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https://www.readbyqxmd.com/read/28409729/neuropsychological-function-after-endovascular-and-neurosurgical-treatment-of-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#1
Peter Egeto, R Loch Macdonald, Tisha J Ornstein, Tom A Schweizer
OBJECTIVE Subarachnoid hemorrhage (SAH) is treated with either surgical clipping or endovascular coiling, though the latter is the preferred treatment method given its more favorable functional outcomes. However, neuropsychological functioning after treatment is rarely taken into account. In this meta-analysis, the authors synthesized relevant data from the literature and compared neuropsychological functioning in patients after coiling and clipping of SAH. They hypothesized that the coiled patients would outperform the clipped patients; that group differences would be greater with higher posterior circulation rupture rates, in older patients, and in more recent publications; that group differences would be smaller with greater rates of middle cerebral artery (MCA) rupture; and that anterior communicating artery (ACoA) rupture rates would not influence effect sizes...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28408258/predictors-of-postoperative-cerebral-ischemia-in-patients-with-ruptured-anterior-communicating-artery-aneurysms
#2
Pei-Sen Yao, Guo-Rong Chen, Shu-Fa Zheng, De-Zhi Kang
OBJECTIVE: Cerebral ischeamia is a major contributor to poor outcome after ruptured anterior communicating artery aneurysms (AcoAs), and is not well classified. Here we develop a classification and identify risk factors of cerebral ischemia after ruptured ACoAs. MATHERIAL AND METHODS: A total of 360 patients with ruptured ACoAs undergoing microsurgical clipping were collected. Sex, age, smoking, Hunt-Hess grade, Fisher grade, hospital stay, surgical timing, hypertension, diabetes, postoperative cerebral ischemia, and postoperative mRS score were collected...
April 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28327983/changing-paradigms-in-the-endovascular-management-of-ruptured-anterior-communicating-artery-aneurysms
#3
Karam Moon, Min S Park, Felipe C Albuquerque, Michael R Levitt, Celene B Mulholland, Cameron G McDougall
BACKGROUND: Approximately 17% of ruptured anterior communicating artery (ACoA) aneurysms were deemed unsuitable for coil embolization during the Barrow Ruptured Aneurysm Trial (BRAT), most commonly due to unfavorable dome-to-neck ratio or small size. OBJECTIVE: To compare patients treated by coil embolization for ruptured ACoA aneurysms during the trial to those treated after the trial to determine whether advances in endovascular techniques have allowed for effective treatment of these lesions...
January 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28267525/relationship-between-white-matter-hyperintensities-volume-and-the-circle-of-willis-configurations-in-patients-with-carotid-artery-pathology
#4
Luca Saba, Roberto Sanfilippo, Michele Porcu, Pierleone Lucatelli, Roberto Montisci, Fulvio Zaccagna, Jasjit Suri, Michele Anzidei, Max Wintermark
PURPOSE: We aimed to assess if there is a difference of distribution and volume of white matter hyperintensities (WMH) in the brain according to the Circle of Willis (CoW) configuration in patients with carotid artery pathology. MATERIAL AND METHODS: One-hundred consecutive patients (79 males, 21 females; mean age 70 years; age range 46-84 years) that underwent brain MRI before carotid endarterectomy (CEA) were included. FLAIR-WMH lesion volume was performed using a semi-automated segmentation technique and the status of the circle of Willis was assessed by two neuroradiologists in consensus...
April 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28130501/endovascular-flow-diversion-for-treatment-of-anterior-communicating-artery-region-cerebral-aneurysms-a-single-center-cohort-of-50-cases
#5
Geoffrey P Colby, Matthew T Bender, Li-Mei Lin, Narlin Beaty, Judy Huang, Rafael Tamargo, Alexander Coon
BACKGROUND: Flow diversion represents a novel but definitive treatment for recurrent and difficult-to-coil aneurysms of the anterior communicating artery (ACoA) region, of which reports are limited. OBJECTIVE: To determine the effectiveness of the Pipeline embolization device (PED) in treating aneurysms in the ACoA region. METHODS: We retrospectively reviewed an IRB-approved database of patients with an aneurysm at a single institution for patients with ACoA or A1-A2 aneurysms treated with PED...
January 27, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28120071/clinical-and-neuropsychological-outcome-after-microsurgical-and-endovascular-treatment-of-ruptured-and-unruptured-anterior-communicating-artery-aneurysms-a-single-enter-experience
#6
Pietrantonio Andrea, Trungu Sokol, Raco Antonino
BACKGROUND: Anterior communicating artery (ACoA) aneurysms have a high risk of rupture. Morbidity and mortality following rupture are higher than at other sites. The aim of this study was to evaluate the long-term clinical and neuropsychological outcomes of patients treated for ruptured and unruptured ACoA aneurysms: a comparison between surgical and endovascular treatment was performed. METHOD: All patients surgically or endovascularly treated for ruptured and unruptured ACoA aneurysms at our institution between January 2011 and December 2013 (n=50) were retrospectively reviewed...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28079351/effect-of-age-on-outcomes-and-practice-patterns-for-patients-with-anterior-communicating-artery-aneurysms
#7
Federico Cagnazzo, Waleed Brinjikji, Giuseppe Lanzino
BACKGROUND: With widespread utilization of noninvasive imaging, small enraptured anterior communicating artery (AcoA) aneurysms are increasingly detected in the general population, particularly in elderly patients. We investigated the association between age and clinical characteristics and outcomes of patients with unruptured AcoA aneurysms. METHODS: Between January 2008 and May 2016, information on 179 consecutive patients with unruptured AcoA aneurysms was obtained and included demographic data, aneurysm features, risk factors for formation and rupture, treatment type, complications, and follow-up information...
January 12, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27977657/delayed-recovery-of-adipsic-diabetes-insipidus-adi-caused-by-elective-clipping-of-anterior-communicating-artery-and-left-middle-cerebral-artery-aneurysms
#8
Jeffrey Tan, Samuel Ndoro, Uchenna Okafo, Aoife Garrahy, Amar Agha, Danny Rawluk
Adipsic diabetes insipidus (ADI) is an extremely rare complication following microsurgical clipping of anterior communicating artery aneurysm (ACoA) and left middle cerebral artery (MCA) aneurysm. It poses a significant challenge to manage due to an absent thirst response and the co-existence of cognitive impairment in our patient. Recovery from adipsic DI has hitherto been reported only once. A 52-year-old man with previous history of clipping of left posterior communicating artery aneurysm 20 years prior underwent microsurgical clipping of ACoA and left MCA aneurysms without any intraoperative complications...
December 16, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27924799/collateral-flow-and-white-matter-disease-in-patients-with-internal-carotid-artery-occlusion
#9
Mami Ishikawa, Hitoshi Sugawara, Mutsumi Nagai, Gen Kusaka, Yuichi Tanaka, Heiji Naritaka
BACKGROUND: When an internal carotid artery (ICA) occludes, a patient may develop cerebral infarction (CI). We investigated whether CI caused by ICA occlusion (ICAO) is associated with collateral flow through the anterior and posterior communicating arteries (ACoA and PCoA). METHODS: In 100 patients with ICAO, we investigated CI and white matter disease by performing an MRI and the anatomy of the ACoA and PCoA were investigated by performing magnetic resonance angiography...
2017: European Neurology
https://www.readbyqxmd.com/read/27876661/fusion-3-dimensional-angiography-of-both-internal-carotid-arteries-in-the-evaluation-of-anterior-communicating-artery-aneurysms
#10
Kuhyun Yang, Hae-Won Koo, Wonhyoung Park, Jin Su Kim, Choong Gon Choi, Jung Cheol Park, Jae Sung Ahn, Do Hoon Kwon, Byung Duk Kwun, Deok Hee Lee
BACKGROUND: To determine whether fusion 3-dimensional (3D) angiography of both internal carotid arteries can better disclose vascular details in patients diagnosed with anterior communicating artery (ACoA) aneurysms by computed tomography angiography (CTA) or magnetic resonance angiography (MRA). METHODS: Thirty-eight patients diagnosed with ACoA aneurysms by CTA or MRA were evaluated by the new postprocessing feature, fusion 3D angiography, with results individually interpreted by 4 experts...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27858574/quantitative-anatomical-analysis-and-clinical-experience-with-mini-pterional-and-mini-orbitozygomatic-approaches-for-intracranial-aneurysm-surgery
#11
Kaan Yagmurlu, Sam Safavi-Abbasi, Evgenii Belykh, M Yashar S Kalani, Peter Nakaji, Albert L Rhoton, Robert F Spetzler, Mark C Preul
OBJECTIVE The aim of this investigation was to modify the mini-pterional and mini-orbitozygomatic (mini-OZ) approaches in order to reduce the amount of tissue traumatization caused and to compare the use of the 2 approaches in the removal of circle of Willis aneurysms based on the authors' clinical experience and quantitative analysis. METHODS Three formalin-fixed adult cadaveric heads injected with colored silicone were examined. Surgical freedom and angle of attack of the mini-pterional and mini-OZ approaches were measured at 9 anatomical points, and the measurements were compared...
November 18, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27847765/relationship-between-gyrus-rectus-resection-and-cognitive-impairment-after-surgery-for-ruptured-anterior-communicating-artery-aneurysms
#12
Myung Sung Joo, Dong Sun Park, Chang Taek Moon, Young Il Chun, Sang Woo Song, Hong Gee Roh
OBJECTIVE: The gyrus rectus (GR) is known as a non-functional gyrus; hence, its resection is agreed to be a safe procedure frequently practiced to achieve a better surgical view during specific surgeries. This study aimed at comparing the cognitive outcomes following GR resection in patients who underwent surgery for ruptured anterior communicating artery (ACoA) aneurysms. MATERIALS AND METHODS: From 2012 to 2015, 39 patients underwent surgical clipping for ruptured ACoA aneurysms...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27743630/sensitivity-of-flow-patterns-in-aneurysms-on-the-anterior-communicating-artery-to-anatomic-variations-of-the-cerebral-arterial-network
#13
Fuyou Liang, Xiaosheng Liu, Ryuhei Yamaguchi, Hao Liu
Recent studies raised increasing concern about the reliability of computer models in reproducing in vivo hemodynamics in cerebral aneurysms. Boundary condition problem is among the most frequently addressed issues since three-dimensional (3-D) modeling is usually restricted to local arterial segments. The present study focused on aneurysms on the anterior communicating artery (ACoA) which represent a large subgroup of detected cerebral aneurysms and, in particular, have a relatively high risk of rupture compared to aneurysms located in other regions...
October 6, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27689465/relationship-of-a1-segment-hypoplasia-to-anterior-communicating-artery-aneurysm-morphology-and-risk-factors-for-aneurysm-formation
#14
Lorenzo Rinaldo, Brandon A McCutcheon, Meghan E Murphy, Mohamad Bydon, Alejandro A Rabinstein, Giuseppe Lanzino
OBJECTIVE Hypoplasia of the A1 segment of the anterior cerebral artery is frequently observed in patients with anterior communicating artery (ACoA) aneurysms. The effect of this anatomical variant on ACoA aneurysm morphology is not well understood. METHODS Digital subtraction angiography images were reviewed for 204 patients presenting to the authors' institution with either a ruptured or an unruptured ACoA aneurysm. The ratio of the width of the larger A1 segment to the smaller A1 segment was calculated. Patients with an A1 ratio greater than 2 were categorized as having A1 segment hypoplasia...
September 30, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27624158/safety-and-effectiveness-of-microsurgical-clipping-endovascular-coiling-and-stent-assisted-coiling-for-unruptured-anterior-communicating-artery-aneurysms-a-systematic-analysis-of-observational-studies
#15
REVIEW
Anthea H O'Neill, Ronil V Chandra, Leon T Lai
OBJECTIVE: Treatment outcomes for unruptured anterior communicating artery (ACoA) aneurysms are not well established. We aimed to investigate the safety and effectiveness of microsurgical clipping (MC), endovascular coiling (EC), and stent assisted coiling (SAC) of unruptured ACoA aneurysms to aid pretreatment clinical decisions. METHODS: A systematic review of the literature was conducted using the Ovid Medline and EMBASE electronic databases, encompassing all English language studies reporting treatment outcomes for unruptured ACoA aneurysms published between 2005 and 2015...
September 13, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27593836/vascular-variations-associated-with-intracranial-aneurysms
#16
Metin Orakdöğen, Selin Tural Emon, Hakan Somay, Taner Engin, Merih Iş, Tayfun Hakan
AIM: Investigation of the vascular variations in patients with intracranial aneurysm in circle of Willis. MATERIAL AND METHODS: We used the data on 128 consecutive intracranial aneurysm cases. Cerebral angiography images were analyzed retrospectively. Arteries grouped as anterior cerebral arterial system (ACS), posterior cerebral arterial system (PCS) and middle cerebral arterial system (MCS) for grouping vascular variations. Lateralization, being single/multiple, gender; and also any connection with accompanying aneurysm's number, localization, dimension, being bleeding/incidental aneurysm has been inspected...
May 25, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27381115/risk-factors-responsible-for-the-volume-of-hemorrhage-in-aneurysmal-subarachnoid-hemorrhage
#17
Jianfeng Liu, Jian Song, Di Zhao, Hui Li, Yingying Lu, Guobiao Wu, Kai Hou, Xuan Gao
BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH) is a medical emergency with a high mortality and morbidity. There is a marked association of the ensuing neurological functional deficits following aSAH with the volume of hemorrhage. The volume of intracranial hemorrhage in aSAH is usually quantified by the revised Fisher grades. MATERIALS AND METHODS: A total of 155 patients who suffered from aSAH were evaluated for risk factors that led to an increased volume of intracranial hemorrhage...
July 2016: Neurology India
https://www.readbyqxmd.com/read/27334737/predicting-the-necessity-of-anterior-communicating-artery-division-in-the-bifrontal-basal-interhemispheric-approach
#18
Shinichiro Teramoto, Helmut Bertalanffy
BACKGROUND: The anterior communicating artery (ACoA) often limits surgical exposure in the anterior interhemispheric approach. Although division of the ACoA has been proposed occasionally, it is rarely practiced, and criteria for such a surgical maneuver remain unknown. Our purpose was to identify key factors that allow for predicting the necessity of controlled ACoA division in the bifrontal basal interhemispheric approach. METHOD: Twenty-two consecutive patients who underwent surgery via the bifrontal basal interhemispheric approach for removal of various pathologic brain lesions were examined...
September 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27315171/down-on-the-upside-redemption-contamination-and-agency-in-the-lives-of-adult-children-of-alcoholics
#19
Tara P McCoy, William L Dunlop
We investigated differences in the nature and implications of Adult Children of Alcoholics (ACOAs; n = 53) and non-ACOAs' (n = 80) narrative identities. Participants described six autobiographical narratives and completed measures of emotional functioning. Narratives were coded for redemptive (bad things turning good), contaminated (good things turning bad), and agentic (perceived control) imagery. ACOAs exhibited similar levels of redemptive and contaminated imagery, and lower levels of agency in their narratives, relative to non-ACOAs...
May 2017: Memory
https://www.readbyqxmd.com/read/27315030/is-there-an-inherited-anatomical-conformation-favoring-aneurysmal-formation-of-the-anterior-communicating-artery
#20
Romain Bourcier, Cédric Lenoble, Béatrice Guyomarch-Delasalle, Benjamin Daumas-Duport, Chrysanthi Papagiannaki, Richard Redon, Hubert Desal
OBJECTIVE The pathophysiological mechanisms responsible for the formation of intracranial aneurysms (IAs) remain only partially elucidated. However, current evidence suggests a genetic component. The purpose of this study was to investigate the specific anatomical variations in the arterial complex that are associated with the presence of anterior communicating artery (ACoA) aneurysms in the familial forms of IAs. METHODS This multicenter study investigated bifurcation IAs in patients who had a sporadic ACoA IA without a family history of IA (SACAA group), in patients who had an ACoA IA with a family history of IA (FACAA group), and in their healthy first-degree relatives (HFDRs)...
May 2017: Journal of Neurosurgery
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