlusion. CASE DESCRIPTION: The first patient was a 61-year-old male who presented with right frontal and intraventricular hemorrhage...
July 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28697712/intravenous-administration-of-tirofiban-versus-loading-dose-of-oral-clopidogrel-for-preventing-thromboembolism-in-stent-assisted-coiling-of-intracranial-aneurysms
#16
Wang Zi-Liang, Liang Xiao-Dong, Li Tian-Xiao, Zhu Liang-Fu, Xue Jiang-Yu, Bai Wei-Xing, He Ying-Kun, Xu Gang-Qin, Shao Qiu-Ji, Li Li, Feng Guang, Li Zhao-Shuo
Background Thromboembolic complications after stenting of intracranial aneurysms may be affected by antiplatelet administration. Aims This retrospective study aimed to assess the safety of intravenous tirofiban versus loading dose of oral clopidogrel for preventing thromboembolism in stent-assisted coiling of intracranial aneurysms. Methods From January 2006 to December 2013, 281 patients with cerebral aneurysms were treated with stent-coiling using two antiplatelet strategies in comparison: the initial strategy (a loading dose of ≥300 mg clopidogrel followed by dual antiplatelet, clopidogrel group) and the modified strategy (intravenous administration of tirofiban 8 µg/kg over 3 min followed by a maintenance dose of 0...
July 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28694647/headache-facial-palsy-and-diplopia-an-unusual-presentation-of-ruptured-distal-anterior-cerebral-artery-aneurysm
#17
Sushant Sahoo, Chhitij Srivastava
No abstract text is available yet for this article.
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28689391/the-incidence-and-characteristics-of-patients-with-small-ruptured-aneurysms-5-mm-in-subarachnoid-hemorrhage
#18
Joon-Ho Choi, Hyun-Seok Park
OBJECTIVE: Small unruptured aneurysms (<5 mm) are known for their very low risk of rupture, and are recommended to be treated conservatively. However, we encounter many patients with small ruptured aneurysms in the clinical practice. We aimed to investigate the incidence and characteristics of patients with small ruptured aneurysms. METHODS: We reviewed all patients admitted to our hospital with subarachnoid hemorrhage from January 2005 to December 2015. The patients were divided into two groups: those with aneurysms <5 mm (group S) and those with aneurysms ≥5 mm (group L)...
July 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28680736/cortical-aneurysms-of-the-middle-cerebral-artery-a-review-of-the-literature
#19
Alessandro Ricci, Hambra Di Vitantonio, Danilo De Paulis, Mattia Del Maestro, Soheila Dehcordi Raysi, Domenico Murrone, Sabino Luzzi, Renato Juan Galzio
BACKGROUND: Middle cerebral artery (MCA) aneurysms constitute from 18-40% of all intracranial aneurysms. They are mainly found in the proximal and bifurcation tracts and only in the 1.1-1.7% of cases they are located in the distal segment. The authors report a case of a ruptured saccular cortical MCA aneurysm with unknown etiology. CASE DESCRIPTION: A 53-year-old female was admitted with a sudden severe headache, nausea, vomiting, and a slight left hemiparesis. The computed tomography (CT) scan showed subarachnoid hemorrhage (SAH) in the left sylvian fissure and intracerebral hemorrhage (ICH) in the left posterior parietal area...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28666912/outcome-after-subarachnoid-hemorrhage-from-blood-blister-like-aneurysm-rupture-depends-on-age-and-aneurysm-morphology
#20
Juergen Konczalla, Florian Gessler, Markus Bruder, Joachim Berkefeld, Gerhard Marquardt, Volker Seifert
BACKGROUND: Blood blister-like aneurysms (BBLA) are rare, prone to rerupture and challenging to treat. OBJECTIVE: To report our results in relationship to the type of BBLA and other prognostic factors. METHODS: Data on patient and aneurysm characteristics, clinical course and treatment results were collected prospectively and analyzed retrospectively including data from patient records and review of imaging findings. RESULTS: Twenty-seven patients had subarachnoid hemorrhage (SAH) from BBLA...
June 27, 2017: World Neurosurgery
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