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Cerebral Aneurysm surgery

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https://www.readbyqxmd.com/read/29053070/relationship-between-patient-safety-indicator-events-and-comprehensive-stroke-center-volume-status-in-the-treatment-of-unruptured-cerebral-aneurysms
#1
Chad W Washington, L Ian Taylor, Robert J Dambrino, Paul R Clark, Gregory J Zipfel
OBJECTIVE The Agency of Healthcare Research and Quality (AHRQ) has defined Patient Safety Indicators (PSIs) for assessments in quality of inpatient care. The hypothesis of this study is that, in the treatment of unruptured cerebral aneurysms (UCAs), PSI events are less likely to occur in hospitals meeting the volume thresholds defined by The Joint Commission for Comprehensive Stroke Center (CSC) certification. METHODS Using the 2002-2011 National (Nationwide) Inpatient Sample, patients treated electively for a nonruptured cerebral aneurysm were selected...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29046469/-a-rare-case-of-ruptured-unruptured-miniature-aneurysms-originating-from-the-infundibular-dilatation-of-the-callosomarginal-artery-branching-from-the-infracallosal-a2-segment-of-the-azygos-anterior-cerebral-artery
#2
Shota Yoshimura, Chika Somagawa, Kei Satoh, Yutaka Fukuda, Takeshi Hiu, Tomonori Ono, Ryujiro Ushijima, Keisuke Toda, Keisuke Tsutsumi
We report the first case of two de novo miniature aneurysms(ruptured/unruptured)emerging from the infundibular dilatation(ID)of the callosomarginal artery, which branches from the infracallosal(A2)segment of the azygos anterior cerebral artery(AACA), in a 36-year-old woman. The patient had previously been diagnosed with a miniature, unruptured aneurysm, occurring in the A2 segment of the AACA, detected by CT angiography(CTA)at another hospital two years ago, and had been followed up with MR angiography(MRA)every 6 months...
October 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29038409/-total-arch-replacement-for-distal-arch-aneurysm-with-isolated-left-vertebral-artery-report-of-a-case
#3
Motonori Uchino, Masaru Yoshikai, Hisashi Sato, Jun Osaki
We herein present a case of distal aortic arch aneurysm with an isolated left vertebral artery(LVA). In surgery, after establishing cardiopulmonary bypass, the LVA was anastomosed to the left common carotid artery (LCCA) while under moderate hypothermia. Selective cerebral perfusion (SCP) was then initiated by inserting catheters into the brachiocephalic artery( BCA), the LCCA and the left subclavian artery (LSA). The aorta was transected between the BCA and the LCCA, and an open stent graft was deployed into the descending aorta during circulatory arrest...
October 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29029292/minimizing-retraction-by-pia-arachnoidal-10-0-sutures-in-intrasulcal-dissection
#4
Kutluay Uluc, Ulas Cikla, Deniz B Morkan, Alperen Sirin, Azam S Ahmed, Kyle Swanson, Mustafa K Baskaya
BACKGROUND: In contemporary microneurosurgery reducing retraction-induced injury to the brain is essential. Self-retaining retractor systems are commonly used to improve visualization and decrease the repetitive microtrauma, but sometimes self-retaining retractor systems can be cumbersome and the force applied can cause focal ischemia or contusions. This may increase the morbidity and mortality. Here, we describe a technique of retraction using 10-0 sutures in the arachnoid. OBJECTIVE: To evaluate the imaging and clinical results in patients where 10-0 suture retraction was used to aid the surgical procedure...
September 19, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29018652/anastomotic-aneurysm-formation-after-high-flow-bypass-surgery-a-case-report-with-histopathological-study
#5
Tatsuya Uchida, Masanori Yoshino, Shinji Ito, Takayuki Hara
Bypass surgery is often used in the treatment of large and giant aneurysms. Major complications that often arise during the perioperative period include cranial nerve palsy, ischemic complications, and hyperperfusion. However, there have been a few reports about late onset complications such as anastomotic aneurysms. In particular, anastomotic aneurysm after high flow bypasses has never been reported. A 57-year-old woman who had been suffering from left eye pain was diagnosed with a large aneurysm of the left internal carotid artery (ICA) in the cavernous portion...
October 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28994832/carotid-endarterectomy-for-treatment-of-carotid-in-stent-restenosis-long-term-follow-up-results-and-surgery-experiences-from-one-single-centre
#6
Le-Bao Yu, Wei Yan, Qian Zhang, Ji-Zong Zhao, Yan Zhang, Rong Wang, Jun-Shi Shao, Dong Zhang
OBJECTIVE: Few studies have reported the surgical treatment of carotid in-stent restenosis (ISR), more data and longer follow-up are needed. We describe the surgical treatment of ISR by standard carotid endarterectomy (CEA) with stent removal, including long-term follow-up in 10 patients from our centre. METHODS: Ten patients from our centre who underwent CEA with stent removal for ISR were retrospectively analysed, including nine symptomatic and one asymptomatic ISR of at least 70% with mean age 67...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28987845/recurrent-cerebral-hemorrhages-in-normal-pregnancy-secondary-to-mycotic-pseudoaneurysms-related-to-choriocarcinoma
#7
Crystal Jing Jing Yeo, Gavin W Britz, Suzanne Z Powell, R Glenn Smith, Yi J Zhang
BACKGROUND: Choriocarcinoma coexisting with or after normal pregnancy is extremely rare. To our knowledge, our case report is the first time cerebral mycotic pseudoaneurysms from choriocarcinoma have been proven angiographically. CASE DESCRIPTION: A 38-week pregnant 26-year old woman presented with an acute left frontal hemorrhage. She underwent emergency Caesarian, followed by hematoma evacuation and resection of what grossly appeared to be a medium-sized arteriovenous malformation at the time of surgery...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28987841/severe-subarachnoid-hemorrhage-due-to-a-fusiform-lateral-anterior-a1-artery-perforator-aneurysm-with-spontaneous-resolution
#8
Gökce Hatipoglu Majernik, Elvis J Hermann, Christian Hartmann, Peter Raab, Joachim K Krauss
Perforating arteries are thin and long vessels which originate from the main cerebral arteries. Subarachnoidal hemorrhage from a perforator aneurysm is rare. Here, we report on a 70-year-old woman who presented with severe subarachnoid hemorrhage from a fusiform lateral anterior (A1) artery perforator aneurysm. Unexpectedly, digital subtraction angiography was non-diagnostic. MR imaging, however, demonstrated occlusion of the aneurysm secondary to thrombosis. Surgery was performed to remove the associated hematoma, and histopathological examination verified intraaneurysmal thrombosis...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28978900/subarachnoid-aneurysmal-hemorrhage-associated-with-coarctation-of-the-aorta-case-report-and-review-of-the-literature
#9
Ryuta Nakae, Yu Fujiki, Shoji Yokobori, Yasutaka Naoe, Hiroyuki Yokota
Intracranial aneurysms (IAs) that undergo rupture causing subarachnoid hemorrhage (SAH), are common in young patients with coarctation of the aorta (CoA), but rarer in middle-aged and elderly patients. The pathogenesis of IAs associated with CoA remains unclear. We report the case of a 50-year-old woman who presented with SAH. On evaluation, six IAs were distributed among the anterior communicating artery (ACoA) (ruptured), distal segments of both anterior cerebral arteries (ACA), the left internal carotid artery (ICA), the bifurcation of the left middle cerebral artery (MCA)/MCA early branch, and the inferior trunk of the left MCA...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28973685/microsurgery-simulator-of-cerebral-aneurysm-clipping-with-interactive-cerebral-deformation-featuring-a-virtual-arachnoid
#10
Naoyuki Shono, Taichi Kin, Seiji Nomura, Satoru Miyawaki, Toki Saito, Hideaki Imai, Hirofumi Nakatomi, Hiroshi Oyama, Nobuhito Saito
BACKGROUND: A virtual reality simulator for aneurysmal clipping surgery is an attractive research target for neurosurgeons. Brain deformation is one of the most important functionalities necessary for an accurate clipping simulator and is vastly affected by the status of the supporting tissue, such as the arachnoid membrane. However, no virtual reality simulator implementing the supporting tissue of the brain has yet been developed. OBJECTIVE: To develop a virtual reality clipping simulator possessing interactive brain deforming capability closely dependent on arachnoid dissection and apply it to clinical cases...
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28966828/sequential-changes-of-arterial-spin-labeling-perfusion-mr-images-with-dual-postlabeling-delay-following-reconstructive-surgery-for-giant-internal-carotid-artery-aneurysm
#11
Takafumi Shimogawa, Takato Morioka, Tomoaki Akiyama, Sei Haga, Shuji Arakawa, Tetsuro Sayama
BACKGROUND: Arterial spin-labeling magnetic resonance perfusion imaging (ASL-MRI) allows noninvasive measurement of cerebral blood flow (CBF) but depends on arterial transit time (ATT). To overcome this problem, we developed a simple ASL technique with dual postlabeling delay (PLD) settings. In addition to the routinely used PLD of 1.5 seconds, we selected another PLD of 2.5 seconds to assess slowly streaming blood flow and detect arterial transit artifacts (ATAs) resulting from stagnant intravascular magnetically labeled spins...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28965667/clinical-outcomes-of-multiple-aneurysms-microsurgical-clipping-evaluation-of-90-patients
#12
Murad Asiltürk, Anas Abdallah
BACKGROUND: The incidence of multiple intracranial aneurysms (MIAs) among patients who are diagnosed with aneurysm is 15-45% in the literature. Treatment options depend on the patient's status, age, aneurysm location and neurosurgeon's experience. In this study outcomes of micro-surgically clipped 90 patients have been evaluated. MATERIALS AND METHODS: Medical records of 90 (49 women and 41 men) patients of MIAs who underwent surgery by the authors, during a 3-year period from 2011 to 2013 were retrospectively reviewed of prospectively collected patients' data...
September 23, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28962962/a-patient-with-a-recurrent-anterior-cerebral-artery-dissecting-aneurysm-after-stent-assisted-coil-embolization-successfully-treated-with-a3-a3-anastomosis
#13
Yoshiharu Takahashi, Hidenori Endo, Toshiki Endo, Miki Fujimura, Kuniyasu Niizuma, Teiji Tominaga
BACKGROUND: With recent advances in endovascular devices and techniques, the use of endovascular treatment has been reported for intracranial dissecting aneurysms. However, the efficacy of this endovascular approach for intracranial dissection is still unknown. We report the case of a patient with a recurrent anterior cerebral artery (ACA) dissecting aneurysm after endovascular treatment. CASE DESCRIPTION: A 67-year-old woman underwent stent-assisted coil embolization for a ruptured ACA dissecting aneurysm of the left A2 segment...
September 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28956204/high-flow-bypass-with-radial-artery-graft-followed-by-internal-carotid-artery-ligation-for-large-or-giant-aneurysms-of-cavernous-or-cervical-portion-clinical-results-and-cognitive-performance
#14
Hideaki Ono, Tomohiro Inoue, Takeo Tanishima, Akira Tamura, Isamu Saito, Nobuhito Saito
High-flow bypass followed by ligation of the internal carotid artery (ICA) is an effective treatment, but the impact of abrupt occlusion of the ICA is unpredictable, especially on postoperative cognitive function. The present study evaluated the clinical results as well as cognitive performances after high-flow bypass using radial artery graft (RAG) with supportive superficial temporal artery (STA)-middle cerebral artery (MCA) bypass, followed by ICA ligation. Ten consecutive patients underwent high-flow bypass surgery for large or giant ICA aneurysms of cavernous or cervical portion...
September 27, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28954339/-concomitant-unruptured-intracranial-aneurysms-and-ischemic-cerebrovascular-diseases-a-surgical-experience-of-31-cases
#15
Y R Zheng, C Wu, H Zhang, Z Xue, H W Wang, Z H Sun
Objective: To summarize the clinic experience of preventing cerebral ischemic events during perioperative period in patients which concomitant unruptured intracranial aneurysms and ischemic cerebrovascular diseases. Methods: The clinical materials of 31 consecutive patients with concomitant unruptured intracranial aneurysms and ischemic cerebrovascular diseases from April 2010 to April 2014 were retrospectively reviewed.A total of 35 aneurysms were detected, and all of them were unruptured aneurysms.Among them, 17 cases were located on the ipsilateral side of artery stenosis or occlusion, and 18 cases were detected in the contralateral side...
September 19, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28951366/-value-of-640-slice-3d-ct-angiography-plus-3d-printing-for-improving-surgeries-for-intracranial-aneurysms
#16
Lu-Qiu Zhou, Ming-Wu Lou, Guo-Chang Chen, Zhi-Song Jiu, Yun-Xia Shen, Lin Lu
OBJECTIVE: To evaluate the value of 640-slice 3D CT angiography (3D-CTA) plus 3D printing for improving the outcomes of surgeries for intracranial aneurysms. METHODS: Sixty patients with intracranial aneurysm were randomly divided into trial group (n=30) and control group (n=30). The control group received routine surgery, and the simulation models of the intracranial aneurysm in trial group was printed using a 3D printer using the imaging data from 3D-CTA. Using the simulation model, the surgery was designed and planned before operation (including surgical approaches and placement of clips) and simulation surgery was also conducted...
September 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28951182/surgical-treatment-of-mirror-mca-aneurysms-bilateral-and-unilateral-approach
#17
Vedat Acik, Gökhan Cavus, Emre Bilgin, Ali Arslan, Yurdal Gezercan, Ali İhsan Okten
OBJECTIVE: Currently, the optimal surgical approach for bilateral aneurysms remains controversial. Alternative interventional methods, such as unilateral or bilateral approaches, have been employed during a single session or two different sessions. The unilateral approach can be employed successfully to treat contralateral aneurysms that develop in a paramedian location. However, such an approach is more difficult for treating contralateral aneurysms in more distant locations. Unilateral approach can decrease complication rates, operation time and the length of hospital stay...
September 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28946178/the-impact-of-temporary-clipping-during-aneurysm-surgery-on-the-incidence-of-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#18
Vesna Malinova, Bawarjan Schatlo, Martin Voit, Patricia Suntheim, Veit Rohde, Dorothee Mielke
OBJECTIVE Clipping of a ruptured intracranial aneurysm requires some degree of vessel manipulation, which in turn is believed to contribute to vasoconstriction. One of the techniques used during surgery is temporary clipping of the parent vessel. Temporary clipping may either be mandatory in cases of premature rupture (rescue) or represent a precautionary or facilitating surgical step (elective). The aim of this study was to study the association between temporary clipping during aneurysm surgery and the incidence of vasospasm and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage (aSAH) in a large clinical series...
September 15, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28929294/neurologic-complications-of-infective-endocarditis-recent-findings
#19
REVIEW
Marie Cantier, Mikael Mazighi, Isabelle Klein, J P Desilles, Michel Wolff, J F Timsit, Romain Sonneville
PURPOSE OF REVIEW: The purpose of this paper is to provide recent insights in management of neurologic complications of left-sided infective endocarditis (IE). RECENT FINDINGS: Cerebral lesions observed in IE patients are thought to involve synergistic pathophysiological mechanisms including thromboembolism, sepsis, meningitis, and small-vessel cerebral vasculitis. Brain MRI represents a major tool for the detection of asymptomatic events occurring in the majority of patients...
September 19, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28914876/-an-aneurysm-of-the-medial-posterior-choroidal-artery-a-case-report-and-a-literature-review
#20
Yu A Grigoryan, A R Sitnikov, A V Timoshenkov, G Yu Grigoryan
INTRODUCTION: Aneurysms of the medial posterior choroidal artery are very rare. To date, only 5 cases have been reported. The article presents a case of successful surgical treatment of an aneurysm of the medial posterior choroidal artery and a literature review. CLINICAL CASE: A 57-year-old male was admitted to the Center 1 month after a massive subarachnoid hemorrhage. CT angiography revealed an aneurysm of the right posterior medial choroidal artery in the perimesencephalic cistern and resolved hemorrhage...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
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