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Cerebral Aneurysms

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https://www.readbyqxmd.com/read/29159154/horizontal-stent-assisted-coiling-of-wide-neck-basilar-tip-aneurysm-comparison-of-two-cases
#1
Young Jin Kim, Jae Hoon Sung, Jae Taek Hong, Sang Won Lee
Currently, endovascular coiling is a popular treatment for basilar tip aneurysms, which usually involve a wide neck. Serious complications can occur when the posterior cerebral artery (PCA) originating from a wide neck is not properly preserved. Accordingly, various adjunctive procedures using stents or a balloon have been introduced. Herein we report two cases of basilar tip aneurysms in which retrograde horizontal (from one PCA to the other PCA) stent-assisted coiling was successful, and we provide a summary of the important technical points...
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29159153/endovascular-treatment-of-a-fusiform-aneurysm-involving-a-premammillary-artery-originating-from-the-internal-carotid-artery-a-case-report
#2
Se Jin Choi, Se-Yang Oh, Yu Shik Shim, Dong Keun Hyun
The premammillary artery (PMA) is a branch of the posterior communicating artery (PCoA). While the PMA is known to originate from the PCoA as demonstrated by most anatomical studies, it originates directly from the internal carotid artery in approximately 1% of patients. Cerebral aneurysms associated with the PMA have rarely been reported. We report an extremely rare case of a ruptured PMA aneurysm that was managed using endovascular treatment.
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29159151/a-case-of-unusual-presentation-of-contrast-induced-encephalopathy-after-cerebral-angiography-using-iodixanol
#3
Jun Chul Park, Jun Hyong Ahn, In Bok Chang, Jae Keun Oh, Ji Hee Kim, Joon Ho Song
Contrast-induced encephalopathy after cerebral angiography is a rare complication and until now, only few cases have been reported. This paper reports on contras-induced encephalopathy mimicking meningoencephalitis after cerebral angiography by using iodixanol, an iso-osmolar non-ionic contrast agent. A 58-year-old woman underwent cerebral angiography for the evaluation of multiple intracranial aneurysms. A few hours later, she had persistent headache, vomiting, fever, and seizures. Brain computed tomography (CT) showed sulcal obliteration of right cerebral hemisphere and cerebrospinal fluid profile was unremarkable...
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29159150/the-blood-blister-like-aneurysm-usefulness-of-sundt-clip
#4
Tae Joon Park, Ki Hong Kim, Jae Hoon Cho
Objective: Blood blister-like aneurysm (BBA) is a kind of dorsal wall aneurysm and it is small, sessile, fragile and hazardous because of its high mortality and morbidity. Many challenges tried to establish the management or strategy. But so far, there is no optimal treatment of choice for the BBA. In this article, 17 cases of the ruptured BBA in one institute were analyzed retrospectively. The operative options were correlated with surgical and clinical outcomes. Materials and Methods: During 14 years between October, 2002 and October, 2016, 23 patients were treated for subarachnoid hemorrhage with ruptured dorsal wall aneurysms...
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29159148/endovascular-treatment-of-symptomatic-vasospasm-after-aneurysmal-subarachnoid-hemorrhage-a-three-year-experience
#5
Eun-Sung Park, Dae-Won Kim, Sung-Don Kang
Objective: The cause of severe clinical vasospasm after aneurysmal subarachnoid hemorrhage remains unknown, despite extensive research over the past 30 years. However, the intra-arterial administration of vasodilating agents and balloon angioplasty have been successfully used in severe refractory cerebral vasospasm. Materials and Methods: We retrospectively analyzed the data of 233 patients admitted to our institute with aneurysmal subarachnoid hemorrhage (SAH) over the past 3 years...
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29158449/induced-hypertension-for-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage-a-randomized-clinical-trial
#6
Celine S Gathier, Walter M van den Bergh, Mathieu van der Jagt, Bon H Verweij, Jan Willem Dankbaar, Marcella C Müller, Annemarie W Oldenbeuving, Gabriel J E Rinkel, Arjen J C Slooter
BACKGROUND AND PURPOSE: Induced hypertension is widely used to treat delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage, but a literature review shows that its presumed effectiveness is based on uncontrolled case-series only. We here report clinical outcome of aneurysmal subarachnoid hemorrhage patients with DCI included in a randomized trial on the effectiveness of induced hypertension. METHODS: Aneurysmal subarachnoid hemorrhage patients with clinical symptoms of DCI were randomized to induced hypertension or no induced hypertension...
November 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29155706/comprehensive-endovascular-and-open-surgical-management-of-cerebral-arteriovenous-malformations
#7
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/29152467/an-unruptured-anterior-communicating-artery-aneurysm-presenting-with-left-homonymous-hemianopsia-a-case-report
#8
Jae Wook Kim, Taek Kyun Nam, Ki Su Park, Yong Sook Park, Jeong Taik Kwon
Unruptured cerebral aneurysms sometimes present with visual symptomsdue to compression of the visual pathways. However, until now, unruptured anterior communicating artery (ACoA) aneurysms presenting visual field defects have been extremely rare. The authors report the case of a 51-year-old woman who presented with left homonymous hemianopsia. Radiological findings demonstrated an ACoA aneurysm filled with thrombus, that was compressing the optic chiasm and post-chiasmal tract. The patient underwent clipping of the aneurysm, which resolved the visual field defect...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29152466/a-less-invasive-strategy-for-ruptured-cerebral-aneurysms-with-intracerebral-hematomas-endovascular-coil-embolization-followed-by-stereotactic-aspiration-of-hematomas-using-urokinase
#9
Sang Heum Kim, Tae Gon Kim, Min Ho Kong
Objective: Aneurysm clipping and simultaneous hematoma evacuation through open craniotomy is traditionally recommended for ruptured cerebral aneurysms accompanied by intracerebral or intrasylvian hemorrhages. We report our experience of adapting a less invasive treatment strategy in poor-grade patients with intracerebral or intrasylvian hemorrhages associated with ruptured cerebral aneurysms, where the associated ruptured cerebral aneurysms were managed by endovascular coil embolization, followed by stereotactic aspiration of hematomas (SRH) using urokinase...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29148905/serum-glucose-potassium-ratio-as-a-clinical-risk-factor-for-aneurysmal-subarachnoid-hemorrhage
#10
Yu Fujiki, Fumihiro Matano, Takayuki Mizunari, Yasuo Murai, Kojiro Tateyama, Kenta Koketsu, Asami Kubota, Shiro Kobayashi, Hiroyuki Yokota, Akio Morita
OBJECTIVE Aneurysmal subarachnoid hemorrhage (SAH) can result in poor outcomes, and biomarkers for predicting poor prognosis have not yet been established. The aim of this study was to clarify the significance of the serum glucose/potassium ratio for predicting the prognosis of aneurysmal SAH. METHODS The authors retrospectively reviewed the records of 565 patients with aneurysmal SAH between 2006 and 2016. The patient group comprised 208 men and 357 women (mean age 61.5 years, range 10-95 years). A statistical analysis was conducted of the clinical and laboratory risk factors of poor outcome, including the serum glucose/potassium ratio...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29147918/aortic-arch-aneurysm-surgery-what-is-the-gold-standard-temperature-in-the-absence-of-randomized-data
#11
Amer Harky, Mohamad Bashir, Giovanni Mariscalco
In the absence randomized data for assessing the best and optimal temperature for managing open aortic arch surgery patients, cerebral protection method is still performed through hypothermic circulatory arrest with or without the use of adjuncts. A recent consensus has emerged setting to define the temperature levels. In an attempt, this was aimed to establish a solid ground for future trials in aortic arch surgery. This article reviews the current literature and the evidences behind using different temperature methods and their outcomes in patients undergoing open aortic arch surgery...
November 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29147735/reduction-of-metallic-artifacts-of-the-post-treatment-intracranial-aneurysms-effects-of-single-energy-metal-artifact-reduction-algorithm
#12
Yu-Ning Pan, Ge Chen, Ai-Jing Li, Zhao-Qian Chen, Xiang Gao, Yi Huang, Bradley Mattson, Shan Li
PURPOSE: This study evaluated the quality of computed tomography (CT) and CT angiography images generated using the single-energy metal artifact reduction (SEMAR) algorithm during perfusion examination in patients who had undergone reconstruction with neurosurgical clipping or endovascular coiling for treatment of aneurysms. METHODS: A total of 55 patients with implanted intracranial clips or coils (24 men and 31 women; mean age 60.15 ± 15.86 years) underwent perfusion studies evaluated by CT and CT angiography with a 320-row CT scanner...
November 16, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29147153/successful-aortic-banding-for-type-ia-endoleak-due-to-neck-dilatation-after-endovascular-abdominal-aortic-aneurysm-repair-case-report
#13
Yasushi Tashima, Koichi Tamai, Takehiro Shirasugi, Kenichiro Sato, Takahiro Yamamoto, Yusuke Imamura, Atsushi Yamaguchi, Hideo Adachi, Toshiyuki Kobinata
A 69-year-old man with a type IA endoleak that developed approximately 21 months after endovascular abdominal aortic aneurysm repair (EVAR) of a 46 mm diameter aneurysm was referred to our department. He had impaired renal function, Parkinson's disease, and previous cerebral infarction. Computed tomography angiography showed a type IA endoleak with neck dilatation and that the aneurysm had grown to 60 mm in diameter. We decided to perform aortic banding. The type IA endoleak disappeared after banding and the patient was discharged on postoperative day 10...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29146831/stent-assisted-coiling-of-cerebral-aneurysms-a-single-center-clinical-and-angiographic-analysis
#14
Jun Wang, Jan Vargas, Alejandro Spiotta, Imran Chaudry, Raymond D Turner, Jonathan Lena, Aquilla Turk
OBJECTIVE: This study retrospectively compared the clinical and angiographic outcomes of treating cerebral aneurysms with Neuroform (NEU), Enterprise (EP), and Low-profile Visualized Intraluminal Support (LVIS/LVIS Jr) stents. MATERIALS AND METHODS: We conducted a retrospective analysis of a procedural database. All aneurysm procedures using any of the three types of self-expanding nitinol stents (NEU, EP and LVIS/LVIS Jr) were included. Intra-procedure complications, post-procedure complications, and angiographic results (Raymond-Roy grade scale, RRGS) were analyzed retrospectively...
November 16, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29146726/endovascular-rescue-treatment-through-stent-positioning-after-surgical-clipping-of-intracranial-aneurysms-complicated-by-parent-artery-obstruction
#15
Giovanni Vitale, Giacomo Talenti, Joseph Gabrieli, Giacomo Cester, Alessandro Della Puppa, Francesco Causin
During aneurysm clipping, ischemic complications may occur and require a rescue treatment, usually surgical. We present two such cases that required urgent rescue treatment, performed through an endovascular route. Our first case presented with a non-ruptured right posterior inferior cerebellar artery (PICA) aneurysm. After permanent clip positioning, occlusion of the PICA occurred. An unsuccessful attempt of clip repositioning was performed. We therefore positioned a stent obtaining complete flow restoration...
November 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29142493/cervical-arterial-fibromuscular-dysplasia-in-a-biethnic-population-a-retrospective-study-in-the-u-s-mexican-border
#16
Ihtesham A Qureshi, Gustavo J Rodriguez, Tatiana Chacon-Quesada, Gavito-Higuera Jose, Salvador Cruz-Flores, Alberto Maud
Background  There have been studies trying to characterize Fibromuscular Dysplasia (FMD); however, most of them are based in mainly non-Hispanic sample. The objective of this study is to better understand the epidemiology and clinical characteristics of craniocervical FMD in the Hispanic population. Methods  We retrospectively reviewed the cerebral angiograms performed in our center in a period of 3.5 years under any indication looking for angiographic patterns of FMD. Exclusion criteria consisted of cases in which the first angiogram was done when the patients were younger than 18 years...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29140523/sequential-coiling-assisted-deployment-of-flow-diverter-for-treatment-of-fusiform-middle-cerebral-artery-aneurysms
#17
Abdulrahman Y Alturki, Philip G R Schmalz, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND AND IMPORTANCE: Fusiform intracranial aneurysms remain challenging lesions to treat. These aneurysms have historically required bypass procedures or clip remodeling constructs for cure. Recently, endovascular specialists have reported experience with flow diversion for complex fusiform aneurysms of the vertebrobasilar system, with mixed results. Vascular anatomy for anterior circulation fusiform aneurysms may make these lesions more amenable to flow diversion and embolization procedures; however, published experience with these techniques is lacking...
November 11, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29136224/reliable-identification-of-benign-clinical-course-in-aneurysmal-subarachnoid-hemorrhage-a-simple-and-qualitative-algorithm
#18
Yifei Duan, James Wright, Christina Wright, Berje Shammassian, Curtis Tatsuoka, Nicholas Bambakidis
BACKGROUND: A reliable method to specifically identify low vasospasm risk in aneurysmal subarachnoid hemorrhage (aSAH) patients has not been previously proposed. OBJECTIVE: To develop a clinical algorithm using admission aSAH clinical severity and subarachnoid blood distribution to identify patients at low risk of clinical vasospasm. METHODS: Clinical severities, admission noncontrasted head computerized tomography (CT) scan, and incidences of vasospasm among 291 aSAH patients treated at our institution were evaluated...
November 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29135346/cerebral-artery-myogenic-reactivity-the-next-frontier-in-developing-effective-interventions-for-subarachnoid-hemorrhage
#19
Darcy Lidington, Jeffrey T Kroetsch, Steffen-Sebastian Bolz
Aneurysmal subarachnoid hemorrhage (SAH) is a devastating cerebral event that kills or debilitates the majority of those afflicted. The blood that spills into the subarachnoid space stimulates profound cerebral artery vasoconstriction and consequently, cerebral ischemia. Thus, once the initial bleeding in SAH is appropriately managed, the clinical focus shifts to maintaining/improving cerebral perfusion. However, current therapeutic interventions largely fail to improve clinical outcome, because they do not effectively restore normal cerebral artery function...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29134343/factors-influencing-cerebral-aneurysm-obliteration-and-reliability-of-indocyanine-green-video-angiography
#20
Masayuki Gekka, Naoki Nakayama, Haruto Uchino, Kiyohiro Houkin
BACKGROUND: Indocyanine green video-angiography (ICG-V) is commonly used for intraoperative confirmation of aneurysm obliteration following clipping. However, direct puncture of the aneurysm wall occasionally results in blood leakage in patients for whom ICG-V has indicated complete closure. Therefore, the present study aimed to determine the reliability of ICG-V for confirming complete aneurysm closure, and to elucidate the factors underlying aneurysm obliteration and the occurrence of false-negative ICG-V findings...
November 13, 2017: Acta Neurochirurgica
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