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Unruptured cerebral aneurysm

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https://www.readbyqxmd.com/read/29348290/an-unusual-case-of-basilar-artery-aneurysm-presenting-with-spastic-quadriparesis
#1
Chandramohan Sharma, Banshi Lal Kumawat, Deepika Sagar, Maulik Panchal
Unruptured aneurysm usually presents with headache and neuro-ophthalmic features; when it ruptures, it presents with subarachnoid haemorrhage. Basilar artery aneurysm represents only 3-5% of cerebral aneurysms. Non-haemorrhagic symptoms and the signs of unruptured aneurysms are manifested as mass effect, thromboembolic phenomenon or epileptical attacks. Clinical presentation of unruptured aneurysm depends on structures which are involved. In our case, the patient had insidious onset headache and spastic quadriparesis with sixth cranial nerve palsy, which implicate involvement of corticospinal pathways at the level of pons...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29348119/cigarette-smoke-initiates-oxidative-stress-induced-cellular-phenotypic-modulation-leading-to-cerebral-aneurysm-pathogenesis
#2
Robert M Starke, John W Thompson, Muhammad S Ali, Crissey L Pascale, Alejandra Martinez Lege, Dale Ding, Nohra Chalouhi, David M Hasan, Pascal Jabbour, Gary K Owens, Michal Toborek, Joshua M Hare, Aaron S Dumont
OBJECTIVE: Cigarette smoke exposure (CSE) is a risk factor for cerebral aneurysm (CA) formation, but the molecular mechanisms are unclear. Although CSE is known to contribute to excess reactive oxygen species generation, the role of oxidative stress on vascular smooth muscle cell (VSMC) phenotypic modulation and pathogenesis of CAs is unknown. The goal of this study was to investigate whether CSE activates a NOX (NAPDH oxidase)-dependent pathway leading to VSMC phenotypic modulation and CA formation and rupture...
January 18, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29342213/circulating-neutrophil-transcriptome-may-reveal-intracranial-aneurysm-signature
#3
Vincent M Tutino, Kerry E Poppenberg, Kaiyu Jiang, James N Jarvis, Yijun Sun, Ashish Sonig, Adnan H Siddiqui, Kenneth V Snyder, Elad I Levy, John Kolega, Hui Meng
BACKGROUND: Unruptured intracranial aneurysms (IAs) are typically asymptomatic and undetected except for incidental discovery on imaging. Blood-based diagnostic biomarkers could lead to improvements in IA management. This exploratory study examined circulating neutrophils to determine whether they carry RNA expression signatures of IAs. METHODS: Blood samples were collected from patients receiving cerebral angiography. Eleven samples were collected from patients with IAs and 11 from patients without IAs as controls...
2018: PloS One
https://www.readbyqxmd.com/read/29340847/comparative-analysis-of-aneurysm-volume-by-different-methods-based-on-angiography-and-computed-tomography-angiography
#4
Víctor Hugo Escobar-de la Garma, Marco Zenteno, Felipe Padilla-Vázquez, Daniel San-Juan, Aurelio Cerón-Morales
Endovascular treatment and prognosis of intracranial aneurysms are based on size and volume, which demand more accurate neuroimaging techniques. Aneurysm volume calculation is important to choose endovascular treatment modalities and packing density calculation. Of all these methods, it remains unknown which one is the most accurate to calculate aneurysm volume. The objective of this study is to compare the accuracy of three angiography-based versus three tomographic-based methods which calculate aneurysm volume...
January 16, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29334776/multiple-intracranial-aneurysms-in-a-patient-with-type-i-gaucher-disease-a-case-report-and-literature-review
#5
Matthew R Reynolds, Daniel M Heiferman, Andrew B Boucher, Brian M Howard, Daniel L Barrow, Jacques E Dion
Multiple intracranial aneurysms (IAs) have never been reported in a patient with Gaucher disease (GD). A 69-year-old-female with type I GD presented with a left sixth nerve palsy due to a large posterior inferior cerebellar artery (PICA) aneurysm. Cerebral angiography demonstrated fifteen unruptured IAs (UIAs).
January 15, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29301051/antiplatelet-premedication-for-stent-assisted-coil-embolization-of-intracranial-aneurysms-low-dose-prasugrel-vs-clopidogrel
#6
Hyun Ho Choi, Jung Jun Lee, Young Dae Cho, Moon Hee Han, Won-Sang Cho, Jeong Eun Kim, Sang Joon An, Jong Hyeon Mun, Dong Hyun Yoo, Hyun-Seung Kang
BACKGROUND: The use of antiplatelet medications to prevent thrombosis in the treatment of cerebral aneurysms with stents has become widely emphasized. OBJECTIVE: To compare low-dose prasugrel with clopidogrel in stent-assisted coil embolization of intracranial aneurysms. METHODS: This is a retrospective review of 311 aneurysms from 297 patients who underwent stent-assisted endovascular coil embolization of unruptured intracranial aneurysm between November 2014 and March 2017...
December 29, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29284057/computational-fluid-dynamics-cfd-using-porous-media-modeling-predicts-recurrence-after-coiling-of-cerebral-aneurysms
#7
Yasuyuki Umeda, Fujimaro Ishida, Masanori Tsuji, Kazuhiro Furukawa, Masato Shiba, Ryuta Yasuda, Naoki Toma, Hiroshi Sakaida, Hidenori Suzuki
OBJECTIVE: This study aimed to predict recurrence after coil embolization of unruptured cerebral aneurysms with computational fluid dynamics (CFD) using porous media modeling (porous media CFD). METHOD: A total of 37 unruptured cerebral aneurysms treated with coiling were analyzed using follow-up angiograms, simulated CFD prior to coiling (control CFD), and porous media CFD. Coiled aneurysms were classified into stable or recurrence groups according to follow-up angiogram findings...
2017: PloS One
https://www.readbyqxmd.com/read/29262391/-ruptured-dissecting-aneurysm-of-m2-portion-of-the-middle-cerebral-artery-a-case-report
#8
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
https://www.readbyqxmd.com/read/29260306/spontaneous-regression-of-an-intracranial-aneurysm-following-remote-aneurysm-clipping-evaluation-with-high-resolution-vessel-wall-mri
#9
Sanghyeon Kim, Myongjin Kang, Jeonghyun Jo, Dongwon Kim
Spontaneous regression of an unruptured aneurysm is very rare. We present a case of a 64-year-old woman with an unruptured cerebral aneurysm in which spontaneous regression occurred after contralateral clipping. High-resolution magnetic resonance imaging showed that the aneurysm had decreased in size and there was no evidence of thrombus. Level of Evidence Case, Level IV.
December 19, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29258945/impacts-of-a-size-ratio-on-outcome-in-patients-with-surgically-treated-unruptured-non-dissecting-anterior-cerebral-artery-aneurysms
#10
Hidetoshi Matsukawa, Hiroyasu Kamiyama, Takanori Miyazaki, Yu Kinoshita, Kosumo Noda, Nakao Ota, Norihiro Saito, Rihee Takeda, Sadahisa Tokuda, Rokuya Tanikawa
BACKGROUND: Anterior cerebral artery aneurysms (ACAs) are characterized by higher rupture rate and small size at rupture. It was revealed that the aneurysm-to-vessel size ratio, and not the absolute size, might predict the risk of rupture in small unruptured intracranial aneurysms.The present study aimed to investigate the relationship between a size ratio and outcome in patients with unruptured non-dissecting ACA aneurysms (UNDAs). METHODS: Consecutive 187 patients with 12 A1 (6...
December 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29235088/middle-cerebral-artery-anatomical-variations-and-aneurysms-retrospective-study-based-on-computed-tomography-angiography-findings
#11
Paweł Brzegowy, Jakub Polak, Jakub Wnuk, Bartłomiej Łasocha, Jerzy Walocha, Tadeusz J Popiela
BACKGROUND: Anatomical variations of the middle cerebral artery (MCA) are an important clinical issue, due to high prevalence of intracranial aneurysms. Anatomical variations of vessels can lead to higher shear stress, which is thought to be the main factor leading to aneurysm formation and consequently to higher prevalence of aneurysms. The aim of this study was to evaluate anatomy of the MCA; to classify MCA aneurysms using CT angiography and to correlate anatomical variations of MCA and circle of Willis with prevalence of MCA aneurysms...
December 13, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29211861/spontaneous-microguidewire-extrusion-from-the-foot-following-cerebral-aneurysm-treatment-first-case-report
#12
Kurdow Nader, Saleh Lamin, Joseph Leyon, Swarupsinh Chavda, Allan Thomas, Sarin Kuruvath
BACKGROUND AND IMPORTANCE: Microguidewire entrapment and failure related to endovascular therapy is a rare complication with limited case reports available, most of which are from cardiac endovascular intervention. Migration of the microguidewire has been reported in coronary intervention with some resulting in severe complications, but there are no reported cases of spontaneous extrusion of wire fragment following a neurointerventional procedure. We report the first case of a microguidewire entrapment with subsequent fracture, followed by spontaneous extrusion of the wire fragment...
November 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29192858/head-up-display-may-facilitate-safe-keyhole-surgery-for-cerebral-aneurysm-clipping
#13
Terushige Toyooka, Naoki Otani, Kojiro Wada, Arata Tomiyama, Satoru Takeuchi, Kazuya Fujii, Kosuke Kumagai, Takashi Fujii, Kentaro Mori
OBJECTIVE The head-up display (HUD) is a modern technology that projects images or numeric information directly into the observer's sight line. Surgeons will no longer need to look away from the surgical view using the HUD system to confirm the preoperative or navigation image. The present study investigated the usefulness of the HUD system for performing cerebral aneurysm clipping surgeries. METHODS Thirty-five patients underwent clipping surgery, including 20 keyhole surgeries for unruptured cerebral aneurysm, using the HUD system...
December 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29171364/endovascular-embolization-of-branch-incorporated-cerebral-aneurysms
#14
Yasuhiro Kawabata, Takuya Nakazawa, Shunichi Fukuda, Satoru Kawarazaki, Tomokazu Aoki, Takumi Morita, Tetsuya Tsukahara
Objectives The aim of this study was to examine the feasibility, technique, and clinical and angiographic outcomes of endovascular coiling to treat a cerebral aneurysm with a branch incorporated into the aneurysmal wall. Methods From 2012 to 2016, 25 patients with 26 cerebral aneurysms having a branch incorporated into the aneurysm (9 unruptured, 17 ruptured) were treated to prevent rupture or re-bleeding from the sac while preserving the incorporated branch by using single-catheter ( n = 18), balloon-remodeling ( n = 4), stent-assisted coiling ( n = 3), or double-catheter ( n = 1) techniques...
December 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/29162525/surgical-outcome-of-very-small-intracranial-aneurysms-utilizing-the-double-clip-technique
#15
Abdolkarim Rahmanian, Fariborz Ghaffarpasand, Ehsanali Alibai, Joham Choque-Velasquez, Behnam Rezai Jahromi, Juha Hernesniemi
OBJECTIVES: To report the outcome of patients with very small intracranial aneurysm (VSIA) undergoing surgical clipping using a double-clip technique. METHODS: This cross-sectional study was conducted in Namazi Hospital, the main referral neurovascular center in Southern Iran during a 6-year period from September 2010 to March 2016. All patients with VSIAs (≤3 mm) undergoing surgery with double-clip technique were included. This technique reduces the clip slippage...
November 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29155706/comprehensive-endovascular-and-open-surgical-management-of-cerebral-arteriovenous-malformations
#16
Robert C Rennert, Jeffrey A Steinberg, Vincent J Cheung, David R Santiago-Dieppa, Jeffrey Scott Pannell, Alexander A Khalessi
Arteriovenious malformations (AVMs) are associated with significant morbidity and mortality, and have a rupture risk of ~3% per year. Treatment of AVMs must be tailored specifically to the lesion, with surgical resection being the gold standard for small, accessible lesions. Pre-operative embolization of AVMs can reduce nidal blood flow and remove high-risk AVM features such as intranidal or venous aneurysms, thereby simplifying a challenging neurosurgical procedure. Herein, we describe our approach for the staged endovascular embolization and open resection of AVMs, and highlight the advantages of having a comprehensively trained neurovascular surgeon leading a multi-disciplinary clinical team...
October 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29152467/an-unruptured-anterior-communicating-artery-aneurysm-presenting-with-left-homonymous-hemianopsia-a-case-report
#17
Jae Wook Kim, Taek Kyun Nam, Ki Su Park, Yong Sook Park, Jeong Taik Kwon
Unruptured cerebral aneurysms sometimes present with visual symptomsdue to compression of the visual pathways. However, until now, unruptured anterior communicating artery (ACoA) aneurysms presenting visual field defects have been extremely rare. The authors report the case of a 51-year-old woman who presented with left homonymous hemianopsia. Radiological findings demonstrated an ACoA aneurysm filled with thrombus, that was compressing the optic chiasm and post-chiasmal tract. The patient underwent clipping of the aneurysm, which resolved the visual field defect...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29130668/-analysis-on-clinical-characteristic-and-risk-factors-of-patients-coexistence-of-cerebral-artery-stenosis-with-unruptured-intracranial-aneurysm
#18
Hai-Yan Zhao, Jin-Tao Han, Dong-Sheng Fan
OBJECTIVE: To analyze the incidence of intracranial unruptured aneurysms in patients with intracranial artery stenosis,clinical features,and investigate the risk factors for unruptured intracranial aneurysms. METHODS: Medical records from all patients performed with digital subtraction angiography (DSA) who had been treated at Peking University Third Hospital,China,from January 2012 to December 2015 were retrospectively reviewed to identify cases coexistence with cerebral artery stenosis and unruptured intracranial aneurysm...
September 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29129762/risk-factors-for-the-rupture-of-intracranial-aneurysms-using-computed-tomography-angiography
#19
Guang-Xian Wang, Li Wen, Liu Yang, Qi-Chuang Zhang, Jin-Bo Yin, Chun-Mei Duan, Dong Zhang
OBJECTIVE: To study the clinical and morphologic characteristics associated with risk factors for the rupture of intracranial aneurysms (IAs). METHODS: A total of 1115 consecutive patients with 1282 IAs were reviewed from August 2011 to February 2016. The patients and IAs were divided into ruptured and unruptured groups. Based on the clinical and morphologic findings, the risk factors for IA rupture were assessed using statistical methods. RESULTS: Age, hypertension, diabetes mellitus, and cerebral atherosclerosis were associated with ruptured IAs...
November 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29114276/predictive-value-of-motor-evoked-potential-monitoring-during-surgery-of-unruptured-anterior-circulation-cerebral-aneurysms
#20
Yasuhiro Yamada, Yoko Kato, Mohsen Nouri, Tsukasa Ganaha, Motoki Oheda, Kohei Ishihara, Shigeta Moriya, Akiyo Sadato, Joji Inamasu, Yuichi Hirose
Objective and Background: Surgery of unruptured aneurysms is always a great challenge to neurovascular surgeons because no postoperative neurological deficits should be expected postoperatively as the patients are fully asymptomatic before the surgery. Here, we present our experience with selective motor evoked potential (MEP) monitoring of our patients in a 2-year time window. Patients and Methods: From 2012 to 2014, 27 patients with unruptured intracranial aneurysms were operated in our institute with the help of MEP monitoring...
October 2017: Asian Journal of Neurosurgery
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