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cerebral aneurysm rupture risk

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https://www.readbyqxmd.com/read/29686163/-coil-embolization-for-very-small-intracranial-aneurysms-with-diameter-less-than-3mm-a-case-series-of-14-patients-and-literature-review
#1
Kazushi Maeda, Ryota Motoie, Satoshi Karashima, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Yoshiaki Ikai, Junji Uno, Hidefuku Gi
INTRODUCTION: Many studies describe aneurysms measuring ≤3mm as "very small" or "tiny, " with a risk of intraoperative rupture higher than that of most cerebral aneurysms. We evaluated the results of endovascular coil embolization for very small aneurysms with diameter ≤3mm. MATERIAL AND METHODS: The same interventional neurosurgeon performed coil embolization for 14 tiny aneurysms in 14 patients(8male and 6 females)at our institution between May 2015 and June 2017...
April 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29685416/phases-score-applied-to-a-prospective-cohort-of-aneurysmal-subarachnoid-hemorrhage-patients
#2
Paul M Foreman, Philipp Hendrix, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Christoph J Griessenauer
The treatment of unruptured intracranial aneurysms remains controversial. The PHASES score was developed to predict the 5-year risk of aneurysm rupture. We have assigned PHASES scores to a cohort of aneurysmal subarachnoid hemorrhage (aSAH) patients to assess the distribution of scores and its ability to predict outcome. In this study, the PHASES score was applied to a prospective cohort of aSAH patients that were enrolled in the Cerebral Aneurysm Renin Angiotensin System (CARAS) study. The CARAS study enrolled patients from two academic institutions in the United States from 2012 to 2015...
April 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29682071/intraoperative-rupture-cerebral-aneurysm-and-computational-flow-dynamics
#3
Ilya Senko, Anton Shatokhin, Ishu Bishnoi, Yasuhiro Yamada, Riki Tanaka, Daisuke Suyama, Tukasa Kawase, Yoko Kato
Intraoperative aneurysmal rupture (IAR) is the most fearsome complication of aneurysm surgery. IAR associates with high morbidity and mortality. In recent years, we have many studies regarding using computational fluid dynamics (CFD) in aneurysm surgery. CFD helps in calculating the velocity of blood flowing in the aneurysm sac, the pressure in the aneurysm sac, and wall shear stress (WSS). CFD also helps in predicting nature of aneurysm wall and thus may warn about different intraoperative microscopy findings in aneurysms...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29671828/nf-%C3%AE%C2%BAb-mediated-inflammation-in-the-pathogenesis-of-intracranial-aneurysm-and-subarachnoid-hemorrhage-does-autophagy-play-a-role
#4
REVIEW
Elzbieta Pawlowska, Joanna Szczepanska, Karol Wisniewski, Paulina Tokarz, Dariusz J Jaskólski, Janusz Blasiak
The rupture of saccular intracranial aneurysms (IA) is the commonest cause of non-traumatic subarachnoid hemorrhage (SAH)—the most serious form of stroke with a high mortality rate. Aneurysm walls are usually characterized by an active inflammatory response, and NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) has been identified as the main transcription factor regulating the induction of inflammation-related genes in IA lesions. This transcription factor has also been related to IA rupture and resulting SAH...
April 19, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29650782/treatment-of-distal-anterior-cerebral-artery-aneurysms-with-flow-diverter-stents-a-single-center-experience
#5
F Cagnazzo, M Cappucci, C Dargazanli, P-H Lefevre, G Gascou, C Riquelme, A Bonafe, V Costalat
BACKGROUND AND PURPOSE: Flow diversion for aneurysms beyond the circle of Willis is still debated. Our aim was to evaluate the safety and efficacy of flow diversion treatment of distal anterior cerebral artery aneurysms. MATERIALS AND METHODS: Consecutive patients with distal anterior cerebral artery aneurysms treated from January 2014 to October 2017 were evaluated retrospectively with prospectively maintained data. Treatment was performed only for unruptured or recanalized aneurysms after coiling...
April 12, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29643435/higher-leukocyte-count-predicts-3-month-poor-outcome-of-ruptured-cerebral-aneurysms
#6
Pei-Sen Yao, Guo-Rong Chen, Xue-Ling Xie, Huang-Cheng Shang-Guan, Jin-Zhen Gao, Yuan-Xiang Lin, Shu-Fa Zheng, Zhang-Ya Lin, De-Zhi Kang
It is not fully established whether leukocyte can predict the poor outcome for ruptured cerebral aneurysms (CA) or not. Here, we retrospectively analyzed the clinical data of 428 patients with ruptured CA between 2010 and 2015. Patients' demographic data, including gender, age, history of smoking, alcohol, hypertension, diabetes and hypercholesterolemia, Hunt-Hess and Fisher grade, occurrence of hydrocephalus, aneurysm location, time to surgery, delayed ischemic neurological deficit (DIND) and peak leukocyte of blood test from day 1 to 3 after aneurysmal rupture were recorded and analyzed...
April 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29608702/flow-diversion-of-posterior-circulation-cerebral-aneurysms-a-single-institution-series-of-59-cases
#7
Matthew T Bender, Geoffrey P Colby, Bowen Jiang, Li-Mei Lin, Jessica K Campos, Risheng Xu, Erick M Westbroek, Chau D Vo, David A Zarrin, Justin M Caplan, Judy Huang, Rafael J Tamargo, Alexander L Coon
BACKGROUND: Posterior circulation cerebral aneurysms are at higher risk of rupture and are more symptomatic than those in the anterior circulation. Existing treatments carry significant morbidity. Early reports of flow diversion for posterior circulation aneurysms have suggested high complication and low occlusion rates. OBJECTIVE: To report safety and efficacy of flow diversion with the pipeline embolization device (ev3, Medtronic Inc, Dublin, Ireland) for aneurysms located throughout the posterior circulation...
March 28, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29605278/rare-case-of-diffuse-spinal-arachnoiditis-following-a-complicated-vertebral-artery-dissection
#8
Elias Atallah, Sophia Dang, Sage Rahm, James Feghali, Chalouhi Nohra, Stavropoula Tjoumakaris, Robert H Rosenwasser, Hekmat Zarzour, Nabeel Herial, Michael Reid Gooch, Pascal Jabbour
Spinal arachnoiditis (SA) is an extremely rare and delayed complication of subarachnoid hemorrhage (SAH). Little is known about its underlying pathogenesis and subsequent clinical course. A middle-aged patient presented with the worst headache of her life and a grade 3 SAH of the basal-cisterns and posterior fossa was identified on Computed Tomography scans (CT). Angiography revealed a ruptured dissecting aneurysm of the left vertebral artery (VA-V4), as well as an unruptured left Anterior Cerebral Artery (ACA-A1) aneurysm...
March 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29602477/flow-instability-detected-in-ruptured-versus-unruptured-cerebral-aneurysms-at-the-internal-carotid-artery
#9
Lijian Xu, Fuyou Liang, Lixu Gu, Hao Liu
Flow instability has emerged as a new hemodynamic metric hypothesized to have potential value in assessing the rupture risk of cerebral aneurysms. However, diverse findings have been reported in the literature. In the present study, high-resolution hemodynamic simulations were performed retrospectively on 35 aneurysms (10 ruptured & 25 unruptured) located at the internal carotid artery (ICA). Simulated hemodynamic parameters were statistically compared between the ruptured and unruptured aneurysms, with emphasis on examining the correlation of flow instability with the status of aneurysm rupture...
March 15, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29584923/rescue-therapy-for-procedural-complications-associated-with-deployment-of-flow-diverting-devices-in-cerebral-aneurysms
#10
Fawaz Al-Mufti, Krishna Amuluru, Eric R Cohen, Vikas Patel, Mohammad El-Ghanem, Ethan Wajswol, Vincent Dodson, Sarmad Al-Marsoummi, Neil Majmundar, Neha S Dangayach, Rolla Nuoman, Chirag D Gandhi
Flow diverting devices (FDDs) have revolutionized the treatment of morphologically complex intracranial aneurysms such as wide-necked, giant, or fusiform aneurysms. Although FDDs are extremely effective, they carry a small yet significant risk of intraprocedural complications. As the implementation of these devices increases, the ability to predict and rapidly treat complications, especially those that are iatrogenic or intraprocedural in nature, is becoming increasingly more necessary.Our objective in this paper is to provide a descriptive summary of the various types of intraprocedural complications that may occur during FDDs deployment and how they may best be treated...
March 22, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29548963/predictive-factors-of-fever-after-aneurysmal-subarachnoid-hemorrhage-and-its-impact-on-delayed-cerebral-ischemia-and-clinical-outcomes
#11
Yung Ki Park, Hyeong-Joong Yi, Kyu-Sun Choi, Young-Jun Lee, Hyoung-Joon Chun, Sae Min Kwon
OBJECTIVE: Fever is relatively common and worsens neurologic injury after aneurysmal subarachnoid hemorrhage (SAH). The aim of this study was to display the time course of body temperature, identify predictive factors of fever after SAH, and evaluate its impact on delayed cerebral ischemia (DCI) and clinical outcomes. METHODS: Four hundred twelve patients with SAH and ruptured aneurysms who were treated at our institution between January 2007 and December 2016 were retrospectively analyzed...
March 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29548958/intraprocedural-rupture-during-endovascular-treatment-of-intracranial-aneurysm-clinical-results-and-literature-review
#12
Yung Ki Park, Hyeong-Joong Yi, Kyu-Sun Choi, Young-Jun Lee, Hyoung-Joon Chun
OBJECTIVE: Intraprocedural rupture (IPR) during endovascular treatment of cerebral aneurysm is the most feared complication with high morbidity and mortality. The aim of this study was to estimate the incidence and risk factors of IPR during endovascular treatment of ruptured and unruptured cerebral aneurysms. METHODS: A total of 235 intracranial aneurysms (80 ruptured and 155 unruptured) in 219 patients who received endovascular treatment in our institution between Jan 2010 and Dec 2016 were enrolled in our study...
March 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29528449/neck-remnants-and-the-risk-of-aneurysm-rupture-after-endovascular-treatment-with-coiling-or-stent-assisted-coiling-much-ado-about-nothing
#13
Stephan A Munich, Marshall C Cress, Leonardo Rangel-Castilla, Ashish Sonig, Christopher S Ogilvy, Giuseppe Lanzino, Ondra Petr, J Mocco, Peter J Morone, Kenneth V Snyder, L Nelson Hopkins, Adnan H Siddiqui, Elad I Levy
BACKGROUND: Neck remnants are not uncommon after endovascular treatment of cerebral aneurysms. Critics of endovascular treatments for cerebral aneurysms cite neck remnants as evidence in favor of microsurgical clipping. However, studies have failed to evaluate the true clinical significance of aneurysm neck remnants following endovascular therapies. OBJECTIVE: To assess the clinical significance of residual aneurysm necks and to determine the rate of subsequent rupture following coiling or stent-assisted coiling of cerebral aneurysms...
March 8, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29526064/management-of-recurrent-cerebral-aneurysm-after-surgical-clipping-clinical-article
#14
Pius Kim, Suk Jung Jang
OBJECTIVE: Surgical clipping of the cerebral aenurysm is considered as a standard therapy with endovascular coil embolization. The surgical clipping is known to be superior to the endovascular coil embolization in terms of recurrent rate. However, a recurrent aneurysm which is initially treated by surgical clipping is difficult to handle. The purpose of this study was to research the management of the recurrent cerebral aneurysm after a surgical clipping and how to overcome them. METHODS: From January 1996 to December 2015, medical records and radiologic findings of 14 patients with recurrent aneurysm after surgical clipping were reviewed retrospectively...
March 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29526058/korean-clinical-practice-guidelines-for-aneurysmal-subarachnoid-hemorrhage
#15
REVIEW
Won-Sang Cho, Jeong Eun Kim, Sukh Que Park, Jun Kyeung Ko, Dae-Won Kim, Jung Cheol Park, Je Young Yeon, Seung Young Chung, Joonho Chung, Sung-Pil Joo, Gyojun Hwang, Deog Young Kim, Won Hyuk Chang, Kyu-Sun Choi, Sung Ho Lee, Seung Hun Sheen, Hyun-Seung Kang, Byung Moon Kim, Hee-Joon Bae, Chang Wan Oh, Hyeon Seon Park
Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, worldwide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs...
March 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29511128/risk-factors-for-and-clinical-consequences-of-multiple-intracranial-aneurysms-a-systematic-review-and-meta-analysis
#16
Ramazan Jabbarli, Thiemo Florin Dinger, Marvin Darkwah Oppong, Daniela Pierscianek, Philipp Dammann, Karsten H Wrede, Klaus Kaier, Martin Köhrmann, Michael Forsting, Christoph Kleinschnitz, Ulrich Sure
BACKGROUND AND PURPOSE: Multiple intracranial aneurysms (MIAs) are common findings of cerebral angiographies; however, MIA prevalence varies in different patient cohorts. We sought to elucidate risk factors influencing MIA prevalence and the clinical consequences. METHODS: We systematically searched PubMed, Scopus, Embase, and Cochrane Library databases for publications before January 15, 2017, reporting MIA prevalence and risk factors. We used random-effects meta-analysis and multivariate regression analysis to assess the impacts of individual, study, and population characteristics...
March 6, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29456977/epidemiologic-and-demographic-features-therapeutic-intervention-and-prognosis-of-the-patients-with-cerebral-aneurysm
#17
Masih Sabouri, Amir Mahabadi, Homayoun Tabesh, Majeed Rezvani, Masih Kouchekzadeh, Ali Namazi
Background: Cerebral aneurysms are a kind of cardiovascular diseases which are accompanied with high morbidity and mortality due to rupturing and causing subarachnoid hemorrhages. The current study aimed to determine epidemiologic and demographic features and prognosis of patients with cerebral aneurysms. Materials and Methods: In this cross-sectional study, 465 patients with cerebral aneurysms hospitalized in Al-Zahra Hospital were studied. The required information including demographic, epidemiologic, and clinical features of the disease were extracted from their records...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29444617/hemodynamic-impingement-and-the-initiation-of-intracranial-side-wall-aneurysms
#18
Gerald J Riccardello, Abhinav R Changa, Fawaz Al-Mufti, I Paul Singh, Chirag Gandhi, Max Roman, Charles J Prestigiacomo
Objective The natural history intracranial aneurysms (IA) remains poorly understood despite significant morbidity and mortality associated with IA rupture. Hemodynamic impingement resulting in elevations in wall shear stress and wall shear stress gradient (WSSG) has been shown to induce aneurysmal remodeling at arterial bifurcations. We investigate the hemodynamic environment specific to side-wall pre-aneurysmal vasculature. We hypothesize that fluid impingement and secondary flow patterns play a role in side-wall aneurysm initiation...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29444616/endovascular-treatment-of-cerebral-aneurysm-after-renal-transplantation-in-polycystic-kidney-disease
#19
Zeferino Demartini, Jennyfer Galdino, Gelson L Koppe, Alexandre T Bignelli, Alexandre N Francisco, Luana Am Gatto
Background Patients with polycystic kidney disease have a higher prevalence of intracranial aneurysms and may progress to renal failure requiring transplantation. The endovascular treatment of intracranial aneurysms may improve prognosis, since rupture often causes premature death or disability, but the nephrotoxicity risk associated with contrast medium must be always considered in cases of renal impairment. Methods A 55-year-old female patient with polycystic kidney disease and grafted kidney associated with anterior communicant artery aneurysm was successfully treated by embolization...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29424648/association-of-plasma-d-dimer-level-with-thromboembolic-events-after-endovascular-coil-treatment-of-ruptured-cerebral-aneurysms
#20
Hitoshi Fukuda, Akira Handa, Masaomi Koyanagi, Benjamin Lo, Sen Yamagata
OBJECTIVE Although endovascular therapy is favored for acutely ruptured intracranial aneurysms, hematological factors associated with acute subarachnoid hemorrhage (SAH) may predispose to procedure-related ischemic complications. The aim of this study was to evaluate whether an elevated level of plasma D-dimer, a parameter of hypercoagulation in patients with acute SAH, is correlated with increased incidence of thromboembolic events during endovascular coiling of ruptured aneurysms. METHODS The authors analyzed data from 103 cases of acutely ruptured aneurysms (in 103 patients) treated with endovascular coil embolization at a single institution...
February 9, 2018: Journal of Neurosurgery
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