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Ruptured aneurysm

Michael A Silva, Alfred P See, Priyank Khandelwal, Ashutosh Mahapatra, Kai U Frerichs, Rose Du, Nirav J Patel, Mohammad A Aziz-Sultan
OBJECTIVE Paraclinoid aneurysms represent approximately 5% of intracranial aneurysms (Drake et al. [1968]). Visual impairment, which occurs in 16%-40% of patients, is among the most common presentations of these aneurysms (Day [1990], Lai and Morgan [2013], Sahlein et al. [2015], and Silva et al. [2017]). Flow-diverting stents, such as the Pipeline Embolization Device (PED), are increasingly used to treat these aneurysms, in part because of their theoretical reduction of mass effect (Fiorella et al. [2009])...
June 22, 2018: Journal of Neurosurgery
Burke A Cunha, Ismail Jimada, Karishma Chawla
Background: Infectious endocarditis (IE) clinically manifests as either subacute bacterial endocarditis (SBE) or acute bacterial endocarditis (ABE). Neurologic manifestations are markedly different for these two entities. ABE is caused by invasive, highly virulent pathogens (e.g., Staphylococcus aureus ), whereas SBE is attributed to relatively avirulent, non-invasive organisms (e.g., viridans streptococci ). Methods: Here, we reviewed the clinical and radiographic presentations of a patient with cranial complications attributed to ABE...
2018: Surgical Neurology International
Erol Kurç, Onur Sokullu, Serdar Akansel, Murat Sargın
Despite technological advances, the long-term outcomes of endovascular aortic aneurysm repair (EVAR) are still debatable. Although most endograft failures after EVAR can be corrected with endovascular techniques, open conversion may still be required. A 70-year-old male patient presented at the emergency unit with abdominal pain. Twice, in the third and fourth years after the first repair, a stent graft had been placed over a non-adhesive portion of the stent graft due to type Ia endoleaks. In the most recent admission, a CT scan showed type III endoleak and ruptured aneurysm sac...
January 2018: Jornal Vascular Brasileiro
Hidetoshi Matsukawa, Hiroyasu Kamiyama, Takanori Miyazaki, Yu Kinoshita, Nakao Ota, Kosumo Noda, Takaharu Shonai, Osamu Takahashi, Sadahisa Tokuda, Rokuya Tanikawa
OBJECT: Regardless of acceptable surgical results of middle cerebral artery aneurysms (MCAs), MCA territory infarction (MCATI) is still one of major problems needing to be solved to archive the better outcome. Authors aimed to investigate the MCATI in patients with surgically treated MCA aneurysms. METHODS: The data of 286 consecutive patients with 322 MCA aneurysms was retrospectively evaluated. The aneurysm location was classified into the early frontal cortical branch (EFCB), early temporal cortical branch (ETCB), bi- or trifurcation (M1-2), and distal aneurysms on the insular, opercular, or cortical segments of MCA (distal MCA)...
June 18, 2018: World Neurosurgery
M'Peko Osawa F Mayele, X Bertrand
Subarachnoid hemorrhage is a neurovascular emergency affecting relatively young adults. A ruptured cerebral aneurysm is the main non-traumatic cause. Except for the non-specific symptom of headache, which frequently occurs in subarachnoid hemorrhage, the clinical presentation is atypical, making the diagnosis difficult with possible dramatic consequences. The diagnosis is based on the CT scan without contrast, which, when negative, will be followed by a lumbar puncture. The etiologic analysis is based on an urgent arteriography, revealing the characteristics of the aneurysm such as the anatomy of the intracerebral vessels, the identification of the bleeding site and the size and location of the aneurysm...
May 2018: Revue Médicale de Liège
D Martin, B Otto, T Darsaut, F Scholtes
The rupture of an intracranial aneurysm is a sudden, unpredictable and potentially severe event. The responsible aneurysm has to be excluded from the cerebral circulation to avoid recurrence. More and more commonly, intracranial aneurysms are detected by coincidence. How to react to these fortuitous discoveries is unclear, because the risk of rupture is difficult to estimate. We present our approach to patients facing this situation and the decision-making process.
May 2018: Revue Médicale de Liège
V Tchana-Sato, N Sakalihasan, J O Defraigne
Ruptured abdominal aortic aneurysm is a cardiovascular emergency associated with a 30 day mortality as high as 70 %. However, recent progresses in the management of these patients have improved the results. From a surgical point of view, endovascular methods such as balloon occlusion and endovascular repair (EVAR) in patients with suitable anatomy are recommended in order to reduce mortality.
May 2018: Revue Médicale de Liège
Stefano D'Errico, Massimo Martelloni, Francesco Pio Cafarelli, Giuseppe Guglielmi
Type 1 neurofibromatosis (NF 1), a rare genetic disease with autosomal dominant transmission, has typical dermatologic manifestations with pathognomonic Lisch nodules, and is rarely known for vascular alterations. Among these, aneurysmal dilatation is the most common form. We report a fatal case of massive hemothorax due to a spontaneous rupture of the left pulmonary artery branch micro-aneurysm in a NF 1 patient. Indeed, spontaneous rupture of these pathologic vessels is very rare in clinical practice and the literature, but, for its potentially life-threatening complications, there is the need for it to be taken into account in differential diagnosis...
June 20, 2018: Forensic Science, Medicine, and Pathology
Betty Leclerc, Lucie Salomon Du Mont, Anne-Laure Parmentier, Guillaume Besch, Simon Rinckenbach
BACKGROUND: The abdominal compartment syndrome (ACS) has been clearly identified as being one of the main causes of mortality after ruptured abdominal aortic aneurysm (rAAA). The ACS is defined as a sustained intra-abdominal pressure > 20 mm Hg associated with a new organ dysfunction or failure. A pilot study was conducted and found that the threshold of 3 among 8 selected criteria, we would predict an ACS occurrence with a 54% positive predictive value and a 92% negative predictive value...
June 2018: Medicine (Baltimore)
Yohei Kawatani, Hirotsugu Kurobe, Yoshitsugu Nakamura, Takaki Hori
A 78-year-old man with no history of allergy, underwent endovascular aortic repair for abdominal aortic aneurysm rupture. Postoperatively, he had low-grade fever and persistently raised white blood cell counts, but tests showed no infection. A skin rash appeared on the trunk and upper arms; we suspected a drug allergy. Despite withdrawal and/or change of medications, the symptoms remained. Finally, a patch test for nickel showed a strongly positive result. Oral prednisone 5 mg·day-1 was started, and the clinical findings resolved thereafter...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
Melanie R Hoehn, Natasha Z Hansraj, Amelia M Pasley, Megan Brenner, Samantha R Cox, Jason D Pasley, Jose J Diaz, Thomas Scalea
BACKGROUND: Hemorrhagic shock is the second leading cause of death in blunt trauma and a significant cause of mortality in non-trauma patients. The increased use of resuscitative endovascular balloon occlusion of the aorta (REBOA) as a bridge to definitive control for massive hemorrhage has provided promising results in the trauma population. We describe an extension of this procedure to our hemodynamically unstable non-trauma patients. METHODS: This is a retrospective review of patients requiring REBOA for end stage non-traumatic abdominal hemorrhage from our tertiary care facility...
June 19, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Felicitas J Detmer, Bong Jae Chung, Fernando Mut, Michael Pritz, Martin Slawski, Farid Hamzei-Sichani, David Kallmes, Christopher Putman, Carlos Jimenez, Juan R Cebral
BACKGROUND: Intracranial aneurysms at the posterior communicating artery (PCOM) are known to have high rupture rates compared to other locations. We developed and internally validated a statistical model discriminating between ruptured and unruptured PCOM aneurysms based on hemodynamic and geometric parameters, angio-architectures, and patient age with the objective of its future use for aneurysm risk assessment. METHODS: A total of 289 PCOM aneurysms in 272 patients modeled with image-based computational fluid dynamics (CFD) were used to construct statistical models using logistic group lasso regression...
June 20, 2018: Acta Neurochirurgica
Masamichi Nogi, Kimio Satoh, Shinichiro Sunamura, Nobuhiro Kikuchi, Taijyu Satoh, Ryo Kurosawa, Junichi Omura, Md Elias Al-Mamun, Mohammad Abdul Hai Siddique, Kazuhiko Numano, Shun Kudo, Satoshi Miyata, Masatoshi Akiyama, Kiichiro Kumagai, Shunsuke Kawamoto, Yoshikatsu Saiki, Hiroaki Shimokawa
Background -Thoracic aortic aneurysm (TAA) and dissection (TAD) are fatal diseases, which cause aortic rupture and sudden death. The small GTP-binding protein GDP dissociation stimulator (SmgGDS) is a crucial mediator of the pleiotropic effects of statins. Previous studies revealed that reduced force generation in AoSMCs causes TAA and TAD. Methods -To examine the role of SmgGDS in TAA formation, we employed an angiotensin II (AngII, 1,000 ng/min/kg, 4 weeks)-induced TAA model. Results -33% Apoe-/- SmgGDS+/- mice died suddenly due to TAA rupture, whereas there was no TAA rupture in Apoe-/- control mice...
June 19, 2018: Circulation
Yuying Tan, Hui Xu, Yongsheng Gao, Chengbin Zhang, Baogang Wang, Xiaocong Wang
Aneurysms of the aortic sinus are well-known clinical entities that can bulge into adjacent heart chambers or vessels. They usually reside in the right ventricle and very rarely bulge into the left ventricle causing mitral valve deformation. A 47-year-old man was admitted for shortness of breath and chest pain after exertion. He was diagnosed with a noncoronary sinus of Valsalva aneurysm bulging into the mitral valve's anterior leaflet. The aortic valve and mitral valve annulus were severely damaged and irreparable...
June 19, 2018: Echocardiography
Manju Mohanty, Sivashanmugam Dhandapani, Sunil Kumar Gupta, Adnan Hussain Shahid, Debi Prasad Patra, Anchal Sharma, Suresh Narayan Mathuriya
BACKGROUND: The cognitive impairments following treatment of ruptured aneurysms have often been underestimated. This study was to assess their prevalence and analyze various associated factors. METHODS: Patients who were operated for ruptured anterior circulation aneurysms and discharged in Glasgow outcome scale 4-5 were studied at 3 months for various cognitive impairments. Continuous scales of memory (recent, remote, verbal, visual and overall memory), verbal fluency (phonemic and category fluency) and others were studied in relation to various factors...
June 16, 2018: World Neurosurgery
Ben A Strickland, Robert C Rennert, Josh Bakhsheshian, Kristine Ravina, Vance Fredrickson, Steven L Giannotta, Jonathan J Russin
Blister aneurysms (BAs) represent a clinical challenge without a consensus treatment strategy. We report our institution's experience with BAs with an emphasis on the use of extracranial-to-intracranial (EC-IC) bypass. 17 patients with BAs (88% [15/17] ruptured) were treated with microsurgical techniques (5 clip wrappings, 4 clip ligations, 4 EC-IC bypasses and clip trappings, 2 internal carotid artery ligations [one combined with clip wrapping], and 2 clip trappings). 6/17 patients experienced intraoperative ruptures...
June 16, 2018: World Neurosurgery
Ricardo Chmelnitsky Wainberg, Marcos Devanir Silva da Costa, Yair A Ugalde Hernández, Ricardo Lourenço Caramanti, César Augusto Ferreira Alves Filho, Helbert Palmiero, Ricardo Pagung Saick, Feres Chaddad-Neto
The distal posterior inferior cerebellar artery (PICA) is a rare site of aneurysm formation. Only small case series and case reports regarding surgical treatment are found in the literature.The PICA is divided into 5 segments (anterior medullary, lateral medullary, tonsilomedullary, telovelotonsillary, and cortical), and the distal ones represent the most complex, due to anatomic variations. We present a case of a 69-yr-old female patient who has suffered from a sudden and intense occipital headache, associated with nausea and vomiting...
June 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
Dean J Arnaoutakis, Gaurav Sharma, Stuart Blackwood, Samir K Shah, Matthew Menard, C Keith Ozaki, Michael Belkin
BACKGROUND: Failure of endovascular aneurysm repairs (EVARs) requiring open conversion remains a major challenge. We analyzed indications for repair, operative strategies, and outcomes with a focus on iliac artery degeneration after endograft removal. METHODS: A prospective, institutional database was reviewed to identify patients who underwent explantation of a failed EVAR device. Demographics, reason for failure, operative details including extent of endograft removal, and complications/survival were examined...
June 15, 2018: Journal of Vascular Surgery
Masaru Kimura, Katsuyuki Hoshina, Kazuhiro Miyahara, Jun Nitta, Masaharu Kobayashi, Sota Yamamoto, Marie Ohshima
OBJECTIVE: The objective of this study was to use parameters to determine the geometric differences between ruptured abdominal aortic aneurysms (AAAs) and nonruptured AAAs. METHODS: Computed tomography data of 38 ruptured AAAs and 215 electively repaired (nonruptured) AAAs were collected from multiple institutes. We compared the ruptured AAA group and nonruptured AAA group with 1:1 matching by using the Mahalanobis distance, which was calculated using the patient's age, sex, and AAA diameter...
June 15, 2018: Journal of Vascular Surgery
Satoshi Murai, Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Shingo Nishihiro, Naoya Kidani, Yu Takahashi, Isao Date
No abstract text is available yet for this article.
June 15, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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