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Cerebral Aneurysms

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https://www.readbyqxmd.com/read/27932668/quantitative-flow-measurement-after-placing-a-flow-diverter-for-a-distal-internal-carotid-artery-aneurysm
#1
Chien-Wei Chen, Ho-Fai Wong, Yu-Ling Ye, Yao-Liang Chen, Wei-Liang Chen, Chang-Hsien Ou, Yuan-Hsiung Tsai
OBJECTIVES: To evaluate the differences in arterial flow after flow diverter placement using quantitative flow measurements based on digital subtraction angiography (DSA). METHODS: Between November 2013 and November 2015, all patients who had flow diverters placed for distal internal carotid artery (ICA) aneurysms were reviewed. Patients in whom the stent was placed across the ostia of the ophthalmic artery (OphA) and anterior choroidal artery (AChA) were enrolled...
December 8, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27932607/randomized-open-label-phase-1-2a-study-to-determine-the-maximum-tolerated-dose-of-intraventricular-sustained-release-nimodipine-for-subarachnoid-hemorrhage-newton-nimodipine-microparticles-to-enhance-recovery-while-reducing-toxicity-after-subarachnoid-hemorrhage
#2
Daniel Hänggi, Nima Etminan, Francois Aldrich, Hans Jakob Steiger, Stephan A Mayer, Michael N Diringer, Brian L Hoh, J Mocco, Herbert J Faleck, R Loch Macdonald
BACKGROUND AND PURPOSE: We conducted a randomized, open-label, phase 1/2a, dose-escalation study of intraventricular sustained-release nimodipine (EG-1962) to determine safety, tolerability, pharmacokinetics, and clinical effects in aneurysmal subarachnoid hemorrhage. METHODS: Subjects with aneurysmal subarachnoid hemorrhage repaired by clipping or coiling were randomized to EG-1962 or enteral nimodipine. Subjects were World Federation of Neurological Surgeons grade 2 to 4 and had an external ventricular drain...
December 8, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27931942/interleukin-6-in-the-cerebrospinal-fluid-as-biomarker-for-onset-of-vasospasm-and-ventriculitis-after-severe-subarachnoidal-hemorrhage
#3
Markus Lenski, Volker Huge, Josef Briegel, Jörg-Christian Tonn, Christian Schichor, Niklas Thon
OBJECTIVE: Study aim was to investigate the diagnostic potential of Interleukin-6(IL-6) and other soluble biomarkers in serum and cerebrospinal fluid(CSF) for early diagnosis of cerebral vasospasm (cVSSAH) and external ventricular drainage (EVD) associated ventriculitis (VCSAH) and to separate these conditions from aneurysmal subarachnoidal hemorrhage (aSAH) without further complication (SAH(w/o/c)). METHODS: The concentrations of serum biomarkers and markers in the CSF were collected in 63 consecutive patients with aSAH and EVD...
December 5, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27931120/outcomes-of-csf-spectrophotometry-in-cases-of-suspected-subarachnoid-haemorrhage-with-negative-ct-two-years-retrospective-review-in-a-birmingham-hospital
#4
A Bakr, D Silva, R Cramb, G Flint, M Foroughi
AIM: The aim of this study was to evaluate the adherence to current guidelines for the investigation of suspected subarachnoid haemorrhage and the prevalence and outcome of computed tomography (CT)-negative aneurysmal subarachnoid haemorrhage. DESIGN: A retrospective review in a single large tertiary referral centre. SUBJECTS: A total of 796 patients, aged 16-90 years, who underwent lumbar puncture (LP) for suspected subarachnoid haemorrhage (SAH) following a negative or equivocal CT scan between January 2012 and November 2013 (23 months)...
December 8, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27927935/large-scale-identification-of-patients-with-cerebral-aneurysms-using-natural-language-processing
#5
Victor M Castro, Dmitriy Dligach, Sean Finan, Sheng Yu, Anil Can, Muhammad Abd-El-Barr, Vivian Gainer, Nancy A Shadick, Shawn Murphy, Tianxi Cai, Guergana Savova, Scott T Weiss, Rose Du
OBJECTIVE: To use natural language processing (NLP) in conjunction with the electronic medical record (EMR) to accurately identify patients with cerebral aneurysms and their matched controls. METHODS: ICD-9 and Current Procedural Terminology codes were used to obtain an initial data mart of potential aneurysm patients from the EMR. NLP was then used to train a classification algorithm with .632 bootstrap cross-validation used for correction of overfitting bias. The classification rule was then applied to the full data mart...
December 7, 2016: Neurology
https://www.readbyqxmd.com/read/27927702/bedside-cerebral-microdialysis-monitoring-of-delayed-cerebral-hypoperfusion-in-comatose-patients-with-poor-grade-aneurysmal-subarachnoid-haemorrhage
#6
Camille Patet, Hervé Quintard, Jean-Baptiste Zerlauth, Thomas Maibach, Laurent Carteron, Tamarah Suys, Pierre Bouzat, David Bervini, Marc Levivier, Roy T Daniel, Philippe Eckert, Reto Meuli, Mauro Oddo
BACKGROUND: Delayed cerebral ischaemia (DCI) is frequent after poor grade aneurysmal subarachnoid haemorrhage (SAH). Owing to the limited accuracy of clinical examination, DCI diagnosis is often based on multimodal monitoring. We examined the value of cerebral microdialysis (CMD) in this setting. METHODS: 20 comatose SAH participants underwent CMD monitoring-for hourly sampling of cerebral extracellular lactate/pyruvate ratio (LPR) and glucose-and brain perfusion CT (PCT)...
December 7, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27924052/magnetic-resonance-imaging-and-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#7
Lisa A van der Kleij, Jill B De Vis, Jean-Marc Olivot, Lionel Calviere, Christophe Cognard, Nicolaas P A Zuithoff, Gabriel J E Rinkel, Jeroen Hendrikse, Mervyn D I Vergouwen
No abstract text is available yet for this article.
December 6, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27923755/safety-and-efficacy-of-surgical-and-endovascular-treatment-for-distal-anterior-cerebral-artery-aneurysms-a-systematic-review-and-meta-analysis
#8
Ondra Petr, Lucie Coufalová, Rafael Rehwald, Berharnd Glodny, Vladimír Beneš
BACKROUND: Aneurysms of the distal anterior cerebral artery (DACA) are rare, representing between 1% and 9% of all intracranial aneurysms. The best treatment strategy for these aneurysms continue to be debated. OBJECTIVE: We conducted a systematic review of the literature to evaluate the safety and efficacy of treatment strategies of DACA-aneurysms. METHODS: A systematic search of Medline, EMBASE, Scopus and Web of Science was done for studies published from 01/2000 to 08/2015...
December 3, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27920207/vascular-angular-remodeling-by-kissing-y-stenting-in-wide-necked-intracranial-bifurcation-aneurysms
#9
Katharina Melber, Dan Meila, Philipp Draheim, Dominik Grieb, Björn Greling, Martin Schlunz-Hendann, Friedhelm Brassel
INTRODUCTION: Single stent deployment leads to a change in vascular geometry in wide necked bifurcation aneurysms. In some complex cases, the use of the single stent technique might not be sufficient or may not be feasible. The kissing-Y stenting technique appears to be an alternative endovascular treatment option. The aim of this study was to evaluate the effects of the kissing-Y stenting technique on vascular angular remodeling. METHODS: 21 patients with wide necked intracranial bifurcation aneurysms at different sites (10 anterior communicating artery, 6 middle cerebral artery, 3 basilar artery, 1 vertebral artery/posterior inferior cerebellar artery, 1 internal carotid artery/posterior communicating artery) were treated with 44 closed cell stents (follow-up 2012-2016) using the kissing-Y stenting technique...
December 5, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27916243/safe-reentry-for-false-aneurysm-operations-in-high-risk-patients
#10
Gian Luca Martinelli, Attilio Cotroneo, Philippe Primo Caimmi, Gabriele Musica, David Barillà, Edmond Stelian, Angelo Romano, Eugenio Novelli, Luca Renzi, Marco Diena
BACKGROUND: In the absence of a standardized safe surgical reentry strategy for high-risk patients with large or anterior postoperative aortic false aneurysm (PAFA), we aimed to describe an effective and safe approach for such patients. METHODS: We prospectively analyzed patients treated for PAFA between 2006 and 2015. According to the preoperative computed tomography scan examination, patients were divided into two groups according to the anatomy and extension of PAFA: in group A, high-risk PAFA (diameter ≥3 cm) developed in the anterior mediastinum; in group B, low-risk PAFA (diameter <3 cm) was situated posteriorly...
December 1, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27913802/combined-use-of-a-pconus-and-a-solitaire-stent-report-of-two-cases
#11
Pervinder Bhogal, Marta Aguilar Pérez, Rosa Martinez Moreno, Marcin Miś, Maciej Miś, Hans Henkes
OBJECTIVE: The aim of this study was to report our initial experience of the use of the pCONus neck protection device in conjunction with the Solitaire AB stent to assist in the endovascular management of complex intracranial aneurysms with arteries arising from both the neck and the dome of the aneurysm. METHODS: Two patients with unruptured aneurysms underwent elective endovascular management of their aneurysms, one arising from the middle cerebral artery bifurcation and one from the anterior communicating artery...
December 2, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27911237/size-and-location-of-ruptured-intracranial-aneurysms-consecutive-series-of-1993-hospital-admitted-patients
#12
Miikka Korja, Riku Kivisaari, Behnam Rezai Jahromi, Hanna Lehto
OBJECTIVE Large consecutive series on the size and location of ruptured intracranial aneurysms (RIAs) are limited, and therefore it has been difficult to estimate population-wide effects of size-based treatment strategies of unruptured intracranial aneurysms. The authors' aim was to define the size and location of RIAs in patients diagnosed with subarachnoid hemorrhage due to aneurysm rupture in a high-volume academic center. METHODS Consecutive patients admitted to a large nonprofit academic hospital with saccular RIAs between 1995 and 2009 were identified, and the size, location, and multiplicity of RIAs were defined and reported by patient sex...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27906765/hemodynamic-disturbances-in-the-early-phase-after-subarachnoid-hemorrhage-regional-cerebral-blood-flow-studied-by-bedside-xenon-enhanced-ct
#13
Henrik Engquist, Anders Lewén, Tim Howells, Ulf Johnson, Elisabeth Ronne-Engström, Pelle Nilsson, Per Enblad, Elham Rostami
BACKGROUND: The mechanisms leading to neurological deterioration and the devastating course of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) are still not well understood. Bedside xenon-enhanced computerized tomography (XeCT) enables measurements of regional cerebral blood flow (rCBF) during neurosurgical intensive care. In the present study, CBF characteristics in the early phase after severe SAH were explored and related to clinical characteristics and early clinical course outcome...
November 30, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27903923/stent-assisted-coil-embolization-of-a-recurrent-posterior-cerebral-artery-aneurysm-following-surgical-clipping
#14
Tomonori Takeshita, Tomoaki Nagamine, Kohei Ishihara, Yasuhiko Kaku
Posterior cerebral artery (PCA) aneurysms are rare, and direct surgery of these is considered difficult. Coil embolization of PCA aneurysms is becoming popular. However, it is difficult to completely obliterate the aneurysm while preserving the flow of the parent artery in large or giant PCA aneurysms with a wide neck with this technique. We report a case of a large and wide-necked PCA aneurysm with multiple recurrences following successful surgical clipping and coil embolization.A 77-year-old man with a large unruptured right PCA (P2) aneurysm was successfully treated by surgical clipping...
November 30, 2016: Neuroradiology Journal
https://www.readbyqxmd.com/read/27903019/osteochondroma-presenting-as-a-calcified-mass-in-the-sellar-region-and-review-of-the-literature
#15
Kazuya Sekiguchi, Satoshi Tsutsumi, Sho Arai, Senshu Nonaka, Takamoto Suzuki, Hisato Ishii, Hiroshi Izumi, Yukimasa Yasumoto
Objective Osteochondroma (OC) is the most common benign bone neoplasm. It infrequently occurs in the cranial cavity as a calcified lesion and very rarely presents in the sellar region. The present study summarizes the knowledge about OCs of the sellar region. Methods We searched the literature search for the clinical appearance of OCs and other calcified pathologies occurring in the sellar region. Results A total of 21 English-language articles published from 1961 to 2015 documented cases of calcified lesions in the sellar region including cerebral aneurysm, chondroid chordoma, chondroma, craniopharyngioma, OC, odontome, osteoma, pituitary adenoma, pituitary stone, Rathke cleft cyst, retinoblastoma, schwannoma, and xanthogranuloma...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27900535/evaluation-of-cerebral-circulation-during-retrograde-perfusion-by-laser-speckle-flowgraphy
#16
Fumiaki Kimura, Hirotsugu Kanda, Yuki Toyama, Takayuki Kunisawa, Taiji Nagaoka, Akitoshi Yoshida, Hiroto Kitahara, Hiroyuki Kamiya
Laser speckle flowgraphy (LSFG) is an ophthalmologic equipment that qualitatively detects the blood flow of the optic nerve head, which is known to be related with cerebral microcirculation. LSFG can also measure the mean blur rate, which quantitatively calculates the blood flow. We aimed to assess the utility of LSFG in the evaluation of cerebral perfusion during aortic surgery under hypothermic circulatory arrest with retrograde and antegrade cerebral perfusion. Two patients underwent total arch replacement for aneurysm...
November 29, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27898547/bilateral-congenital-iris-sphincter-agenesis-diagnosed-after-massive-bleeding-episode-during-repair-of-aneurysmal-dilation-of-patent-ductus-arteriosus
#17
Tomohiro Yamamoto, Martin Schmidt-Niemann, Ehrenfried Schindler
We report a rare case of an infant with both an aneurysmal dilation of the patent ductus arteriosus (PDA) and bilateral congenital iris sphincter agenesis. Her mydriasis without pupillary light reflex was first noted after a massive intraoperative bleeding episode during the PDA ligation. The assumption that the mydriasis was a sign of cerebral ischemia led to additional examinations and intensive medical therapies that in retrospect were unnecessary. This is the first reported case of combined aneurysmal dilation of a PDA and congenital iris sphincter agenesis in the anesthesia literature...
November 28, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27895300/thsd1-thrombospondin-type-1-domain-containing-protein-1-mutation-in-the-pathogenesis-of-intracranial-aneurysm-and-subarachnoid-hemorrhage
#18
Teresa Santiago-Sim, Xiaoqian Fang, Morgan L Hennessy, Stephen V Nalbach, Steven R DePalma, Ming Sum Lee, Steven C Greenway, Barbara McDonough, Georgene W Hergenroeder, Kyla J Patek, Sarah M Colosimo, Krista J Qualmann, John P Hagan, Dianna M Milewicz, Calum A MacRae, Susan M Dymecki, Christine E Seidman, J G Seidman, Dong H Kim
BACKGROUND AND PURPOSE: A ruptured intracranial aneurysm (IA) is the leading cause of a subarachnoid hemorrhage. This study seeks to define a specific gene whose mutation leads to disease. METHODS: More than 500 IA probands and 100 affected families were enrolled and clinically characterized. Whole exome sequencing was performed on a large family, revealing a segregating THSD1 (thrombospondin type 1 domain containing protein 1) mutation. THSD1 was sequenced in other probands and controls...
December 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27891172/vortex-analysis-of-intra-aneurismal-flow-in-cerebral-aneurysms
#19
Kevin Sunderland, Christopher Haferman, Gouthami Chintalapani, Jingfeng Jiang
This study aims to develop an alternative vortex analysis method by measuring structure ofIntracranial aneurysm (IA) flow vortexes across the cardiac cycle, to quantify temporal stability of aneurismal flow. Hemodynamics were modeled in "patient-specific" geometries, using computational fluid dynamics (CFD) simulations. Modified versions of known λ2 and Q-criterion methods identified vortex regions; then regions were segmented out using the classical marching cube algorithm. Temporal stability was measured by the degree of vortex overlap (DVO) at each step of a cardiac cycle against a cycle-averaged vortex and by the change in number of cores over the cycle...
2016: Computational and Mathematical Methods in Medicine
https://www.readbyqxmd.com/read/27890755/predictors-of-shunt-insertion-in-aneurysmal-subarachnoid-hemorrhage
#20
Rouzbeh Motiei-Langroudi, Nimer Adeeb, Paul M Foreman, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Beverly C Walters, Shane R Tubbs, Mohammadali M Shoja, Justin M Moore, Raghav Gupta, Christopher S Ogilvy, Ajith T Thomas, Christoph J Griessenauer
OBJECTS: Hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage (aSAH) requiring permanent cerebrospinal fluid (CSF) diversion in up to two thirds of patients. Factors that predict permanent CSF diversion are not well established. METHODS: An exploratory analysis of 149 patients enrolled in the Cerebral Aneurysm Renin Angiotensin System (CARAS) study was performed in an effort to identify factors predictive of permanent CSF diversion following aSAH; only the 135 patients surviving the initial hospitalization were included in the present study...
November 24, 2016: World Neurosurgery
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