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cerebral aneurysm rupture risk

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https://www.readbyqxmd.com/read/29190810/aneurysmal-subarachnoid-haemorrhage-asah-five-consecutive-years-experience-of-fars-province-iran
#1
Abdolkarim Rahmanian, Mohammad Jamali, Kamran Bagheri Lankarani, Sulmaz Ghahramani
OBJECTIVE: Subarachnoid haemorrhage (SAH), caused by the rupture of intracranial aneurysms, is a devastating event with high rates of morbidity and mortality. Aneurysmal subarachnoid haemorrhage (aSAH) plays a critical role in the potential loss of life as its sufferers are usually of a young age. We aimed to investigate the incidence of aSAH along with the patients' characteristics over five consecutive years in Fars, a large province located in Southern Iran. METHODS: In this prospective study, anonymous data of all patients diagnosed with aSAH in Fars province were collected after patient admission and surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29172205/-a-case-of-multiple-atherosclerotic-fusiform-cerebral-aneurysms-with-repeated-subarachnoid-hemorrhage
#2
Kotaro Oshio, Tetsuya Ikeda, Takashi Matsumori, Daisuke Wakui, Hidemichi Ito, Hiroshi Takasuna, Yuichiro Tanaka
Pure fusiform aneurysms without dissection are considered to have a low risk of rupture. Furthermore, aneurysm wall with atherosclerotic change tends to be less susceptible to rupture. We present a rare case of multiple atherosclerotic fusiform aneurysms associated with repeated subarachnoid hemorrhage(SAH)during a 9-year observation period. A 34-year-old woman was admitted to our hospital because of SAH. SAH with a temporal hematoma due to a fusiform aneurysm of the right middle cerebral artery(MCA)was detected using computed tomography(CT)...
November 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29155706/comprehensive-endovascular-and-open-surgical-management-of-cerebral-arteriovenous-malformations
#3
Robert C Rennert, Jeffrey A Steinberg, Vincent J Cheung, David R Santiago-Dieppa, Jeffrey Scott Pannell, Alexander A Khalessi
Arteriovenious malformations (AVMs) are associated with significant morbidity and mortality, and have a rupture risk of ~3% per year. Treatment of AVMs must be tailored specifically to the lesion, with surgical resection being the gold standard for small, accessible lesions. Pre-operative embolization of AVMs can reduce nidal blood flow and remove high-risk AVM features such as intranidal or venous aneurysms, thereby simplifying a challenging neurosurgical procedure. Herein, we describe our approach for the staged endovascular embolization and open resection of AVMs, and highlight the advantages of having a comprehensively trained neurovascular surgeon leading a multi-disciplinary clinical team...
October 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29129762/risk-factors-for-the-rupture-of-intracranial-aneurysms-using-ct-angiography
#4
Guang-Xian Wang, Li Wen, Liu Yang, Qi-Chuang Zhang, Jin-Bo Yin, Chun-Mei Duan, Dong Zhang
PURPOSE: To study the clinical and morphological characteristics associated with risk factors for the rupture of intracranial aneurysms (IAs). METHODS: A total of 1115 consecutive patients with 1282 IAs were reviewed from August 2011 to February 2016. The patients and IAs were divided into ruptured and unruptured groups. Based on the clinical and morphologic findings, the risk factors for IA rupture were assessed using statistical methods. RESULTS: Age, hypertension, diabetes mellitus and cerebral atherosclerosis were associated with ruptured IAs...
November 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29125027/thromboembolic-complications-during-endovascular-treatment-of-ruptured-cerebral-aneurysms
#5
Motohiro Nomura, Kentaro Mori, Akira Tamase, Tomoya Kamide, Syunsuke Seki, Yu Iida, Kazutaka Shirokane, Eiichi Baba, Atsushi Tsuchiya, Hiroshi Shima
Background In cases of subarachnoid hemorrhage due to aneurysm rupture, the administration of an anticoagulant or antiplatelet agent involves the risk of rebleeding from the aneurysm. There is a possibility of inducing thromboembolic events during the endovascular embolization of ruptured cerebral aneurysms. Patients and methods From April 2006 to March 2017, we treated a total of 70 patients with ruptured cerebral aneurysms with an endovascular technique. Among them, five patients (7.1%) showed intra-arterial thrombus formation...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29107725/proximal-stenosis-is-associated-with-rupture-status-in-middle-cerebral-artery-aneurysms
#6
Alexei Antonov, Kenichi Kono, Kilian Greim-Kuczewski, James E Hippelheuser, Alexandra Lauric, Adel M Malek
BACKGROUND: Hemodynamic factors impact cerebral aneurysm development and progression. Parent vessel architectural features, such as caliber, curvature and angle can affect downstream pressure and shear stress. OBJECTIVE: Investigate the association between proximal parent vessel stenosis and aneurysm rupture status at the middle cerebral artery (MCA) bifurcation. METHODS: Catheter 3D rotational angiographic datasets from 69 Japanese patients with MCA aneurysms (58 unruptured/11 ruptured) were analyzed...
October 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29103932/incidence-and-prognostic-factors-related-to-major-adverse-cerebrovascular-events-in-patients-with-complex-aortic-diseases-treated-by-the-chimney-technique
#7
Michel J Bosiers, Kenneth Tran, Jason T Lee, Konstantinos P Donas, Frank J Veith, Giovanni Torsello, Felice Pecoraro, Konstantinos Stavroulakis
OBJECTIVE: Endovascular aneurysm repair (EVAR) with the chimney technique (ch-EVAR) has been used for the treatment of aortic aneurysms as an alternative approach to fenestrated endografting or open repair. Nonetheless, the need for an upper extremity arterial access may contribute to a higher risk for periprocedural cerebrovascular events. This study reports on the perioperative cerebral and major adverse cardiac and cerebrovascular events (MACCE) after ch-EVAR. METHODS: The PERICLES registry (PERformance of the chImney technique for the treatment of Complex aortic pathoLogiES) is an international, retrospective multicenter study evaluating the performance of ch-EVAR for the treatment of complex aortic pathologies...
November 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29103480/risk-factors-analysis-of-mirror-aneurysms-a-multi-center-retrospective-study-based-on-clinical-and-demographic-profile-of-patients
#8
Zhong-Qing Huang, Xin-Wei Zhou, Zhong-Jun Hou, Sui-Qiao Huang, Zhi-Hua Meng, Xian-Long Wang, Hao Yu, Lv-Jin Feng, Qiu-Jing Wang, Ping-An Li, Zhi-Bo Wen
As a special subgroup of multiple intracranial aneurysms, mirror aneurysms are located bilaterally on the corresponding intracranial arteries. The current study sought to compare the clinical and demographic features of patients harboring mirror aneurysm, and to elucidate the corresponding risk factors. We performed a retrospective cohort study of 2641 intracranial aneurysms patients, who were admitted to our hospitals between January 2005 and June 2014. Patients were subdivided into three groups based on the inclusion criteria: (i) single (n=2250); (ii) non-mirror multiple (n=285); and (iii) mirror aneurysms (n=106)...
November 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/29103103/heroin-use-is-associated-with-ruptured-saccular-aneurysms
#9
Anil Can, Victor M Castro, Yildirim H Ozdemir, Sarajune Dagen, Dmitriy Dligach, Sean Finan, Sheng Yu, Vivian Gainer, Nancy A Shadick, Guergana Savova, Shawn Murphy, Tianxi Cai, Scott T Weiss, Rose Du
While cocaine use is thought to be associated with aneurysmal rupture, it is not known whether heroin use increases the risk of rupture in patients with non-mycotic saccular aneurysms. Our goal was to investigate the association between heroin and cocaine use and the rupture of saccular non-mycotic aneurysms. The medical records of 4701 patients with 6411 intracranial aneurysms, including 1201 prospective patients, diagnosed at the Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016 were reviewed and analyzed...
November 4, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29100674/size-and-location-correlations-with-higher-rupture-risk-of-intracranial-aneurysms
#10
Cezary Grochowski, Jakub Litak, Bartłomiej Kulesza, Paweł Szmygin, Dominik Ziemianek, Piotr Kamieniak, Dariusz Szczepanek, Radosław Rola, Tomasz Trojanowski
AIM: The purpose of this study was to investigate the impact of size and location of the intracranial aneurysm on rupture probability. MATERIAL AND METHODS: 265 patients with diagnosis of intracranial aneurysms were admitted to the department from January 2012 to December 2013. The characteristic of aneurysm, such as median size, location, single and multiple aneurysms and presentation were retrospectively reviewed using cerebral angiography reports. RESULTS: There were 265 patients admitted with the diagnosis of intracranial aneurysms, 193 with single and 72 with multiple aneurysms...
October 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29076786/adenosine-induced-cardiac-arrest-as-an-alternative-to-temporary-clipping-during-intracranial-aneurysm-surgery
#11
Patcharin Intarakhao, Peeraphong Thiarawat, Behnam Rezai Jahromi, Danil A Kozyrev, Mario K Teo, Joham Choque-Velasquez, Teemu Luostarinen, Juha Hernesniemi
OBJECTIVE The purpose of this study was to analyze the impact of adenosine-induced cardiac arrest (AiCA) on temporary clipping (TC) and the postoperative cerebral infarction rate among patients undergoing intracranial aneurysm surgery. METHODS In this retrospective matched-cohort study, 65 patients who received adenosine for decompression of aneurysms during microsurgical clipping were identified (Group A) and randomly matched with 65 selected patients who underwent clipping but did not receive adenosine during surgery (Group B)...
October 27, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29076779/cigarette-smoking-and-outcomes-after-aneurysmal-subarachnoid-hemorrhage-a-nationwide-analysis
#12
Hormuzdiyar H Dasenbrock, Robert F Rudy, Pui Man Rosalind Lai, Timothy R Smith, Kai U Frerichs, William B Gormley, M Ali Aziz-Sultan, Rose Du
OBJECTIVE Although cigarette smoking is one of the strongest risk factors for cerebral aneurysm development and rupture, there are limited data evaluating the impact of smoking on outcomes after aneurysmal subarachnoid hemorrhage (SAH). Additionally, two recent studies suggested that nicotine replacement therapy was associated with improved neurological outcomes among smokers who had sustained an SAH compared with smokers who did not receive nicotine. METHODS Patients who underwent endovascular or microsurgical repair of a ruptured cerebral aneurysm were extracted from the Nationwide Inpatient Sample (NIS, 2009-2011) and stratified by cigarette smoking...
October 27, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29062560/use-of-a-minimally-invasive-cardiac-output-monitor-to-optimise-haemodynamics-in-a-patient-with-mitral-valve-disease-undergoing-cerebrovascular-surgery
#13
Ali M Al-Mashani, Niranjan D Waje, Neeraj Salhotra, Samaresh Das, Neelam Suri, Rashid A Al-Sheheimi, Nilay Chatterjee
Patients with mitral valve disease undergoing cerebrovascular surgery face increased inherent risks due to their associated cardiac comorbidities. As such, the anaesthetic management of such patients is distinctly challenging. Simultaneous consideration of both the cerebrovascular and underlying cardiac conditions determines key anaesthetic issues, as fluids and vasopressors or inotropes need to be titrated according to haemodynamic variables in order to optimise cerebral blood flow without compromising cardiac function...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29061331/screening-for-intracranial-aneurysms-in-autosomal-dominant-polycystic-kidney-disease-is-cost-effective
#14
Adrien Flahault, Denis Trystram, François Nataf, Marie Fouchard, Bertrand Knebelmann, Jean-Pierre Grünfeld, Dominique Joly
Intracranial aneurysm rupture is a dramatic complication of autosomal dominant polycystic kidney disease (ADPKD). It remains uncertain whether screening should be widespread or only target patients with risk factors (personal or familial history of intracranial aneurysm), with an at-risk profession, or those who request screening. We evaluated this in a single-center cohort of 495 consecutive patients with ADPKD submitted to targeted intracranial aneurysm screening. Cerebral magnetic resonance angiography was proposed to 110 patients with a familial history of intracranial aneurysm (group 1), whereas it was not our intention to propose it to 385 patients without familial risk (group 2)...
October 20, 2017: Kidney International
https://www.readbyqxmd.com/read/29046918/flow-diverter-treatment-of-cerebral-blister-aneurysms
#15
Russell Cerejo, Mark Bain, Seby John, Julian Hardman, Nina Moore, M Shazam Hussain, Gabor Toth
PURPOSE: Blood blister-like aneurysms (BBA) are small, friable, broad-based aneurysms that represent high risk for rerupture. Treatment of BBA is challenging, and may include surgical wrapping, clipping, multiple overlapping stents, and/or coiling. Flow diversion is a rapidly evolving treatment strategy for intracranial aneurysms, but the evidence for its use in cases of BBA is scarce. METHODS: A retrospective review of flow-diverter-treated, ruptured BBA cases at our tertiary care institution was undertaken...
December 2017: Neuroradiology
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
#16
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
#17
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
#18
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
#19
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
#20
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
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