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Cerebral Aneurysm surgery

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https://www.readbyqxmd.com/read/28819885/adenosine-assisted-clipping-of-intracranial-aneurysms
#1
Torstein R Meling, Luis Romundstad, Geir Niemi, Jon Narum, Per Kristian Eide, Angelika G Sorteberg, Wilhelm A Sorteberg
Temporary parent vessel clip occlusion in aneurysm surgery is not always practical or feasible. Adenosine-induced transient cardiac arrest may serve as an alternative. We retrospectively reviewed our clinical database between September 2011 and July 2014. All patients who underwent microsurgical clipping of intracranial aneurysms under adenosine-induced asystole were included. A total of 18 craniotomies were performed, and 18 aneurysms were clipped under adenosine-induced asystole (7 basilar arteries, 8 internal carotid arteries, 1 middle cerebral artery, and 1 anterior communicating artery) in 16 patients (10 females, 6 males)...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28805753/-prognostic-significance-of-leukocyte-count-in-the-venous-blood-in-the-acute-stage-of-cerebral-aneurism-rupture
#2
A A Kalinkin, S S Petrikov, L T Khamidova, V V Krylov
AIM: To determine a prognostic role of leukocyte count in the venous blood in the acute stage of cerebral aneurysm (CA) rupture. MATERIAL AND METHODS: Fifty-one patients with CA rupture, aged from 20 to 65 years, hospitalized in the first 72 h over the period from 01.10.12 to 01.02.16 were examined. The severity of disease and anatomical form of hemorrhage was corresponded to III-IV degree on the W. Hunt - R. Hess scale and Fisher scale. All patients underwent surgery...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28803174/intraoperative-vascular-neuromonitoring-in-patients-with-subarachnoid-hemorrhage-a-pilot-study-using-combined-laser-doppler-spectrophotometry
#3
Emilija Schmitz, Barbara Bischoff, Dennis Wolf, Hubert Schmitt, Ilker Y Eyupoglu, Karl Roessler, Michael Buchfelder, Björn Sommer
OBJECTIVE: Intraoperative monitoring of cerebral microcirculation in patients with subarachnoid hemorrhage (SAH) may predict the postoperative neurological outcome. In this pilot study, we examined the value of a novel non-invasive real-time measurement technique to detect changes in local microcirculation. METHODS: We used the laser-Doppler spectrophotometry system "Oxygen-to-see(O2C)" in 14 patients with SAH Hunt & Hess grade 2 to 5, who underwent microsurgical clipping of cerebral aneurysms...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28790215/-a-case-of-ruptured-distal-anterior-choroidal-artery-aneurysm-associated-with-a-twig-like-middle-cerebral-artery-treated-with-single-stage-aneurysm-clipping-and-sta-mca-double-anastomoses-in-the-acute-phase
#4
Toshimoto Seno, Kanehisa Kohno, Hideo Tanaka, Shinji Iwata, Shinya Fukumoto, Haruhisa Ichikawa, Noriyuki Fumoto, Akihiro Inoue, Saya Ozaki, Yawara Nakamura, Shohei Kohno, Shiro Ohue
We report the case of a patient who has progressed well over 5 years following single-stage aneurysm clipping and superficial temporal artery-middle cerebral artery(STA-MCA)double anastomoses in the acute phase, for a ruptured distal anterior choroidal artery(AChA)aneurysm accompanied by a twig-like MCA. The patient was a 49-year-old female who developed a sudden severe headache and disturbance of consciousness due to subarachnoid hemorrhage and intraventricular hemorrhage(IVH). Cerebral angiography showed a right twig-like MCA associated with an abnormal vascular network and a ruptured aneurysm in the distal AChA...
August 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28781921/ruptured-mycotic-aneurysms-report-and-outcomes-of-two-surgically-managed-patients
#5
Aleena Khan, Muhammad Waqas, Waseem M Nizamani, Muhammad E Bari
BACKGROUND: Mycotic aneurysm is a rare potentially life-threatening complication of infective endocarditis (IE). Little data is available on the management and outcomes of ruptured mycotic aneurysms with large intracerebral hematoma. Few cases have been described on the management of mycotic aneurysm in the presence of life-threatening hematoma and mass effect. CASE DESCRIPTION: We are presenting two cases of ruptured mycotic aneurysm with intracerebral hematoma and impending brain herniation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28765030/relationship-of-a1-segment-hypoplasia-to-the-radiological-and-clinical-outcomes-of-surgical-clipping-anterior-communicating-artery-aneurysm
#6
Fan Yang, Hao Li, Jun Wu, Maogui Li, Xin Chen, Pengjun Jiang, Zhengsong Li, Yong Cao, Shuo Wang
OBJECTIVE: This study aims to assess whether the A1 segment hypoplasia is a risk factor for unfavorable radiological and clinical outcomes of surgical clipping anterior communicating artery (ACoA) aneurysm. METHODS: We retrospectively reviewed 251 patients with ACoA aneurysm who underwent surgical clipping in Beijing Tiantan Hospital between September 2011 and September 2016. Their clinical and radiologic features, as well as clinical outcomes were reviewed. In addition, univariate and multivariate logistic regression analysis was performed to identify independent risk factors for the postoperative infarction and unfavorable clinical outcomes of surgical clipping ACoA aneurysm...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28762110/technique-for-rerouting-a-bridging-vein-that-hinders-the-anterior-interhemispheric-approach-a-technical-note
#7
Kenta Ohara, Tomohiro Inoue, Hideaki Ono, Satoshi Kiyofuji, Akira Tamura, Isamu Saito
BACKGROUND: The frontal bridging vein, which is the venous drainage route of the frontal cortex into the superior sagittal sinus (SSS), sometimes poses an obstacle in the anterior interhemispheric approach during surgery for anterior cerebral artery aneurysms. Although severe complications including venous infarction or edema due to damage to the bridging vein are well known, only a few reports have discussed how to avoid venous injury when we must sacrifice the bridging vein to obtain an appropriate surgical field...
August 1, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28761512/surgical-treatment-of-large-and-giant-cavernous-carotid-aneurysms
#8
REVIEW
Kitiporn Sriamornrattanakul, Ittichai Sakarunchai, Kei Yamashiro, Yasuhiro Yamada, Daisuke Suyama, Tsukasa Kawase, Yoko Kato
Cavernous carotid aneurysms (CCAs) are uncommon pathologic entities. Extradural place and the skull base location make this type of an aneurysm different in clinical features and treatment techniques. Direct aneurysm clipping is technically difficult and results in a significant postoperative neurological deficit. Therefore, several techniques of indirect surgical treatment were developed with different surgical outcomes, such as proximal occlusion of internal carotid artery (ICA) or trapping with or without bypass (superficial temporal artery-middle cerebral artery bypass or high-flow bypass)...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28740717/hybrid-repair-of-aortic-arch-aneurysms-a-comprehensive-review
#9
REVIEW
Steve Xydas, Christos G Mihos, Roy F Williams, Angelo LaPietra, Maurice Mawad, S Howard Wittels, Orlando Santana
Open total arch replacement (TAR) has become safer with refinements in cerebral protection techniques. The frequent extension of aortic arch aneurysms into the descending thoracic aorta customarily requires a two-staged conventional elephant trunk procedure, carrying relatively high mortality and morbidity risks and high rates of rupture in the interval between the two open surgeries. The technical demands and invasive nature of TAR has therefore precluded many high-risk patients from being surgical candidates for aneurysm repair...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28736346/shifting-treatment-paradigms-for-ruptured-aneurysms-from-open-surgery-to-endovascular-therapy-over-25-years
#10
Matthew T Bender, Haley Wendt, Thomas Monarch, Li-Mei Lin, Bowen Jiang, Judy Huang, Alexander L Coon, Rafael J Tamargo, Geoffrey P Colby
BACKGROUND: Since the introduction of Gugliemi detachable coils in the early 1990s, major clinical studies have supported an increasing role for coil embolization of ruptured aneurysms. We assessed aneurysm location and treatment modality in aneurysmal subarachnoid hemorrhage (aSAH) over the past 25 years. METHODS: A prospective, institutional review board-approved aneurysm database was screened for patients presenting with aSAH from 1991 to 2016. Microsurgical and endovascular capabilities were present throughout...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735438/adenosine-assisted-neurovascular-surgery-initial-case-series-and-review-of-literature
#11
REVIEW
Alaa Al-Mousa, Gahan Bose, Katharine Hunt, Ahmed K Toma
Cerebral aneurysms in complex anatomical locations and intraoperative rupture of aneurysms are challenging for neurosurgeons and anaesthetists alike. Mechanical and non-mechanical methods to reduce blood flow into aneurysms are well-recognised techniques to facilitate aneurysm exclusion from the circulation. Mechanical methods like temporary clipping of parent arteries, carotid artery ligation and endovascular balloon occlusion are commonly used in clinical practice. However, non-mechanical techniques such as rapid ventricular pacing and adenosine-induced cardiac standstill with hypotension are still emerging strategies...
July 22, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28733225/microneurosurgical-clip-ligation-of-acutely-ruptured-cerebral-aneurysm-immediately-preceded-by-intentional-subtotal-endovascular-coil-embolization-under-a-single-anesthesia-observations-using-a-deliberate-combined-sequential-treatment-strategy-in-13-cases
#12
Jeffrey E Thomas, Jack C Rose
BACKGROUND: Endovascular coil embolization and craniotomy with clip ligation are the two most commonly used treatments for ruptured cerebral aneurysm. While coiling maintains the advantages of brevity and complete avoidance of brain retraction and manipulation, clipping offers the benefits of decompression of the injured brain and lower aneurysm recurrence rates. A combined, immediately sequential treatment strategy for acutely ruptured cerebral aneurysm that simultaneously maximizes the advantages of both techniques, while minimizing their respective disadvantages, may be a useful paradigm...
July 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28680736/cortical-aneurysms-of-the-middle-cerebral-artery-a-review-of-the-literature
#13
Alessandro Ricci, Hambra Di Vitantonio, Danilo De Paulis, Mattia Del Maestro, Soheila Dehcordi Raysi, Domenico Murrone, Sabino Luzzi, Renato Juan Galzio
BACKGROUND: Middle cerebral artery (MCA) aneurysms constitute from 18-40% of all intracranial aneurysms. They are mainly found in the proximal and bifurcation tracts and only in the 1.1-1.7% of cases they are located in the distal segment. The authors report a case of a ruptured saccular cortical MCA aneurysm with unknown etiology. CASE DESCRIPTION: A 53-year-old female was admitted with a sudden severe headache, nausea, vomiting, and a slight left hemiparesis. The computed tomography (CT) scan showed subarachnoid hemorrhage (SAH) in the left sylvian fissure and intracerebral hemorrhage (ICH) in the left posterior parietal area...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28673672/electrophysiological-influence-of-temporal-occlusion-of-the-parent-artery-during-aneurysm-surgery
#14
Katsuya Komatsu, Takeshi Mikami, Rintaro Yokoyama, Yuto Suzuki, Shoichi Komura, Rei Enatsu, Shouhei Noshiro, Kei Miyata, Yukinori Akiyama, Nobuhiro Mikuni
Intraoperative monitoring of the motor evoked potential (MEP) during cerebral aneurysm surgery has been widely used to confirm surgical safety. In this study, we retrospectively analyzed the influence of the MEP amplitude resulting from temporal occlusion of the parent artery, and appropriate judgement in the surgery was discussed. Ten patients underwent temporal occlusion of the parent artery during aneurysm surgery, and five of these patients showed a decrease in the MEP amplitude following temporal arterial occlusion...
June 30, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28671863/rethinking-the-paradigm-modern-approach-to-proximal-aortic-reconstruction-demonstrates-excellent-outcomes
#15
Jonathan M Hemli, Edward R R DeLaney, Kush R Dholakia, Dror Perk, Nirav C Patel, S Jacob Scheinerman, Derek R Brinster
BACKGROUND: Techniques for aortic surgery continue to evolve. A real-world snapshot of patients undergoing elective surgery for aneurysm in the modern era is helpful to assist in deciding the appropriate timing for intervention. We herein describe our experience with 100 consecutive patients who underwent primary elective surgery for aneurysm of the proximal thoracic aorta over a two-year period at a single institution. METHODS: The majority of our patients were male, mean age 61...
June 20, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28660741/split-brain-phenomena-in-anterior-communicating-artery-aneurysm-rupture-a-case-report
#16
Natalya Korsakova, Elizabeth Liebson, Lena Moskovich
In 1976, a patient with an anterior communicating artery aneurysm (ACoAA) rupture (diagnosed on angiography) and sub-arachnoid hemorrhage (SAH) underwent serial neuropsychological testing revealing a classical anterior cerebral artery (ACA) spasm picture with severe anterograde amnesia of Korsakoff's type and dysexecutive syndrome. In addition, the patient demonstrated impaired hemispheric interaction with alien hand syndrome, dyscopia-dysgraphia, complete left ear neglect, and other, more complex, split-brain phenomena...
June 2017: PsyCh Journal
https://www.readbyqxmd.com/read/28647655/face-content-and-construct-validity-of-an-aneurysm-clipping-model-using-human-placenta
#17
Evgenii Belykh, Eric J Miller, Ting Lei, Kristina Chapple, Vadim A Byvaltsev, Robert F Spetzler, Peter Nakaji, Mark C Preul
OBJECTIVE: Proficient open surgical treatment of cerebral aneurysms requires extensive training and practice. The goal of this study was to test the validity of a human placenta aneurysm model for surgical simulation training of aneurysm clipping. METHODS: Thirty participants were divided into 3 groups (n=10 per group) according to their neurosurgical experience: low experience, intermediate experience, and attending. Subjective measures were collected using the Aneurysm Clipping Participant Survey (n=27)...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28642178/neurological-outcome-after-decompressive-craniectomy-predictors-of-outcome-in-different-pathologies
#18
Taco Goedemans, Dagmar Verbaan, Bert A Coert, Bertjan Kerklaan, René van den Berg, Jonathan M Coutinho, Tessa van Middelaar, Paul J Nederkoorn, W Peter Vandertop, Pepijn van den Munckhof
OBJECTIVE: Decompressive craniectomy (DC) has been proposed as lifesaving treatment in patients with elevated intracranial pressure, but its effectiveness on reaching favorable neurological outcome remains unclear. We identified predictors of outcome in a large, single-center cohort of patients undergoing DC for different pathologies. METHODS: This retrospective study included all patients undergoing DC from 2006-2014. One-year outcome, assessed using the Glasgow Outcome Scale (GOS), was dichotomized into favorable (GOS 4-5) and unfavorable (GOS 1-3) outcome...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28640793/intraoperative-computed-tomography-ct-for-treating-giant-carotid-intracavernous-aneurysms
#19
Zhe Xue, Fuyu Wang, Zhenghui Sun, Hui Zhang, Chen Wu, Dongsheng Kong, Bainan Xu
BACKGROUND Giant carotid intracavernous aneurysm refers to those lesions larger than 2.5 cm and derived from a cavernous segment, accounting for about 30% of all intracranial tumors. Dynamic CT perfusion imaging (PCT) is a common method recently employed to evaluate cerebral perfusion. This study investigated the efficacy and clinical application of intraoperative CT in the surgery for giant symptomatic carotid intracavernous aneurysm. MATERIAL AND METHODS A retrospective analysis was performed on 23 cases with giant symptomatic carotid intracavernous aneurysm...
June 22, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28637249/bypass-surgery-for-complex-intracranial-aneurysms-15-years-of-experience-at-a-single-institution-and-review-of-pertinent-literature
#20
Seung Pil Ban, Won-Sang Cho, Jeong Eun Kim, Chang Hyeun Kim, Jae Seung Bang, Young-Je Son, Hyun-Seung Kang, O-Ki Kwon, Chang Wan Oh, Moon Hee Han
BACKGROUND: Bypass surgery is a treatment option for complex intracranial aneurysms. OBJECTIVE: To determine the utility of bypass surgery for the treatment of complex intracranial aneurysms and to review the literature on this topic. METHODS: Sixty-two patients were included in this retrospective study. Unruptured aneurysms were dominant (80.6%), and the internal carotid artery was the most common location of the aneurysm (56.4%), followed by the middle cerebral artery (21...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
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