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Ruptured cerebral aneurysm

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https://www.readbyqxmd.com/read/28323184/associations-of-endothelin-polymorphisms-and-aneurysm-size-at-the-time-of-rupture
#1
Philipp Hendrix, Paul M Foreman, Robert M Starke, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Minkuan Lin, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Jean-Francois Pittet, Mali Mathru, Christoph J Griessenauer
BACKGROUND: and Purpose: Aneurysm size is an important risk factor for aneurysm rupture. The pathophysiological mechanisms underlying aneurysm growth remain poorly understood. Endothelin signaling is critical for cerebrovascular blood flow regulation. The influence of endothelin single nucleotide polymorphisms (SNPs) on aneurysm size at the time of rupture has not been previously investigated. METHODS: Eight common endothelin SNPs were assessed using blood samples from aneurysmal subarachnoid hemorrhage (aSAH) patients enrolled in the CARAS (Cerebral Aneurysm Renin Angiotensin System) study...
March 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28323182/treatment-of-large-and-giant-middle-cerebral-artery-aneurysms-risk-factors-for-unfavorable-outcomes
#2
Wonhyoung Park, Jaewoo Chung, Jae Sung Ahn, Jung Cheol Park, Byung Duk Kwun
OBJECTIVE: This study aimed to assess the clinical and radiological outcomes after neurosurgical treatment of large and giant aneurysms of the middle cerebral artery (MCA). In addition, we aimed to identify risk factors for unfavorable outcomes. METHODS: This retrospective study included 105 patients with 106 large or giant MCA aneurysms treated with neurosurgical methods, including microsurgery and endovascular treatment, over a 15-year period. RESULTS: The mean aneurysm size was 15...
March 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28320123/relationship-of-the-angle-between-the-a1-and-a2-segments-of-the-anterior-cerebral-artery-with-formation-and-rupture-of-anterior-communicating-artery-aneurysm
#3
Jingya Ye, Peidong Zheng, Muhammad Hassan, Shengnan Jiang, Jiesheng Zheng
PURPOSE: To measure the angle between A1 and A2 segments of the anterior cerebral artery and analyze the relationship of this angle with the formation and rupture of anterior communicating artery aneurysm (ACoAA). METHODS: Patients with ACoAA (n=64) and with non-ACoAA (n=187) randomly chosen were included. The A1-A2 segment angles were measured using multislice spiral computed tomography angiography. The angular dimensions and differences were recorded and compared between the ACoAA and non-ACoAA groups and the ruptured (n=23) and unruptured group (n=41)...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28303205/aneurysm-of-azygos-anterior-cerebral-artery-associated-with-falcine-meningioma-case-report-and-review-of-the-literature
#4
Lucas C Meguins, Raquel C T Hidalgo, Antônio R Spotti, Dionei F de Morais
BACKGROUND: The azygos anterior cerebral artery (ACA) is an uncommon intracranial vascular anomaly of the circle of Willis. Identification of aneurysm from azygos ACA with anterior falcine meningioma is an extremely rare association. The aim of the present study is to report the case of an adult female with a ruptured aneurysm from azygos ACA in association with an anterior falcine meningioma. CASE DESCRIPTION: A 65-year-old female was admitted in the Emergency Department reporting sudden onset of severe headache...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28298037/impact-of-bifurcation-angle-and-inflow-coefficient-on-the-rupture-risk-of-bifurcation-type-basilar-artery-tip-aneurysms
#5
Sherif Rashad, Shin-Ichiro Sugiyama, Kuniyasu Niizuma, Kenichi Sato, Hidenori Endo, Shunsuke Omodaka, Yasushi Matsumoto, Miki Fujimura, Teiji Tominaga
OBJECTIVE Risk factors for aneurysm rupture have been extensively studied, with several factors showing significant correlations with rupture status. Several studies have shown that aneurysm shape and hemodynamics change after rupture. In the present study the authors investigated a static factor, the bifurcation angle, which does not change after rupture, to understand its effect on aneurysm rupture risk and hemodynamics. METHODS A hospital database was retrospectively reviewed to identify patients with cerebral aneurysms treated surgically or endovascularly in the period between 2008 and 2015...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28297692/-ruptured-aneurysm-of-bihemispheric-anterior-cerebral-artery-a1-a2-junction-a-case-report
#6
Nao Shimooka, Shiromaru Ishida, Masato Kawai
We report a rare case with a ruptured aneurysm of the bihemispheric anterior cerebral artery(ACA), a rare anomaly of the ACA. A 50-year-old female experienced a sudden onset of severe posterior cervical pain. CT revealed diffuse subarachnoid hemorrhage(SAH)and intra cerebral hemorrhage of the left rectal gyrus. Cerebral angiography showed the left bihemispheric ACA and hypoplasia of the right ACA. A saccular aneurysm was indicated at the A1-A2 junction of the left bihemispheric ACA. A neck clipping was performed completely through the right transsylvian approach...
March 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28294669/-visceral-complications-of-the-aortic-dissections-indications-and-technique-of-the-thoracoabdominal-refenestration
#7
Csaba Dzsinich, Jenő Szolnoky, Gábor Vallus, Gábor Darabos, Gabriella Nyiri, Dániel Teknős
Aortic dissection is a life threatening cardiovascular catastrophy. Its incidence estimated to 5-6 cases per 100,000 patients/year. The intimal tear happens at the ascending aorta in Type A, meanwhile at the aortic isthmus in Type B, but entry point may develop anywhere alongside the entire aorta. All types may affect a short aortic segment resulting in a localized false aneurysm, others separate the intimal layer at longer extension down to the visceral segment and far beyond to the femoral arteries. Dissection of orifices of side branches may lead to cerebral, upper extremity, spinal, visceral, renal and lower extremity malperfusion...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28283187/successful-delayed-coiling-of-a-ruptured-growing-distal-posterior-cerebral-artery-mycotic-aneurysm
#8
C Champeaux, N Walker, J Derwin, A Grivas
Intracranial infectious aneurysm (IIA) is a rare form of cerebrovascular malformation for which obliteration may be undertaken after rupture or non-response to targeted antibiotic therapy. We discuss the case of a 19-year-old man who presented with acute neurologic decline (Glasgow Coma Scale of 8) and endocarditis. CT images demonstrated subarachnoid haemorrhage, hydrocephalus and a mycotic aneurysm on the left posterior cerebral artery. Conservative management was initially decided due to the high risk of stroke and hemianopia...
March 7, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28281190/ruptured-dissecting-aneurysms-of-the-a1-segment-of-the-anterior-cerebral-artery-three-case-reports-and-a-review-of-the-literature
#9
REVIEW
Takafumi Mitsuhara, Fusao Ikawa, Toshikazu Hidaka, Yasuharu Kurokawa, Ushio Yonezawa
Dissecting aneurysms in the anterior cerebral artery (ACA), although rare, can cause ischemic and/or hemorrhagic stroke. Hemorrhagic dissecting aneurysms in the A1 portion of the ACA are often associated with a poor prognosis. We retrospectively investigated three rare cases of hemorrhagic dissecting aneurysms in the A1 portion. Dissecting aneurysms were diagnosed by carotid angiography or computed tomography angiography to visualize morphological changes in the vessel. All patients presented with diffuse subarachnoid hemorrhage...
March 10, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28279774/conscious-sedation-versus-general-anesthesia-for-the-treatment-of-cerebral-aneurysms-with-flow-diversion-a-matched-cohort-study
#10
Christoph J Griessenauer, Hussain Shallwani, Nimer Adeeb, Raghav Gupta, Leonardo Rangel-Castilla, Adnan H Siddiqui, Elad I Levy, Myles D Boone, Ajith J Thomas, Christopher S Ogilvy
INTRODUCTION: Flow diversion has become a popular treatment option for a variety of cerebral aneurysms. We sought to compare conscious sedation and general anesthesia for flow diverter placement in a matched cohort study. MATERIALS AND METHODS: Patients who underwent flow diverter placement under conscious sedation were matched on the basis of age, sex, American Society of Anesthesiologists (ASA) classification, aneurysm location, and aneurysm size with patients who received general anesthesia...
March 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28273502/ruptured-berry-aneurysm-with-minimal-subarachnoid-hemorrhage
#11
Tyler J Gardner, Joseph A Prahlow
Cerebral artery aneurysm rupture is usually associated with significant subarachnoid hemorrhage; however, there are rare cases where there is a lack of hemorrhage into the subarachnoid space. While subdural hemorrhage can occur with ruptured aneurysms, isolated subdural hemorrhage is more often associated with trauma. In this case, a 51-year-old obese woman, who recently visited an Urgent Care Center for elevated blood pressure, was found dead roughly a month later. She had been complaining of headaches, and received medication for her blood pressure at the visit...
February 28, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28271159/inflow-hemodynamics-evaluated-by-using-four-dimensional-flow-magnetic-resonance-imaging-and-the-size-ratio-of-unruptured-cerebral-aneurysms
#12
Kazuya Futami, Iku Nambu, Tomohiro Kitabayashi, Hiroki Sano, Kouichi Misaki, Naoyuki Uchiyama, Mitsutoshi Nakada
PURPOSE: Prediction of the rupture risk is critical for the identification of unruptured cerebral aneurysms (UCAs) eligible for invasive treatments. The size ratio (SR) is a strong morphological predictor for rupture. We investigated the relationship between the inflow hemodynamics evaluated on four-dimensional (4D) flow magnetic resonance (MR) imaging and the SR to identify specific characteristics related to UCA rupture. METHODS: We evaluated the inflow jet patterns and inflow hemodynamic parameters of 70 UCAs on 4D flow MR imaging and compared them among 23 aneurysms with an SR ≧2...
March 7, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28268870/the-impact-of-deformation-of-an-aneurysm-model-under-pulsatile-flow-on-hemodynamic-analysis
#13
T Kawakami, H Takao, C Ichikawa, K Kamiya, Y Murayama, M Motosuke
Hemodynamic analysis of cerebral aneurysms has been widely carried out to clarify the mechanisms of their growth and rupture. In several cases, patient-specific aneurysm models made of transparent polymers have been used. Even though periodic changes in aneurysms due to the pulsation of blood flow could be important, the deformation of the model geometry and its effect on hemodynamic evaluation has not been fully investigated. In addition, the fabrication accuracy of aneurysm models has not been evaluated even though it may affect the hemodynamic parameters to be analyzed...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28265012/cerebral-aneurysm-morphology-before-and-after-rupture-nationwide-case-series-of-29-aneurysms
#14
Torbjørn Øygard Skodvin, Liv-Hege Johnsen, Øivind Gjertsen, Jørgen Gjernes Isaksen, Angelika Sorteberg
BACKGROUND AND PURPOSE: Using postrupture morphology to predict rupture risk of an intracranial aneurysm may be inaccurate because of possible morphological changes at or around the time of rupture. The present study aims at comparing morphology from angiograms obtained prior to and just after rupture and to evaluate whether postrupture morphology is an adequate surrogate for rupture risk. METHODS: Case series of 29 aneurysms from a nationwide retrospective data collection...
March 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28264247/pterional-or-subfrontal-access-for-proximal-vascular-control-in-anterior-interhemispheric-approach-for-ruptured-pericallosal-artery-aneurysms-at-risk-of-premature-rupture
#15
Jaechan Park
OBJECTIVE: Cases of a ruptured pericallosal artery aneurysm with a high risk of intraoperative premature rupture and technical difficulties for proximal vascular control require a technique for the early and safe establishment of proximal vascular control. METHODS: A combined pterional or subfrontal approach exposes the bilateral A1 segments or the origin of the ipsilateral A2 segment of the anterior cerebral artery (ACA) for proximal vascular control. Proximal control far from the ruptured aneurysm facilitates tentative clipping of the rupture point of the aneurysm without a catastrophic premature rupture...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28258681/-evaluation-of-the-effectiveness-of-endovascular-embolization-for-the-treatment-of-ruptured-cerebral-aneurysms
#16
Grzegorz Turek, Andrzej Lewszuk, Jan Kochanowicz, Justyna Zielińska-Turek, Paweł Wilk, Zenon Mariak
Endovascular embolization of ruptured intracranial aneurysms is a relatively new and still developing technique, therefore its efficiency and risks should be assessed recurrently, including also results obtained in national centers. AIM: The aim of the study was to present a synthetic review of the literature, which, including the data published by the Polish centers, typify the global assessment of the effectiveness and early complication of endovascular embolization in patients with ruptured brain aneurysms...
February 20, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28254540/endothelial-nitric-oxide-synthase-polymorphism-is-associated-with-delayed-cerebral-ischemia-following-aneurysmal-subarachnoid-hemorrhage
#17
Philipp Hendrix, Paul M Foreman, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Minkuan Lin, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Jean-Francois Pittet, Mali Mathru, Christoph J Griessenauer
BACKGROUND: and Purpose: Nitric oxide (NO) is critical in the regulation of cerebral blood flow and smooth muscle proliferation. It is synthesized by three nitric oxide synthase (NOS) isoforms: neuronal (nNOS), inducible (iNOS), and endothelial NOS (eNOS). Aneurysmal subarachnoid hemorrhage (aSAH) causes endothelial dysfunction which, in turn, contributes to pathophysiological processes surrounding aSAH. Previous studies reported an association of an eNOS single nucleotide polymorphism (SNP) with the clinical sequelae of aSAH...
February 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28251324/middle-cerebral-artery-aneurysm-rupture-in-a-neonate-with-interrupted-aortic-arch-case-report
#18
Joaquin Hidalgo, James Charles Dickerson, Brandon Burnsed, Ali Luqman, James Mason Shiflett
INTRODUCTION: Arterial cerebral aneurysms in the neonatal population are rare, and while the association of interrupted aortic arch and intracranial aneurysm has been reported in the adult and pediatric population (three cases each), to date, it has not been reported in the neonate. CASE REPORT: We report the case of a 26-day-old girl who presented with a generalized seizure 2 weeks after undergoing congenital heart surgery. Head CT revealed diffuse SAH with a 1...
March 1, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28250282/a-single-center-experience-with-coil-embolization-for-cerebral-aneurysms-greater-than-10-mm-in-the-internal-carotid-artery
#19
Kensuke Suzuki, Ryotaro Suzuki, Tomoji Takigawa, Nobuyuki Shimizu, Yoshiyuki Matsumoto, Yoshiko Fujii, Yuki Inoue, Yoshiki Sugiura, Koji Hirata, Kyoji Tsuda, Yosuke Kawamura, Issei Takano, Ryuta Nakae, Masaya Nagaishi, Yoshihiro Tanaka, Akio Hyodo
We investigated endovascular treatment for 10 mm or larger aneurysms in the internal carotid artery (IC), including the cavernous portion, the paraclinoid portion, and the posterior communication artery (PC). Between 2011 and 2014 at our hospital, there were 35 cases of aneurysms that were 10 mm or larger in the carotid artery. We analyzed these 35 cases retrospectively based on the size and location of the aneurysms, method of treatment, number of coils implanted, use of a stent, complications, rupture after treatment, ophthalmologic symptoms, and need for re-treatment...
March 2, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28244000/changes-in-cerebral-perfusion-with-induced-hypertension-in-aneurysmal-subarachnoid-hemorrhage-a-pilot-and-feasibility-study
#20
Amanda Murphy, Airton Leonardo de Oliveira Manoel, R Loch Macdonald, Andrew Baker, Ting-Yim Lee, Tom Marotta, Walter Montanera, Richard Aviv, Aditya Bharatha
BACKGROUND: The effects of induced hypertension (IH) on cerebral perfusion after subarachnoid hemorrhage (SAH) are unclear. The objectives of this investigation are to: (1) determine whether there are differences in cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) measured with computed tomography perfusion (CTP) before and after IH; (2) evaluate differences in the presence of infarction and clinical outcome between patients with and without IH. METHODS: We performed a retrospective cohort analysis of 25 aneurysmal SAH patients...
February 27, 2017: Neurocritical Care
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