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unruptured aneurysm

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https://www.readbyqxmd.com/read/28799869/predictive-factors-of-medullary-infarction-after-endovascular-internal-trapping-using-coils-for-vertebral-artery-dissecting-aneurysms
#1
Masanori Aihara, Isao Naito, Tatsuya Shimizu, Masahiro Matsumoto, Ken Asakura, Naoko Miyamoto, Yuhei Yoshimoto
OBJECTIVE The first choice of treatment in cases of vertebral artery dissecting aneurysms (VADAs) is endovascular internal trapping (EIT) of the dissecting segment using coils. However, this procedure carries the risk of medullary infarction, and the risk factors for this complication are not well understood. This study investigated the risk factors causing medullary infarction. METHODS One hundred patients who underwent EIT for VADAs were included in this study. Ninety-three patients presented with subarachnoid hemorrhage...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28792146/a-novel-association-between-lysyl-oxidase-gene-polymorphism-and-intracranial-aneurysm-in-koreans
#2
Eun Pyo Hong, Jin Pyeong Jeon, Sung Eun Kim, Jin Seo Yang, Hyuk Jai Choi, Suk Hyung Kang, Yong Jun Cho
PURPOSE: Lysyl oxidase (LOX) controls the cross-linking and maturation of elastin and collagen fibers. In this study, we investigated the association between LOX gene polymorphisms and intracranial aneurysm (IA) formation in a homogeneous Korean population. MATERIALS AND METHODS: This cross-sectional study involved 80 age-sex matched patients with IA and controls. Fisher's exact test was performed to analyze allelic associations between ten single nucleotide polymorphisms (SNPs) and IA, including 41 ruptured and 39 unruptured cases...
September 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28774792/macrophage-imaging-of-cerebral-aneurysms-with-ferumoxytol-an-exploratory-study-in-an-animal-model-and-in-patients
#3
Tomohiro Aoki, Makoto Saito, Hirokazu Koseki, Keiichi Tsuji, Atsushi Tsuji, Kiyoshi Murata, Hidetoshi Kasuya, Akio Morita, Shuh Narumiya, Kazuhiko Nozaki
OBJECTIVE: The purpose of this study is to assess the validity and feasibility of macrophage imaging using an ultrasmall superparamagnetic iron oxide nanoparticle, ferumoxytol, in the cerebral aneurysmal wall in an animal model and in humans. MATERIALS AND METHODS: Engulfment of ferumoxytol by primary culture of macrophages and RAW264.7 cells was assessed. Uptake of ferumoxytol was evaluated histologically in a cerebral aneurysmal model in rats. In an exploratory clinical study of magnetic resonance macrophage imaging, 17 unruptured aneurysms in 17 patients were imaged using thin-slice gapless magnetic resonance images of 2D-gradient-recalled echo (2D-GRE) and 3D-T1-fast-spin echo sequences on day 0 and of the same sequences with infusion of ferumoxytol 24 hours after the first imaging...
July 31, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28765026/passive-smoking-is-not-associated-with-risk-of-intracranial-aneurysm-rupture-in-nonsmoking-women
#4
Xin Feng, Luyao Wang, Erkang Guo, Baorui Zhang, Zenghui Qian, Xiaolong Wen, Wenjuan Xu, Youxiang Li, Chuhan Jiang, Zhongxue Wu, Aihua Liu
BACKGROUND: Active smoking is a major risk factor for intracranial aneurysm (IA) rupture (IAR); however, little is known about the effects of passive smoking on IAR. In China, female passive smoking is widespread and severe. This study aimed to assess whether passive smoking is associated with increased risk of IAR among nonsmoking women. METHODS: We enrolled and retrospectively analyzed 385 consecutive female patients with IAs (87 ruptured, 298 unruptured) who were admitted to our center between June 2015 and January 2017...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28765019/the-resolution-of-oculomotor-nerve-palsy-due-to-unruptured-posterior-communicating-artery-aneurysms-a-cohort-study-and-narrative-review
#5
Samuel Hall, Ahmed Ramadan-Sadek, Alexander Dando, Adam Grose, Borislav D Dimitrov, John Millar, Jason Hm Macdonald, Adam Ditchfield, Owen Sparrow, Diederik Bulters
OBJECTIVE: Recovery of oculomotor nerve palsy following microsurgical and endovascular treatment has been studied in numerous small series of predominantly ruptured aneurysms. Little consideration has been given to the distinction between ruptured and unruptured aneurysms. This study examines the influence of treatment modality on oculomotor palsy recovery due to unruptured posterior communicating artery aneurysms. METHODS: Patients who presented between 2003 and 2015 with an oculomotor palsy secondary to an unruptured posterior communicating artery aneurysm were identified from the hospital database...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28761525/the-minipterional-approach-for-ruptured-and-unruptured-anterior-circulation-aneurysms-our-initial-experience
#6
Kenan A Alkhalili, Jack R Hannallah, Gasser H Alshyal, Mohab M Nageeb, Khaled M Abdel Aziz
OBJECTIVE: To report our experience with the minipterional (MPT) craniotomy approach for anterior circulation aneurysms and to discuss the clinical outcomes as well as to evaluate the advantages of this unique approach. MATERIALS AND METHODS: Single-center retrospective review of 57 cases involving anterior circulation aneurysms both ruptured and unruptured aneurysms treated with the MPT. We analyzed the clinical and patient demographic data, aneurysm characteristics, surgical outcomes, and complications in these individuals...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28752411/alcohol-consumption-and-aneurysmal-subarachnoid-hemorrhage
#7
Anil Can, Victor M Castro, Yildirim H Ozdemir, Sarajune Dagen, Dmitriy Dligach, Sean Finan, Sheng Yu, Vivian Gainer, Nancy A Shadick, Guergana Savova, Shawn Murphy, Tianxi Cai, Scott T Weiss, Rose Du
Alcohol consumption may be a modifiable risk factor for rupture of intracranial aneurysms. Our aim is to evaluate the association between ruptured aneurysms and alcohol consumption, intensity, and cessation. The medical records of 4701 patients with 6411 radiographically confirmed intracranial aneurysms diagnosed at the Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016 were reviewed. Individuals were divided into cases with ruptured aneurysms and controls with unruptured aneurysms...
July 27, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28751517/packing-density-necessary-to-reach-a-high-complete-occlusion-rate-in-circumferential-unruptured-intracranial-aneurysms-treated-with-stent-assisted-coil-embolization
#8
R T Tosello, U C Batista, B J A Pereira, R L Piske
BACKGROUND AND PURPOSE: This study is a homogeneous series of circumferential unruptured intracranial aneurysms with large necks treated with stent-assisted coil embolization. Our purpose was to demonstrate which value of packing density is required to produce a durable occlusion. MATERIALS AND METHODS: We retrospectively evaluated all patients with unruptured intracranial aneurysms who were treated with stent-assisted coil embolization having late angiographic control between 2004 and 2014, in a single large cerebrovascular referral center...
July 27, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28735142/bifurcation-location-and-growth-of-aneurysm-size-are-significantly-associated-with-an-irregular-shape-of-unruptured-intracranial-aneurysms
#9
Xin Feng, Baorui Zhang, Erkang Guo, Luyao Wang, Zenguhi Qian, Peng Liu, Xiaolong Wen, Wenjuan Xu, Chuhan Jiang, Youxiang Li, Zhongxue Wu, Aihua Liu
BACKGROUND AND OBJECTIVE: Previous studies firmly proved that an irregular aneurysmal shape was strongly associated with intracranial aneurysm (IA) rupture, but it is unclear how irregularly shaped intracranial aneurysms (IAs) form. We aimed to identify the factors related to irregular shape of IAs. METHOD: We retrospectively analyzed of consecutive patients evaluated or treated for IA at our institution from June 2015 to July 2016. According to the imaging morphology of aneurysm, the enrolled patients are divided into irregular and regular group...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28733907/multiple-intracranial-aneurysms-a-direct-hemodynamic-comparison-between-ruptured-and-unruptured-vessel-malformations
#10
Philipp Berg, Oliver Beuing
PURPOSE: Despite numerous studies addressing the rupture risk of intracranial aneurysms that have been published, the assessment thereof still remains challenging. Image-based simulations enable a precise prediction of patient-specific blood flow information. However, those approaches normally consider only small segments of the complete cerebral vasculature. METHODS: To test the validity of the consideration of single aneurysms in one computational setup, domains of the complete anterior and posterior circulations with multiple intracranial aneurysms (MIA) were simulated...
July 21, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28711529/initial-treatment-strategy-for-intracranial-mycotic-aneurysms-two-case-reports-and-literature-review
#11
Makoto Ohtake, Kensuke Tateishi, Naoki Ikegaya, Junya Iwata, Shoji Yamanaka, Hidetoshi Murata
BACKGROUND: Intracranial mycotic aneurysm (IMA) is a rare neurovascular disease and a well-known complication following infective endocarditis. IMAs potentially carry a high mortality risk due to intracranial hemorrhage. Therefore, initial treatment is crucial for IMA patients, but an optimal treatment strategy remains unknown. Herein, we report two cases of IMA patients treated with the current usual modalities, and we provide a comprehensive literature review to propose an optimal initial treatment strategy for IMAs...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28711292/perioperative-stroke-after-cerebral-aneurysm-clipping-risk-factors-and-postoperative-impact
#12
Ahmed I Kashkoush, Brian T Jankowitz, Chris Nguyen, Paul A Gardner, Daniel A Wecht, Robert M Friedlander, Yue-Fang Chang, Miguel Habeych, Donald Crammond, Jeffrey Balzer, Parthasarathy D Thirumala
Stroke is a devastating complication after intracranial aneurysm clipping. Understanding the risk factors that prognosticate perioperative stroke may help to identify patients that would benefit from neuroprotective therapy. This study assesses patient-specific independent predictors of perioperative stroke in relation to surgical aneurysm clipping. Additionally, this study evaluates the postoperative complications of stroke. We performed a retrospective chart review of 437 patients with ruptured and unruptured intracranial aneurysms, which underwent surgical clipping from 2006 to 2013...
July 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28710522/cta-analysis-and-assessment-of-morphological-factors-related-to-rupture-in-413-posterior-communicating-artery-aneurysms
#13
Justiina Huhtakangas, Martin Lehecka, Hanna Lehto, Behnam Rezai Jahromi, Mika Niemelä, Riku Kivisaari
Posterior communicating artery (PcomA) aneurysms are frequently encountered, but there are few publications on their morphology. A growing number of aneurysms are incidental findings, which makes evaluation of rupture risk important. Our goal was to identify morphological features and anatomical variants associated with PComA aneurysms and to assess parameters related to rupture. We studied CT angiographies of 391 consecutive patients treated between 2000 and 2014 at a single institution. We determined clinically important morphological parameters and performed univariate and multivariate analysis...
July 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28710085/risk-factors-for-and-outcomes-of-intraprocedural-rupture-during-endovascular-treatment-of-unruptured-intracranial-aneurysms
#14
Shuhei Kawabata, Hirotoshi Imamura, Hidemitsu Adachi, Shoichi Tani, So Tokunaga, Takayuki Funatsu, Keita Suzuki, Nobuyuki Sakai
BACKGROUND AND PURPOSE: The risk factors for intraprocedural rupture (IPR) of unruptured intracranial aneurysms (UIAs) and the outcomes of IPR itself are unclear. This study was performed to identify the independent risk factors for and outcomes of IPR. MATERIALS AND METHODS: We retrospectively evaluated the medical records and radiologic data of 1375 patients (1406 UIAs) who underwent coil embolization from January 2001 to October 2016. RESULTS: IPR occurred in 20 aneurysms of 20 patients (1...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28705342/unruptured-multiple-intracranial-aneurysms-associated-with-beh%C3%A3-et-s-disease
#15
N Belfeki, K Argillos, R Dahmani, A Fkihi, N Velmans
Behçet's disease is a systemic inflammatory disorder with a wide variety of cardiovascular complications. Intracranial aneurysm is extremely rare. Herein, we are presenting a 41-year-old male with Behçet's disease and a headache. A cranial computed tomography scan angiography showed unruptured right supra cavernus internal carotid aneurysm and right sylvian artery aneurysm. Treatment consisted of prednisone and azathioprine. Control imaging showed no aneurysm.
July 2017: J Med Vasc
https://www.readbyqxmd.com/read/28692510/giant-serpentine-middle-cerebral-artery-aneurysm
#16
Xiao-Xiao Peng, Ming-Xing Wang, Hong-Xing Li, Ji-Rong Zhang
Giant serpentine aneurysms are rare entity, which have unique presentations and distinct angiographic features, with poor prognosis if not treated. In this paper, a patient with a giant serpentine aneurysm originated from right middle cerebral artery was reported. A 38-year-old woman suffered from progressively headache and vision declined. The computed tomography and magnetic resonance image revealed a partially calcified, large mass (approximately 80 × 70 × 60 mm sized) in the right frontal-temple lobe...
July 7, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28689391/the-incidence-and-characteristics-of-patients-with-small-ruptured-aneurysms-5-mm-in-subarachnoid-hemorrhage
#17
Joon-Ho Choi, Hyun-Seok Park
OBJECTIVE: Small unruptured aneurysms (<5 mm) are known for their very low risk of rupture, and are recommended to be treated conservatively. However, we encounter many patients with small ruptured aneurysms in the clinical practice. We aimed to investigate the incidence and characteristics of patients with small ruptured aneurysms. METHODS: We reviewed all patients admitted to our hospital with subarachnoid hemorrhage from January 2005 to December 2015. The patients were divided into two groups: those with aneurysms <5 mm (group S) and those with aneurysms ≥5 mm (group L)...
July 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28689386/surgical-informed-consent-process-in-neurosurgery
#18
REVIEW
Jaechan Park, Hyojin Park
The doctrine of informed consent, as opposed to medical paternalism, is intended to facilitate patient autonomy by allowing patient participation in the medical decision-making process. However, regrettably, the surgical informed consent (SIC) process is invariably underestimated and reduced to a documentary procedure to protect physicians from legal liability. Moreover, residents are rarely trained in the clinical and communicative skills required for the SIC process. Accordingly, to increase professional awareness of the SIC process, a brief history and introduction to the current elements of SIC, the obstacles to patient autonomy and SIC, benefits and drawbacks of SIC, planning of an optimal SIC process, and its application to cases of an unruptured intracranial aneurysm are all presented...
July 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28684458/influence-of-carotid-siphon-anatomy-on-brain-aneurysm-presentation
#19
E Waihrich, P Clavel, G A C Mendes, C Iosif, I Moraes Kessler, C Mounayer
BACKGROUND AND PURPOSE: Intracranial aneurysm is a devastating disease of complex etiology that is not fully understood. The purpose of this study was to assess the implications of carotid siphon anatomy for the formation and development of intracranial aneurysms. MATERIALS AND METHODS: Between January 2007 and May 2015, lateral view digital subtraction angiographic images of 692 consecutive patients with intracranial aneurysms treated in our department of interventional neuroradiology were reviewed and had their angles measured...
July 6, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28669879/unruptured-paraclinoid-aneurysm-treatment-effects-on-visual-function-a-systematic-review-and-meta-analysis
#20
Mina Asaid, Anthea H O'Neill, David Bervini, Ronil V Chandra, Leon T Lai
OBJECTIVE: Postoperative visual outcomes following repair of unruptured paraclinoid aneurysms (UPAs) are not well defined. We aim to investigate the influence of treatment modality on visual function. METHODS: A systematic literature analysis using the Ovid Medline and EMBASE databases was performed, encompassing English language studies (published between 1996 - 2016) reporting treatment outcomes for UPAs. Rates of visual morbidity (new, permanent postoperative deficit, worsening preoperative deficit), angiographic (recurrence, retreatment) and clinical outcomes (death, disability, post-treatment SAH) were recorded...
June 29, 2017: World Neurosurgery
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