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Cerebral Aneurysm surgery

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https://www.readbyqxmd.com/read/29456977/epidemiologic-and-demographic-features-therapeutic-intervention-and-prognosis-of-the-patients-with-cerebral-aneurysm
#1
Masih Sabouri, Amir Mahabadi, Homayoun Tabesh, Majeed Rezvani, Masih Kouchekzadeh, Ali Namazi
Background: Cerebral aneurysms are a kind of cardiovascular diseases which are accompanied with high morbidity and mortality due to rupturing and causing subarachnoid hemorrhages. The current study aimed to determine epidemiologic and demographic features and prognosis of patients with cerebral aneurysms. Materials and Methods: In this cross-sectional study, 465 patients with cerebral aneurysms hospitalized in Al-Zahra Hospital were studied. The required information including demographic, epidemiologic, and clinical features of the disease were extracted from their records...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29456901/awake-craniotomy-for-the-treatment-of-a-cortical-pseudoaneurysm-in-a-pregnant-patient
#2
Hirad Hedayat, Daniel R Felbaum, John E Reynolds, Rashid M Janjua
Neurosurgical pathologies presenting during pregnancy are uncommon. If present, the situation creates a unique diagnostic, observational, and therapeutic challenge as both lives are placed at potential risk. Surgical procedures during pregnancy are approached carefully as physiological stressors associated with surgery and anesthesia may cause fetal or maternal compromise. We present the only known case of a pseudoaneurysm treated with an awake craniotomy, allowing us to abate the risks associated with general anesthesia in pregnancy...
December 7, 2017: Curēus
https://www.readbyqxmd.com/read/29449516/-a-case-of-a-ruptured-cerebral-aneurysm-associated-with-microscopic-polyangiitis
#3
Toshihide Takahashi, Wataru Katayama, Yuji Kujiraoka, Tetsuya Yamamoto, Akira Matsumura
CASE: A 71-year-old woman was receiving dialysis for microscopic polyangiitis(MPA). She was transported to the emergency room after developing a headache and losing consciousness. She was in a coma and had dense left paralysis. Head computed tomography(CT)showed a subarachnoid hemorrhage. Head three-dimensional CT angiography showed an aneurysm proximal to the right M2(inferior trunk), which was considered as the source of bleeding. We performed an emergency aneurysm clipping surgery...
February 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29439905/three-dimensional-intracranial-middle-cerebral-artery-aneurysm-models-for-aneurysm-surgery-and-training
#4
Liang Wang, Xun Ye, Qiang Hao, Li Ma, Xiaolin Chen, Hao Wang, Yuanli Zhao
To develop a realistic model of middle cerebral artery (MCA) aneurysms using three-dimensional (3D) printing for surgical planning, research, and training of neurosurgical residents. This study included eight MCA aneurysm cases. The aneurysm together with the adjacent arteries and skull base were printed based on raw computed tomography angiography (CTA) data using a 3D printer with acrylonitrile-butadiene-styrene as the model material. The aneurysm models were used for surgical planning, and craniotomy and clipping practice by neurosurgical residents...
February 10, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29419591/application-of-micromirror-in-microsurgical-clipping-to-the-intracranial-aneurysms
#5
Chao Zhao, Zhiguo Ma, Yuhai Zhang, Shanling Mou, Yunxue Yang, Yonglin Yang, Guoqing Sun, Weicheng Yao
OBJECTIVE: The aim of the study was to explore the values and disadvantages of micromirror in the intracranial aneurysm clipping surgery. METHODS: Micromirror was used to assist microsurgical clipping to 36 intracranial aneurysms in 31 patients, of which 3 were carotid-ophthalmic artery aneurysms, 3 were anterior choroidal artery aneurysms, 11 were posterior communicating artery aneurysms, 7 were middle cerebral artery aneurysms, 10 were anterior communicating artery or anterior cerebral artery aneurysms, and the rest were a posterior cerebral artery aneurysm and a posterior inferior cerebellar artery aneurysm...
February 6, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29417290/secondary-coiling-after-incomplete-surgical-clipping-of-cerebral-aneurysms-a-rescue-strategy-or-a-treatment-option-for-complex-cases-institutional-series-and-systematic-review
#6
REVIEW
Giuseppe Maria Della Pepa, Federico Bianchi, Alba Scerrati, Alessio Albanese, Enrico Cotroneo, Alberto Delitala, Renato Gigli, Giuseppe La Rocca, Enrico Marchese, Alessandro Pedicelli, Alfredo Puca, Giovanni Sabatino, Alessando Olivi, Carmelo Lucio Sturiale
Residual and recurrent intracranial aneurysms after surgical clipping present a persistent risk of bleeding. Secondary coiling after incomplete clipping represents a strategy to occlude the residual sac: feasibility, bleeding risk and outcome were evaluated through a systematic review of literature along with the series of two tertiary referral neurovascular centres. Demographics, ruptured status, aneurysm morphology, topography, exclusion at surgery, timing of secondary coiling, complications, occlusion rate and outcome were analysed...
February 7, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29408346/true-cortical-saccular-aneurysm-presenting-as-an-acute-subdural-hematoma
#7
Leonard H Verhey, Weichen Wang, Joseph G Adel
BACKGROUND: Subdural hematoma, without any radiographic evidence of subarachnoid hemorrhage, is a rare presentation of a ruptured intracranial aneurysm. Even more rare is the occurrence of a pure subdural hematoma due to a ruptured cortical saccular aneurysm. We report the eighth case of pure subdural hematoma secondary to a ruptured non-mycotic cortical berry aneurysm. CASE DESCRIPTION: We report a case of pure subdural hematoma secondary to a ruptured true saccular aneurysm of a cortical artery branch...
February 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29396066/successful-deep-brain-stimulation-for-central-post-stroke-pain-and-dystonia-in-a-single-operation
#8
Marshall T Holland, Mario Zanaty, Luyuan Li, Teri Thomsen, James H Beeghly, Jeremy D W Greenlee, Chandan G Reddy
BACKGROUND: Central post-stroke pain is known to be refractory to medications and difficult to manage. We present a case of central post-stroke pain associated with dystonia. Both conditions were successfully treated with a single deep brain stimulation (DBS) operation. CASE DESCRIPTION: A 60-year-old female suffered a right posterior cerebral artery stroke following emergent clipping of a ruptured posterior cerebral artery aneurysm resulting in central post-stroke pain...
January 26, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29380063/intraoperative-monitoring-of-cerebral-cortical-blood-flow-and-middle-cerebral-artery-pressure-as-a-substitute-for-preoperative-balloon-test-occlusion-in-patients-with-internal-carotid-artery-aneurysms
#9
Yoshitaka Kubo, Takahiro Koji, Ryushi Kondo, Kenji Yoshida, Kuniaki Ogasawara
BACKGROUND: Balloon test occlusion (BTO) is a useful examination to evaluate the indications and methods for revascularization when treating unclippable internal carotid artery (ICA) aneurysms by parent artery occlusion. The purpose of the present study was to investigate the relationship between intraoperative monitoring of cerebral cortical blood flow (CoBF) and middle cerebral artery (MCA) pressure during surgical parent artery occlusion and the findings of BTO. METHODS: Eleven patients with an ICA aneurysm in the cavernous portion underwent preoperative BTO with brain perfusion single-photon emission tomography...
January 29, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29373230/hyperperfusion-after-clipping-of-aneurysm-a-rare-entity
#10
Hideaki Nagashima, Tomoru Miwa, Takashi Horiguchi, Ryosuke Tomio, Yu Nakagawa, Kazunari Yoshida
BACKGROUND: Cerebral vasospasm is an uncontrollable and sometimes fatal complication occurring after subarachnoid hemorrhage. However, cerebral hyperperfusion syndrome is a rare complication after subarachnoid hemorrhage. Although plain computed tomography of cerebral hyperperfusion syndrome looks similar to cerebral infarction induced by cerebral vasospasm, they should be distinguished from each other because they require completely different treatments. CASE DESCRIPTION: A 65-year-old man complained of severe headache and vomiting...
January 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29362932/increased-rate-of-ventriculostomy-related-hemorrhage-following-endovascular-treatment-of-ruptured-aneurysms-compared-to-clipping
#11
Christian Scheller, Christian Strauss, Julian Prell, Sebastian Simmermacher, Silvio Brandt
OBJECTIVE: Acutely ruptured aneurysms can be treated by endovascular intervention or via surgery (clipping). After endovascular treatment, the risk of thromboembolic complications is reduced by the use of anticoagulative agents, which is not required after clipping. The aim of the study is to investigate the rate of ventriculostomy-related hemorrhage after endovascular treatment and clipping. METHODS: A consecutive series of 99 patients treated for a ruptured aneurysm which required an external ventricular drainage between 2010 and 2015 were included...
January 23, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29350605/in-situ-administration-of-abciximab-for-thrombus-resolution-during-intracranial-bypass-surgery-case-report
#12
Ian A Buchanan, Brian Lee, Arun P Amar, Steven L Giannotta
Abciximab is a glycoprotein IIb/IIIa receptor antagonist that functions to prevent platelet aggregation, thus reducing thrombus initiation and propagation. It has been widely used during percutaneous endovascular interventions, such as aneurysm coil embolization, angioplasty, atherectomy, and stent placement, as both a preventative and a salvage therapy. The use of abciximab in cardiac and neurosurgical procedures has been associated with a reduced incidence of ischemic complications and a decreased need for repeated intervention...
January 19, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29337170/virtual-cerebral-aneurysm-clipping-with-real-time-haptic-force-feedback-in-neurosurgical-education
#13
Matthias Gmeiner, Johannes Dirnberger, Wolfgang Fenz, Maria Gollwitzer, Gabriele Wurm, Johannes Trenkler, Andreas Gruber
OBJECTIVE: Realistic, safe and efficient modalities for simulation-based training are highly warranted to enhance the quality of surgical education and should be incorporated in resident training. The aim of this study was to develop a patient-specific virtual cerebral aneurysm-clipping simulator with haptic force-feedback and real-time deformation of the aneurysm and vessels. METHODS: A prototype simulator was developed from 2012-2016. Evaluation of virtual clipping by blood flow simulation was integrated in this software and the prototype was evaluated by 18 neurosurgeons...
January 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325471/intracranial-subarachnoid-hemorrhage-following-cervical-laminoplasty-a-report-of-two-cases
#14
Yuichi Kondo, Kazunari Fushimi, Makoto Takasawa, Shigeo Kanamori, Takaki Miyagawa, Kenji Kawashima, Kazutoshi Yokoyama, Haruhiko Akiyama
Intracranial hemorrhage is a rare complication of spinal surgery. Case 1 was a 58-year-old man who underwent cervical laminoplasty. No apparent iatrogenic dural rupture or cerebrospinal fluid leakage was observed. An hour after the surgery, the patient had convulsions and became restless thereafter. CT revealed an intracranial SAH. The patient recovered normal consciousness the next morning. Case 2 was a 68-year-old woman who underwent cervical laminoplasty without postoperative CSF leakage. Six days after the surgery, the patient continued to complain of nausea and headache...
January 12, 2018: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29322968/treatment-strategies-for-traumatic-cervico-cranial-pseudoaneurysms-a-single-institution-experience
#15
Ming-Jun Cai, Guo-Zheng Xu, Ming Yang, Lian-Ting Ma, Xin-Jian Yang, Bao-Chang Shi, Jun Li, Li Pan
AIM: Limited clinical and angiographic data exists for patients with traumatic cervico-cerebral pseudoaneurysms. In this paper, we present our limited experience with various management strategies for traumatic cervico-cranial pseudoaneurysms. MATERIALS AND METHODS: We retrospectively analyzed 37 consecutive cases of traumatic pseudoaneurysms involving the cervico-cranial or the cerebral arteries diagnosed at our center from September 2009 to December 2014. The demographic data, etiology, clinical presentation, lesion location, treatment modality, and follow-up outcomes of these patients were reviewed...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29307022/fluorescein-videoangiography-during-extracranial-to-intracranial-bypass-surgery-preliminary-results
#16
Alessandro Narducci, Julia Onken, Marcus Czabanka, Nils Hecht, Peter Vajkoczy
BACKGROUND: Over the last years, intraoperative use of fluorescein is gaining ground in the field of neurosurgery, due to development of a microscope-integrated YELLOW 560 module, with reported experiences in brain malignancies, aneurysms, and arteriovenous malformation surgery. The aim of this study is to determine the feasibility and value of fluorescein videoangiography during bypass procedures. METHODS: The authors enrolled 11 patients who underwent extracranial-to-intracranial bypass for moyamoya disease, atherosclerotic steno-occlusive cerebrovascular disease, and flow replacement during a giant middle cerebral artery (MCA) aneurysm treatment...
January 6, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29305756/on-aneurysmal-rupture-and-rerupture
#17
Eelco F M Wijdicks
A warning leak is a curious phenomenon attributed to cerebral aneurysms. Once the leak occurs, it has been postulated it could lead to a more catastrophic rebleeding. The designation "warning leak" trickled into neurosurgery vocabulary as early as the 1950s. The phenomenon has been poorly understood and characterized, but its presence spurs emergency physicians and neurointensivists to take action to secure the aneurysm. Rapid treatment of a recently discovered aneurysm is now commonplace, but it has not always been so...
January 5, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29299821/brain-protection-in-aortic-arch-aneurysm-antegrade-or-retrograde
#18
Amer Harky, Matthew Fok, Mohamad Bashir, Anthony L Estrera
During open aortic arch repair, there is an interruption of cerebral perfusion and to prevent neurological sequelae, the hypothermic circulatory arrest has been established to provide sufficient brain protection coupled with adjuncts including retrograde and antegrade cerebral perfusion. To date, brain protection during open aortic arch repair is a contested topic as to which provides superior brain protection with little evidence existing to suggest supremacy of one modality over the other. This article reviews current literature reflecting on key and emerging studies in brain protection and their associated outcomes in patients undergoing open aortic arch surgery...
January 3, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29296615/minocycline-protects-against-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage-via-matrix-metalloproteinase-9-inhibition
#19
Ananth K Vellimana, Meng-Liang Zhou, Itender Singh, Diane J Aum, James W Nelson, Glenn R Harris, Umeshkumar Athiraman, Byung H Han, Gregory J Zipfel
Objective: Delayed cerebral ischemia (DCI) is an independent risk factor for poor outcome after aneurysmal subarachnoid hemorrhage (SAH) and is multifactorial in etiology. While prior studies have suggested a role for matrix metalloproteinase-9 (MMP-9) in early brain injury after SAH, its contribution to the pathophysiology of DCI is unclear. Methods: In the first experiment, wild-type (WT) and MMP-9 -/- mice were subjected to sham or endovascular perforation SAH surgery...
December 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29284568/clinical-characteristics-of-subarachnoid-hemorrhage-with-an-intracerebral-hematoma-and-prognostic-factors
#20
Masaaki Nemoto, Hiroyuki Masuda, Yuki Sakaeyama, Sinichi Okonogi, Yasuhiro Node, Keita Ueda, Shunpei Ando, Kosuke Kondo, Naoyuki Harada, Nobuo Sugo
BACKGROUND: Subarachnoid hemorrhage (SAH) with an intracerebral hematoma (ICH) shows an unfavorable prognosis. In the present study, we examined the characteristics of SAH with ICH and its prognosis. METHODS: Subjects comprised 218 patients with SAH who underwent surgery between January 2007 and December 2015. We compared age, sex, the location of the aneurysm, treatment procedures, medical history (hypertension, diabetes, and heart disease), the Glasgow Coma Scale (GCS) score on admission, rerupture rate, hydrocephalus, the diameter of the aneurysm, cerebral vasospasm, perioperative cardiopulmonary complications, and the Glasgow Outcome Scale (GOS) score after 2 months between patients with SAH with and without ICH...
December 25, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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