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Ruptured cerebral aneurysm

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https://www.readbyqxmd.com/read/28216398/engaging-in-a-keyhole-concept-for-the-management-of-ruptured-and-unruptured-aneurysms
#1
Daniel D Cavalcanti, Roberto C de Paula, Paula L Alvarenga, Paulo José P da Mata, Paulo Niemeyer Filho
OBJECTIVE: Many new endovascular devices have been used under the guidance of the International Subarachnoid Aneurysm Trial (ISAT). Clipping still offers higher occlusion rates, and its technique continues to evolve, resulting in smaller exposures and reduced manipulation to brain tissue. We sought to evaluate the routine use of the minisphenoidal approach to manage intracranial aneurysms in a high-volume institution. METHODS: We retrospectively reviewed our database of aneurysm patients from October 2013 to May 2016...
February 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28216212/-sentinel-seizure-as-a-warning-sign-preceding-fatal-rupture-of-a-giant-middle-cerebral-artery-aneurysm
#2
Lukas Andereggen, Robert H Andres
BACKGROUND: Sentinel headache is a well-known warning sign preceding subarachnoid hemorrhage (SAH) due to rupture of an intracranial aneurysm. New-onset seizure or "sentinel seizure" preceding aneurysmal SAH, however, is uncommon. CASE DESCRIPTION: We report on a 51-year-old man who presented with a new-onset seizure. Diagnostic work-up revealed a giant middle cerebral artery aneurysm without evidence of subarachnoid or intracerebral hemorrhage. Anti-epileptic therapy was initiated, elective diagnostic angiography and subsequent treatment was scheduled and the patient discharged home...
February 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28213195/blunt-traumatic-brain-injury-patients-a-role-for-ct-angiography-of-the-head-to-evaluate-non-traumatic-etiologies
#3
REVIEW
Ha Nguyen, Ninh Doan, Michael Gelsomino, Saman Shabani
BACKGROUND: In the setting of trauma, the etiology of intracranial hemorrhage (ICH) is frequently attributed to the physical, traumatic event. Caution should still be directed towards non-traumatic (or spontaneous) etiologies responsible for the trauma, such as hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformation, and hemorrhagic infarcts. The role for immediate CT angiography (CTA) remains controversial to evaluate for non-traumatic etiologies. METHODS: A systematic review of the available literature in Medline PubMed database...
February 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28210239/flow-diversion-for-the-treatment-of-mca-bifurcation-aneurysms-a-single-centre-experience
#4
Pervinder Bhogal, Muhammad AlMatter, Hansjörg Bäzner, Oliver Ganslandt, Hans Henkes, Marta Aguilar Pérez
BACKGROUND: Intracranial aneurysms located at the bifurcation of the middle cerebral artery (MCA) can often be challenging for the neurointerventionalist. We aimed to evaluate the efficacy and safety of flow diverting stents (FDS) in the treatment of these aneurysms. MATERIALS AND METHODS: We retrospectively reviewed our prospectively maintained database to collect information for all patients with unruptured saccular bifurcation MCA aneurysms treated with FDS between January 2010 and January 2016...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28209576/differences-in-hemodynamics-and-rupture-rate-of-aneurysms-at-the-bifurcation-of-the-basilar-and-internal-carotid-arteries
#5
R Doddasomayajula, B Chung, F Hamzei-Sichani, C M Putman, J R Cebral
BACKGROUND AND PURPOSE: Cerebral aneurysms in the posterior circulation are known to have a higher rupture risk than those in the anterior circulation. We sought to test the hypothesis that differences in hemodynamics can explain the difference in rupture rates. MATERIALS AND METHODS: A total of 117 aneurysms, 63 at the tip of the basilar artery (27 ruptured, 36 unruptured, rupture rate = 43%) and 54 at the bifurcation of the internal carotid artery (11 ruptured, 43 unruptured, rupture rate = 20%) were analyzed with image-based computational fluid dynamics...
February 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28209306/successful-coil-embolization-of-a-ruptured-mycotic-aneurysm-that-developed-three-days-after-septic-embolic-infarction-case-report-and-review-of-the-literature
#6
Joshua L Wang, Archana P Hinduja, Ciarán J Powers
BACKGROUND: Infectious intracranial aneurysms (IIAs) are rare entities and are often associated with septic embolus from infectious endocarditis. They may develop rapidly and carry a higher risk of rupture and mortality compared to noninfectious aneurysms. However, the development and rupture of an IIA within 48h in a patient with septic infarction patient is exceedingly rare. CASE DESCRIPTION: In this report, we describe a 25-year-old male who presented with left-sided hemiparesis and dysarthria from septic embolus to the right middle cerebral artery...
February 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28186451/techniques-and-outcomes-of-microsurgical-management-of-ruptured-and-unruptured-fusiform-cerebral-aneurysms
#7
Sam Safavi-Abbasi, M Yashar S Kalani, Ben Frock, Hai Sun, Kaan Yagmurlu, Felix Moron, Laura A Snyder, Randy J Hlubek, Joseph M Zabramski, Peter Nakaji, Robert F Spetzler
OBJECTIVE Fusiform cerebral aneurysms represent a small portion of intracranial aneurysms; differ in natural history, anatomy, and pathology; and can be difficult to treat compared with saccular aneurysms. The purpose of this study was to examine the techniques of treatment of ruptured and unruptured fusiform intracranial aneurysms and patient outcomes. METHODS In 45 patients with fusiform aneurysms, the authors retrospectively reviewed the presentation, location, and shape of the aneurysm; the microsurgical technique; the outcome at discharge and last follow-up; and the change in the aneurysm at last angiographic follow-up...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28184353/spontaneous-regression-of-aneurysm-remnant-after-incomplete-surgical-clipping-in-a-patient-with-ruptured-cerebral-aneurysm
#8
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/28184003/a-survey-of-intracranial-aneurysm-treatment-practices-among-united-states-physicians
#9
Kyle M Fargen, Hector E Soriano-Baron, Julia T Rushing, William Mack, J Mocco, Felipe Albuquerque, Andrew F Ducruet, Maxim Mokin, Italo Linfante, Stacey Q Wolfe, John A Wilson, Joshua A Hirsch
BACKGROUND: Recent surveys have failed to examine cerebrovascular aneurysm treatment practices among US physicians. OBJECTIVE: To survey physicians who are actively involved in the care of patients with cerebrovascular aneurysms to determine current aneurysm treatment preferences. METHODS: A 25-question SurveyMonkey online survey was designed and distributed electronically to members of the Society of NeuroInterventional Surgery, Society of Vascular and Interventional Neurology, and the American Association of Neurological Surgeons/Congress of Neurological Surgeons Combined Cerebrovascular Section...
February 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28169856/postinterventional-critical-care-management-of-aneurysmal-subarachnoid-hemorrhage
#10
Sudhir Datar, Alejandro A Rabinstein
PURPOSE OF REVIEW: Subarachnoid hemorrhage from a ruptured aneurysm (aSAH) is a complex disorder with the potential to have devastating effects on the brain as well as other organ systems. After more than 3 decades of research, the underlying pathophysiologic mechanisms remain incompletely understood and important questions remain regarding the evaluation and management of these patients. The purpose of this review is to analyze the recent literature and improve our understanding of certain key clinical aspects...
February 4, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28155701/exploring-potential-association-between-flow-instability-and-rupture-in-patients-with-matched-pairs-of-ruptured-unruptured-intracranial-aneurysms
#11
Lijian Xu, Lixu Gu, Hao Liu
BACKGROUND: Patients with multiple intracranial aneurysms present a great challenge to the neurosurgeon, particularly when presenting with subarachnoid hemorrhage. Misjudgment may result in disastrous postoperative rebleeding from the untreated but true-ruptured lesion. METHODS: In this study, computational fluid dynamic simulations of two matched-pairs of ruptured-unruptured cerebral aneurysms were performed to investigate the potential association between flow instability and aneurysm rupture...
December 28, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28153852/effect-of-heparin-on-secondary-brain-injury-in-patients-with-subarachnoid-hemorrhage-an-additional-h-therapy-in-vasospasm-treatment
#12
REVIEW
Markus Bruder, Sae-Yeon Won, Sepide Kashefiolasl, Marlies Wagner, Nina Brawanski, Nazife Dinc, Volker Seifert, Juergen Konczalla
OBJECTIVE: Secondary brain injury leads to high morbidity and mortality rates in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, evidence-based treatment strategies are sparse. Since heparin has various effects on neuroinflammation, microthromboembolism and vasomotor function, our objective was to determine whether heparin can be used as a multitarget prophylactic agent to ameliorate morbidity in SAH. METHODS: Between June 1999 and December 2014, 718 patients received endovascular treatment after rupture of an intracranial aneurysm at our institution; 197 of them were treated with continuous unfractionated heparin in therapeutic dosages after the endovascular procedure...
February 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28153625/ruptured-mycotic-aneurysm-and-cerebral-vasospasm-in-the-setting-of-endocarditis-and-heart-failure-requiring-cardiothoracic-surgery-case-report-and-review
#13
Chih-Ta Lin, Bruce Tranmer, Susan Durham, David Johnson, Mark Hamlin, R Morton Bolman
BACKGROUND: Ruptured mycotic aneurysm in the setting of cardiac failure and cerebral vasospasm presents unique management challenges. CASE DESCRIPTION: The authors describe a case of a ruptured mycotic aneurysm with subarachnoid hemorrhage (SAH), cerebral vasospasm, and endocarditis with heart failure who successfully underwent craniotomy, neuro-endovascular treatments, and cardiopulmonary bypass for mitral valve replacement while in cerebral vasospasm. This case highlights the clinical management strategies of a patient with a ruptured mycotic aneurysm, SAH, cerebral vasospasm, endocarditis, and heart failure...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28149111/acute-subdural-hematoma-from-a-ruptured-aneurysm-of-the-distal-middle-cerebral-artery
#14
Dale Ding, Arnold P Bok
No abstract text is available yet for this article.
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28131928/treatment-strategies-for-intracranial-mirror-aneurysms
#15
Wen-Xin Wang, Zhe Xue, Lin Li, Chen Wu, Yan-Yang Zhang, Xin Lou, Lin Ma, Zheng-Hui Sun
OBJECTIVE: Intracranial mirror aneurysms are clinically rare and uncommonly reported in the literature. Therefore, the present study evaluated a series of mirror aneurysm cases with respect to the clinical features of the patients and the treatment strategies that were used. METHODS: This study retrospectively reviewed and systematically analyzed the clinical features, imaging data, treatment methods, and treatment outcomes of 68 cases of mirror aneurysms (a total of 70 pairs) that were admitted to our department between November 2007 and May 2016...
January 25, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28126980/-a-case-of-cervical-internal-carotid-artery-occlusion-presenting-with-subarachnoid-hemorrhage-caused-by-rupture-of-leptomeningeal-anastomosis
#16
Tsuyoshi Tsukada, Toru Masuoka, Hideo Hamada, Shoutarou Itou, Takuya Akai, Hideaki Iizuka
A 71-year-old man was admitted to our hospital with a diagnosis of subarachnoid hemorrhage (SAH). Angiographies revealed neither aneurysms nor vascular anomalies. However, these images elucidated the occlusion of the left cervical internal carotid artery as well as developed leptomeningeal anastomoses through the ipsilateral posterior cerebral artery, which resulted in blood perfusing the ipsilateral middle and anterior cerebral artery territories. Because the localization of SAH coincided with the developed leptomeningeal anastomosis, we speculated that the rupture of the developed leptomeningeal anastomosis in the basal cistern was the cause of SAH...
January 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28120769/ruptured-intracranial-aneurysm-in-patients-with-osteogenesis-imperfecta-2-familial-cases-and-a-systematic-review-of-the-literature
#17
T Gaberel, A Rochey, C di Palma, F Lucas, E Touze, E Emery
OBJECTIVE: Osteogenesis imperfecta is an inherited connective tissue disorder that causes bone fragility. Vascular complications have been described, but only few cases of ruptured intracranial aneurysm have been reported. MATERIALS AND METHODS: We first described 2 familial cases of ruptured intracranial aneurysm and then conducted a systematic review of the literature. RESULTS: A mother and her daughter with a typical history of osteogenesis imperfecta presented with subarachnoid hemorrhage, which was related to a posterior communicating artery aneurysm in both cases...
December 2016: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28116528/cerebral-abscess-after-neuro-vascular-embolization-own-experience-and-review-of-the-literature
#18
G Cossu, R T Daniel, M Messerer
BACKGROUND: Cerebral abscesses are a rare complication after therapeutic neuro-endovascular procedures. METHOD: The aim of this article is to report a case of cerebral abscess after the endovascular embolization of a cerebral aneurysm and to discuss and review all the cases of cerebral abscess secondary to neurovascular embolization described in the literature up to now. RESULTS: A 40-year-old female patient was treated using an endovascular embolization for a ruptured aneurysm of the basilar artery tip...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28108855/causes-of-poor-outcome-in-patients-admitted-with-good-grade-subarachnoid-haemorrhage
#19
Vladimír Beneš, Lubomír Jurák, Radim Brabec, Nina Nechanická, Miroslav Šercl, Ladislav Endrych, Pavel Buchvald, Petr Suchomel
BACKGROUND: Surgical risk in patients with unruptured aneurysms is well known. The relative impact of surgery and natural history of subarachnoid haemorrhage (SAH) on patients in good clinical condition (World Federation of Neurological Surgeons [WFNS] grades 1 and 2) is less well quantified. The aim of this study was to determine causes of poor outcome in patients admitted in good grade SAH. METHODS: A retrospective study of prospectively collected data among WFNS-1 and -2 patients: demographics, SAH and aneurysm-related data, surgical complications and outcome as assesed by the Glasgow Outcome Scale (GOS)...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28106497/association-of-renin-angiotensin-system-genetic-polymorphisms-and-aneurysmal-subarachnoid-hemorrhage
#20
Christoph J Griessenauer, R Shane Tubbs, Paul M Foreman, Michelle H Chua, Nilesh A Vyas, Robert H Lipsky, Mingkuan Lin, Ramaswamy Iyer, Rishikesh Haridas, Beverly C Walters, Salman Chaudry, Aisana Malieva, Samantha Wilkins, Mark R Harrigan, Winfield S Fisher, Mohammadali M Shoja
OBJECTIVE Renin-angiotensin system (RAS) genetic polymorphisms are thought to play a role in cerebral aneurysm formation and rupture. The Cerebral Aneurysm Renin-Angiotensin System (CARAS) study prospectively evaluated common RAS polymorphisms and their relation to aneurysmal subarachnoid hemorrhage (aSAH). METHODS The CARAS study prospectively enrolled aSAH patients and controls at 2 academic centers in the United States. A blood sample was obtained from all patients for genetic evaluation and measurement of plasma angiotensin-converting enzyme (ACE) concentration...
January 20, 2017: Journal of Neurosurgery
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