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extracranial artery surgery

Sang-Beom Jeon, Sun U Kwon, Jung Cheol Park, Deok Hee Lee, Sung-Cheol Yun, Yeon-Jung Kim, Jae-Sung Ahn, Byung-Duk Kwun, Dong-Wha Kang, H Alex Choi, Kiwon Lee, Jong S Kim
BACKGROUND AND PURPOSE: Hemicraniectomy is a decompressive surgery used to remove a large bone flap to allow edematous brain tissue to bulge extracranially. However, early indicators of the decompressive effects of hemicraniectomy are unclear. We investigated whether reduction of midline shift following hemicraniectomy is associated with improved consciousness and survival in patients with malignant middle cerebral artery infarctions. METHODS: We studied 70 patients with malignant middle cerebral artery infarctions (MMI) who underwent hemicraniectomies...
September 2016: Journal of Stroke
Toshiharu Yanagisawa, Hiroyuki Kinouchi, Toshio Sasajima, Hiroaki Shimizu
The authors describe a case of a basilar trunk aneurysm with long-term follow-up after successful bypass and proximal occlusion. A 64-year-old woman had a giant aneurysm of the basilar trunk and underwent external carotid artery-to-posterior cerebral artery vein graft bypass surgery and proximal clipping of the basilar artery, which was followed by low-dose aspirin (100 mg/d) treatment. No ischemic symptoms and lesions developed and the thrombosed aneurysm was stable during 11 years of follow-up. An extracranial-intracranial high flow bypass combined with immediate proximal occlusion and aspirin administration may be an acceptable treatment option for patients with giant posterior circulation aneurysms...
September 23, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Shin-Joe Yeh, Sung-Chun Tang, Li-Kai Tsai, Ya-Fang Chen, Hon-Man Liu, Ying-An Chen, Yu-Lin Hsieh, Shih-Hung Yang, Yu-Hsuan Tien, Chi-Cheng Yang, Meng-Fai Kuo, Jiann-Shing Jeng
The marked cerebral hypoperfusion of moyamoya disease (MMD) can be treated with encephaloduroarteriosynangiosis (EDAS), an indirect revascularization surgery. Collateral establishment after the surgery is a gradual process; thus, easy access to serial assessment is of great importance. We prospectively recruited 15 pediatric moyamoya patients who underwent EDAS surgeries on a total of 19 hemispheres. Ultrasonography of extracranial and intracranial arteries was performed pre-operatively and post-operatively at 1, 3 and 6 mo...
September 14, 2016: Ultrasound in Medicine & Biology
Mario Teo, Jeremiah N Johnson, Teresa E Bell-Stephens, Michael P Marks, Huy M Do, Robert L Dodd, Michael B Bober, Gary K Steinberg
OBJECTIVE Majewski osteodysplastic primordial dwarfism Type II (MOPD II) is a rare genetic disorder. Features of it include extremely small stature, severe microcephaly, and normal or near-normal intelligence. Previous studies have found that more than 50% of patients with MOPD II have intracranial vascular anomalies, but few successful surgical revascularization or aneurysm-clipping cases have been reported because of the diminutive arteries and narrow surgical corridors in these patients. Here, the authors report on a large series of patients with MOPD II who underwent surgery for an intracranial vascular anomaly...
September 9, 2016: Journal of Neurosurgery. Pediatrics
Joo Lian Julian Ong, Salmah Jalaludin
The purpose is to describe a case of traumatic right extracranial internal carotid artery (EICA) pseudoaneurysm, which is a rare entity and the evolution of treatment from surgery to minimally invasive intervention by endovascular stenting and coiling. We reported a case of traumatic right EICA pseudoaneurysm who presented with multiple cranial nerve palsies. Multiple radiological examinations [including magnetic resonance imaging (MRI) with angiogram, computed tomography angiogram (CTA), and digital subtraction angiogram (DSA)] demonstrated right EICA pseudoaneurysm...
March 2016: Malaysian Journal of Medical Sciences: MJMS
Mert Calis, Zeynep Oz, Ilkay Isikay, Ersoy Konas, Burcak Bilginer, Gokhan Tuncbilek
Many intracranial as well as extracranial complications can be seen following craniosynostosis surgeries. In this article, we would like to share an extremely rare complication of the infarction of the recurrent artery of Heubner, occurred following frontoorbital advancement. In this case, an 18-month-old male patient underwent supraorbital bar and frontal bone remodeling surgery for nonsyndromic metopic suture synostosis. The preoperative neurosurgical evaluation revealed no signs of increased intracranial pressure...
August 15, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Dagmar Kollmann, Christian Kinstner, Katharina Teleky, Alexander Wressnegger, Renate Koppensteiner, Ihor Huk, Christoph Neumayer, Martin Funovics
The rupture of an extracranial vertebral artery aneurysm has only been rarely described in the literature and treatment options are therefore not standardized. Here we report the successful endovascular repair of a spontaneously ruptured extracranial left vertebral artery aneurysm using Onyx instillation. A 48-year old woman was transferred to our clinic after having been intubated due to a massive hematoma of the left neck. A contrast enhanced computed tomography (CECT) showed a rupture of the left extracranial vertebral artery...
July 6, 2016: Annals of Vascular Surgery
Naokado Ikeda, Hideki Hayashi, Masanori Goto, Hitoshi Satoi, Koichi Iwasaki, Hiroki Toda
Symptomatic extracranial vertebral artery (VA) dissection may need surgery. We describe such a case successfully treated with atlantoaxial fusion based on its rare dynamic angiographic findings. A 27-year-old woman suffered from repeated brainstem and cerebellar infarctions from a left extracranial VA dissecting aneurysm. Dynamic angiography showed the dissecting aneurysm of the V3 segment in the neutral head position, and deflation of the aneurysm during rightward head rotation. She underwent posterior atlantoaxial fusion, and the lesion was repaired with no subsequent ischemia...
September 2016: Acta Neurochirurgica
Chetan P Huded, Quentin R Youmans, Jyothy J Puthumana, Ranya N Sweis, Mark J Ricciardi, Sukit Chris Malaisrie, Charles J Davidson, James D Flaherty
BACKGROUND: Carotid artery stenosis is a risk factor for stroke after surgical aortic valve replacement, but it is unknown whether carotid and vertebral artery disease impacts the risk of stroke after transcatheter aortic valve replacement (TAVR). METHODS: We reviewed 294 consecutive cases of TAVR at a tertiary care medical centre. Thirty-one patients without preoperative carotid/vertebral duplex ultrasonograms were excluded. Carotid or vertebral artery disease was defined on the basis of >50% stenosis...
March 29, 2016: Canadian Journal of Cardiology
Chengyuan Wang, Summit Kundaria, Juan Fernandez-Miranda, Umamaheswar Duvvuri
OBJECTIVES/HYPOTHESIS: To illustrate detailed anatomy of the extracranial portion of the glossopharyngeal nerve in the parapharyngeal space as encountered during transoral surgery. STUDY DESIGN: Prospective cadaveric dissection. All dissections were performed transorally and confirmed with transcervical dissection. METHODS: Eight color-injected cadaveric heads (16 sides) were dissected to demonstrate the course and anatomy of the glossopharyngeal nerve...
September 2016: Laryngoscope
T Radovnicky, P Vachata, R Bartos, M Sames
Patients with symptomatic internal carotid artery (ICA) occlusion with haemodynamic impairment are at higher risk of ischaemic stroke, and they require treatment. There are two main options: the best medical treatment and an extracranial-intracranial bypass. The aims of this study are to analyse the 30-day and 2-year risk of stroke and death in patients with extracranial-intracranial bypass performed by our department and to compare our results with major published studies. This retrospective study enrolled patients who underwent surgery from 1998 to 2012...
May 18, 2016: Neurosurgical Review
Jan Paweł Skóra, Jacek Kurcz, Krzysztof Korta, Przemysław Szyber, Tadeusz Andrzej Dorobisz, Andrzej Tadeusz Dorobisz
BACKGROUND: We present the methods and results of the surgical management of extracranial carotid artery aneurysms (ECCA). Postoperative complications including early and late neurological events were analysed. Correlation between reconstruction techniques and morphology of ECCA was assessed in this retrospective study. PATIENTS AND METHODS: In total, 32 reconstructions of ECCA were performed in 31 symptomatic patients with a mean age of 59.2 (range 33-84) years...
2016: VASA. Zeitschrift Für Gefässkrankheiten
Osama Jamil, Philipp Taussky, Richard H Schmidt, Min S Park
BACKGROUND: Central nervous system vasculitis has multiple presentations, including stroke, seizures, cranial nerve palsies, and encephalopathy. CASE DESCRIPTION: We present the case of an unresponsive 45-year-old woman with vasculitis associated with fulminant intracranial vessel dissection and occlusion with ischemic strokes and subarachnoid hemorrhage secondary to aneurysm rupture. Imaging studies demonstrated both ischemic and hemorrhagic strokes. She had a ruptured right internal carotid artery dorsal variant aneurysm, right vertebral artery dissection with occlusion and posterior inferior cerebellar artery infarct, left vertebral artery dissection, and severe vasculitis involving intracranial and extracranial vessels...
July 2016: World Neurosurgery
D Yu Usachev, V A Lukshin, A V Shmigel'skiy, A D Akhmedov
The article presents a case of successful surgical treatment of a patient with progressive chronic cerebral ischemia due to occlusions of both internal carotid arteries combined with occlusion of the vertebral artery in the first and second segments. We describe a surgical technique that includes an auto arterial carotid-subclavian bypass in the third segment of the vertebral artery, with an extracranial portion of the occluded internal carotid artery (after preliminary thromboendarterectomy) being used as a shunt...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Tomohiro Inoue, Kazuhiro Ohwaki, Akira Tamura, Kazuo Tsutsumi, Isamu Saito, Nobuhito Saito
Clinical results as well as cognitive performances after extracranial to intracranial (EC-IC) bypass in conjunction with contralateral carotid endarterectomy (CEA) are poorly understood. Data from 14 patients who underwent unilateral EC-IC bypass for atherosclerotic internal carotid artery (ICA)/middle cerebral artery (MCA) steno-occlusive disease in conjunction with CEA for contralateral cervical carotid stenosis were retrospectively reviewed. Postoperative results were evaluated by MRI imagings. Nine patients also underwent neuropsychological examinations (NPEs), including assessment by the Wechsler Adult Intelligence Scale-Third Edition and the Wechsler Memory Scale-Revised (WMS-R) before and about 6 months after bilateral surgeries...
October 2016: Neurosurgical Review
Luís Almeida-Morais, Sofia Galego, Nélia Marques, Tiago Pack, Hugo Rodrigues, Rodolfo Abreu, Leonor Vasconcelos, Hugo Marques, António Sousa Guerreiro
Giant cell arteritis (GCA) is a systemic large vessel vasculitis, with extracranial arterial involvement described in 10-15% of cases, usually affecting the aorta and its branches. Patients with GCA are more likely to develop aortic aneurysms, but these are rarely present at the time of the diagnosis. We report the case of an 80-year-old Caucasian woman, who reported proximal muscle pain in the arms with morning stiffness of the shoulders for eight months. In the previous two months, she had developed worsening bilateral arm claudication, severe pain, cold extremities and digital necrosis...
April 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Ran Sun, Xiao-Yan Peng, Qi-Sheng You, Li-Qun Jiao, Jost B Jonas
The central retinal artery (CRA), which can be non-invasively examined with ophthalmoscopy, may be regarded as an extracranial part of the cerebrovascular system. Assessment of CRA pressure may be of help in assessing the impediment of the intracranial blood circulation in patients with a carotid artery stenosis (CAS). The aim of this study was to explore the potential associations between diastolic central retinal artery pressure (diastCRAP) and CAS. The prospective longitudinal clinical observational study included patients with CAS and a control group without CAS...
March 2016: Experimental and Therapeutic Medicine
Salvatore Cappabianca, Francesco Somma, Alberto Negro, Michele Rotondo, Assunta Scuotto, Antonio Rotondo
The anatomical variations of internal carotid artery (ICA) are mostly asymptomatic, thus being disregarded and only incidentally diagnosed, with very few symptomatic patients. The awareness of these anomalies is crucial to solve the differential with other neck lesions, preventing accidental injuries during neck surgery. Therefore, the aim of our study is to estimate the prevalence of ICA anomalies, using magnetic resonance angiography (MRA) and computed tomography angiography (CTA). 253 patients underwent head and neck MRA and CTA examinations, with multiplanar and volumetric reformations...
October 2016: Surgical and Radiologic Anatomy: SRA
Y C Ooi, A N Laiwalla, R Liou, N R Gonzalez
BACKGROUND AND PURPOSE: Encephaloduroarteriosynangiosis has been shown to generate collateral vessels from the extracranial-to-intracranial circulation in patients with Moyamoya disease and intracranial arterial steno-occlusive disease. The mechanisms involved are not well-understood. We hypothesized that angiogenesis is the leading mechanism forming collaterals after encephaloduroarteriosynangiosis because there are no pre-existing connections. Angiogenesis-generated collaterals should exhibit higher architectural complexity compared with innate collaterals...
June 2016: AJNR. American Journal of Neuroradiology
Michael T Lawton, Adib A Abla, W Caleb Rutledge, Arnau Benet, Zsolt Zador, Vitaliy L Rayz, David Saloner, Van V Halbach
BACKGROUND: The treatment of dolichoectatic basilar trunk aneurysms has been ineffectual or morbid due to nonsaccular morphology, deep location, and involvement of brainstem perforators. Treatment with bypass surgery has been advocated to eliminate malignant hemodynamics and to stabilize aneurysm growth. OBJECTIVE: To validate that flow alteration with bypass and parent artery occlusion favorably impacts aneurysm progression. METHODS: Surgical management evolved in 3 phases, each with different hemodynamic alterations...
July 2016: Neurosurgery
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