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Internal carotid aneurysm

Z Y Jia, L B Zhao, D H Lee
BACKGROUND AND PURPOSE: Segmental intracranial dolichoectasia of the distal ICA is a feature of PHACE syndrome or a sporadic phenomenon. We evaluated the relationship between intracranial dolichoectasia of the distal ICA and PHACE syndrome and illustrated the characteristic radiologic findings of the lesions. MATERIALS AND METHODS: Intracranial dolichoectasia of the distal ICA was identified in 20 patients at our institution from 2005 to 2016 through a review of diagnostic cerebral angiography results...
March 15, 2018: AJNR. American Journal of Neuroradiology
Yoshitaka Shimizu, Takahito Okazaki, Tomoaki Hamana, Masahiro Irifune
Treatment of pseudoaneurysms in the internal carotid artery (ICA) is associated with a high risk of cerebral infarction; therefore, vessel ligation for hemostasis must be avoided. A 66-year-old man had intraoral hemorrhaging. At the time of the initial examination, computed tomography angiography showed jaw plate displacement near the ICA. A more detailed image was obtained using digital-subtraction angiography. After evaluation of the image, a pseudoaneurysm was diagnosed. Six days later, there were concerns about aspiration and airway obstruction; therefore, tracheostomy was performed...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
Poonam Sagar, Arif Kavungal Nambillath, Vikas Malhotra, Ajay Raj, Abhay Anand
Extracranial carotid artery aneurysms are rare but important entity. Impending rupture of such aneurysms can lead to catastrophic hemorrhage, airway compromise and may prove fatal. The authors report a case of true aneurysm of cervical internal carotid artery in a four-year-old girl who presented with fever and swelling of neck and oropharynx. High clinical suspicion is required to differentiate aneurysm from peritonsillar and parapharyngeal abscess as incision and drainage can prove fatal. Securing airway beforehand and timely embolization has led to the favorable outcome in the present case...
March 15, 2018: Indian Journal of Pediatrics
Soumik Das, Arun Kumar Gupta, Arvinda Hanumathapura Ramalingiah
We report here a rare complication in the form of kinking of flow diverter in a case of giant wide-necked supraclinoid internal carotid artery (ICA) aneurysm 48 hours after the procedure. This 28-year female presented with giant wide-necked right supraclinoid ICA aneurysm which was managed by flow diversion. On 2nd post-op day, patient developed weakness of left side with altered sensorium - angiography and CT showed kinking of flow diverter at the neck of the aneurysm with poor distal flow. Eventually, the patient developed right middle cerebral artery infarct for which decompressive hemicraniectomy was done...
March 2018: Neurointervention
Shigeomi Yokoya, Akihiko Hino, Yukihiro Goto, Youichi Hashimoto, Hideki Oka
BACKGROUND: The headache preceding an intracranial aneurysm (AN) rupture is called a sentinel headache (SH), and it is characterized by a sudden, intense, and persistent headache. As subarachnoid hemorrhage (SAH) often develops within several weeks of SH, its rapid diagnosis and treatment can improve the prognosis. CASE DESCRIPTION: A 52-year-old woman with migraine in her medical history visited the outpatient clinic due to left orbital pain. There was no neurological deficit...
March 9, 2018: World Neurosurgery
Tigran Khachatryan, Marina Khachatryan, Ruben Fanarjyan, Mikayel Grigoryan, Arthur Grigorian
Background: Currently, transsphenoidal surgery (TSS) is the preferred method for surgical treatment of intrasellar pituitary adenomas. However, it carries some risk of intraoperative arterial injuries, which is mainly attributed to direct iatrogenic rupture of the internal carotid artery (ICA). There is anecdotal evidence suggesting that intracranial aneurysms are coincidentally found significantly more frequently in the setting of pituitary adenomas than when the incidence is compared to other intracranial neoplasms...
2018: Surgical Neurology International
Anshu Mahajan, Gaurav Goel, Biplab Das, Karanjit Singh Narang
No abstract text is available yet for this article.
March 7, 2018: World Neurosurgery
Themistoklis I Papasilekas, Konstantinos M Themistoklis, Alexandros A Andreou
Blister aneurysms are rare lesions characterized by a bleb-like appearance in combination with prominent fragility. They mainly affect the supraclinoid internal carotid artery and they are often thought of as dissecting or even false lesions. Treatment of such lesions has been a matter of debate during the past few years with authors competing, in an ever changing field, for best results. Both surgical and endovascular modalities have been tried, with every technique having though its own limitations and pitfalls...
March 7, 2018: Clinical Neurology and Neurosurgery
Tomoya Watanabe, Haruo Isoda, Yasuo Takehara, Masaki Terada, Takehiro Naito, Takafumi Kosugi, Yuki Onishi, Chiharu Tanoi, Takashi Izumi
PURPOSE: We performed computational fluid dynamics (CFD) for patients with and without paraclinoid internal carotid artery (ICA) aneurysms to evaluate the distribution of vascular biomarkers at the aneurysm initiation sites of the paraclinoid ICA. METHODS: This study included 35 patients who were followed up for aneurysms using 3D time of flight (TOF) magnetic resonance angiography (MRA) and 3D cine phase-contrast MR imaging. Fifteen affected ICAs were included in group A with the 15 unaffected contralateral ICAs in group B...
March 8, 2018: Neuroradiology
S P Ban, O-K Kwon, S U Lee, J S Bang, C W Oh, H J Jeong, M J Cho, E-A Jeong, T Kim
BACKGROUND AND PURPOSE: During stent-assisted coiling of ICA aneurysms, stent tips are sometimes unintentionally embedded into ICA branches. Stent tips can be visualized because they have radiopaque markers. Concerns regarding stent tip misplacement include risks of artery perforation and occlusion. The aim of this study was to evaluate the long-term outcomes of ICA branches with embedded stent tips. MATERIALS AND METHODS: ICA branches with embedded stent tips were identified among 35 patients with unruptured ICA aneurysms treated with stent-assisted coiling between November 2003 and November 2014...
March 8, 2018: AJNR. American Journal of Neuroradiology
H Y Zhao, Z C Jia, D S Fan
Objective: To analyze the incidence of intracranial unruptured aneurysms in patients with internal carotid artery (ICA) stenosis (≥30%), the characteristics of aneurysms and risk factors in patients with ICA stenosis and intracranial aneurysm. Methods: Clinical data of patients receiving digital subtraction angiography (DSA) at Peking University Third Hospital between January 2012 and June 2015 were retrospectively reviewed to identify patients with ICA stenosis and unruptured intracranial aneurysm. Results: Among 247 patients with ICA stenosis, 16 patients (6...
March 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Jong Young Lee, Jong-Hwa Park, Hong Jun Jeon, Dae Young Yoon, Seoung Woo Park, Byung Moon Cho
PURPOSE: A complicated course of the femoral route for neurointervention can prevent approaching the target. Thus, we determined whether transcervical access in the hybrid angiosuite is applicable and beneficial in real practice. METHODS: From January 2014 to March 2017, this approach was used in 17 of 453 (3.75%) cases: 11 cerebral aneurysms (4 ruptured, 7 unruptured), 4 acute occlusions of the large cerebral artery, 1 proximal internal carotid artery (ICA) stenosis, and 1 direct carotid cavernous fistula (CCF)...
March 1, 2018: Neuroradiology
Daniel L Faden, Marion A Hughes, Philippe Lavigne, Brian T Jankowitz, Eric W Wang, Juan C Fernandez-Miranda, Paul A Gardner, Carl H Snyderman
BACKGROUND: Nontraumatic pseudoaneurysms of the cranial base are rare and present unique diagnostic and treatment dilemmas compared with both true aneurysms and pseudoaneurysms outside of the cranial base. There is a dearth of knowledge regarding the management of these complicated lesions. METHODS: Nontraumatic pseudoaneurysms of the cranial base internal carotid artery (ICA) were retrospectively identified at the University of Pittsburgh Medical Center through a key word search of cranial base cases from 2010 to 2017...
February 27, 2018: International Forum of Allergy & Rhinology
Meng Qi, Yan Ma, Liqun Jiao
Extracranial carotid artery aneurysms (ECAA) are less commonly seen disease. It is still difficult to determine the optimal treatment strategy because of limitations in reporting of results and confounding by indications based on the available literature. We depict a hybrid operation combining surgery with balloon occlusion to achieve distal outlet control, aneurysm resection, and reconstruction of parent internal carotid artery for the treatment of extracranial carotid artery aneurysms with good outcomes according to a 2-year follow up...
February 4, 2018: Turkish Neurosurgery
Maxim Mokin, Angel Chinea, Christopher T Primiani, Zeguang Ren, Peter Kan, Visish M Srinivasan, Ricardo Hanel, Pedro Aguilar-Salinas, Aquilla S Turk, Raymond D Turner, M Imran Chaudry, Andrew J Ringer, Babu G Welch, Vitor Mendes Pereira, Leonardo Renieri, Mariangela Piano, Lucas Elijovich, Adam S Arthur, Ahmed Cheema, Demetrius Klee Lopes, Ahmed Saied, Blaise W Baxter, Harris Hawk, Ajit S Puri, Ajay K Wakhloo, Hussain Shallwani, Elad I Levy, Adnan H Siddiqui, Guilherme Dabus, Italo Linfante
BACKGROUND: Blood blister aneurysms (BBA) are a rare subset of intracranial aneurysms that represent a therapeutic challenge from both a surgical and endovascular perspective. OBJECTIVE: To report multicenter experience with flow diversion exclusively for BBA, located at non-branching segments along the anteromedial wall of the supraclinoidal internal carotid artery (ICA). METHODS: Consecutive cases of BBA located at non-branching segments along the anteromedial wall of the supraclinoidal ICA treated with flow diversion were included in the final analysis...
February 24, 2018: Journal of Neurointerventional Surgery
Alessandro Prior, Luca Allegretti, Ilaria Melloni, Marta Bovio, Francesco Laganà, Marco Ceraudo, Gianluigi Zona
We present a case of ophthalmic artery (OA) traumatic avulsion, leading to a post-traumatic subarachnoid hemorrhage (SAH) with ventricular blood invasion and hydrocephalus, mimicking an internal carotid aneurysm rupture. This is the third case of such an event reported in literature and the first without orbital fractures and optic nerve avulsion. Conservative treatment was sufficient for the avulsion, but surgery was needed for the coexisting eye luxation. Traumatic OA avulsion is a rare but possible event and should be suspected in case of basal cisterns SAH, evidence of orbital trauma and CT angiogram or angiographic absence of opacification of the OA...
February 14, 2018: Acta Neurochirurgica
Gerald J Riccardello, Abhinav R Changa, Fawaz Al-Mufti, I Paul Singh, Chirag Gandhi, Max Roman, Charles J Prestigiacomo
Objective The natural history intracranial aneurysms (IA) remains poorly understood despite significant morbidity and mortality associated with IA rupture. Hemodynamic impingement resulting in elevations in wall shear stress and wall shear stress gradient (WSSG) has been shown to induce aneurysmal remodeling at arterial bifurcations. We investigate the hemodynamic environment specific to side-wall pre-aneurysmal vasculature. We hypothesize that fluid impingement and secondary flow patterns play a role in side-wall aneurysm initiation...
January 1, 2018: Interventional Neuroradiology
X M Wu, G Zhang, Q Wang, Z X Ni, M Liu, L B Yun, X F Yi
Internal carotid arterial system is the main source of blood supply in brain. In forensic identification practice, blunt injures of internal carotid arterial system usually cause complications such as thrombus, aneurysm and arteriovenous fistula, etc. The deaths following delayed cerebral infarction or intracranial haemorrhage are not rare. At present, literature of deaths caused by blunt injuries of internal carotid arterial system mainly consist of case reports in China. This paper reviews related literature and case reports at home and abroad, and summarizes forensic medical features and identification method of the deaths caused by such injuries...
December 2017: Fa Yi Xue za Zhi
Sang-Bae Ko
Although perioperative stroke is uncommon during low-risk non-vascular surgery, if it occurs, it can negatively impact recovery from the surgery and functional outcome. Based on the Society for Neuroscience in Anesthesiology and Critical Care Consensus Statement, perioperative stroke includes intraoperative stroke, as well as postoperative stroke developing within 30 days after surgery. Factors related to perioperative stroke include age, sex, a history of stroke or transient ischemic attack, cardiac surgery (aortic surgery, mitral valve surgery, or coronary artery bypass graft surgery), and neurosurgery (external carotid-internal carotid bypass surgery, carotid endarterectomy, or aneurysm clipping)...
February 2018: Korean Journal of Anesthesiology
Benjamin Gory, Raphaël Blanc, Francis Turjman, Jérôme Berge, Michel Piotin
BACKGROUND AND PURPOSE: The Barrel vascular reconstruction device (Barrel VRD) is a novel stent with design features that allow endovascular coiling of wide-necked bifurcation aneurysms while preserving adjacent branches, without necessitating dual stent implantation. This study aimed to assess the safety and effectiveness of the Barrel VRD at 12-month follow-up. MATERIALS AND METHODS: The Barrel VRD trial is a prospective, multicenter, observational post-marketing registry evaluating the use of the Barrel VRD for treatment of wide-necked bifurcation aneurysms...
February 2, 2018: Journal of Neurointerventional Surgery
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