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Cerebral Aneurysms

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https://www.readbyqxmd.com/read/29778299/cerebral-perfusion-pressure-threshold-to-prevent-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#1
Jiawei Cai, Wenhua Fang, Fuxiang Chen, Zhangya Lin, Yuanxiang Lin, Lianghong Yu, Peisen Yao, Dezhi Kang
OBJECTIVE: To seek a cerebral perfusion pressure (CPP) threshold that can reduce the occurrence of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: We analyzed the clinical data of patients with the diagnosis of aSAH and underwent CPP monitoring in our department from February 2014 to December 2015. CPP was divided into four specified thresholds by every 10 mmHg increments, which were from 50 mmHg to 80 mmHg. The totally time ratio of CPP below each threshold was calculated...
May 16, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29777883/atypical-presentation-of-giant-aneurysm-in-a-pediatric-patient-with-duane-syndrome
#2
Chao-Hung Kuo, Lynn B McGrath, Joseph A Carnevale, Neena I Marupudi, Jeffery G Ojemann, Richard G Ellenbogen, Anthony C Wang
BACKGROUND: Duane syndrome is a congenital eye movement disorder characterized by congenital malformation of the abducens nucleus. Thrombogenic conditions during development may lead to vascular anomalies in Duane syndrome, however, the presence of a giant aneurysm in this patient population is a rarely documented phenomenon. CASE DESCRIPTION: We reported a case of a large cerebral aneurysm in a pediatric patient with Duane syndrome, and performed a review of the literatures to identify other potential cases and associations...
May 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29775770/treatment-of-ruptured-vertebral-artery-dissection-and-abdominal-hemorrhage-associated-with-segmental-arterial-mediolysis-using-endovascular-coil-embolization-va-dissection-associated-with-sam
#3
Taiki Isaji, Tomotaka Ohshima, Sigeru Miyachi, Naoki Matsuo, Reo Kawaguchi, Masakazu Takayasu
BACKGROUND: Segmental arterial mediolysis is a rare disease characterized by idiopathic noninflammatory vasculopathy involving small to medium arteries. Here, we report a case of ruptured cerebral and abdominal aneurysms, which were successfully treated using emergency endovascular coil embolization. CASE DESCRIPTION: A 45-year-old male suffered subarachnoid hemorrhage caused by the rupture of the right vertebral artery dissecting aneurysm, which was treated using emergency endovascular coiling...
May 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29775150/computer-aided-analysis-of-middle-cerebral-artery-tortuosity-association-with-aneurysm-development
#4
Kornelia M Kliś, Roger M Krzyżewski, Borys M Kwinta, Krzysztof Stachura, Marek Moskała, Krzysztof A Tomaszewski
OBJECTIVE Blood vessel tortuosity may play an important role in the development of vessel abnormalities such as aneurysms. Currently, however, there are no studies analyzing the impact of brain blood vessel tortuosity on the risk of aneurysm formation. Therefore, the authors performed a computer-aided analysis of middle cerebral artery (MCA) tortuosity, especially among patients diagnosed with MCA aneurysms. METHODS Anatomy of the MCAs of 54 patients with unruptured MCA aneurysms was retrospectively analyzed, as was that of 54 sex-, age-, and vessel side-matched control patients without MCA aneurysms...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29774181/embolization-with-ethylene-vinyl-alcohol-copolymer-onyx-%C3%A2-for-peripheral-hemostatic-and-non-hemostatic-applications-a-feasibility-and-safety-study
#5
Romaric Né, Olivier Chevallier, Nicolas Falvo, Olivier Facy, Pierre-Emmanuel Berthod, Christophe Galland, Sophie Gehin, Marco Midulla, Romaric Loffroy
Background: Onyx® is a liquid embolic agent, which is approved for the treatment of cerebral vascular lesions but still rarely used in peripheral interventional radiology. The goal of this study is to report the feasibility and safety of embolization with Onyx® for peripheral hemostatic and non-hemostatic endovascular procedures. Methods: Retrospective study of all consecutive patients who underwent visceral or peripheral embolization with Onyx® for hemostatic or non-hemostatic purpose in our department between May 2014 and November 2016...
April 2018: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/29770118/neuroinflammation-as-a-target-for-intervention-in-subarachnoid-hemorrhage
#6
REVIEW
Airton Leonardo de Oliveira Manoel, R Loch Macdonald
Aneurysmal subarachnoid hemorrhage (SAH) is a sub-type of hemorrhagic stroke associated with the highest rates of mortality and long-term neurological disabilities. Despite the improvement in the management of SAH patients and the reduction in case fatality in the last decades, disability and mortality remain high in this population. Brain injury can occur immediately and in the first days after SAH. This early brain injury can be due to physical effects on the brain such as increased intracranial pressure, herniations, intracerebral, intraventricular hemorrhage, and hydrocephalus...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29768963/the-woven-endobridge-web-as-primary-treatment-for-unruptured-intracranial-aneurysms
#7
Sanne Bt van Rooij, Willem Jan van Rooij, Jo P Peluso, Menno Sluzewski
Purpose The intrasaccular flow disruptor Woven EndoBridge (WEB) device is developed for the treatment of wide-necked aneurysms without supportive devices. We used the WEB as primary treatment for unruptured aneurysms suitable for the device, regardless of neck size. Methods Between February 2015 and June 2017, 59 aneurysms in 51 patients were selectively treated with the WEB. There were 15 men and 36 women with a mean age of 59 years. Mean aneurysm size was 7.0 mm (range 3-22 mm). Of 59 aneurysms, 45 (76%) had a wide neck defined as ≥4 mm or dome-neck ratio ≤1...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29768961/a-rare-case-of-ruptured-aneurysm-of-the-paramedian-artery-of-percheron
#8
Gianvincenzo Sparacia, Francesco Agnello, Massimo Midiri, Alberto Iaia
Introduction The artery of Percheron is a rare anatomic variant supplying bilateral medial thalamic nuclei and a variable portion of the rostral part of midbrain. Case report A 48-year-old female with massive subarachnoid hemorrhage due to a ruptured aneurysm of the paramedian artery of Percheron presented to the emergency room. Because of significant risk of recurrent intracranial hemorrhage, it was decided to proceed with endovascular embolization of the aneurysm. The patient was ultimately sent to a rehabilitation center and her presenting neurologic deficits showed significant improvements in the weeks following endovascular embolization treatment...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29767773/aneurysm-size-is-the-strongest-risk-factor-for-intracranial-aneurysm-growth-in-the-eastern-finnish-population
#9
Joel Björkman, Juhana Frösen, Olli Tähtinen, Terhi Huttunen, Jukka Huttunen, Mitja I Kurki, Mikael von Und Zu Fraunberg, Timo Koivisto, Hannu Manninen, Juha E Jääskeläinen, Antti E Lindgren
BACKGROUND: Saccular intracranial aneurysm (sIA) growth during follow-up is associated with high risk for subsequent rupture. Finnish patients have been suggested to have higher risk for subarachnoid hemorrhage, but follow-up studies of sIA growth in the Finnish population are scarce. OBJECTIVE: To identify the strongest risk factors for sIA growth in Eastern Finnish population by studying 205 patients with 350 unruptured sIAs with angiographic follow-up imaging...
May 15, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29766973/large-serpentine-aneurysm-of-the-anterior-cerebral-artery
#10
Amith S Kumar, Julie Sachdeva, Neeraj Balaini, Ritu Shree, Manoj K Goyal, Vivek Lal, Chirag Ahuja
No abstract text is available yet for this article.
May 2018: Neurology India
https://www.readbyqxmd.com/read/29766928/parent-artery-sacrifice-for-ruptured-aneurysms-in-acute-and-chronic-phases-a-systematic-review
#11
REVIEW
Xianli Lv, Wei Li, Huijian Ge, Hengwei Jin, Hongwei He, Chuhan Jiang, Youxiang Li
Background: Experience with respect to parent vessel sacrifice (PVS) for unclippable/uncoilable ruptured aneurysms is limited. Objective: The aim of the present systematic review was to evaluate the risk of PVS for unclippable/uncoilable ruptured aneurysms. Materials and Methods: The PUBMED and SCIENCEDIRECT databases were searched using "parent vessel occlusion OR parent artery occlusion" AND "acute subarachnoid hemorrhage" till December 27, 2015, and 1 journal was searched from November 1995 to April 2016 for relevant results...
May 2018: Neurology India
https://www.readbyqxmd.com/read/29766916/what-is-the-current-role-of-bypass-surgery-in-the-management-of-cerebral-aneurysms
#12
EDITORIAL
Laligam N Sekhar, Chun-Yu Cheng, Harley Brito Da Silva, Zeeshan Qazi
No abstract text is available yet for this article.
May 2018: Neurology India
https://www.readbyqxmd.com/read/29765397/lvis-jr-device-for-y-stent-assisted-coil-embolization-of-wide-neck-intracranial-aneurysms-a-multicenter-experience
#13
Edgar A Samaniego, Aldo A Mendez, Thanh N Nguyen, Vladimir Kalousek, Waldo R Guerrero, Sudeepta Dandapat, Guilherme Dabus, Italo Linfante, Ameer E Hassan, Alexander Drofa, Evgueni Kouznetsov, David Leedahl, David Hasan, Alberto Maud, Santiago Ortega-Gutierrez
Background and Purpose: Complex wide-neck intracranial aneurysms are challenging to treat. We report a multicenter experience using the LVIS Jr stent for "Y-stent"-assisted coiling embolization of wide-neck bifurcation aneurysms. Methods: Seven centers provided retrospective data on patients who underwent Y-stenting. Technical complications, immediate posttreatment angiographic results, clinical outcomes, and imaging follow-up were assessed. Results: Thirty patients/aneurysms were treated: 15 basilar tip, 8 middle cerebral artery, 4 anterior communicating artery, 1 pericallosal, and 2 posterior inferior cerebellar artery aneurysms...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29765391/abciximab-reopro-dosing-strategy-for-the-management-of-acute-intraprocedural-thromboembolic-complications-during-pipeline-flow-diversion-treatment-of-intracranial-aneurysms
#14
Li-Mei Lin, Bowen Jiang, Jessica K Campos, Narlin B Beaty, Matthew T Bender, Rafael J Tamargo, Judy Huang, Geoffrey P Colby, Alexander L Coon
Background: Flow diversion with the Pipeline embolization device (PED) is an effective neuro-endovascular method and increasingly accepted for the treatment of cerebral aneurysms. Acute in situ thrombosis is a known complication of PED procedures. There is limited experience in the flow diversion literature on the use of abciximab (ReoPro) for the management of acute thrombus formation in PED cases. Methods: Data were collected retrospectively on patients who received intra-arterial (IA) ReoPro with or without subsequent intravenous (IV) infusion during PED flow diversion treatment of intracranial aneurysms...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29764206/management-of-incidental-aneurysms-comparison-of-single-centre-multi-disciplinary-team-decision-making-with-the-unruptured-incidental-aneurysm-treatment-score
#15
Alex Smedley, Nate Yusupov, Alaa Almousa, Thomas Solbach, Ahmed K Toma, Joan P Grieve
OBJECTIVE: To compare multidisciplinary team (MDT) decision making at our centre with the suggested management from the recently published Unruptured Intracranial Aneurysm Treatment Score (UIATS), with particular focus on disagreements between the two bodies of expert opinion. DESIGN: A retrospective audit of local practice. SUBJECTS: Adult patients with incidental cerebral saccular aneurysms referred to The National Hospital for Neurology and Neurosurgery Neurovascular MDT...
May 15, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29764034/-application-of-low-profile-visualized-intraluminal-support-lvis-stents-in-assisting-coil-embolization-of-intracranial-aneurysms
#16
D C Xu, J Li, Z Q Jiang
Objective: To evaluate the safety and effectiveness of application of LVIS stent-assisted coiling endovascular procedures in cerebral aneurysms . Methods: The clinical data of 41 patients with intracranial aneurysms , which were performed in LVIS stent-assisted coiling endovascular therapies from June 2015 to October 2017 in The First Affiliated Hospital of Bengbu Medical College were analyzed retrospectively. 13 patients were unruptured and 28 patients were ruptured. Immediate angiography outcomes and follow-up angiography outcomes were assessed by DSA...
May 8, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29763749/combined-surgical-and-endovascular-treatment-of-a-complex-posterior-communicating-artery-aneurysm-at-one-stage-in-a-hybrid-operating-room
#17
Can Xin, Zhengwei Li, Jianjian Zhang, Zhongwei Xiong, Xiaolin Wu, Shiyu Zhao, Mingjun Cai, Wenyuan Zhao, Jincao Chen
BACKGROUND: Although clipping and coiling of intracranial aneurysms are effective treatment options, they each have respective limitations. With the advent of hybrid operating room, combined clipping and coiling for complex aneurysms at one stage becomes feasible. In this article, we report a successful case of a left posterior communicating artery (PCoA) aneurysm where combined clipping and endovascular treatment were applied. CASE DESCRIPTION: A 57-year-old man had been complaining of severe headache for 10 days...
May 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29762775/combination-superficial-temporal-artery-middle-cerebral-artery-bypass-and-m2-m2-reanastomosis-with-trapping-of-a-stented-distal-middle-cerebral-artery-aneurysm-3-dimensional-operative-video
#18
Jan-Karl Burkhardt, Sonia Yousef, Halima Tabani, Arnau Benet, Roberto Rodriguez Rubio, Michael T Lawton
Distal middle cerebral artery (MCA) aneurysms often have non-saccular morphology and cannot be clipped, requiring revascularization and trapping instead. Combination bypasses are needed when 2 arteries exit the aneurysm, and extracranial-intracranial and intracranial-intracranial bypasses can be used. This video demonstrates a combination bypass used to treat a previously stented distal MCA aneurysm with both a superficial temporal artery (STA)-to-MCA bypass and an M2-to-M2 reanastomosis. This 56-yr-old man presented with distal left-sided MCA aneurysm 2 years earlier and attempted stent-assisted coiling was aborted after the aneurysm was perforated with stenting alone...
May 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29762759/measuring-the-impact-of-delayed-cerebral-ischemia-on-neuropsychological-outcome-after-aneurysmal-subarachnoid-hemorrhage-protocol-of-a-swiss-nationwide-observational-study-moca-dci-study
#19
Martin N Stienen, Christian Fung, Philippe Bijlenga, Daniel W Zumofen, Rodolfo Maduri, Thomas Robert, Martin A Seule, Serge Marbacher, Olivia Geisseler, Peter Brugger, Klemens Gutbrod, Christian Chicherio, Andreas U Monsch, Valérie Beaud, Stefania Rossi, Severin Früh, Nicole Schmid, Nicolas R Smoll, Emanuela Keller, Luca Regli
BACKGROUND: The exact relationship between delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH) and neuropsychological impairment remains unknown, as previous studies lacked a baseline examination after aneurysm occlusion but before the DCI-period. Neuropsychological evaluation of acutely ill patients is often applied in a busy intensive care unit (ICU), where distraction represents a bias to the obtained results. OBJECTIVE: To evaluate the relationship between DCI and neuropsychological outcome after aSAH by comparing the Montreal Cognitive Assessment (MoCA) results in aSAH patients with and without DCI at 3 mo with a baseline examination before the DCI-period (part 1)...
May 11, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29762758/in-situ-left-azygous-anterior-cerebral-artery-to-right-pericallosal-artery-bypass-for-treatment-of-a-giant-right-a1-2-aneurysm-2-dimensional-operative-video
#20
Gary Rajah, Mark Hoeprich, Sandra Narayanan, Murali Guthikonda, Sandeep Mittal
Here we present a 46-yr-old man with recurrent syncopal episodes thought to be of cardiac origin. He was eventually found to harbor a giant, partially thrombosed, saccular aneurysm arising from the A1/A2 segment of the right anterior cerebral artery with foramen of Monro obstruction and a trapped left-sided ventricular system. An azygous left A2 artery segment supplied both callosomarginal arteries. We performed an in situ side-to-side anastomosis between the distal left azygous anterior cerebral artery and the right pericallosal artery, which was previously supplied by the right A1...
May 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
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