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unruptured internal aneurysms

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https://www.readbyqxmd.com/read/28637249/bypass-surgery-for-complex-intracranial-aneurysms-15-years-of-experience-at-a-single-institution-and-review-of-pertinent-literature
#1
Seung Pil Ban, Won-Sang Cho, Jeong Eun Kim, Chang Hyeun Kim, Jae Seung Bang, Young-Je Son, Hyun-Seung Kang, O-Ki Kwon, Chang Wan Oh, Moon Hee Han
BACKGROUND: Bypass surgery is a treatment option for complex intracranial aneurysms. OBJECTIVE: To determine the utility of bypass surgery for the treatment of complex intracranial aneurysms and to review the literature on this topic. METHODS: Sixty-two patients were included in this retrospective study. Unruptured aneurysms were dominant (80.6%), and the internal carotid artery was the most common location of the aneurysm (56.4%), followed by the middle cerebral artery (21...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28605486/aneurysm-morphology-and-prediction-of-rupture-an-international-study-of-unruptured-intracranial-aneurysms-analysis
#2
J Mocco, Robert D Brown, James C Torner, Ana W Capuano, Kyle M Fargen, Madhavan L Raghavan, David G Piepgras, Irene Meissner, John Huston Iii
BACKGROUND: There are conflicting data between natural history studies suggesting a very low risk of rupture for small, unruptured intracranial aneurysms and retrospective studies that have identified a much higher frequency of small, ruptured aneurysms than expected. OBJECTIVE: To use the prospective International Study of Unruptured Intracranial Aneurysms cohort to identify morphological characteristics predictive of unruptured intracranial aneurysm rupture. METHODS: A case-control design was used to analyze morphological characteristics associated with aneurysm rupture in the International Study of Unruptured Intracranial Aneurysms database...
June 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28584682/safe-time-duration-for-temporary-middle-cerebral-artery-occlusion-in-aneurysm-surgery-based-on-motor-evoked-potential-monitoring
#3
Jun Tanabe, Tatsuya Ishikawa, Junta Moroi
BACKGROUND: Temporary vessel occlusion of the parent artery is an essential technique for aneurysm surgery. Our aim was to clarify the safe time for temporary occlusion for aneurysm surgery, that is the "safe time duration" (STD), in which brain tissue exposed to ischemia will almost never fall into even the ischemic penumbra during temporary occlusion of the middle cerebral artery (MCA), and even transient postoperative motor impairment will be rare using intraoperative motor-evoked potentials (MEP)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28583450/intraprocedural-rupture-of-unruptured-cerebral-aneurysms-during-coil-embolization-a-single-center-experience
#4
Su Hee Cho, Mohammed Denewer, Won Hyong Park, Jae Sung Ahn, Byung Duk Kwun, DeokHee Lee, Jung Cheol Park
OBJECTIVE: The incidence of intraprocedural rupture (IPR) during endovascular coiling is reported to range from 2% to 5%. In this study, we reviewed the single center experiences of IPR during coil embolization for unruptured intracranial aneurysm. METHODS: At our institution, 849 patients were treated with endovascular therapy for unruptured intracranial aneurysm between January 2011 and April 2016. Ten (1.18%) of these patients had documented IPR. We reviewed the medical data to evaluate the characteristics of the aneurysms, angiographic findings related to rupture, management, and outcomes...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28565984/novel-use-of-flow-diversion-for-the-treatment-of-aneurysms-associated-with-arteriovenous-malformations
#5
Craig Kilburg, Philipp Taussky, M Yashar S Kalani, Min S Park
The use of flow-diverting stents for intracranial aneurysms has become more prevalent, and flow diverters are now routinely used beyond their initial scope of approval at the proximal internal carotid artery. Although flow diversion for the treatment of cerebral aneurysms is becoming more commonplace, there have been no reports of its use to treat flow-related cerebral aneurysms associated with arteriovenous malformations (AVMs). The authors report the cases of 2 patients whose AVM-associated aneurysms were managed with flow diversion...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28523215/migraine-prevalence-in-patients-with-unruptured-intracranial-aneurysms-a-case-control-study
#6
Elbert H Witvoet, Nadine Pelzer, Gisela M Terwindt, Gabriël J E Rinkel, Monique H M Vlak, Ale Algra, Marieke J H Wermer
OBJECTIVES: Migraine is a suggested risk factor for aneurysmal subarachnoid hemorrhage (aSAH). An increased risk of aSAH in migraineurs may be explained by an increased prevalence of unruptured intracranial aneurysms (UIA). We performed a case-control study to compare lifetime migraine prevalence in patients with UIA, patients with a history of transient ischemic attact (TIA) or ischemic stroke and controls without a history of aSAH, TIA or ischemic stroke. MATERIALS AND METHODS: Patients with UIA were recruited from two university hospitals...
May 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28490685/-ruptured-c2-aneurysm-of-the-internal-carotid-artery-with-ipsilateral-unruptured-giant-internal-carotid-artery-aneurysm-a-case-report
#7
Saya Ozaki, Hideo Tanaka, Shinya Fukumoto, Haruhisa Ichikawa, Shinji Onoue, Noriyuki Fumoto, Hajime Miyazaki, Kanehisa Kohno
A giant intracranial internal carotid artery(ICA)aneurysm is difficult to treat. We encountered a case with an unruptured giant intracranial ICA aneurysm with a ruptured C2 aneurysm of the ipsilateral ICA. In this case report, we describe how the treatment and review the literature. A 59-year-old man presented with sudden-onset headache and vomiting. He was diagnosed at a local neurosurgical unit as having a subarachnoid hemorrhage and admitted to our hospital. Cerebral angiogram revealed an unruptured giant ICA C3-4 aneurysm with a ruptured aneurysm of the ipsilateral ICA C2...
May 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28458385/recent-trends-in-neuro-endovascular-treatment-for-acute-ischemic-stroke-cerebral-aneurysms-carotid-stenosis-and-brain-arteriovenous-malformations
#8
Yuji Matsumaru, Eiichi Ishikawa, Tetsuya Yamamoto, Akira Matsumura
The efficacy of mechanical thrombectomy with stent retrievers for emergent large vessel occlusion has been proved by randomized trials. Mechanical thrombectomy is increasingly being adopted in Japan since stent retrievers were first approved in 2014. An urgent clinical task is to offer structured systems of care to provide this treatment in a timely fashion to all patients with emergent large vessel occlusion. Treatment with flow-diverting stents is currently a preferred treatment option worldwide for large and giant unruptured aneurysms...
May 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28448420/inflow-angle-of-small-paraophthalmic-aneurysms-is-a-determinant-of-adjacent-sphenoid-bone-remodeling
#9
Gianni Giancaspro, Thierry Gagné, Donatella Tampieri, Maria DelPilar Cortes
OBJECTIVE: Large internal carotid artery aneurysms can cause remodeling of the sphenoid bone with subsequent hemorrhage into the sinus. No reports have demonstrated small unruptured lesions causing similar bone remodeling. The purpose of this study was to demonstrate our experience with small unruptured paraophthalmic aneurysms causing sphenoid bone remodeling, specifically when the optimal aneurysm inflow angle is present. METHODS: We searched our database for computed tomography angiography studies of small paraophthalmic aneurysms and assessed adjacent sphenoid bone remodeling and inflow angle...
April 26, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28443483/aneurysm-size-and-the-windkessel-effect-an-analysis-of-contrast-intensity-in-digital-subtraction-angiography
#10
Ahmed E Hussein, Darian R Esfahani, Andreas Linninger, Fady T Charbel, Chih-Yang Hsu, Fady T Charbel, Ali Alaraj
Large cerebral aneurysms are considered more dangerous than their smaller counterparts, with higher risk of subarachnoid hemorrhage. Understanding the hemodynamics of large aneurysms has potential to predict their response to treatment. Digital subtraction angiography images for patients with intracranial aneurysms over a seven-year period were reviewed. Unruptured solitary aneurysms of the internal carotid artery (ICA) proximal to the terminus and posterior communicating artery were included. Contrast intensity over time was analyzed at the center of the M1 segment of the middle cerebral artery distal to the aneurysm and compared to the contralateral side...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28439656/-management-of-paraophthalmic-aneurysms-review-of-endovascular-treatment-strategies
#11
P Bhogal, M Aguilar Pérez, G Sauder, H Bäzner, O Ganslandt, H Henkes
BACKGROUND: Aneurysms of the cerebral vessels are relatively common and aneurysms of the ophthalmic segment of the internal carotid artery (ICA) represent approximately 10% of intradural aneurysms. ANATOMICAL ASPECTS: The ophthalmic segment of the ICA extends from the origin of the ophthalmic artery to the origin of the posterior communicating artery. Aneurysms can originate from the ophthalmic artery itself or directly from the ICA at a distance from the ophthalmic artery...
April 24, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28438653/the-fate-of-side-branches-covered-by-flow-diverters-results-from-140-patients
#12
P Bhogal, O Ganslandt, H Bäzner, H Henkes, M Aguilar Perez
BACKGROUND: Flow diverter stents (FDS) are a recognised treatment option for intracranial aneurysms. There remain on-going concerns regarding the safety of FDS especially when it comes to the fate of covered side branches. We sought to report on the patency of side branches covered by FDS. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated with FDS for an unruptured saccular aneurysm of the clinoid, ophthalmic, and terminating segments of the internal carotid artery between September 2009 and July 2016...
April 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28431024/radiosurgery-for-unruptured-brain-arteriovenous-malformations-an-international-multicenter-retrospective-cohort-study
#13
Dale Ding, Robert M Starke, Hideyuki Kano, John Y K Lee, David Mathieu, John Pierce, Paul Huang, Symeon Missios, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
BACKGROUND: The role of intervention in the management of unruptured brain arteriovenous malformations (AVM) is controversial. OBJECTIVE: To analyze in a multicenter, retrospective cohort study, the outcomes following radiosurgery for unruptured AVMs and determine predictive factors. METHODS: We evaluated and pooled AVM radiosurgery data from 8 institutions participating in the International Gamma Knife Research Foundation. Patients with unruptured AVMs and ≥12 mo of follow-up were included in the study cohort...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28377249/trends-in-resident-operative-teaching-opportunities-for-treatment-of-intracranial-aneurysms
#14
Matthew Piazza, Nikhil Nayak, Zarina Ali, Gregory Heuer, Matthew Sanborn, Sherman Stein, James Schuster, M Sean Grady, Neil R Malhotra
OBJECTIVE: The International Subarachnoid Aneurysm Trial heralded a paradigm shift in the treatment of intracranial aneurysms. During this same time frame neurosurgical training programs increased in size and scope. The present study examines the impact of trends in surgical clipping and the endovascular treatment of intracranial aneurysms, over one decade, and the neurosurgical resident complement on the resident teaching environment using the Nationwide Inpatient Sample (NIS). METHODS: The NIS was used to estimate the number of aneurysms treated with either surgical clipping and endovascular methods from 2002 through 2011 at teaching institutions...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28304199/jailed-double-microcatheter-technique-following-horizontal-stenting-for-coil-embolization-of-intracranial-wide-necked-bifurcation-aneurysms-a-technical-report-of-two-cases
#15
Takahiro Kitahara, Taketo Hatano, Makoto Hayase, Etsuko Hattori, Akinori Miyakoshi, Takehiko Nakamura
The horizontal stenting technique facilitates endovascular treatment of wide-necked bifurcation intracranial aneurysms. Previous literature shows, however, that subsequent coil embolization at initial treatment results in incomplete obliteration in many cases. The authors present two consecutive cases of wide-necked large bifurcation aneurysms to describe an additional coil embolization technique following horizontal stenting. The patients were a 53-year-old female with an unruptured internal carotid artery terminus aneurysm and a 57-year-old female with a recurrent basilar artery tip aneurysm...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28236049/analysis-of-the-venous-channel-within-the-clivus-using-multidetector-computed-tomography-digital-subtraction-venography
#16
Katsuhiro Mizutani, Masahiro Toda, Jun Kurasawa, Takenori Akiyama, Hirokazu Fujiwara, Masahiro Jinzaki, Kazunari Yoshida
PURPOSE: Although neuroradiologists and skull base neurosurgeons are aware of the existence of veins within the clivus, such vessels have seldom been described in the literature. The aim of the present study is to elucidate the detailed venous structure of the clivus. METHODS: Computed tomography digital subtraction venography (CT-DSV) images of 50 unruptured aneurysm cases were examined retrospectively. RESULTS: Eighteen emissary veins were identified in 14 (28...
February 24, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28235953/nickel-associated-delayed-multiple-white-matter-lesions-after-stent-assisted-coil-embolization-of-intracranial-unruptured-aneurysm
#17
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Daisuke Wajima, Takeshi Wada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
Metal-induced encephalopathy after stent-assisted coil embolization is extremely rare. The present report describes two patients who presented with symptomatic intracranial parenchymal edematous lesions after stent-assisted coil embolization. A 64-year-old woman underwent stent-assisted coil embolization for a left internal carotid artery aneurysm; 21 days after the procedure she presented with right hand weakness and MRI revealed multifocal white matter lesions. Another woman aged 52 years underwent stent-assisted coil embolization for right vertebral artery aneurysm; 18 days after the procedure she presented with left-sided sensory disturbance and MRI demonstrated multiple white matter lesions...
February 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28219914/nickel-associated-delayed-multiple-white-matter-lesions-after-stent-assisted-coil-embolization-of-intracranial-unruptured-aneurysm
#18
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Daisuke Wajima, Takeshi Wada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
Metal-induced encephalopathy after stent-assisted coil embolization is extremely rare. The present report describes two patients who presented with symptomatic intracranial parenchymal edematous lesions after stent-assisted coil embolization. A 64-year-old woman underwent stent-assisted coil embolization for a left internal carotid artery aneurysm; 21 days after the procedure she presented with right hand weakness and MRI revealed multifocal white matter lesions. Another woman aged 52 years underwent stent-assisted coil embolization for right vertebral artery aneurysm; 18 days after the procedure she presented with left-sided sensory disturbance and MRI demonstrated multiple white matter lesions...
February 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28216398/engaging-in-a-keyhole-concept-for-the-management-of-ruptured-and-unruptured-aneurysms
#19
Daniel D Cavalcanti, Roberto C de Paula, Paula L Alvarenga, Paulo José da Mata Pereira, Paulo Niemeyer Filho
OBJECTIVE: Many new endovascular devices have been used under the guidance of the International Subarachnoid Aneurysm Trial. Clipping still offers higher occlusion rates, and its technique continues to evolve, resulting in smaller exposures and reduced manipulation to brain tissue. We sought to evaluate the routine use of the minisphenoidal approach to manage intracranial aneurysms in a high-volume institution. METHODS: We retrospectively reviewed our database of patients with aneurysm from October 2013 to May 2016...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28209576/differences-in-hemodynamics-and-rupture-rate-of-aneurysms-at-the-bifurcation-of-the-basilar-and-internal-carotid-arteries
#20
R Doddasomayajula, B Chung, F Hamzei-Sichani, C M Putman, J R Cebral
BACKGROUND AND PURPOSE: Cerebral aneurysms in the posterior circulation are known to have a higher rupture risk than those in the anterior circulation. We sought to test the hypothesis that differences in hemodynamics can explain the difference in rupture rates. MATERIALS AND METHODS: A total of 117 aneurysms, 63 at the tip of the basilar artery (27 ruptured, 36 unruptured, rupture rate = 43%) and 54 at the bifurcation of the internal carotid artery (11 ruptured, 43 unruptured, rupture rate = 20%) were analyzed with image-based computational fluid dynamics...
February 16, 2017: AJNR. American Journal of Neuroradiology
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