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Unruptured cerebral aneurysm

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https://www.readbyqxmd.com/read/28637249/bypass-surgery-for-complex-intracranial-aneurysms-15-years-of-experience-at-a-single-institution-and-review-of-pertinent-literature
#1
Seung Pil Ban, Won-Sang Cho, Jeong Eun Kim, Chang Hyeun Kim, Jae Seung Bang, Young-Je Son, Hyun-Seung Kang, O-Ki Kwon, Chang Wan Oh, Moon Hee Han
BACKGROUND: Bypass surgery is a treatment option for complex intracranial aneurysms. OBJECTIVE: To determine the utility of bypass surgery for the treatment of complex intracranial aneurysms and to review the literature on this topic. METHODS: Sixty-two patients were included in this retrospective study. Unruptured aneurysms were dominant (80.6%), and the internal carotid artery was the most common location of the aneurysm (56.4%), followed by the middle cerebral artery (21...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28637201/size-is-the-most-important-predictor-of-aneurysm-rupture-among-multiple-cerebral-aneurysms-post-hoc-subgroup-analysis-of-unruptured-cerebral-aneurysm-study-japan
#2
Masaaki Shojima, Akio Morita, Hirofumi Nakatomi, Shinjiro Tominari
BACKGROUND: Multiple cerebral aneurysms are encountered in approximately 15% to 35% of patients harboring unruptured cerebral aneurysms. It would be of clinical value to determine which of them is most likely to rupture. OBJECTIVE: To characterize features of the ruptured aneurysm relative to other concomitant fellow aneurysms in patients with multiple cerebral aneurysms. METHODS: From a total of 5720 patients who were prospectively registered in the Unruptured Cerebral Aneurysm Study in Japan, a subgroup of patients with multiple cerebral aneurysms who developed subarachnoid hemorrhage was extracted for this post hoc analysis...
June 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28623116/comparison-of-the-prevalence-of-ruptured-and-unruptured-cerebral-aneurysms-in-a-poor-urban-minority-population
#3
Todd S Miller, David Altschul, Nrupen Baxi, Joaquim Farinhas, David Pasquale, Judah Burns, David Gordon, Jacqueline Bello, Allan Brook, Eugene Flamm
BACKGROUND: Most ruptured cerebral aneurysms are small (<7 mm). Evidence suggests low rupture rates for such lesions (<1% per year). Population studies demonstrate a prevalence rate of 3.2%. This study simultaneously estimates the prevalence of aneurysms in a single geographic population while reporting the observed rate of aneurysmal subarachnoid hemorrhage (aSAH) in the same geographic region composed of a poor urban minority demographic. METHODS: This is an institutional review board-approved, Health Insurance Portability and Accountability Act of 1996-compliant retrospective study performed between 2005 and 2011 at a single center...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28611648/complete-recovery-from-blindness-in-case-of-compressive-optic-neuropathy-due-to-unruptured-anterior-cerebral-artery-aneurysm
#4
Yurie Fukiyama, Hidehiro Oku, Yusuke Hashimoto, Yuko Nishikawa, Masahiro Tonari, Jun Sugasawa, Shigeru Miyachi, Tsunehiko Ikeda
It is not common for an isolated visual symptom to be the first indication of an aneurysm compressing the optic nerve. The compression can lead to blindness, and a recovery from the blindness is rare. We report a female with a left painless optic neuropathy caused by an unruptured anterior cerebral artery aneurysm. The patient had a temporal hemianopic visual field defect, which progressed to blindness in the left eye, while the right visual function was not affected. A coil embolization of the aneurysm completely restored her visual acuity to 20/20...
January 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28605486/aneurysm-morphology-and-prediction-of-rupture-an-international-study-of-unruptured-intracranial-aneurysms-analysis
#5
J Mocco, Robert D Brown, James C Torner, Ana W Capuano, Kyle M Fargen, Madhavan L Raghavan, David G Piepgras, Irene Meissner, John Huston Iii
BACKGROUND: There are conflicting data between natural history studies suggesting a very low risk of rupture for small, unruptured intracranial aneurysms and retrospective studies that have identified a much higher frequency of small, ruptured aneurysms than expected. OBJECTIVE: To use the prospective International Study of Unruptured Intracranial Aneurysms cohort to identify morphological characteristics predictive of unruptured intracranial aneurysm rupture. METHODS: A case-control design was used to analyze morphological characteristics associated with aneurysm rupture in the International Study of Unruptured Intracranial Aneurysms database...
June 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28586440/circumferential-wall-enhancement-on-magnetic-resonance-imaging-is-useful-to-identify-rupture-site-in-patients-with-multiple-cerebral-aneurysms
#6
Shunsuke Omodaka, Hidenori Endo, Kuniyasu Niizuma, Miki Fujimura, Toshiki Endo, Kenichi Sato, Shin-Ichiro Sugiyama, Takashi Inoue, Teiji Tominaga
BACKGROUND: Identification of rupture sites in patients with multiple intracranial aneurysms is largely based on aneurysm size, location, and shape. Finding circumferential enhancement along the aneurysm wall (CEAW) on magnetic resonance (MR) vessel wall imaging was recently shown to be indicative of ruptured aneurysm. OBJECTIVE: To investigate the hypothesis that a higher degree of CEAW would identify the site of rupture in patients with multiple aneurysms. METHODS: We prospectively performed quantitative analysis of CEAW in consecutive patients with both aneurysmal subarachnoid hemorrhage and multiple aneurysms (26 patients with a total of 62 aneurysms), using MR vessel wall imaging...
June 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28584682/safe-time-duration-for-temporary-middle-cerebral-artery-occlusion-in-aneurysm-surgery-based-on-motor-evoked-potential-monitoring
#7
Jun Tanabe, Tatsuya Ishikawa, Junta Moroi
BACKGROUND: Temporary vessel occlusion of the parent artery is an essential technique for aneurysm surgery. Our aim was to clarify the safe time for temporary occlusion for aneurysm surgery, that is the "safe time duration" (STD), in which brain tissue exposed to ischemia will almost never fall into even the ischemic penumbra during temporary occlusion of the middle cerebral artery (MCA), and even transient postoperative motor impairment will be rare using intraoperative motor-evoked potentials (MEP)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28583450/intraprocedural-rupture-of-unruptured-cerebral-aneurysms-during-coil-embolization-a-single-center-experience
#8
Su Hee Cho, Mohammed Denewer, Won Hyong Park, Jae Sung Ahn, Byung Duk Kwun, DeokHee Lee, Jung Cheol Park
OBJECTIVE: The incidence of intraprocedural rupture (IPR) during endovascular coiling is reported to range from 2% to 5%. In this study, we reviewed the single center experiences of IPR during coil embolization for unruptured intracranial aneurysm. METHODS: At our institution, 849 patients were treated with endovascular therapy for unruptured intracranial aneurysm between January 2011 and April 2016. Ten (1.18%) of these patients had documented IPR. We reviewed the medical data to evaluate the characteristics of the aneurysms, angiographic findings related to rupture, management, and outcomes...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28575518/outcomes-of-elective-cerebral-aneurysm-treatment-performed-by-attending-neurosurgeons-after-night-work
#9
Kimon Bekelis, Ymeon Missios, Todd A MacKenzie
BACKGROUND: The association between long work hours and outcomes among attending surgeons remains an issue of debate. OBJECTIVE: To investigate whether operating emergently the night before an elective case was associated with inferior outcomes among attending neurosurgeons. METHODS: We executed a cohort study with unruptured cerebral aneurysm patients, who underwent endovascular coiling or surgical clipping from 2009 to 2013 and were registered in the Statewide Planning and Research Cooperative System database...
May 30, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28574388/specifications-of-intracranial-saccular-aneurysms-treated-by-endovascular-approach-using-detachable-coils
#10
D Gunia, G Ingorokva, E Ekvtimishvili, G Basiladze
The treatment of intracranial saccular aneurysms remains an actual problem due to this pathology prevalence among the human population (about 1-10%). For definition of efficiency and preventive importance of endovascular treatment, it is necessary to clear define which aneurysms are more suitable and operable for endovascular occlusion with minimal risk of complications and better final outcome. The aim of this study is to analyze anatomical features (location and structure) of intracranial saccular aneurysms and clinical data of patients who have been operated endovascular, with detachable coils in High Technology Medical Center University Clinic,Tbilisi, Georgia for the last 6 years...
April 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28565988/postprocedural-midterm-and-long-term-results-of-cerebral-aneurysms-treated-with-flow-diverter-devices-7-year-experience-at-a-single-center
#11
Francesco Briganti, Giuseppe Leone, Luigi Cirillo, Oreste de Divitiis, Domenico Solari, Paolo Cappabianca
OBJECTIVE Flow diversion has emerged as a viable treatment option for selected intracranial aneurysms and recently has been gaining traction. The aim of this study was to evaluate the safety and effectiveness of flow-diverter devices (FDDs) over a long-term follow-up period. METHODS The authors retrospectively reviewed all cerebral aneurysm cases that had been admitted to the Division of Neurosurgery of the Università degli Studi di Napoli between November 2008 and November 2015 and treated with an FDD. The records of 60 patients (48 females and 12 males) harboring 69 cerebral aneurysms were analyzed...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565984/novel-use-of-flow-diversion-for-the-treatment-of-aneurysms-associated-with-arteriovenous-malformations
#12
Craig Kilburg, Philipp Taussky, M Yashar S Kalani, Min S Park
The use of flow-diverting stents for intracranial aneurysms has become more prevalent, and flow diverters are now routinely used beyond their initial scope of approval at the proximal internal carotid artery. Although flow diversion for the treatment of cerebral aneurysms is becoming more commonplace, there have been no reports of its use to treat flow-related cerebral aneurysms associated with arteriovenous malformations (AVMs). The authors report the cases of 2 patients whose AVM-associated aneurysms were managed with flow diversion...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565981/complications-associated-with-the-use-of-flow-diverting-devices-for-cerebral-aneurysms-a-systematic-review-and-meta-analysis
#13
Geng Zhou, Ming Su, Yan-Ling Yin, Ming-Hua Li
OBJECTIVE The objective of this study was to review the literature on the use of flow-diverting devices (FDDs) to treat intracranial aneurysms (IAs) and to investigate the safety and complications related to FDD treatment for IAs by performing a meta-analysis of published studies. METHODS A systematic electronic database search was conducted using the Springer, EBSCO, PubMed, Medline, and Cochrane databases on all accessible articles published up to January 2016, with no restriction on the publication year...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28552137/the-natural-history-of-cerebral-arteriovenous-malformations
#14
Anil Can, Bradley A Gross, Rose Du
Cerebral arteriovenous malformations (AVMs) are composed of a complex tangle of abnormal arteries and veins and are a significant source of cerebral hemorrhage and consequent morbidity and mortality in young adults, representing a diagnostic and therapeutic challenge. Current natural-history studies of cerebral AVMs report overall annual rates of 1% and 3% for the risk of epilepsy and hemorrhage, respectively. Unruptured AVMs have an annual hemorrhage rate of 2.2% while ruptured lesions have an annual hemorrhage rate of 4...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28549641/treatment-of-moyamoya-disease-and-unruptured-intracranial-aneurysm-in-floating-harbor-syndrome-a-case-report
#15
Daniel J Coughlin, Charles A Miller, A Jesse Schuette
BACKGROUND: This is the first report of the successful treatment of moyamoya disease (MMD) and an unruptured intracranial aneurysm in a patient with Floating-Harbor Syndrome (FHS). CASE DESCRIPTION: A 35 year-old, phenotypically syndromic woman presented with signs and symptoms consistent with ischemic stroke. MRI and catheter angiography confirmed diagnosis of moyamoya and a 6 mm basilar apex artery aneurysm (BAA). She underwent right sided craniotomy for direct and indirect revascularization by means of superficial temporal artery-middle cerebral artery (STA-MCA) bypass and encephalo-duro-arterio-synangiosis (EDAS)...
May 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28541503/reduced-efficacy-of-the-pipeline-embolization-device-in-the-treatment-of-posterior-communicating-region-aneurysms-with-fetal-posterior-cerebral-artery-configuration
#16
Anil K Roy, Brian M Howard, Diogo C Haussen, Joshua W Osbun, Sameer H Halani, Susana L Skukalek, Frank Tong, Raul G Nogueira, Jacques E Dion, Charles M Cawley, Jonathan A Grossberg
BACKGROUND: Aneurysms at the origin of the posterior communicating artery (PcommA) have been demonstrated to be effectively treated with the pipeline embolization device (PED). Much less is known about the efficacy of the PED for aneurysms associated with a fetal posterior cerebral artery (fPCA) variant. OBJECTIVE: To study PED treatment efficacy of PcommA aneurysms, including fPCA aneurysms. METHODS: A prospectively maintained university database of aneurysm patients treated with the PED was retrospectively reviewed...
May 25, 2017: Neurosurgery
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
#17
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
#18
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
#19
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
#20
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
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