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cerebral aneurysm rupture risk

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https://www.readbyqxmd.com/read/28711292/perioperative-stroke-after-cerebral-aneurysm-clipping-risk-factors-and-postoperative-impact
#1
Ahmed I Kashkoush, Brian T Jankowitz, Chris Nguyen, Paul A Gardner, Daniel A Wecht, Robert M Friedlander, Yue-Fang Chang, Miguel Habeych, Donald Crammond, Jeffrey Balzer, Parthasarathy D Thirumala
Stroke is a devastating complication after intracranial aneurysm clipping. Understanding the risk factors that prognosticate perioperative stroke may help to identify patients that would benefit from neuroprotective therapy. This study assesses patient-specific independent predictors of perioperative stroke in relation to surgical aneurysm clipping. Additionally, this study evaluates the postoperative complications of stroke. We performed a retrospective chart review of 437 patients with ruptured and unruptured intracranial aneurysms, which underwent surgical clipping from 2006 to 2013...
July 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28698088/microsurgical-repair-of-ruptured-aneurysms-associated-with-moyamoya-pattern-collateral-vessels-of-the-middle-cerebral-artery-a-report-of-two-cases
#2
Min Lang, Nina Z Moore, Alex M Witek, Varun R Kshettry, Mark Bain
BACKGROUND: Patients with Moyamoya or other intracranial steno-occlusive disease are at risk for developing aneurysms associated with flow through collateral vessels. Because these lesions are rare, the optimal management remains unclear. Here, we describe two cases of microsurgical repair of ruptured collateral vessel aneurysms associated with middle cerebral artery (MCA) occlusion. CASE DESCRIPTION: The first patient was a 61-year-old male who presented with right frontal and intraventricular hemorrhage...
July 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28689391/the-incidence-and-characteristics-of-patients-with-small-ruptured-aneurysms-5-mm-in-subarachnoid-hemorrhage
#3
Joon-Ho Choi, Hyun-Seok Park
OBJECTIVE: Small unruptured aneurysms (<5 mm) are known for their very low risk of rupture, and are recommended to be treated conservatively. However, we encounter many patients with small ruptured aneurysms in the clinical practice. We aimed to investigate the incidence and characteristics of patients with small ruptured aneurysms. METHODS: We reviewed all patients admitted to our hospital with subarachnoid hemorrhage from January 2005 to December 2015. The patients were divided into two groups: those with aneurysms <5 mm (group S) and those with aneurysms ≥5 mm (group L)...
July 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28666912/outcome-after-subarachnoid-hemorrhage-from-blood-blister-like-aneurysm-rupture-depends-on-age-and-aneurysm-morphology
#4
Juergen Konczalla, Florian Gessler, Markus Bruder, Joachim Berkefeld, Gerhard Marquardt, Volker Seifert
BACKGROUND: Blood blister-like aneurysms (BBLA) are rare, prone to rerupture and challenging to treat. OBJECTIVE: To report our results in relationship to the type of BBLA and other prognostic factors. METHODS: Data on patient and aneurysm characteristics, clinical course and treatment results were collected prospectively and analyzed retrospectively including data from patient records and review of imaging findings. RESULTS: Twenty-seven patients had subarachnoid hemorrhage (SAH) from BBLA...
June 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28605486/aneurysm-morphology-and-prediction-of-rupture-an-international-study-of-unruptured-intracranial-aneurysms-analysis
#5
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/28586919/small-cerebral-aneurysms-can-we-identify-patients-at-risk-for-rupture
#6
EDITORIAL
Robert M Starke
No abstract text is available yet for this article.
July 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28565981/complications-associated-with-the-use-of-flow-diverting-devices-for-cerebral-aneurysms-a-systematic-review-and-meta-analysis
#7
Geng Zhou, Ming Su, Yan-Ling Yin, Ming-Hua Li
OBJECTIVE The objective of this study was to review the literature on the use of flow-diverting devices (FDDs) to treat intracranial aneurysms (IAs) and to investigate the safety and complications related to FDD treatment for IAs by performing a meta-analysis of published studies. METHODS A systematic electronic database search was conducted using the Springer, EBSCO, PubMed, Medline, and Cochrane databases on all accessible articles published up to January 2016, with no restriction on the publication year...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28552137/the-natural-history-of-cerebral-arteriovenous-malformations
#8
Anil Can, Bradley A Gross, Rose Du
Cerebral arteriovenous malformations (AVMs) are composed of a complex tangle of abnormal arteries and veins and are a significant source of cerebral hemorrhage and consequent morbidity and mortality in young adults, representing a diagnostic and therapeutic challenge. Current natural-history studies of cerebral AVMs report overall annual rates of 1% and 3% for the risk of epilepsy and hemorrhage, respectively. Unruptured AVMs have an annual hemorrhage rate of 2.2% while ruptured lesions have an annual hemorrhage rate of 4...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28490680/-a-ruptured-aneurysm-at-the-origin-of-a-duplicated-middle-cerebral-artery-treated-by-coil-embolization-a-case-report
#9
Kentaro Hayashi, Yoshitaka Matsuo, Yukishige Hayashi, Kiyoshi Shirakawa, Makio Kaminogo
Duplication of the middle cerebral artery(MCA)is an anatomical variant of the MCA, originating from the distal portion of the internal carotid artery(ICA)and supplying blood flow to the tip of the temporal lobe. Cerebral aneurysms rarely develop at the bifurcation of the ICA and the duplicated MCA, but when they do develop, they may result in subarachnoid hemorrhage. We treated a 41-year-old man, who was urgently brought to our hospital because of severe headache. A computed tomography(CT)scan showed subarachnoid hemorrhage due to the rupture of an aneurysm at the origin of the duplicated MCA...
May 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28469595/apolipoprotein-e-%C3%AE%C2%B54-a-possible-risk-factor-of-intracranial-pressure-and-white-matter-perfusion-in-good-grade-aneurysmal-subarachnoid-hemorrhage-patients-at-early-stage
#10
Jian-Hua Peng, Xing-Hu Qin, Jin-Wei Pang, Yue Wu, Jin-Hu Dong, Chang-Ren Huang, Wei-Feng Wan, Xiao-Bo Yang, Xiao-Chuan Sun, Li-Gang Chen, Yong Jiang
Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating and complicated disease with significant morbidity and mortality. Previous studies have shown that genetic susceptibility may play an important role in the outcome of a given individual with aSAH. This study evaluates the potential association in effects of the APOE allele on the early brain injury (EBI) in light of elevated intracranial pressure (ICP) and cerebral perfusion disorders in a consecutive series of non-comatose Chinese patients with aSAH...
2017: Frontiers in Neurology
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/28430600/risk-factors-for-the-recurrence-of-an-intracranial-saccular-aneurysm-following-endovascular-treatment
#12
De-Zhang Huang, Bin Jiang, Wei He, Yi-Hua Wang, Zhi-Gang Wang
BACKGROUND: This study was aimed to determine risk factors for the recurrence of an intracranial saccular aneurysm (ISA) following endovascular treatment. The findings will help medical professionals to identify patients having a high risk of ISA recurrence and assist them in developing appropriate follow-up plans. RESULTS: During the follow-up period, 12.6% of the patients (83/658) experienced recurrent ISAs. An analysis of related factors, including gender, age, hypertension, diabetes mellitus, smoking, tumor size, width of the aneurysm neck, the presence or absence of a rupture, the volume embolization ratio (VER), the application or nonapplication of a stent, and follow-up time, revealed that a tumor size > 10 mm in diameter, wide-necked aneurysms, an anterior communicating or middle cerebral artery aneurysm, an aneurysm rupture, a VER < 20%, the absence of stent assistance, and follow-up time were high-risk factors for the recurrence of ISAs...
May 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28428448/unruptured-cerebral-aneurysms-in-elderly-patients
#13
Tomohito Hishikawa, Isao Date
The prevalence of unruptured cerebral aneurysms (UCAs) in elderly patients is increasing in our aging population. UCA management in elderly patients has some difficulties, such as reduced life expectancy, increased comorbidities and treatment risks, and poor prognosis in case of rupture. In this review article, we summarize the most recent findings on the natural history, therapeutic options and treatment results for UCAs exclusively in elderly patients, and describe possible medical treatments for patients with UCAs...
April 19, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28412541/endothelin-polymorphisms-as-a-risk-factor-for-cerebral-aneurysm-rebleeding-following-aneurysmal-subarachnoid-hemorrhage
#14
Paul M Foreman, Robert M Starke, Philipp Hendrix, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Minkuan Lin, Beverly C Walters, Jean-Francois Pittet, Mali Mathru, Christoph J Griessenauer
BACKGROUND: Aneurysm rebleeding following presentation with aneurysmal subarachnoid hemorrhage (aSAH) is associated with high mortality and poor functional outcome. While a substantial genetic contribution to aneurysm formation and rupture is known, the genetic influence on the risk of rebleeding is poorly understood. OBJECTIVE: To evaluate the role of common endothelin polymorphisms in aneurysm rebleeding. PATIENTS AND METHODS: Blood sample from all patients enrolled in the CARAS (Cerebral Aneurysm Renin Angiotensin System) study were used for genetic evaluation...
June 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28408258/predictors-of-postoperative-cerebral-ischemia-in-patients-with-ruptured-anterior-communicating-artery-aneurysms
#15
Pei-Sen Yao, Guo-Rong Chen, Shu-Fa Zheng, De-Zhi Kang
OBJECTIVE: Cerebral ischemia is a major contributor to poor outcome after ruptured anterior communicating artery aneurysms (ACoAs), and is not well classified. In this article, we develop a classification and identify risk factors of cerebral ischemia after ruptured ACoAs. METHODS: Three hundred sixty patients with ruptured ACoAs undergoing microsurgical clipping were collected. Sex, age, smoking status, Hunt-Hess grade, Fisher grade, hospital stay, surgical timing, hypertension, diabetes, postoperative cerebral ischemia, and postoperative modified Rankin Scale score were collected...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28355763/-late-reoperations-after-repaired-stanford-type-a-aortic-dissection
#16
F H Huang, L P Li, C H Su, W Qin, M Xu, L M Wang, Y S Jiang, Z B Qiu, L Q Xiao, C Zhang, H W Shi, X Chen
Objective: To summarize the experience of reoperations on patients who had late complications related to previous aortic surgery for Stanford type A dissection. Methods: From August 2008 to October 2016, 14 patients (10 male and 4 female patients) who underwent previous cardiac surgery for Stanford type A aortic dissection accepted reoperations on the late complications at Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University. The range of age was from 41 to 76 years, the mean age was (57±12) years...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28323184/associations-of-endothelin-polymorphisms-and-aneurysm-size-at-time-of-rupture
#17
Philipp Hendrix, Paul M Foreman, Robert M Starke, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Minkuan Lin, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Jean-Francois Pittet, Mali Mathru, Christoph J Griessenauer
BACKGROUND AND PURPOSE: Aneurysm size is an important risk factor for aneurysm rupture. The pathophysiologic mechanisms underlying aneurysm growth remain poorly understood. Endothelin signaling is critical for cerebrovascular blood flow regulation. The influence of endothelin single nucleotide polymorphisms (SNPs) on aneurysm size at the time of rupture has not been previously investigated. METHODS: Eight common endothelin SNPs were assessed using blood samples from aneurysmal subarachnoid hemorrhage (aSAH) patients enrolled in the Cerebral Aneurysm Renin Angiotensin System study, a prospective, 2-center study that enrolled aSAH patients and controls in the United States from 2012-2015...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28323182/treatment-of-large-and-giant-middle-cerebral-artery-aneurysms-risk-factors-for-unfavorable-outcomes
#18
Wonhyoung Park, Jaewoo Chung, Jae Sung Ahn, Jung Cheol Park, Byung Duk Kwun
OBJECTIVE: This study aimed to assess the clinical and radiologic outcomes after neurosurgical treatment of large and giant aneurysms of the middle cerebral artery (MCA). In addition, we aimed to identify risk factors for unfavorable outcomes. METHODS: This retrospective study included 105 patients with 106 large or giant MCA aneurysms treated with neurosurgical methods, including microsurgery and endovascular treatment, over a 15-year period. RESULTS: The mean aneurysm size was 15...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28298037/impact-of-bifurcation-angle-and-inflow-coefficient-on-the-rupture-risk-of-bifurcation-type-basilar-artery-tip-aneurysms
#19
Sherif Rashad, Shin-Ichiro Sugiyama, Kuniyasu Niizuma, Kenichi Sato, Hidenori Endo, Shunsuke Omodaka, Yasushi Matsumoto, Miki Fujimura, Teiji Tominaga
OBJECTIVE Risk factors for aneurysm rupture have been extensively studied, with several factors showing significant correlations with rupture status. Several studies have shown that aneurysm shape and hemodynamics change after rupture. In the present study the authors investigated a static factor, the bifurcation angle, which does not change after rupture, to understand its effect on aneurysm rupture risk and hemodynamics. METHODS A hospital database was retrospectively reviewed to identify patients with cerebral aneurysms treated surgically or endovascularly in the period between 2008 and 2015...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28283187/successful-delayed-coiling-of-a-ruptured-growing-distal-posterior-cerebral-artery-mycotic-aneurysm
#20
C Champeaux, N Walker, J Derwin, A Grivas
Intracranial infectious aneurysm (IIA) is a rare form of cerebrovascular malformation for which obliteration may be undertaken after rupture or non-response to targeted antibiotic therapy. We discuss the case of a 19-year-old man who presented with acute neurologic decline (Glasgow Coma Scale of 8) and endocarditis. CT images demonstrated subarachnoid haemorrhage, hydrocephalus and a mycotic aneurysm on the left posterior cerebral artery. Conservative management was initially decided due to the high risk of stroke and hemianopia...
March 7, 2017: Neuro-Chirurgie
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