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cerebral aneurysm rupture risk

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https://www.readbyqxmd.com/read/29029314/small-aneurysms-account-for-the-majority-and-increasing-percentage-of-aneurysmal-subarachnoid-hemorrhage-a-25-year-single-institution-study
#1
Matthew T Bender, Haley Wendt, Thomas Monarch, Narlin Beaty, Li-Mei Lin, Judy Huang, Alexander Coon, Rafael J Tamargo, Geoffrey P Colby
BACKGROUND: Prospective studies of unruptured aneurysms have shown very low rates of rupture for small aneurysms (<10 mm) and suggested that the risk of treatment outweighs benefit. However, common clinical practice shows that patients with aneurysmal subarachnoid hemorrhage (aSAH) frequently have small aneurysms. OBJECTIVE: To investigate trends in size and location of ruptured aneurysms over a 25-yr period. METHODS: A prospective, Institutional Review Board-approved database of all patients presenting to our institution with aSAH from 1991 to 2016 was analyzed...
October 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28987853/early-hemodynamic-changes-based-on-initial-color-coding-angiography-as-a-predictor-for-developing-subsequent-symptomatic-vasospasm-after-aneurysmal-sah
#2
Jan-Karl Burkhardt, Xiaolin Chen, Ethan A Winkler, Miriam Weiss, John Yue, Daniel L Cooke, Helen Kim, Michael T Lawton
INTRODUCTION: Prediction of vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) remains imperfect and currently relies on clinical and radiographic characteristics. Whether early hemodynamic changes may refine risk stratification for delayed vasospasm (DV) after aSAH was analyzed. METHODS: Patients with aSAH (n=53) and a control of unruptured intracranial aneurysms (UIA) (n=12) with initial color-coding angiography at admission were included in this study (n=65)...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28987845/recurrent-cerebral-hemorrhages-in-normal-pregnancy-secondary-to-mycotic-pseudoaneurysms-related-to-choriocarcinoma
#3
Crystal Jing Jing Yeo, Gavin W Britz, Suzanne Z Powell, R Glenn Smith, Yi J Zhang
BACKGROUND: Choriocarcinoma coexisting with or after normal pregnancy is extremely rare. To our knowledge, our case report is the first time cerebral mycotic pseudoaneurysms from choriocarcinoma have been proven angiographically. CASE DESCRIPTION: A 38-week pregnant 26-year old woman presented with an acute left frontal hemorrhage. She underwent emergency Caesarian, followed by hematoma evacuation and resection of what grossly appeared to be a medium-sized arteriovenous malformation at the time of surgery...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28973585/characteristics-of-unruptured-compared-to-ruptured-intracranial-aneurysms-a-multicenter-case-control-study
#4
Isabel C Hostettler, Varinder S Alg, Nichole Shahi, Fatima Jichi, Stephen Bonner, Daniel Walsh, Diederik Bulters, Neil Kitchen, Martin M Brown, Henry Houlden, Joan Grieve, David J Werring
BACKGROUND: Only a minority of intracranial aneurysms rupture to cause subarachnoid hemorrhage. OBJECTIVE: To test the hypothesis that unruptured aneurysms have different characteristics and risk factor profiles compared to ruptured aneurysms. METHODS: We recruited patients with unruptured aneurysms or aneurysmal subarachnoid hemorrhages at 22 UK hospitals between 2011 and 2014. Demographic, clinical, and imaging data were collected using standardized case report forms...
July 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28969701/bazedoxifene-a-selective-estrogen-receptor-modulator-reduces-cerebral-aneurysm-rupture-in-ovariectomized-rats
#5
Hidetsugu Maekawa, Yoshiteru Tada, Kenji Yagi, Takeshi Miyamoto, Keiko T Kitazato, Masaaki Korai, Junichiro Satomi, Tomoki Hashimoto, Shinji Nagahiro
BACKGROUND: Estrogen deficiency is thought to be responsible for the higher frequency of aneurysmal subarachnoid hemorrhage in post- than premenopausal women. Estrogen replacement therapy appears to reduce this risk but is associated with significant side effects. We tested our hypothesis that bazedoxifene, a clinically used selective estrogen receptor (ER) modulator with fewer estrogenic side effects, reduces cerebral aneurysm rupture in a new model of ovariectomized rats. METHODS: Ten-week-old female Sprague-Dawley rats were subjected to ovariectomy, hemodynamic changes, and hypertension to induce aneurysms (ovariectomized aneurysm rats) and treated with vehicle or with 0...
October 2, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28962962/a-patient-with-a-recurrent-anterior-cerebral-artery-dissecting-aneurysm-after-stent-assisted-coil-embolization-successfully-treated-with-a3-a3-anastomosis
#6
Yoshiharu Takahashi, Hidenori Endo, Toshiki Endo, Miki Fujimura, Kuniyasu Niizuma, Teiji Tominaga
BACKGROUND: With recent advances in endovascular devices and techniques, the use of endovascular treatment has been reported for intracranial dissecting aneurysms. However, the efficacy of this endovascular approach for intracranial dissection is still unknown. We report the case of a patient with a recurrent anterior cerebral artery (ACA) dissecting aneurysm after endovascular treatment. CASE DESCRIPTION: A 67-year-old woman underwent stent-assisted coil embolization for a ruptured ACA dissecting aneurysm of the left A2 segment...
September 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28945889/cerebral-aneurysm-size-and-distal-intracranial-hemodynamics-an-assessment-of-flow-and-pulsatility-index-using-quantitative-magnetic-resonance-angiography
#7
Ahmed E Hussein, Denise Brunozzi, Sophia F Shakur, Rahim Ismail, Fady T Charbel, Ali Alaraj
BACKGROUND: The relationship between cerebral aneurysm size and risk of rupture is well documented, but the impact of aneurysms on distal intracranial hemodynamics is unknown. OBJECTIVE: To examine the relationship between aneurysm size and distal intracranial hemodynamics prior to treatment. METHODS: Patients seen at our institution between 2006 and 2015 with cerebral aneurysms within the internal carotid artery (ICA) segments (proximal to ICA terminus) were retrospectively reviewed...
August 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28919570/initial-clinical-experience-with-aview-a-clinical-computational-platform-for-intracranial-aneurysm-morphology-hemodynamics-and-treatment-management
#8
Jianping Xiang, Nicole Varble, Jason M Davies, Ansaar T Rai, Kenichi Kono, Shin-Ichiro Sugiyama, Mandy J Binning, Rabih G Tawk, Hoon Choi, Andrew J Ringer, Kenneth V Snyder, Elad I Levy, L Nelson Hopkins, Adnan H Siddiqui, Hui Meng
BACKGROUND: Intracranial aneurysm (IA) management is challenging. Clinicians often rely on varied and intuitively disparate ways of evaluating rupture risk that may only partially take into account complex hemodynamic and morphologic factors. We developed a prototype of a clinically-oriented, streamlined, computational platform, AView, for rapid assessment of hemodynamics and morphometrics in clinical settings. To show the potential clinical utility of AView, we report our initial multicenter experience highlighting the possible advantages of morphologic and hemodynamic analysis of IAs...
September 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28906352/clinical-and-angiographic-outcomes-following-endovascular-treatment-of-very-small-3%C3%A2-mm-or-smaller-intracranial-aneurysm-a-single-center-experience
#9
Yongsheng Liu, Feng Wang, Xiaochen Fu, Yongjian Liu, Guodong Zhang, Ke Xu
Treatments for very small (3 mm or smaller) intracranial aneurysms (VSAs) remain controversial. The aim of this study was to evaluate the efficacy of endovascular treatment for VSAs and to evaluate clinical risk factors associated with complications.This retrospective study enrolled 82 VSA patients who underwent coil embolization in our institution. Angiographic outcomes were assessed according to the Meyers classification. The clinical results were evaluated using the modified Rankin scale (mRS) immediately after coiling, at discharge, and during follow-up...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28900857/endovascular-biopsy-in-vivo-cerebral-aneurysm-endothelial-cell-sampling-and-gene-expression-analysis
#10
Daniel L Cooke, David B McCoy, Van V Halbach, Steven W Hetts, Matthew R Amans, Christopher F Dowd, Randall T Higashida, Devon Lawson, Jeffrey Nelson, Chih-Yang Wang, Helen Kim, Zena Werb, Charles McCulloch, Tomoki Hashimoto, Hua Su, Zhengda Sun
There is limited data describing endothelial cell (EC) gene expression between aneurysms and arteries partly because of risks associated with surgical tissue collection. Endovascular biopsy (EB) is a lower risk alternative to conventional surgical methods, though no such efforts have been attempted for aneurysms. We sought (1) to establish the feasibility of EB to isolate viable ECs by fluorescence-activated cell sorting (FACS), (2) to characterize the differences in gene expression by anatomic location and rupture status using single-cell qPCR, and (3) to demonstrate the utility of unsupervised clustering algorithms to identify cell subpopulations...
September 13, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28881112/morphological-and-hemodynamic-parameters-for-middle-cerebral-artery-bifurcation-aneurysm-rupture-risk-assessment
#11
Hao Qin, Qixia Yang, Qiang Zhuang, Jianwu Long, Fan Yang, Hongqi Zhang
OBJECTIVE: To investigate the morphological and hemodynamic parameters associated with middle cerebral artery (MCA)bifurcation aneurysm rupture. METHODS: A retrospective study of 67 consecutive patients was carried out based on 3D digital subtraction angiography data. Morphological and hemodynamic parameters including aneurysm size parameters (dome width, height, and perpendicular height), longest dimension from the aneurysm neck to the dome tip, neck width, aneurysm area, aspect ratio, Longest dimension from the aneurysm neck to the dome tip (Dmax) to dome width, and height-width, Bottleneck factor, as well as wall shear stress (WSS), low WSS area (LSA), percentage of LSA (LSA%) and energy loss (EL) were estimated...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28852853/predicting-symptomatic-cerebral-vasospasm-after-aneurysmal-subarachnoid-hemorrhage-with-an-artificial-neural-network-in-a-pediatric-population
#12
Jesse Skoch, Rizwan Tahir, Todd Abruzzo, John M Taylor, Mario Zuccarello, Sudhakar Vadivelu
PURPOSE: Artificial neural networks (ANN) are increasingly applied to complex medical problem solving algorithms because their outcome prediction performance is superior to existing multiple regression models. ANN can successfully identify symptomatic cerebral vasospasm (SCV) in adults presenting after aneurysmal subarachnoid hemorrhage (aSAH). Although SCV is unusual in children with aSAH, the clinical consequences are severe. Consequently, reliable tools to predict patients at greatest risk for SCV may have significant value...
August 29, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28843755/association-of-perforator-infarction-with-clinical-courses-and-outcomes-following-surgical-clipping-of-ruptured-anterior-communicating-artery-aneurysms
#13
Yu Yamamoto, Hitoshi Fukuda, Daisuke Yamada, Yoshitaka Kurosaki, Akira Handa, Benjamin Lo, Sen Yamagata
BACKGROUND: Perforator infarction is one of the procedure-related complications of surgical clipping of ruptured anterior communicating artery (ACoA) aneurysms. Patients with perforator infarction may represent specific clinical features; it is not well studied. The aim of this study is to elucidate incidence, risk factors, clinical courses, and outcomes of perforator infarction following surgical clipping of ruptured ACoA aneurysms. METHODS: A total of 104 patients who underwent surgical clipping for ruptured ACoA aneurysm were retrospectively analyzed from a single center, observational cohort database...
August 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28841119/predictive-anatomical-factors-for-rupture-in-middle-cerebral-artery-mirror-bifurcation-aneurysms
#14
Homajoun Maslehaty, Crescenzo Capone, Roman Frantsev, Igor Fischer, Ramazan Jabbarli, Jan F Cornelius, Marcel A Kamp, Paolo Cappabianca, Ulrich Sure, Hans-Jakob Steiger, Athanasios K Petridis
OBJECTIVE The aim of this study was to define predictive factors for rupture of middle cerebral artery (MCA) mirror bifurcation aneurysms. METHODS The authors retrospectively analyzed the data in patients with ruptured MCA bifurcation aneurysms with simultaneous presence of an unruptured MCA bifurcation mirror aneurysm treated in two neurosurgical centers. The following parameters were measured and analyzed with the statistical software R: neck, dome, and width of both MCA aneurysms-including neck/dome and width/neck ratios, shape of the aneurysms (regular vs irregular), inflow angle of both MCA aneurysms, and the diameters of the bilateral A1 and M1 segments and the frontal and temporal M2 trunks, as well as the bilateral diameter of the internal carotid artery (ICA)...
August 25, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28839527/a-new-imaging-tool-for-realtime-measurement-of-flow-velocity-in-intracranial-aneurysms
#15
Athanasios K Petridis, Marius Kaschner, Jan F Cornelius, Marcel A Kamp, Angelo Tortora, Hans-Jakob Steiger, Bernd Turowski
With modern imaging modalities of the brain a significant number of unruptured aneurysms are detected. However, not every aneurysm is prone to rupture. Because treatment morbidity is about 10% it is crucial to identify unstable aneurysms for which treatment should be discussed. Recently, new imaging tools allow analysis of flow dynamics and wall stability have become available. It seems that they might provide additional data for better risk profiling. In this study we present a new imaging tool for analysis of flow dynamics, which calculates fluid velocity in an aneurysm (Phillips Electronics, N...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28826580/comparison-of-rates-of-growth-between-unruptured-and-ruptured-aneurysms-using-magnetic-resonance-angiography
#16
Zenichiro Watanabe, Noriaki Tomura, Isao Akasu, Ryoji Munakata, Kazuomi Horiuchi, Kazuo Watanabe
BACKGROUND AND PURPOSE: Growth is a key risk factor for rupture of unruptured cerebral aneurysms. There are few reports of investigations into the actual growth of ruptured intracranial aneurysms. The aim of the present study was to ascertain the risk of rupture of aneurysms based on the growth of unruptured and ruptured aneurysms. METHODS: Changes in size on magnetic resonance angiography (MRA) were examined in 50 patients with ruptured cerebral aneurysms. Images obtained before and after subarachnoid hemorrhage were used...
August 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28821992/analysis-of-outcome-at-discharge-after-aneurysmal-subarachnoid-hemorrhage-in-japan-according-to-the-japanese-stroke-databank
#17
Fusao Ikawa, Masaru Abiko, Daizo Ishii, Jyunpei Ohshita, Toshinori Matsushige, Takahito Okazaki, Shigeyuki Sakamoto, Eisuke Hida, Shotai Kobayashi, Kaoru Kurisu
The outcomes at discharge for ruptured cerebral aneurysms after subarachnoid hemorrhage (SAH) were investigated using data from the Japanese stroke databank. Among 101,165 patients with acute stroke registered between 2000 and 2013, 4693 patients had SAH caused by ruptured saccular aneurysm. Of these, 3593 patients (1140 men and 2453 women; mean age 61.3 ± 13.7 years) were treated by surgical clipping (SC) and/or endovascular coiling (EC). The outcomes of modified Rankin scale (mRS) at discharge were compared between the SC and EC groups...
August 19, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28813082/middle-cerebral-artery-aneurysms-aneurysm-angiographic-morphology-and-its-relation-to-pre-operative-and-intra-operative-rupture
#18
Iracema Araújo Estevão, Bruno Camporeze, Antonio Santos de Araujo, Breno Nery, Ápio Claudio Martins Antunes, Timothy R Smith, Paulo Henrique Pires de Aguiar
Objective: Correlate the middle cerebral artery bifurcation aneurysm morphology with the pre-operative and intra-operative risk of rupture. Methods: Forty patients with 46 middle cerebral artery bifurcation aneurysms were treated microsurgically by the same surgeon. Aneurysms were classified according to shape and the Fisher test was applied to analyze the effect of morphology on the pre-operative and intra-operative rupture. Results: Pre-operative and intra-operative ruptures were observed in 8/46 patients (17...
August 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28812108/ultra-early-detection-of-microcirculatory-injury-as-predictor-of-developing-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#19
Philipp Gölitz, Philip Hoelter, Julie Rösch, Karl Roessler, Frauke Knossalla, Arnd Doerfler
PURPOSE: Delayed cerebral ischemia (DCI) still remains a major complication after subarachnoid hemorrhage (SAH). The aim of our study was to evaluate whether flow analysis of admission digital subtraction angiography (DSA) using parametric color coding (PCC), a postprocessing algorithm, allows ultra-early identification of SAH patients at risk for developing subsequent symptomatic vasospasm. METHODS: In this study 52 patients who suffered SAH from aneurysm rupture, were retrospectively enrolled...
August 15, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28805753/-prognostic-significance-of-leukocyte-count-in-the-venous-blood-in-the-acute-stage-of-cerebral-aneurism-rupture
#20
A A Kalinkin, S S Petrikov, L T Khamidova, V V Krylov
AIM: To determine a prognostic role of leukocyte count in the venous blood in the acute stage of cerebral aneurysm (CA) rupture. MATERIAL AND METHODS: Fifty-one patients with CA rupture, aged from 20 to 65 years, hospitalized in the first 72 h over the period from 01.10.12 to 01.02.16 were examined. The severity of disease and anatomical form of hemorrhage was corresponded to III-IV degree on the W. Hunt - R. Hess scale and Fisher scale. All patients underwent surgery...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
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