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(Intracranial OR brain) AND aneurysm

Li Liang, David A Steinman, Olivier Brina, Christophe Chnafa, Nicole M Cancelliere, Vitor M Pereira
BACKGROUND: Intracranial aneurysms (IAs) are vascular dilations on cerebral vessels that affect between 1%-5% of the general population, and can cause life-threatening intracranial hemorrhage when ruptured. Computational fluid dynamics (CFD) has emerged as a promising tool to study IAs in recent years, particularly for rupture risk assessment. However, despite dozens of studies, CFD is still far from clinical use due to large variations and frequent contradictions in hemodynamic results between studies...
October 19, 2018: Journal of Neurointerventional Surgery
Daniel McLennan, Gareth Morgan
Background: Infective endocarditis (IE) is extremely rare in infants with structurally normal hearts. We present a case of Group B Streptococcus (GBS) endocarditis in a 5 week old. Clinical Case: A 5-week old male presented to his local hospital with fever and was diagnosed with GBS sepsis. He received 4 days of intravenous antibiotics and was discharged home with 6 days of oral antibiotics. He re-presented 5 days after discharge with severe sepsis as well as a new pathological pan systolic murmur and was diagnosed with IE following echocardiographic identification of a mitral valve vegetation...
2018: Frontiers in Pediatrics
Ciril Khorolsky, Andrew Castellano, David Comstock, Nooshin K Brinster, Sein Y See, Bruce F Garner
Systemic lupus erythematosus (SLE) and antineutrophil cytoplasmic antibody-associated vasculitis (AAV) overlap syndrome is an inflammatory disorder with a mixed presentation that is characterized by clinical features of both SLE and AAV. Although renal disease predominates, any organ system in the body may be affected. Neurologic manifestation in patients with SLE-AAV overlap syndrome is rare and has only been previously documented as cerebral ischemia. We report a patient with SLE-AAV overlap syndrome diagnosed based on clinical, serologic and biopsy-proven histologic findings who presented with subarachnoid hemorrhage (SAH) secondary to ruptured right anterior cerebral artery aneurysm...
October 16, 2018: Rheumatology International
Giuseppe Esposito, Sandra Fernandes Dias, Jan-Karl Burkhardt, Jorn Fierstra, Carlo Serra, Oliver Bozinov, Luca Regli
BACKGROUND: /Objective: The lateral supraorbital (LS) and minipterional (MP) approaches have been reported for treating intracranial aneurysms as alternative to the pterional approach. We present our decision-making for selecting the mini-craniotomy, LS vs. MP, for managing non-complex aneurysms of the middle cerebral artery (MCA), based on the depth of the aneurysm within the Sylvian fissure. METHODS: We report on a consecutive case-series of 50 patients who received clipping of 54 ruptured/unruptured MCA-aneurysms by means of LS or MP craniotomies...
October 13, 2018: World Neurosurgery
Jian-Zhong Zhang, Dan Chen, Li-Quan Lv, Zheng Xu, Yi-Ming Li, Jun-Yu Wang, Kai-Wei Han, Ming-Kun Yu, Cheng-Guang Huang, Li-Jun Hou
microRNAs (miRNAs) control several processes known to be involved in progression of aneurysm. Here, intracranial aneurysms (IAs) were surgically induced in Sprague-Dawley rats, and we found that miR-448-3p was downregulated and KLF5 was upregulated in IA rats. We identified Klf5 as a direct target of miR-448-3p in smooth muscle cells (SMCs). In addition, aneurysms size and the lumen area of the aneurysms were smaller 4 weeks after IA induction in the miR-448-3p-treated group. miR-448-3p treatment protected the wall thickness ratio and suppressed macrophage infiltration after IA induction...
October 12, 2018: Biochemical and Biophysical Research Communications
Eleni Vourla, Andreas Filis, Jan F Cornelius, Richard Bostelmann, Bernd Turowski, Piyush Kalakoti, Christian Rubbert, Marian Preetham Suresh, Angelo Tortora, Hans Jakob Steiger, Athanasios K Petridis
INTRODUCTION: De novo aneurysm formation after completely occluded aneurysms via clipping or coiling is generally not well studied. Although known to occur several years following initial aneurysm management, the natural history of de novo aneurysms is obscure. The current study investigated the formation of new aneurysms in patients who were previously treated for intracranial aneurysms. METHODS: In a retrospective, single-institutional series, eligible patients that underwent management for ruptured cerebral aneurysms between 2000-2011 were included...
October 12, 2018: World Neurosurgery
O E Idowu, O A Ayodele, H A Oshola
We describe the unique case of a 6-year old boy who presented with recalcitrant generalized tonic-clonic seizures and clinicoradiological features of congenital Cirsoid aneurysm. The lesion was supplied by occipital arteries and a large right parietal parasagittal intracranial feeding artery in a Yokouchi type C pattern. The venous drainage was communicating with the posterior part of the superior sagittal sinus. Six months after successful ligation of the feeding arteries and complete surgical excision of the lesion, the patient remains seizure free...
October 13, 2018: British Journal of Neurosurgery
Jianfeng Zheng, Rui Xu, Guojing Liu, Zongduo Guo, Xiaochuan Sun
OBJECTIVE: Hypertension is common in patients with aneurysmal subarachnoid hemorrhage (SAH). However, it is still unclear whether premorbid antihypertensive therapy can help to reduce the risk of severe aneurysmal bleeding. Therefore, this study aims to assess the effect of premorbid hypertension control on outcome of patients with aneurysmal SAH. METHODS: We retrospectively reviewed the clinical data of patients with intracranial aneurysms admitted to our institution from February 2012 to December 2017...
October 12, 2018: Acta Neurochirurgica
Adam N Wallace, Yasha Kayan, Josser E Delgado Almandoz, Jennifer L Fease, Anna A Milner, Jill M Scholz
BACKGROUND: The Scepter XC balloon catheter can be used for balloon-assisted coiling (BAC) of cerebral aneurysms, but also accommodates delivery of a low profile visible intraluminal stent (LVIS Jr.). We assessed the safety and effectiveness of BAC using the Scepter XC, with LVIS Jr. stent-assisted coiling (SAC) as a bailout option. METHODS: A single-institution prospectively-maintained neurointerventional database was reviewed for wide-necked (neck width ≥ 4 mm or dome-to-neck ratio < 2) saccular aneurysms treated using the Scepter XC...
October 9, 2018: World Neurosurgery
Jae Hoon Kim, Hee In Kang
BACKGROUND: Intraoperative ventriculostomy in the surgical management of aneurysmal subarachnoid hemorrhage (SAH) is frequently performed to reduce increased intracranial pressure. The previously suggested ventriculostomy points have some limitations because the dura mater must be opened to be accessed and it is difficult to measure the exact entry point in patients with brain edema. We propose a new intraoperative ventriculostomy point (K point) for use in the surgical management of aneurysmal SAH patient with severe brain edema...
October 9, 2018: World Neurosurgery
Olimpia Musumeci, Silvia Marino, Francesca Granata, Rosa Morabito, Lilla Bonanno, Teresa Brizzi, Viviana Lo Buono, Francesco Corallo, Marcello Longo, Antonio Toscano
BACKGROUND: Late Onset Pompe Disease (LOPD) is a rare, multisystem disorder, that is well established to mainly impair skeletal muscle function. Systematic studies exploring brain functions in LOPD are lacking. Aim of this study is to detect morphological and functional brain alterations as well as neuropsychological impairment in LOPD. MATERIALS AND METHODS: We studied 21 patients (10M, 11F, mean-age 49±18,4years), with defined diagnosis of LOPD, divided in two groups: one with presymptomatic hyperCKemia with no muscle weakness and the second with Limb-Girdle Muscle Weakness (LGMW group)...
October 12, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Sung-Min Cho, Tiffany Lee, Randall C Starling, Nicolas R Thompson, Ken Uchino
Despite the common occurrence left ventricular assist device (LVAD)-associated intracranial hemorrhage, the etiology of intracranial hemorrhage is uncertain. We aim to explore the impact of infection and international normalized ratio (INR) on intracranial hemorrhage in a case-crossover study. We reviewed consecutive patients with intracranial hemorrhage in a prospectively collected data of LVAD patients from a single, tertiary center from October 2004 to December 2016. Information on infection and INR values were collected at the time and 1 month before the intracranial hemorrhage as controls...
October 9, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Jonathan Rychen, Davide Croci, Michel Roethlisberger, Erez Nossek, Matthew B Potts, Ivan Radovanovic, Howard A Riina, Luigi Mariani, Raphael Guzman, Daniel W Zumofen
OBJECTIVE: To clarify the reported experience with keyhole approaches for the treatment of intracranial aneurysms. METHODS: The PubMed and Embase databases were searched up to December 2017 for full-text publications that report the treatment of aneurysms with the eyebrow variant of the supraorbital craniotomy (SOC), the minipterional craniotomy, or the eyelid variant of the SOC. The anatomical distribution of aneurysms, the postoperative aneurysm occlusion rate, and the type and rate of complications were examined using univariate analysis...
October 12, 2018: Neurological Research
Arianna Rustici, Ciro Princiotta, Corrado Zenesini, Carlo Bortolotti, Carmelo Sturiale, Massimo Dall'olio, Marco Leonardi, Luigi Cirillo
BACKGROUND: In many clinical trials endovascular procedures are suggested as the treatment of choice for aneurysmal Subarachnoid Hemorrhage (aSAH) whenever possible. However, in clinical practice this management is often controversial. The aim of this study is to analyze factors involved in this decision. METHODS: Our study included 317 consecutive cases of aSAH between 2010 and 2016, assessing clinical and neuroradiological features to evaluate their role in this choice...
October 10, 2018: Journal of Neurosurgical Sciences
Haydn Hoffman, Gentian Toshkezi, Amar Swarnkar, Grahame Gould, Lawrence S Chin, Satish Krishnamurthy
There are few reliable morphologic indices to aid in the determination of an intracranial aneurysm's rupture risk. We sought to characterize morphological characteristics of aneurysm sacs and their lobes that are associated with ruptured status at time of initial evaluation with diagnostic angiography. These factors could be associated with an aneurysm's risk of rupturing. We retrospectively reviewed all aneurysms imaged with digital subtraction angiography (DSA) at a single institution over five years. Patients presenting with aneurysmal subarachnoid hemorrhage (aSAH) were assigned to the ruptured group, and those presenting without aSAH were assigned to the unruptured group...
October 8, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
S Vulcu, F Wagner, Santos A Fernandes, R Reitmeir, N Söll, D Schöni, C Fung, R Wiest, A Raabe, J Beck, W J Z Graggen
BACKGROUND: Delayed cerebral infarction after aneurysmal subarachnoid hemorrhage (aSAH) still remains the leading cause of disability in patients that survive the initial ictus. It has been shown that CT perfusion (CTP) imaging can detect hypoperfused brain areas. The aim of this study was to evaluate if a single acute CTP examination at time of neurological deterioration is sufficient or if an additional baseline CTP increases diagnostic accuracy. METHODS: Retrospective analysis of acute and baseline (within 24 hours after aneurysm treatment) CTP examinations of patients with neurological deterioration because of vasospasm-related hypoperfusion...
October 8, 2018: World Neurosurgery
JianPing Zeng, LiPing Qin, DuanBu Wang, JiangBiao Gong, JianWei Pan, Yu Zhu, TianFu Sun, KangLi Xu, RenYa Zhan
BACKGROUND: This meta-analysis aimed to evaluate the risk of shunt-dependent hydrocephalus among patients with ruptured intracranial aneurysms treated with either coil placement or clipping. METHODS: A systematic literature search of EMBASE, PubMed, Web of Science, and the Cochrane Library was performed to confirm relevant studies. The scientific literature was screened in accordance with the predetermined inclusion and exclusion criteria. After quality assessment and data extraction from the eligible studies, a meta-analysis was conducted using Stata SE 12...
October 8, 2018: World Neurosurgery
Roger M Krzyżewski, Kornelia M Kliś, Renata Kucala, Jarosław Polak, Borys M Kwinta, Anna Starowicz-Filip, Krzysztof Stachura, Karolina Piszczek, Marek Moskała, Krzysztof A Tomaszewski
OBJECTIVE: Female sex is associated with a greater prevalence of cerebral aneurysms. However, it also might be linked to the location and size of the aneurysm. The aim of this study was to find the link between female sex and aneurysm characteristics. METHODS: Our study group consisted of 357 patients admitted to the hospital with both unruptured and ruptured aneurysms confirmed by Digital Subtraction Angiography or Computed Tomography Angiography and aneurysmal subarachnoid haemorrhage confirmed by head CT...
October 11, 2018: British Journal of Neurosurgery
Samuel Natzeder, David J Mack, Gabriela Maissen, Christian Strässle, Emanuela Keller, Carl Muroi
BACKGROUND: Portable automated infrared pupillometry is becoming increasingly popular. To generate an objective reference base, the Neurological Pupil index (NPi) which combines different values of the pupillary light reflex is being introduced into clinical practice. In this explorative study, we examined different aspects of the NPi in relation to clinical severity and outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS AND METHODS: Patients with serial assessment of the NPi (NeurOptics pupillometer NPi-200, Irvine, CA) starting no later than day 2 after aSAH onset were included in the study...
October 9, 2018: Journal of Neurosurgical Anesthesiology
Hidenori Oishi, Kosuke Teranishi, Kenji Yatomi, Takashi Fujii, Munetaka Yamamoto, Hajime Arai
Flow diverters (FDs) have been developed for intracranial aneurysms difficult to treat with conventional endovascular therapy and surgical clipping. We reviewed 94 patients with 100 large or giant unruptured internal carotid artery (ICA) aneurysms treated with Pipeline embolization device (PED) embolization from December 2012 to June 2017 at Juntendo University Hospital. The patients' mean age was 63.4 years (range, 19-88), and there were 90 women 89.4%. Aneurysm locations were: C4 (45), C3 (4), and C2 (51) in ICA segments...
October 6, 2018: Neurologia Medico-chirurgica
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