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Unruptured cerebral aneurysm

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https://www.readbyqxmd.com/read/28217397/a5-segment-aneurysm-of-the-anterior-cerebral-artery-imbedded-into-the-body-of-the-corpus-callosum-a-case-report
#1
Fransua Sharafeddin, Ahmad Hafez, Martin Lehecka, Rahul Raj, Roberto Colasanti, Ahmadreza Rafiei, Joham Choque, Behnam R Jahromi, Mika Niemelä, Juha Hernesniemi
BACKGROUND: The A5 segment aneurysms of the anterior cerebral artery are rare, approximately 0.5% of all intracranial aneurysms. They are small with a wide base located in the midline, with the domes mostly projecting upward or backward. CASE DESCRIPTION: The authors describe a unique case of A5 segment aneurysm, with the dome embedded into the body of the corpus callosum. This 41-year-old female was admitted to the neurology department for possible multiple sclerosis investigation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28216398/engaging-in-a-keyhole-concept-for-the-management-of-ruptured-and-unruptured-aneurysms
#2
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
#3
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/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/28209313/the-arborization-bypass-sequential-intracranial-intracranial-bypasses-for-an-unruptured-fusiform-mca-aneurysm
#6
Jonathan J Russin
Revascularization techniques are being featured more prominently as endovascular treatments continue to select out complex cerebrovascular pathologies for open surgical management. The current healthcare environment requires decreased hospital stays and improved clinical outcomes despite the growing complexity of open surgical cases. Recent efforts to reduce operative room time and decrease risk for bypass surgery have focused on avoiding graft harvest and maintaining the entire bypass intracranial. The presented technique features an arborization bypass to serially anastomose the middle cerebral artery vessels allowing for proximal trapping of a complex aneurysm without graft harvest...
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/28184003/a-survey-of-intracranial-aneurysm-treatment-practices-among-united-states-physicians
#8
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/28179597/sinus-pericranii-with-dominant-venous-outflow-in-the-superior-eyelid
#9
Eiji Ito, Syuntaro Takasu, Kenichi Hattori
Sinus pericranii (SP) located in the superior eyelid is an unusual clinical presentation. Here, we report a case of 72-year-old woman with an unruptured cerebral aneurysm presented with an SP located in the left superior eyelid. The SP was found to have a dominant venous outflow from the bilateral frontal region with an arterialized blood flow pattern on color Doppler ultrasonography (CDUS). During the aneurysmal surgery, intraoperative monitoring of the dominant venous outflow with CDUS was useful for the prevention of venous outflow obstruction...
February 9, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28179247/impact-of-intraoperative-cefazolin-on-postoperative-seizures-after-elective-repair-of-unruptured-cerebral-aneurysm
#10
Alan Rozycki, John J Lewin, Rafael Tamargo, Betsy Zink, Marek Mirski, Haley Gibbs
PURPOSE: The impact of intraoperative cefazolin on postoperative seizures after elective repair of an unruptured cerebral aneurysm was evaluated. METHODS: Chart review of a prospectively accrued database was performed for patients admitted from January 1, 2003, through December 31, 2013. Patients were included in the study if they underwent elective repair of an unruptured aneurysm with surgical clipping or wrapping. The primary objective was to determine if the use of cefazolin increased patients' odds of having a seizure within six hours of surgical intervention...
February 15, 2017: American Journal of Health-system Pharmacy: AJHP
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/28131928/treatment-strategies-for-intracranial-mirror-aneurysms
#12
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/28121936/fatal-remote-cerebellar-hemorrhage-after-supratentorial-unruptured-aneurysm-surgery-in-patient-with-previous-cerebellar-infarction-a-case-report
#13
Eun-Jeong Koh, Jung-Soo Park
RATIONALE: Remote cerebellar hemorrhage (RCH) is a rare complication of supratentorial and spinal surgeries, seldom requiring intervention but occasionally causing significant morbidity or even mortality. Although a number of theories have been proposed, the exact pathophysiology of RCH remains incompletely understood. PATIENT CONCERNS: We present a 62-year-old patient with RCH encountered following surgical clipping of an unruptured middle cerebral artery bifurcation aneurysm in a patient with previous cerebellar infarction...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28120059/minipterional-craniotomy-for-treatment-of-unruptured-middle-cerebral-artery-aneurysms-a-single-center-comparative-analysis-with-standard-pterional-approach-as-regard-to-safety-and-efficacy-of-aneurysm-clipping-and-the-advantages-of-reconstruction
#14
Carmelo Lucio Sturiale, Giuseppe La Rocca, Alfredo Puca, Eduardo Fernandez, Massimiliano Visocchi, Enrico Marchese, Giovanni Sabatino, Alessio Albanese
Pterional craniotomy (PT) has long been the standard approach for the treatment of middle cerebral artery (MCA) aneurysms, even though it may cause temporalis muscle atrophy, facial nerve injury, and masticatory difficulties. Minipterional craniotomy (MPT) is an alternative approach that may provide the same surgical corridor, limiting the risk of postoperative esthetic and functional complications. From January 2011 to December 2014 we consecutively performed 68 craniotomies for surgical treatment of unruptured MCA aneuryms: 37 were standard PT and 31 were MPT...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28111312/dual-channel-endoscopic-indocyanine-green-fluorescence-angiography-for-clipping-of-cerebral-aneurysms
#15
Won-Sang Cho, Jeong Eun Kim, Hyun-Seung Kang, Eun Jin Ha, Minwoong Jung, Choonghee Lee, Il Hyung Shin, Uk Kang
OBJECTIVE: Neuroendoscopy is useful for assessing the status of perforators, parent arteries, and aneurysms beyond the straight line of microscopic view during aneurysm clipping. We aimed to evaluate the clinical usefulness of our endoscopic indocyanine green angiography (eICGA) system, which can simultaneously display both visible light and ICG fluorescent images. METHODS: A total of 16 unruptured aneurysms in 10 patients were surgically clipped via the keyhole approach...
January 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28108855/causes-of-poor-outcome-in-patients-admitted-with-good-grade-subarachnoid-haemorrhage
#16
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/28101173/particularly-interesting-cys-his-rich-protein-is-highly-expressed-in-human-intracranial-aneurysms-and-resists-aneurysmal-rupture
#17
Yu-Tao Peng, Xiang-En Shi, Zhi-Qiang Li, Xin He, Yu-Ming Sun
Particularly interesting Cys-His-rich protein (PINCH) has several biological functions in cancer development, invasion and metastasis in malignant cells, and the expression of PINCH is upregulated in several cancer types, including breast cancer, gastric adenocarcinoma and rectal cancer. However, the contribution of PINCH to human cerebral aneurysms remains largely unknown. Therefore, the significance of PINCH expression in cerebral aneurysm growth and rupture was examined in the present study. The protein expression levels of alpha-smooth muscle actin, osteopontin (OPN), matrix metalloproteinase (MMP) 9 and PINCH were evaluated using immunohistochemistry and western blot analyses...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28091826/paradigms-for-single-patient-multimodality-treatment-for-cerebral-aneurysms-single-center-eleven-year-experience
#18
Abdullah Alobaid, Erez Nossek, Katherine Wagner, Avi Setton, Amir R Dehdashti, David Langer, David Chalif
Endovascular and surgical techniques are conventional options for treating intracranial aneurysms, but criteria for selecting an optimal approach for individual patients remain variable across practitioners and institutions. While endovascular and surgical approaches are generally used alone, both modalities combined in single patients can produce efficacious outcomes. The aim of this study was to evaluate outcomes of combined, concomitant endovascular and surgical modalities in the treatment of multiple and/or complex aneurysms in single patients...
January 14, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28061486/superficial-temporal-artery-sparing-mini-pterional-approach-for-cerebral-aneurysm-surgery
#19
Jun-Young Ahn, Sung-Tae Kim, Ki-Chang Yi, Won-Hee Lee, Sung Hwa Paeng, Young-Gyun Jeong
OBJECTIVE: The purposes of this study were to introduce a superficial temporal artery (STA)-sparing mini-pterional approach for the treatment of cerebral aneurysms and review the surgical results of this approach. METHODS: Between June 2010 and December 2015, we performed the STA-sparing mini-pterional approach for 117 patients with 141 unruptured intracranial aneurysms. We analyzed demographic, radiologic, and clinical variables including age, sex, craniotomy size, aneurysm location, height of STA bifurcation, and postoperative complications...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28057589/microsurgical-clipping-of-unruptured-intracranial-aneurysms-a-single-surgeon-s-experience-over-sixteen-years
#20
Anil Nanda, Devi Prasad Patra, Shyamal C Bir, Tanmoy K Maiti, Piyush Kalakoti, Papireddy Bollam
INTRODUCTION: Unruptured intracranial aneurysms (UIA) have become an issue of greater significance as their detection rates have increased over the years. We present the overall experience of microsurgical clipping of unruptured aneurysms by a single surgeon over a period of more than 16 years. METHODS: The clinical and radiological data were retrospectively reviewed. Clinical outcome at follow-up was assessed by Glasgow Outcome Scale (GOS), and angiograms were reviewed for the degree of occlusion...
January 2, 2017: World Neurosurgery
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