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intracranial aneurism

Rie Yako, Hiroyuki Matsumoto, Osamu Masuo, Naoyuki Nakao
BACKGROUND AND IMPORTANCE: Stent-assisted coil embolization has been established as a treatment option for wide-necked or complex aneurysms. However, concerns have been raised about the incidence of thromboembolic complications, which is higher for coil embolization without stent assistance. Long-term antiplatelet therapy is necessary to prevent acute or delayed ischemic events potentially associated with incomplete stent apposition after treatment with stent-assisted coil embolization...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
Pierre-François Plouin, Jean-Philippe Baguet, Frédéric Thony, Olivier Ormezzano, Arshid Azarine, François Silhol, Catherine Oppenheim, Béatrice Bouhanick, Louis Boyer, Alexandre Persu, Frank Hammer, Philippe Gosse, Claire Mounier-Vehier, Claire Le Hello, Xavier Jeunemaitre, Michel Azizi, Laurence Amar, Gilles Chatellier, Elie Mousseaux, Emmanuel Touzé
Fibromuscular dysplasia (FMD) commonly affects the renal and cervical arteries but has been described to affect other vascular beds as well. The prevalence of and clinical characteristics associated with multisite FMD (string-of-beds or focal stenoses affecting at least 2 vascular beds) are not known. In the prospective ARCADIA registry (Assessment of Renal and Cervical Artery Dysplasia), symptomatic patients with renal artery (RA) FMD underwent tomographic- or magnetic resonance-angiography from the aortic arch to the intracranial arteries and those with cervical FMD from the diaphragm to the pelvis...
September 2017: Hypertension
Adrien Flahault, Bertrand Knebelmann, François Nataf, Denis Trystram, Jean-Pierre Grünfeld, Dominique Joly
Autosomal dominant polycystic kidney disease is the most frequent hereditary kidney disease. Intracranial aneurysm prevalence in this population is four to five times higher than the prevalence in the general population. The most frequent complication of intracranial aneurysms is rupture with subarachnoidal hemorrhage, which is associated with a high morbidity and mortality. The only identified risk factor for unruptured intracranial aneurysm is a family history of intracranial aneurysm. However, most cases of aneurysm rupture occur without any family history of intracranial aneurysm...
April 2017: Néphrologie & Thérapeutique
Ana Paula Devite Cardoso Gasparotto, Antonio Luis Eiras Falcão, Carolina Kosour, Sebastião Araújo, Eliane Araújo Cintra, Rosmari Aparecida Rosa Almeida de Oliveira, Luiz Claudio Martins, Desanka Dragosavac
OBJECTIVE: To evaluate the presence of hyponatremia and natriuresis and their association with atrial natriuretic factor in neurosurgery patients. METHODS: The study included 30 patients who had been submitted to intracranial tumor resection and cerebral aneurism clipping. Both plasma and urinary sodium and plasma atrial natriuretic factor were measured during the preoperative and postoperative time periods. RESULTS: Hyponatremia was present in 63...
June 2016: Revista Brasileira de Terapia Intensiva
Blandine Simonnet, Pierre Deharo, Karim Rouabah, François Silhol, Raphael Soler, Jean Michel Bartoli, Olivier Lévrier, Michel Alain Bartoli, Pierre Edouard Magnan, Gabrielle Sarlon-Bartoli
Fibromuscular dysplasia (FMD) is an underdiagnosed disease which can affect young people and with poor prognosis such as dissection or aneurysm rupture if unknown. This case illustrates a multi-vessel FMD with symptomatic severe bilateral ostial renal artery stenosis and intracranial aneurysms. One of the original features is a very late delay to diagnosis with 23 years between onset of hypertension and renal stenosis diagnosis, particularly due to lower quality of initial CT scan with milder and uncommon abnormalities...
July 2016: Annals of Vascular Surgery
Yoshifumi Okada, Tomoko Hayasaka, Satoko Chiba, Ryou Nishino, Yasuhiro Endo, Masanori Yamauchi
We report a case of subarachnoid hemorrhage due to rupture of a cerebral aneurysm in a 29-year-old woman in the 34th week of pregnancy. The aneurysm at the anterior communicating artery was up to 10 mm in diameter on magnetic resonance imaging and scheduled for emergent coil embolization. Simultaneously, obstetricians determined that cesarean section should be performed. Maintaining anesthesia by propofol and remifentanil, coil embolization was first performed to avoid aneurism re-rupture, and the patient was then transferred from an angiography room to an operating room where a cesarean section was performed...
September 2015: Masui. the Japanese Journal of Anesthesiology
L A Kalashnikova, L A Dobrinina, M V Dreval, E V Doronina, M A Nazarova
OBJECTIVE: To analyze clinical and neuroimaging data in patients with neck pain and headache as the only manifestation of the internal carotid artery (ICA) dissection (ICAD) and vertebral artery (VA) dissection (VAD). MATERIAL AND METHODS: One hundred and sixty-one patients (mean age - 37.4±4,99 years, 84 women, 52%) with cervical artery dissection (CAD) verified by magnetic resonance imaging (MRI) were enrolled. Neck pain and headache were the only CAD manifestation in 33 patients (mean age 37,3±7,4 yars, 28 women, 85%)...
2015: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
S O Lytvak, M V Ieleĭnik
Hemorrhagic insult (HI) with formation of intracranial hemorrhage of various anatomic form constitutes a typical clinical sign of the brain arterial aneurism rupture. Surgical intervention is the only one method of treatment in such patients. Some of them need performance of a one-staged or multi-staged operative interventions, directed on devascularization of the brain arterial aneurisms, evacuation or drainage of intracranial hemorrhage. One of physiological and perspective methods of clinical situation improvement is a local fibrinolytic therapy (LFTH) in complex of surgical treatment of the brain arterial aneurisms...
December 2014: Klinichna Khirurhiia
Giancarlo D'Andrea, Alessandro Frati, Andrea Pietrantonio, Pietro Familiari, Antonino Raco, Luigi Ferrante
INTRODUCTION: The BrainSuite(®) is a highly integrated operating theater designed mainly for brain tumor surgery. The issues concerning its routine use in vascular neurosurgery have not been discussed in literature to date. We report our experience of surgical treatment of cerebral aneurysms in the BrainSuite(®), with a view to evaluating safety, feasibility, advantages, disadvantages, and contraindications. MATERIAL AND METHODS: Retrospectively, we reviewed all the patients affected by ruptured and unruptured aneurysms that underwent craniotomy with clipping between January 2007 and May 2013 and a subsequent minimum 12-month follow up...
June 2015: Clinical Neurology and Neurosurgery
J B Jia, C S Green, A J Cohen, M Helmy
Onyx(®) (ev3, Irvine, CA, USA) is a liquid embolic agent composed of ethylene vinyl alcohol copolymer dissolved in dimethyl sulphoxide used for the treatment of intracranial arteriovenous malformations. Onyx is a preferred embolizing agent due to its unique properties, non-adhesive nature, and durability. In addition to its approved intracranial application, Onyx is also being used successfully in extracranial embolization in areas including extracranial aneurisms and vascular malformations, trauma, gastrointestinal bleeding, and neoplasms...
March 2015: Clinical Radiology
C Charbonnel, L Fanon, J-L Georges, G Colonna, L Stefas, C Isorni, R Convers-Domart, G Galuscan, N Baron, F Pico, B Livarek
AIM OF THE STUDY: In the setting of ischemic stroke, the place of transesophageal echocardiography (TEE) is still matter of debate. The aim of the study is to evaluate the therapeutic impact provided by TEE and to characterize patients in whom TEE is warranted. PATIENTS AND METHOD: Three hundred and fifty-nine consecutive patients were included in the study. "Decisive TEE" (DTEE) was defined by echographic findings resulting in a change of treatment, whereas "informative TEE" (ITEE) was defined by TEE revealing a potential cardiac or aortic source of embolism...
November 2014: Annales de Cardiologie et D'angéiologie
Dmitry Ivanov, Alexander Dol, Olga Pavlova, Asel Aristambekova
PURPOSE: This paper includes results of the first stage of research aimed at the development of recommendations for physicians in order to help them to choose a particular type of cerebral arteries aneurysms treatment. METHODS: Recent studies show that the majority of aneurysms develop as a result of hemodynamic and degenerative lesions of the vascular wall. Obviously, such wall damage can be studied using the methods of continuum mechanics and numerical simulations...
2014: Acta of Bioengineering and Biomechanics
Iu V Pilipenko, Sh Sh Éliava, S B Iakovlev, O B Belousova, S B Buklina, S R Arustomian, K G Mikeladze, A A Bondarenko, A E Bykanov
UNLABELLED: Most patients with brain aneurisms were operated on in the late posthemorrhagic period at the Burdenko Neurosurgical Institute. OBJECTIVE: To investigate the rate and structure of complications of microsurgical and endovascular surgery for different topographic anatomic variants of cerebral aneurysms in patients operated on in the late posthemorrhagic period in order to assess the risk of intervention in these patients. MATERIAL AND METHODS: The study group comprised 1074 patients with single brain aneurysms who had been treated at the Burdenko Neurosurgical Institute (Russian Academy of Medical Sciences) for the period from 2005 to 2012...
2014: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Hisato Nakazawa, Osamu Yamamuro, Yukio Uchiyama, Masataka Komori
In gamma knife stereotactic radiosurgery (GKSRS) treatment planning, 1.5 tesla (T)-magnetic resonance imaging (MRI) is normally used to identify the target lesion. Image artifacts and distortion arise in MRI if a titanium clip is surgically implanted in the brain to treat cerebral aneurysm. 3-T MRI scanners, which are increasingly being adopted, provide imaging of anatomic structures with better clinical usefulness than 1.5-T MRI machines. We investigated signal defects and image distortions both close to and more distant from the titanium clip in 1...
June 2014: Nihon Hoshasen Gijutsu Gakkai Zasshi
(no author information available yet)
Recently vascular neurosurgery is on stage of comparing of different techniques for intracranial aneurisms treatment. Clinical and randomized studies provide with data that different drugs and techniques have neuroprotective effect, for example haemogenesis growth factors. To introduce any growth factors in practice the research proving the effectiveness of the drug must be carried out. Accurate and complete characteristics of treatment outcomes play the main role in all studies. Terms of outcomes assessment must be characterized and patients must be distributed in order of their condition...
September 2013: Anesteziologiia i Reanimatologiia
Iu V Titova, S S Petrikov, A A Solodov, V V Krylov
The article contains results of examination of correlation between systemic hemodynamic and brain oxygenation and metabolism in patients with intracranial hemorrhage. Cardiac index (CI) and cerebral perfusion pressure (CPP) levels were compared to brain oxygenation and metabolism in 8 patients with intracranial hemorrhage (137 measurements). CI alterations didn't influence on PbrO2, glucose level or lactate/pyruvate ratio in the brain interstitial fluid in patients with traumatic brain injury. CPP elevation led to cerebral metabolism improvement...
July 2013: Anesteziologiia i Reanimatologiia
Alvaro Valencia, Patricio Burdiles, Miguel Ignat, Jorge Mura, Eduardo Bravo, Rodrigo Rivera, Juan Sordo
Computational Structural Dynamics (CSD) simulations, Computational Fluid Dynamics (CFD) simulation, and Fluid Structure Interaction (FSI) simulations were carried out in an anatomically realistic model of a saccular cerebral aneurysm with the objective of quantifying the effects of type of simulation on principal fluid and solid mechanics results. Eight CSD simulations, one CFD simulation, and four FSI simulations were made. The results allowed the study of the influence of the type of material elements in the solid, the aneurism's wall thickness, and the type of simulation on the modeling of a human cerebral aneurysm...
2013: Computational and Mathematical Methods in Medicine
Agreta Gecaj-Gashi, Zorica Nikolova-Todorova, Vlora Ismaili-Jaha, Musli Gashi
OBJECTIVE: Fentanyl-induced cough is usually mild and transitory, but it can be undesirable in patients with increased intracranial pressure, open wounds of the eye, dissecting aortic aneurism, pneumothorax, and reactive airway disease. The aim of this study is to evaluate the efficacy of lidocaine in suppressing fentanyl-induced cough in children during induction in general anesthesia. METHODS: One hundred and eighty-six children of both sexes, aged between 4-10 years, ASA physical status I and II, and scheduled for elective surgery, were recruited for the study...
2013: Cough
S Bracard, C Barbier, A L Derelle, R Anxionnat
The most frequent risk in endovascular aneurysm treatment is thromboembolic complications. Thus adjuvant pharmaceuticals are largely focused on preventing and treating these latter. Additionally symptomatic treatment of subarachnoid hemorrhage (SAH) and treatments to avoid vasospasm will enter into play in cases of ruptured aneurisms. Consensus exists in the literature neither for the necessity of heparin or antiplatelets nor for the doses to be administered. The principles and rationale of the use of these medications are reviewed with a discussion of protocols according with clinical situations and technical choices...
October 2013: European Journal of Radiology
J Svahn, T-H Cho, L Derex, L Mechtouff, N Nighoghossian
β-thalassemia is a genetic hemoglobinopathy, which can cause hypercoagulability, vessel wall damages and thromboembolic events. Spontaneous subarachnoidal hemorrhages are not commonly described in this affection. We report subarachnoidal hemorrhage, observed during the post-partum period in a 27-year-old woman suffering from β-thalassemia major. Brain MRI revealed complex vascular abnormalities: intracranial carotid occlusion, carotid micro-aneurisms, abnormally developed deep perforators and cortical arteries...
March 2013: Revue Neurologique
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