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Cerebral Aneurysm surgery

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https://www.readbyqxmd.com/read/28093349/combining-internal-carotid-ligation-with-low-flow-bypass-for-treating-large-giant-cavernous-sinus-segment-aneurysms-a-report-of-four-cases
#1
Chuan Chen, Bo Hou, Wen-Shen Li, Ying Guo
OBJECTIVE: We summarize the treatment effectiveness and experience of four cases that underwent internal carotid ligation combined with low-flow bypass as a treatment for large-giant cavernous sinus segment aneurysms (CS ICA aneurysms). METHOD: Surgery-suitable patients with large-giant CS ICA aneurysms received internal carotid ligation combined with low-flow superficial temporal artery - middle cerebral artery bypass surgery. All the patients were followed up for aneurysm prognosis, anastomosis patency, and occurrences of low flow-related ischemic complications...
January 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089662/electroacupuncture-pretreatment-attenuates-spinal-cord-ischemia-reperfusion-injury-via-inhibition-of-high-mobility-group-box-1-production-in-a-lxa4-receptor-dependent-manner
#2
Xiao-Ling Zhu, Xin Chen, Wei Wang, Xu Li, Jia Huo, Yu Wang, Yu-Yuan Min, Bin-Xiao Su, Jian-Ming Pei
Paraplegia caused by spinal cord ischemia is a severe complication following surgeries in the thoracic aneurysm. HMGB1 has been recognized as a key mediator in spinal inflammatory response after spinal cord injury. Electroacupuncture (EA) pretreatment could provide neuroprotection against cerebral ischemic injury through inhibition of HMGB1 release. Therefore, the present study aims to test the hypothesis that EA pretreatment protects against spinal cord ischemia-reperfusion (I/R) injury via inhibition of HMGB1 release...
January 12, 2017: Brain Research
https://www.readbyqxmd.com/read/28065970/superficial-temporal-artery-middle-cerebral-artery-bypass-for-internal-carotid-artery-petrous-aneurysm-a-case-report
#3
Muhammad Usama Akhtar, Maqsood Akram, Tahir Mansoor Ahmed, Ahsin Manzoor Bhatti
A 13 years old boy presented with persistent ear bleed following a blow to the head. The boy was found to have a bleeding congenital aneurysm of the Petrous part of the internal carotid artery. He underwent a bypass surgery for the aneurysm and a successful Superficial Temporal Artery to Middle Cerebral Artery bypass was made.
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28061486/superficial-temporal-artery-sparing-mini-pterional-approach-for-cerebral-aneurysm-surgery
#4
Jun-Young Ahn, Sung-Tae Kim, Ki-Chang Yi, Won-Hee Lee, Sung Hwa Paeng, Young-Gyun Jeong
OBJECTIVE: The purposes of this study were to introduce a superficial temporal artery (STA)-sparing mini-pterional approach for the treatment of cerebral aneurysms and review the surgical results of this approach. METHODS: Between June 2010 and December 2015, we performed the STA-sparing mini-pterional approach for 117 patients with 141 unruptured intracranial aneurysms. We analyzed demographic, radiologic, and clinical variables including age, sex, craniotomy size, aneurysm location, height of STA bifurcation, and postoperative complications...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28057589/microsurgical-clipping-of-unruptured-intracranial-aneurysms-a-single-surgeon-s-experience-over-sixteen-years
#5
Anil Nanda, Devi Prasad Patra, Shyamal C Bir, Tanmoy K Maiti, Piyush Kalakoti, Papireddy Bollam
INTRODUCTION: Unruptured intracranial aneurysms (UIA) have become an issue of greater significance as their detection rates have increased over the years. We present the overall experience of microsurgical clipping of unruptured aneurysms by a single surgeon over a period of more than 16 years. METHODS: The clinical and radiological data were retrospectively reviewed. Clinical outcome at follow-up was assessed by Glasgow Outcome Scale (GOS), and angiograms were reviewed for the degree of occlusion...
January 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28049738/when-the-heart-rules-the-head-ischaemic-stroke-and-intracerebral-haemorrhage-complicating-infective-endocarditis
#6
REVIEW
Estabrak Jiad, Sumanjit K Gill, Maria Krutikov, David Turner, Michael H Parkinson, Carmel Curtis, David J Werring
Sir William Osler meticulously described the clinical manifestations of infective endocarditis in 1885, concluding that: 'few diseases present greater difficulties in the way of diagnosis … which in many cases are practically insurmountable'. Even with modern investigation techniques, diagnosing infective endocarditis can be hugely challenging, yet is critically important in patients presenting with stroke (both cerebral infarction and intracranial haemorrhage), its commonest neurological complication. In ischaemic stroke, intravenous thrombolysis carries an unacceptably high risk of intracranial haemorrhage, while in intracerebral haemorrhage, mycotic aneurysms require urgent treatment to avoid rebleeding, and in all cases, prompt treatment with antibiotics and valve surgery may be life-saving...
January 2017: Practical Neurology
https://www.readbyqxmd.com/read/28031096/impact-of-intraoperative-blood-pressure-control-and-temporary-parent-artery-blocking-on-prognosis-in-cerebral-aneurysms-surgery
#7
Min Xu, Zheng-Song Gu, Cun-Zu Wang, Xiao-Feng Lu, Ding-Chao Xiang, Zhi-Cheng Yuan, Qiao-Yu Li, Min Wu
Objective In cerebral aneurysm clipping and embolization, blood pressure control and temporary parent artery blocking are common methods to prevent aneurysm rupture. Their influence on the prognosis is uncertain. In this study, we try to find out the association between methods above and prognostic indicators.Methods We held a retrospective analysis on patients' medical records of cerebral aneurysms surgical clipping and endovascular coiling , and recorded gender, age, diagnosis, Hunt-Hess grade, Glasgow coma scale score, treatment methods, a history of hypertension, preoperative systolic blood pressure, with or without controlled hypotension, systolic blood pressure difference before and after controlled hypotension, with or without temporary artery blocking, with or without hypertension after treated aneurysm, prognostic indicators including mortality after 1 month, intensive care unit (ICU) stay time of survivors, discharged Glasgow outcome scale (GOS) score...
June 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28028955/unruptured-intracranial-aneurysms-surgery-still-safe-as-a-treatment-option
#8
Marta Koźba-Gosztyła, Bogdan Czapiga, Włodzimierz Jarmundowicz, Łukasz Tomiałowicz
BACKGROUND: Despite a number of studies on the treatment of unruptured intracranial aneurysms (UIA), the optimal method still remains unclear. OBJECTIVES: The aim of the study was to demonstrate that UIA clipping is a safe procedure and can be a good alternative for patients not qualified for endovascular procedures and who have refused conservative management. MATERIAL AND METHODS: Results were gathered from a sample of 104 patients with UIA treated in our facility over a 9-year period starting January 2005...
September 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/27981065/art-3-5d-an-algorithm-to-label-arteries-and-veins-from-three-dimensional-angiography
#9
Beatrice Barra, Elena De Momi, Giancarlo Ferrigno, Guglielmo Pero, Francesco Cardinale, Giuseppe Baselli
Preoperative three-dimensional (3-D) visualization of brain vasculature by digital subtraction angiography from computerized tomography (CT) in neurosurgery is gaining more and more importance, since vessels are the primary landmarks both for organs at risk and for navigation. Surgical embolization of cerebral aneurysms and arteriovenous malformations, epilepsy surgery, and stereoelectroencephalography are a few examples. Contrast-enhanced cone-beam computed tomography (CE-CBCT) represents a powerful facility, since it is capable of acquiring images in the operation room, shortly before surgery...
October 2016: Journal of Medical Imaging
https://www.readbyqxmd.com/read/27977657/delayed-recovery-of-adipsic-diabetes-insipidus-adi-caused-by-elective-clipping-of-anterior-communicating-artery-and-left-middle-cerebral-artery-aneurysms
#10
Jeffrey Tan, Samuel Ndoro, Uchenna Okafo, Aoife Garrahy, Amar Agha, Danny Rawluk
Adipsic diabetes insipidus (ADI) is an extremely rare complication following microsurgical clipping of anterior communicating artery aneurysm (ACoA) and left middle cerebral artery (MCA) aneurysm. It poses a significant challenge to manage due to an absent thirst response and the co-existence of cognitive impairment in our patient. Recovery from adipsic DI has hitherto been reported only once. A 52-year-old man with previous history of clipping of left posterior communicating artery aneurysm 20 years prior underwent microsurgical clipping of ACoA and left MCA aneurysms without any intraoperative complications...
December 16, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27939498/elective-primary-aortic-root-replacement-with-and-without-hemiarch-repair-in-patients-with-no-previous-cardiac-surgery
#11
Ourania Preventza, Joseph S Coselli, Matt D Price, Katherine H Simpson, Ouyang Yafei, Kim de la Cruz, Qianzi Zhang, Susan Green
OBJECTIVE: Excellent outcomes have been established for elective aortic root replacement (ARR). It is less clear whether extending the repair into the proximal aortic arch with hypothermic circulatory arrest increases risk. We examined the early outcomes of elective, primary ARR, with and without hemiarch replacement, in patients without previous cardiac surgery. METHODS: Over a 4-year period, 140 non-redo patients (median age, 54 years) underwent elective, primary ARR for root aneurysms; 119 patients (85%) had hemiarch replacement, and 21 (15%) had only ascending aortic replacement...
November 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27936431/description-of-the-anterior-cerebral-artery-and-its-cortical-branches-variation-in-presence-origin-and-size
#12
K Cilliers, B J Page
OBJECTIVE: Certain aspects of the anterior cerebral artery (ACA) cortical branches tend to vary, including absent or additional arteries, variation in origin, and changes to diameter and length. Knowledge of these factors can be crucial in aneurysm and arteriovenous malformation surgery. Few studies report on these aspects and a South African study have not been completed. Therefore, the aim of this study is to report absent or additional arteries, the origin, diameter and length of ACA cortical branches in a Western Cape population...
January 2017: Clinical Neurology and Neurosurgery
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
#13
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/27916243/safe-reentry-for-false-aneurysm-operations-in-high-risk-patients
#14
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/27903923/stent-assisted-coil-embolization-of-a-recurrent-posterior-cerebral-artery-aneurysm-following-surgical-clipping
#15
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/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/27890748/small-unruptured-intracranial-aneurysm-%C3%A2-5-mm-associated-with-epilepsy-report-of-2-cases-and-literature-review
#17
Fuxin Lin, Hui Wan, Dezhi Kang, Yuanxiang Lin
BACKGROUND: Owing to the continuing improvements in imaging technology, an increasing number of epileptogenic small (≤5 mm) unruptured intracranial aneurysms (sUIAs) are being diagnosed. However, these sUIAs have not been systematically described and reviewed until now. CASE DESCRIPTION AND LITERATURE REVIEW: We report 2 patients with sUIAs who initially presented with complex partial seizures. Scalp electroencephalography identified the seizure activity as arising from the mesial temporal/frontal areas, but conventional magnetic resonance imaging (MRI) was normal in both patients...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27881343/-surgical-management-of-proximal-anterior-cerebral-artery-a1-aneurysms
#18
Hua-Wei Wang, Zhe Xue, Yu-Dong Ma, Wen-Xin Wang, Chen Wu, Zheng-Hui Sun
OBJECTIVE: To review our experience in surgical management of proximal anterior cerebral artery (A1) aneurysms in 23 patients. METHODS: Between January, 2004 and December, 2014, 23 patients (1.6%) with A1 aneurysms diagnosed by CTA or DSA were treated surgically. The "3H" therapy was adopted for postoperative prevention of cerebrovascular spasm. All the patients were followed up and examined with cerebrovascular CTA at 6, 12, 48 and 60 months after the operation with their Glasgow Outcome Scale score recorded...
November 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27873519/use-of-three-dimensional-curved-multiplanar-reconstruction-images-for-sylvian-dissection-in-microsurgery-of-middle-cerebral-artery-aneurysms
#19
Taek Kyun Nam, Yong Sook Park, Jun Soo Byun, Seung Won Park, Jeong Taik Kwon
PURPOSE: The purpose of this study was to introduce a method of using three-dimensional (3D) curved-multiplanar reconstruction (MPR) images for sylvian dissection during microsurgical treatment of middle cerebral artery (MCA) aneurysms. MATERIALS AND METHODS: Forty-nine patients who had undergone surgery for MCA aneurysms were enrolled. We obtained the 3D curved-MPR images along the sphenoid ridge using OsiriX MD™ imaging software, compared sylvian dissection time according to several 3D MPR image factors, and investigated the correlations between these images and intraoperative findings...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27858574/quantitative-anatomical-analysis-and-clinical-experience-with-mini-pterional-and-mini-orbitozygomatic-approaches-for-intracranial-aneurysm-surgery
#20
Kaan Yagmurlu, Sam Safavi-Abbasi, Evgenii Belykh, M Yashar S Kalani, Peter Nakaji, Albert L Rhoton, Robert F Spetzler, Mark C Preul
OBJECTIVE The aim of this investigation was to modify the mini-pterional and mini-orbitozygomatic (mini-OZ) approaches in order to reduce the amount of tissue traumatization caused and to compare the use of the 2 approaches in the removal of circle of Willis aneurysms based on the authors' clinical experience and quantitative analysis. METHODS Three formalin-fixed adult cadaveric heads injected with colored silicone were examined. Surgical freedom and angle of attack of the mini-pterional and mini-OZ approaches were measured at 9 anatomical points, and the measurements were compared...
November 18, 2016: Journal of Neurosurgery
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