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cerebral aneurysm rupture risk

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https://www.readbyqxmd.com/read/28209576/differences-in-hemodynamics-and-rupture-rate-of-aneurysms-at-the-bifurcation-of-the-basilar-and-internal-carotid-arteries
#1
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
https://www.readbyqxmd.com/read/28209306/successful-coil-embolization-of-a-ruptured-mycotic-aneurysm-that-developed-three-days-after-septic-embolic-infarction-case-report-and-review-of-the-literature
#2
Joshua L Wang, Archana P Hinduja, Ciarán J Powers
BACKGROUND: Infectious intracranial aneurysms (IIAs) are rare entities and are often associated with septic embolus from infectious endocarditis. They may develop rapidly and carry a higher risk of rupture and mortality compared to noninfectious aneurysms. However, the development and rupture of an IIA within 48h in a patient with septic infarction patient is exceedingly rare. CASE DESCRIPTION: In this report, we describe a 25-year-old male who presented with left-sided hemiparesis and dysarthria from septic embolus to the right middle cerebral artery...
February 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28186451/techniques-and-outcomes-of-microsurgical-management-of-ruptured-and-unruptured-fusiform-cerebral-aneurysms
#3
Sam Safavi-Abbasi, M Yashar S Kalani, Ben Frock, Hai Sun, Kaan Yagmurlu, Felix Moron, Laura A Snyder, Randy J Hlubek, Joseph M Zabramski, Peter Nakaji, Robert F Spetzler
OBJECTIVE Fusiform cerebral aneurysms represent a small portion of intracranial aneurysms; differ in natural history, anatomy, and pathology; and can be difficult to treat compared with saccular aneurysms. The purpose of this study was to examine the techniques of treatment of ruptured and unruptured fusiform intracranial aneurysms and patient outcomes. METHODS In 45 patients with fusiform aneurysms, the authors retrospectively reviewed the presentation, location, and shape of the aneurysm; the microsurgical technique; the outcome at discharge and last follow-up; and the change in the aneurysm at last angiographic follow-up...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28184003/a-survey-of-intracranial-aneurysm-treatment-practices-among-united-states-physicians
#4
Kyle M Fargen, Hector E Soriano-Baron, Julia T Rushing, William Mack, J Mocco, Felipe Albuquerque, Andrew F Ducruet, Maxim Mokin, Italo Linfante, Stacey Q Wolfe, John A Wilson, Joshua A Hirsch
BACKGROUND: Recent surveys have failed to examine cerebrovascular aneurysm treatment practices among US physicians. OBJECTIVE: To survey physicians who are actively involved in the care of patients with cerebrovascular aneurysms to determine current aneurysm treatment preferences. METHODS: A 25-question SurveyMonkey online survey was designed and distributed electronically to members of the Society of NeuroInterventional Surgery, Society of Vascular and Interventional Neurology, and the American Association of Neurological Surgeons/Congress of Neurological Surgeons Combined Cerebrovascular Section...
February 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28116528/cerebral-abscess-after-neuro-vascular-embolization-own-experience-and-review-of-the-literature
#5
G Cossu, R T Daniel, M Messerer
BACKGROUND: Cerebral abscesses are a rare complication after therapeutic neuro-endovascular procedures. METHOD: The aim of this article is to report a case of cerebral abscess after the endovascular embolization of a cerebral aneurysm and to discuss and review all the cases of cerebral abscess secondary to neurovascular embolization described in the literature up to now. RESULTS: A 40-year-old female patient was treated using an endovascular embolization for a ruptured aneurysm of the basilar artery tip...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28108855/causes-of-poor-outcome-in-patients-admitted-with-good-grade-subarachnoid-haemorrhage
#6
Vladimír Beneš, Lubomír Jurák, Radim Brabec, Nina Nechanická, Miroslav Šercl, Ladislav Endrych, Pavel Buchvald, Petr Suchomel
BACKGROUND: Surgical risk in patients with unruptured aneurysms is well known. The relative impact of surgery and natural history of subarachnoid haemorrhage (SAH) on patients in good clinical condition (World Federation of Neurological Surgeons [WFNS] grades 1 and 2) is less well quantified. The aim of this study was to determine causes of poor outcome in patients admitted in good grade SAH. METHODS: A retrospective study of prospectively collected data among WFNS-1 and -2 patients: demographics, SAH and aneurysm-related data, surgical complications and outcome as assesed by the Glasgow Outcome Scale (GOS)...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28017208/subjective-hearing-impairment-after-subarachnoid-haemorrhage-prevalence-and-risk-factors
#7
Erik M Vos, Paut Greebe, J M Anne Visser-Meily, Gabriel J E Rinkel, Mervyn D I Vergouwen
BACKGROUND: Sensorineural hearing impairment is a key symptom in patients with superficial siderosis of the central nervous system, a disease caused by chronic or intermittent haemorrhage into the subarachnoid space. We investigated the prevalence and risk factors of subjective hearing impairment after SAH. METHODS: We systematically interviewed all SAH patients admitted between June 2011 and December 2014, who were able to visit the SAH outpatient clinic six to eight weeks after hospital discharge...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28009232/clinical-relevance-of-anterior-cerebral-artery-asymmetry-in-aneurysmal-subarachnoid-hemorrhage
#8
Ramazan Jabbarli, Matthias Reinhard, Roland Roelz, Klaus Kaier, Astrid Weyerbrock, Christian Taschner, Christian Scheiwe, Mukesch Shah
OBJECTIVE An asymmetry of the A1 segments (A1SA) of the anterior cerebral arteries (ACAs) is an assumed risk factor for the development of anterior communicating artery aneurysms (ACoAAs). It is unknown whether A1SA is also clinically relevant after aneurysm rupture. The authors of this study investigated the impact of A1SA on the clinical course and outcome of patients with aneurysmal subarachnoid hemorrhage (SAH). METHODS The authors retrospectively analyzed data on consecutive SAH patients treated at their institution between January 2005 and December 2012...
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27943077/outcome-and-prognostic-factors-after-delayed-second-subarachnoid-haemorrhage
#9
Nina Brawanski, Johannes Platz, Markus Bruder, Christian Senft, Joachim Berkefeld, Volker Seifert, Juergen Konczalla
BACKGROUND: Data of patients suffering from delayed second subarachnoid haemorrhage (SAH) after aneurysm treatment are still missing. Patients become clearly older than before. Thus, the risk suffering from a second delayed SAH rises. The aim of this study was to analyse clinical outcome and prognostic factors in patients after delayed second SAH. METHOD: From 1999 to 2013, 18 of 1,493 patients (1.2%) suffered from a second SAH. Clinical and radiological characteristics were entered into a prospective conducted database...
February 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27935361/acute-impairment-of-saccadic-eye-movements-is-associated-with-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#10
Matthew J Rowland, Payashi Garry, Jon Westbrook, Rufus Corkill, Chrystalina A Antoniades, Kyle T S Pattinson
OBJECTIVE Delayed cerebral ischemia (DCI) causing cerebral infarction remains a significant cause of morbidity and mortality following aneurysmal subarachnoid hemorrhage (aSAH). Early brain injury in the first 72 hours following rupture is likely to play a key role in the pathophysiology underlying DCI but remains difficult to quantify objectively. Current diagnostic modalities are based on the concept of vasoconstriction causing cerebral ischemia and infarction and are either invasive or have a steep learning curve and user variability...
December 9, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27882440/hemodynamic-changes-in-a-middle-cerebral-artery-aneurysm-at-follow-up-times-before-and-after-its-rupture-a-case-report-and-a-review-of-the-literature
#11
A Sejkorová, K D Dennis, H Švihlová, O Petr, G Lanzino, A Hejčl, D Dragomir-Daescu
Hemodynamic parameters play a significant role in the development of cerebral aneurysms. Parameters such as wall shear stress (WSS) or velocity could change in time and may contribute to aneurysm growth and rupture. However, the hemodynamic changes at the rupture location remain unclear because it is difficult to obtain data prior to rupture. We analyzed a case of a ruptured middle cerebral artery (MCA) aneurysm for which we acquired imaging data at three time points, including at rupture. A patient with an observed MCA aneurysm was admitted to the emergency department with clinical symptoms of a subarachnoid hemorrhage...
November 24, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/27880805/feasibility-of-quantification-of-intracranial-aneurysm-pulsation-with-4d-cta-with-manual-and-computer-aided-post-processing
#12
Till Illies, Dennis Saering, Manabu Kinoshita, Toshiyuki Fujinaka, Maxim Bester, Jens Fiehler, Noriyuki Tomiyama, Yoshiyuki Watanabe
BACKGROUND AND PURPOSE: The analysis of the pulsation of unruptured intracranial aneurysms might improve the assessment of their stability and risk of rupture. Pulsations can easily be concealed due to the small movements of the aneurysm wall, making post-processing highly demanding. We hypothesized that the quantification of aneurysm pulsation is technically feasible and can be improved by computer-aided post-processing. MATERIALS AND METHODS: Images of 14 cerebral aneurysms were acquired with an ECG-triggered 4D CTA...
2016: PloS One
https://www.readbyqxmd.com/read/27875190/combined-visualization-of-vessel-deformation-and-hemodynamics-in-cerebral-aneurysms
#13
Monique Meuschke, Samuel Voss, Oliver Beuing, Bernhard Preim, Kai Lawonn
We present the first visualization tool that combines patient-specific hemodynamics with information about the vessel wall deformation and wall thickness in cerebral aneurysms. Such aneurysms bear the risk of rupture, whereas their treatment also carries considerable risks for the patient. For the patient-specific rupture risk evaluation and treatment analysis, both morphological and hemodynamic data have to be investigated. Medical researchers emphasize the importance of analyzing correlations between wall properties such as the wall deformation and thickness, and hemodynamic attributes like the Wall Shear Stress and near-wall flow...
January 2017: IEEE Transactions on Visualization and Computer Graphics
https://www.readbyqxmd.com/read/27871451/aneurysm-rebleeding-after-poor-grade-aneurysmal-subarachnoid-hemorrhage-predictors-and-impact-on-clinical-outcomes
#14
Bing Zhao, Yilin Fan, Ye Xiong, Rong Yin, Kuang Zheng, Zequn Li, Xianxi Tan, Hua Yang, Ming Zhong
BACKGROUND: Aneurysm rebleeding is a major cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage (aSAH) and more often occurs in patients with poor-grade aSAH. Limited data on predictors of rebleeding in these patients are available. OBJECTIVE: To investigate predictors of aneurysm rebleeding after poor-grade aSAH and the association of rebleeding with clinical outcomes. METHODS: A multicenter poor-grade aneurysm study was a prospective and observational registry of consecutive patients who presented with poor-grade aSAH defined as a World Federation of Neurosurgical Societies (WFNS) grade of IV or V...
December 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27856436/diffusion-weighted-imaging-detected-ischemic-lesions-following-endovascular-treatment-of-cerebral-aneurysms-a-systematic-review-and-meta-analysis
#15
K M Bond, W Brinjikji, M H Murad, D F Kallmes, H J Cloft, G Lanzino
BACKGROUND AND PURPOSE: Endovascular treatment of intracranial aneurysms is associated with the risk of thromboembolic ischemic complications. Many of these events are asymptomatic and identified only on diffusion-weighted imaging. We performed a systematic review and meta-analysis to study the incidence of DWI positive for thromboembolic events following endovascular treatment of intracranial aneurysms. MATERIALS AND METHODS: A comprehensive literature search identified studies published between 2000 and April 2016 that reported postprocedural DWI findings in patients undergoing endovascular treatment of intracranial aneurysms...
November 17, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27852140/impact-of-pregnancy-on-the-size-of-small-cerebral-aneurysm
#16
Hiroaki Tanaka, Shinji Katsuragi, Kayo Tanaka, Naoko Iwanaga, Jun Yoshimatsu, Jun C Takahashi, Tomoaki Ikeda
OBJECTIVE: Because the management of cerebral aneurysms during pregnancy remains controversial, the objective of this study was to perform a retrospective review of pregnant women with cerebral aneurysms to determine whether pregnancy is a risk factor for aneurysm rupture. METHODS: The change in size of aneurysms during pregnancy was examined by performing repeat magnetic resonance angiography in five pregnant women with cerebral aneurysms between 2005 and 2013...
December 14, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27744074/prevalence-of-asymptomatic-unruptured-intracranial-aneurysms-in-a-southeast-asian-population
#17
Ady Thien, Angela An Qi See, Samantha Ya Lyn Ang, Nishal Kishinchand Primalani, Mervyn Jun Rui Lim, Yew Poh Ng, Nicolas Kon Kam King
BACKGROUND: The prevalence of asymptomatic unruptured intracranial aneurysms (AUIA) in a Southeast Asian population has not been previously studied. Knowing the disease burden and population at risk can assist us in making informed decisions when managing AUIAs. We aimed to determine if the local prevalence of AUIAs differed from other populations in the published literature. METHODS: Magnetic resonance angiography radiology reports and images for 4572 patients between January 2013 and January 2014 were reviewed for AUIAs...
January 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27743630/sensitivity-of-flow-patterns-in-aneurysms-on-the-anterior-communicating-artery-to-anatomic-variations-of-the-cerebral-arterial-network
#18
Fuyou Liang, Xiaosheng Liu, Ryuhei Yamaguchi, Hao Liu
Recent studies raised increasing concern about the reliability of computer models in reproducing in vivo hemodynamics in cerebral aneurysms. Boundary condition problem is among the most frequently addressed issues since three-dimensional (3-D) modeling is usually restricted to local arterial segments. The present study focused on aneurysms on the anterior communicating artery (ACoA) which represent a large subgroup of detected cerebral aneurysms and, in particular, have a relatively high risk of rupture compared to aneurysms located in other regions...
October 6, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27703635/anesthetic-management-during-surgery-for-left-ventricular-aneurysm-and-false-aneurysm-occurring-in-stage-a-case-report
#19
Chung Hun Lee, Dong Kyu Lee, Sang Ho Lim, Heezoo Kim
Left ventricular aneurysm (LVA) and false aneurysm are complications of acute myocardial infarction, trauma, and cardiac surgery. Left ventricular false aneurysm (LVFA) is a particularly catastrophic complication owing to its high propensity for rupture. Surgical resection should be considered for LVFA occurring within three months after myocardial infarction or development of congestive heart failure. In this report, we describe a case of acute heart failure with LVA and LVFA occurring in stage as a complication of myocardial infarction in a 55-year-old man...
October 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27695537/comparison-of-computational-fluid-dynamics-findings-with-intraoperative-microscopy-findings-in-unruptured-intracranial-aneurysms-an-initial-analysis
#20
Sandeep Talari, Yoko Kato, Hanbing Shang, Yasuhiro Yamada, Kei Yamashiro, Daisuke Suyama, Tsukasa Kawase, Vladimir Balik, Wu Rile
CONTEXT: The increase in the detection of unruptured cerebral aneurysms has led to management dilemma. Prediction of risk based on the size of the aneurysm is not always accurate. There is no objective way of predicting rupture of aneurysm so far. Computational fluid dynamics (CFDs) was proposed as a tool to identify the rupture risk. AIMS: To know the correlation of CFD findings with intraoperative microscopic findings and to know the relevance of CFD in the prediction of rupture risk and in the management of unruptured intracranial aneurysms...
October 2016: Asian Journal of Neurosurgery
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