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Unruptured cerebral aneurysm

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https://www.readbyqxmd.com/read/28490685/-ruptured-c2-aneurysm-of-the-internal-carotid-artery-with-ipsilateral-unruptured-giant-internal-carotid-artery-aneurysm-a-case-report
#1
Saya Ozaki, Hideo Tanaka, Shinya Fukumoto, Haruhisa Ichikawa, Shinji Onoue, Noriyuki Fumoto, Hajime Miyazaki, Kanehisa Kohno
A giant intracranial internal carotid artery(ICA)aneurysm is difficult to treat. We encountered a case with an unruptured giant intracranial ICA aneurysm with a ruptured C2 aneurysm of the ipsilateral ICA. In this case report, we describe how the treatment and review the literature. A 59-year-old man presented with sudden-onset headache and vomiting. He was diagnosed at a local neurosurgical unit as having a subarachnoid hemorrhage and admitted to our hospital. Cerebral angiogram revealed an unruptured giant ICA C3-4 aneurysm with a ruptured aneurysm of the ipsilateral ICA C2...
May 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28490608/expanding-the-use-of-flow-diverters-beyond-their-initial-indication-treatment-of-small-unruptured-aneurysms
#2
J M Pumar, A Mosqueira, H Cuellar, B Dieguez, L Guimaraens, J Masso, S Miralbes, M Blanco-Ulla, M Souto-Bayarri, F Vazquez-Herrero
BACKGROUND: Experience with the endovascular treatment of unruptured small intracranial aneurysms by flow diverter devices is still limited. OBJECTIVE: To assess the safety and efficacy of the SILK flow diverter (SFD) in the treatment of small unruptured cerebral aneurysms (<10 mm). METHODS: We performed a retrospective review of a prospectively maintained database of patients treated with a SFD between July 2008 and December 2013 at 4 institutions in Spain to identify all patients with small unruptured aneurysms (<10 mm)...
May 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28488952/aneurysm-tears-caused-by-an-aneurysm-clip-springing-from-the-clip-applier
#3
Yasuo Murai, Kazutaka Shirokane, Takao Kitamura, Fumihiro Matano, Akio Morita
We experienced two cases in which aneurysm clips sprang from the applier. In case 1, a subdural haematoma from a ruptured anterior cerebral artery aneurysm was detected. When the clip was opened for final positioning, it suddenly sprang from the applier and ruptured the aneurysm. In case 2, the clip suddenly sprang from the applier as the surgeon opened the applier to clip an unruptured anterior cerebral aneurysm. These accidental phenomena are rare but dangerous. We present these cases to help prevent similar occurrences in the future...
May 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28479183/numerous-fusiform-and-saccular-cerebral-aneurysms-in-central-nervous-system-lupus-presenting-with-ischemic-stroke
#4
Shahram Majidi, Christopher R Leon Guerrero, Shreya Gandhy, Kathleen M Burger, Dimitri Sigounas
Central nervous system (CNS) involvement occurs in up to 50% of patients with systemic lupus erythematosus (SLE). Cerebral aneurysm formation is a rare complication of CNS lupus. The majority of these patients present with subarachnoid hemorrhage. We report a patient with an active SLE flare who presented with a recurrent ischemic stroke and was found to have numerous unruptured fusiform and saccular aneurysms in multiple vascular territories. He was treated with high-dose steroid and rituximab along with aspirin and blood pressure control for stroke prevention...
May 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28458385/recent-trends-in-neuro-endovascular-treatment-for-acute-ischemic-stroke-cerebral-aneurysms-carotid-stenosis-and-brain-arteriovenous-malformations
#5
Yuji Matsumaru, Eiichi Ishikawa, Tetsuya Yamamoto, Akira Matsumura
The efficacy of mechanical thrombectomy with stent retrievers for emergent large vessel occlusion has been proved by randomized trials. Mechanical thrombectomy is increasingly being adopted in Japan since stent retrievers were first approved in 2014. An urgent clinical task is to offer structured systems of care to provide this treatment in a timely fashion to all patients with emergent large vessel occlusion. Treatment with flow-diverting stents is currently a preferred treatment option worldwide for large and giant unruptured aneurysms...
May 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28443483/aneurysm-size-and-the-windkessel-effect-an-analysis-of-contrast-intensity-in-digital-subtraction-angiography
#6
Ahmed E Hussein, Darian R Esfahani, Andreas Linninger, Fady T Charbel, Chih-Yang Hsu, Fady T Charbel, Ali Alaraj
Large cerebral aneurysms are considered more dangerous than their smaller counterparts, with higher risk of subarachnoid hemorrhage. Understanding the hemodynamics of large aneurysms has potential to predict their response to treatment. Digital subtraction angiography images for patients with intracranial aneurysms over a seven-year period were reviewed. Unruptured solitary aneurysms of the internal carotid artery (ICA) proximal to the terminus and posterior communicating artery were included. Contrast intensity over time was analyzed at the center of the M1 segment of the middle cerebral artery distal to the aneurysm and compared to the contralateral side...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28439656/-management-of-paraophthalmic-aneurysms-review-of-endovascular-treatment-strategies
#7
P Bhogal, M Aguilar Pérez, G Sauder, H Bäzner, O Ganslandt, H Henkes
BACKGROUND: Aneurysms of the cerebral vessels are relatively common and aneurysms of the ophthalmic segment of the internal carotid artery (ICA) represent approximately 10% of intradural aneurysms. ANATOMICAL ASPECTS: The ophthalmic segment of the ICA extends from the origin of the ophthalmic artery to the origin of the posterior communicating artery. Aneurysms can originate from the ophthalmic artery itself or directly from the ICA at a distance from the ophthalmic artery...
April 24, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28438653/the-fate-of-side-branches-covered-by-flow-diverters-results-from-140-patients
#8
P Bhogal, O Ganslandt, H Bäzner, H Henkes, M Aguilar Perez
BACKGROUND: Flow diverter stents (FDS) are a recognised treatment option for intracranial aneurysms. There remain on-going concerns regarding the safety of FDS especially when it comes to the fate of covered side branches. We sought to report on the patency of side branches covered by FDS. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated with FDS for an unruptured saccular aneurysm of the clinoid, ophthalmic, and terminating segments of the internal carotid artery between September 2009 and July 2016...
April 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28428448/unruptured-cerebral-aneurysms-in-elderly-patients
#9
Tomohito Hishikawa, Isao Date
The prevalence of unruptured cerebral aneurysms (UCAs) in elderly patients is increasing in our aging population. UCA management in elderly patients has some difficulties, such as reduced life expectancy, increased comorbidities and treatment risks, and poor prognosis in case of rupture. In this review article, we summarize the most recent findings on the natural history, therapeutic options and treatment results for UCAs exclusively in elderly patients, and describe possible medical treatments for patients with UCAs...
April 19, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28427983/effect-of-headache-on-the-pathological-findings-of-unruptured-cerebral-saccular-aneurysms
#10
Masaaki Hokari, Naoki Nakayama, Yusuke Shimoda, Kiyohiro Houkin
BACKGROUND: Some patients with aneurysm exhibit warning headaches without minor bleeding, and this could be caused by stretching of the aneurysm wall. Recently, our pathological study observed subintimal fibrin deposition in a majority of the ruptured aneurysms. However, these findings were also observed in some unruptured aneurysms. In this report, two unruptured aneurysms exhibited subintimal fibrin, and interestingly, one of the patients experienced severe headache within 1 month before neuroimaging...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28387620/reoperation-and-readmission-after-clipping-of-an-unruptured-intracranial-aneurysm-a-national-surgical-quality-improvement-program-analysis
#11
Hormuzdiyar H Dasenbrock, Timothy R Smith, Robert F Rudy, William B Gormley, M Ali Aziz-Sultan, Rose Du
OBJECTIVE Although reoperation and readmission have been used as quality metrics, there are limited data evaluating the rate of, reasons for, and predictors of reoperation and readmission after microsurgical clipping of unruptured aneurysms. METHODS Adult patients who underwent craniotomy for clipping of an unruptured aneurysm electively were extracted from the prospective National Surgical Quality Improvement Program registry (2011-2014). Multivariable logistic regression and recursive partitioning analysis evaluated the independent predictors of nonroutine hospital discharge, unplanned 30-day reoperation, and readmission...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28385886/preliminary-experience-with-stent-assisted-coiling-of-aneurysms-arising-from-small-2-5-mm-cerebral-vessels-using-the-low-profile-visualized-intraluminal-support-device
#12
C-C Wang, W Li, Z-Z Feng, B Hong, Y Xu, J-M Liu, Q-H Huang
BACKGROUND AND PURPOSE: The Low-Profile Visualized Intraluminal Support (LVIS) stent is a new device recently introduced for the treatment of wide-neck intracranial aneurysms. This single-center study presents the authors' preliminary experience using the LVIS stent to treat saccular aneurysms with parent arteries smaller than 2.5 mm. MATERIALS AND METHODS: Aneurysms with a LVIS stent used in a small parent vessel (<2.5 mm in diameter) between October 2014 and April 2016 were included...
April 6, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28366751/risk-factors-to-predict-neurological-complications-after-endovascular-treatment-of-unruptured-paraclinoid-aneurysms
#13
Wenjun Ji, Lianfang Xu, Pengfei Wang, Liqian Sun, Xin Feng, Xianli Lv, Aihua Liu, Zhongxue Wu
OBJECTIVE: Unruptured paraclinoid aneurysms are often asymptomatic, and endovascular coiling is the main treatment. However, endovascular treatment of these lesions still leads to neurological complications. We aimed to identify predictors of neurological complications in these lesions. METHODS: We retrospectively analyzed patients with unruptured paraclinoid aneurysms who were treated with endovascular coiling between January 2014 and December 2015. A neurological complication was defined as any transient or permanent increase in the modified Rankin Scale score after aneurysm embolization...
March 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28343249/intraobserver-and-interobserver-variability-in-ct-angiography-and-mr-angiography-measurements-of-the-size-of-cerebral-aneurysms
#14
Hye Jeong Kim, Dae Young Yoon, Eun Soo Kim, Hyung Jin Lee, Hong Jun Jeon, Jong Young Lee, Byung-Moon Cho
PURPOSE: Accurate and reliable measurement of aneurysm size is important for treatment planning. The purpose of this study was to determine intraobserver and interobserver variability of CTA and MRA for measurement of the size of cerebral aneurysms. METHODS: Thirty patients with 33 unruptured cerebral aneurysms (saccular, >3 mm in their maximal dimension, with no daughter sacs or lobulations) who underwent 256-row multislice CTA, 3-D TOF MRA at 3.0T, and 3D rotational angiography (3DRA) were retrospectively analyzed...
March 25, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28338438/learning-brain-aneurysm-microsurgical-skills-in-a-human-placenta-model-predictive-validity
#15
Marcelo Magaldi Ribeiro de Oliveira, Carlos Eduardo Ferrarez, Taise Mosso Ramos, Jose Augusto Malheiros, Arthur Nicolato, Carla Jorge Machado, Mauro Tostes Ferreira, Fellype Borges de Oliveira, Cecília Félix Penido Mendes de Sousa, Pollyana Helena Vieira Costa, Sebastiao Gusmao, Giuseppe Lanzino, Rolando Del Maestro
OBJECTIVE Surgery for brain aneurysms is technically demanding. In recent years, the process to learn the technical skills necessary for these challenging procedures has been affected by a decrease in the number of surgical cases available and progressive restrictions on resident training hours. To overcome these limitations, surgical simulators such as cadaver heads and human placenta models have been developed. However, the effectiveness of these models in improving technical skills is unknown. This study assessed concurrent and predictive validity of brain aneurysm surgery simulation in a human placenta model compared with a "live" human brain cadaveric model...
March 24, 2017: Journal of 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
#16
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/28298037/impact-of-bifurcation-angle-and-inflow-coefficient-on-the-rupture-risk-of-bifurcation-type-basilar-artery-tip-aneurysms
#17
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/28298012/association-of-hypothyroidism-with-unruptured-cerebral-aneurysms-a-case-control-study
#18
Kunakorn Atchaneeyasakul, Anita Tipirneni, Tony Zhang, Priyank Khandelwal, Sudheer Ambekar, Brian Snelling, Sushrut Dharmadhikari, Chuanhui Dong, Luis Guada, Kevin Ramdas, Seemant Chaturvedi, Tatjana Rundek, Dileep R Yavagal
OBJECTIVE Thyroid disorder has been known to affect vascular function and has been associated with aortic aneurysm formation in some cases; however, the connection has not been well studied. The authors hypothesized that hypothyroidism is associated with the formation of cerebral aneurysms. METHODS The authors performed a retrospective case-control study of consecutive patients who had undergone cerebral angiography at an academic, tertiary care medical center in the period from April 2004 through April 2014...
February 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28273502/ruptured-berry-aneurysm-with-minimal-subarachnoid-hemorrhage
#19
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...
April 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
#20
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
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