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Cerebral Aneurysm surgery

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https://www.readbyqxmd.com/read/28217397/a5-segment-aneurysm-of-the-anterior-cerebral-artery-imbedded-into-the-body-of-the-corpus-callosum-a-case-report
#1
Fransua Sharafeddin, Ahmad Hafez, Martin Lehecka, Rahul Raj, Roberto Colasanti, Ahmadreza Rafiei, Joham Choque, Behnam R Jahromi, Mika Niemelä, Juha Hernesniemi
BACKGROUND: The A5 segment aneurysms of the anterior cerebral artery are rare, approximately 0.5% of all intracranial aneurysms. They are small with a wide base located in the midline, with the domes mostly projecting upward or backward. CASE DESCRIPTION: The authors describe a unique case of A5 segment aneurysm, with the dome embedded into the body of the corpus callosum. This 41-year-old female was admitted to the neurology department for possible multiple sclerosis investigation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28209313/the-arborization-bypass-sequential-intracranial-intracranial-bypasses-for-an-unruptured-fusiform-mca-aneurysm
#2
Jonathan J Russin
Revascularization techniques are being featured more prominently as endovascular treatments continue to select out complex cerebrovascular pathologies for open surgical management. The current healthcare environment requires decreased hospital stays and improved clinical outcomes despite the growing complexity of open surgical cases. Recent efforts to reduce operative room time and decrease risk for bypass surgery have focused on avoiding graft harvest and maintaining the entire bypass intracranial. The presented technique features an arborization bypass to serially anastomose the middle cerebral artery vessels allowing for proximal trapping of a complex aneurysm without graft harvest...
February 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28207465/two-rare-variants-of-left-vertebral-artery
#3
Rajani Singh
Though the variations of vertebral artery are clinically asymptomatic yet abnormalities are of diagnostic importance either prior to vascular surgery in the neck region or in patients of intravascular diseases such as arteriovenous malformations or cerebral aneurysms. Therefore, the aim of the study is to bring out 2 variations in the configuration of vertebral artery and their clinical implication. During dissection of thorax of 2 female cadavers, 2 different variants of configurations of left vertebral arteries were observed...
February 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28184003/a-survey-of-intracranial-aneurysm-treatment-practices-among-united-states-physicians
#4
Kyle M Fargen, Hector E Soriano-Baron, Julia T Rushing, William Mack, J Mocco, Felipe Albuquerque, Andrew F Ducruet, Maxim Mokin, Italo Linfante, Stacey Q Wolfe, John A Wilson, Joshua A Hirsch
BACKGROUND: Recent surveys have failed to examine cerebrovascular aneurysm treatment practices among US physicians. OBJECTIVE: To survey physicians who are actively involved in the care of patients with cerebrovascular aneurysms to determine current aneurysm treatment preferences. METHODS: A 25-question SurveyMonkey online survey was designed and distributed electronically to members of the Society of NeuroInterventional Surgery, Society of Vascular and Interventional Neurology, and the American Association of Neurological Surgeons/Congress of Neurological Surgeons Combined Cerebrovascular Section...
February 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28181086/bilateral-cavernous-carotid-aneurysms-treated-by-two-stage-extracranial-intracranial-bypass-followed-by-parent-artery-occlusion-case-report-and-literature-review
#5
Yaoling Liu, Xiang'en Shi, Fangjun Liu, Yuming Sun, Hai Qian, Ting Lei
Bilateral cavernous carotid aneurysms (CCAs) are often not amenable to neurosurgical clipping or endovascular coiling. Here, we report the case of a 50-year-old female who presented with a 1-year history of gradual severe headache. Preoperative angiograms revealed bilateral CCAs. Among these findings, the right giant CCA had been trapped after the external carotid artery-saphenous vein-middle cerebral artery (ECA-SV-MCA) bypass 8 years prior. Additionally, the left CCA was again trapped after the internal maxillary artery-radial artery-middle cerebral artery (IMA-RA-MCA) bypass, followed by parent artery occlusion (PAO), because of the enlargement of a 0...
February 8, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28180096/the-frozen-elephant-trunk-technique-european-association-for-cardio-thoracic-surgery-position-and-bologna-experience
#6
REVIEW
Luca Di Marco, Antonio Pantaleo, Alessandro Leone, Giacomo Murana, Roberto Di Bartolomeo, Davide Pacini
Complex lesions of the thoracic aorta are traditionally treated in 2 surgical steps with the elephant trunk technique. A relatively new approach is the frozen elephant trunk (FET) technique, which potentially allows combined lesions of the thoracic aorta to be treated in a 1-stage procedure combining endovascular treatment with conventional surgery using a hybrid prosthesis. These are very complex and time-consuming operations, and good results can be obtained only if appropriate strategies for myocardial, cerebral, and visceral protection are adopted...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28179597/sinus-pericranii-with-dominant-venous-outflow-in-the-superior-eyelid
#7
Eiji Ito, Syuntaro Takasu, Kenichi Hattori
Sinus pericranii (SP) located in the superior eyelid is an unusual clinical presentation. Here, we report a case of 72-year-old woman with an unruptured cerebral aneurysm presented with an SP located in the left superior eyelid. The SP was found to have a dominant venous outflow from the bilateral frontal region with an arterialized blood flow pattern on color Doppler ultrasonography (CDUS). During the aneurysmal surgery, intraoperative monitoring of the dominant venous outflow with CDUS was useful for the prevention of venous outflow obstruction...
February 9, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28179247/impact-of-intraoperative-cefazolin-on-postoperative-seizures-after-elective-repair-of-unruptured-cerebral-aneurysm
#8
Alan Rozycki, John J Lewin, Rafael Tamargo, Betsy Zink, Marek Mirski, Haley Gibbs
PURPOSE: The impact of intraoperative cefazolin on postoperative seizures after elective repair of an unruptured cerebral aneurysm was evaluated. METHODS: Chart review of a prospectively accrued database was performed for patients admitted from January 1, 2003, through December 31, 2013. Patients were included in the study if they underwent elective repair of an unruptured aneurysm with surgical clipping or wrapping. The primary objective was to determine if the use of cefazolin increased patients' odds of having a seizure within six hours of surgical intervention...
February 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28154343/surgical-outcome-of-cerebral-aneurysm-clipping-treated-with-immunosuppressants-report-of-11-cases-and-review-of-the-literature
#9
Masaaki Hokari, Naoki Nakayama, Ken Kazumata, Toshiya Osanai, Hideo Shichinohe, Takeo Abumiya, Kiyohiro Houkin
There are no reports on the outcomes of clippings in patients who receive immunosuppressants, for example, due to connective tissue diseases or following organ transplantation. We thoroughly reviewed these cases focusing on the perioperative management phase. The study included 11 patients with intracranial aneurysms who were taking immunosuppressants; between 2007 and 2014. We performed 12 clipping surgeries. Their clinical records were reviewed for age and gender, aneurysms' location and size, perioperative management of the immunosuppressive drugs, and surgical complications...
January 31, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28153625/ruptured-mycotic-aneurysm-and-cerebral-vasospasm-in-the-setting-of-endocarditis-and-heart-failure-requiring-cardiothoracic-surgery-case-report-and-review
#10
Chih-Ta Lin, Bruce Tranmer, Susan Durham, David Johnson, Mark Hamlin, R Morton Bolman
BACKGROUND: Ruptured mycotic aneurysm in the setting of cardiac failure and cerebral vasospasm presents unique management challenges. CASE DESCRIPTION: The authors describe a case of a ruptured mycotic aneurysm with subarachnoid hemorrhage (SAH), cerebral vasospasm, and endocarditis with heart failure who successfully underwent craniotomy, neuro-endovascular treatments, and cardiopulmonary bypass for mitral valve replacement while in cerebral vasospasm. This case highlights the clinical management strategies of a patient with a ruptured mycotic aneurysm, SAH, cerebral vasospasm, endocarditis, and heart failure...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28126980/-a-case-of-cervical-internal-carotid-artery-occlusion-presenting-with-subarachnoid-hemorrhage-caused-by-rupture-of-leptomeningeal-anastomosis
#11
Tsuyoshi Tsukada, Toru Masuoka, Hideo Hamada, Shoutarou Itou, Takuya Akai, Hideaki Iizuka
A 71-year-old man was admitted to our hospital with a diagnosis of subarachnoid hemorrhage (SAH). Angiographies revealed neither aneurysms nor vascular anomalies. However, these images elucidated the occlusion of the left cervical internal carotid artery as well as developed leptomeningeal anastomoses through the ipsilateral posterior cerebral artery, which resulted in blood perfusing the ipsilateral middle and anterior cerebral artery territories. Because the localization of SAH coincided with the developed leptomeningeal anastomosis, we speculated that the rupture of the developed leptomeningeal anastomosis in the basal cistern was the cause of SAH...
January 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28121936/fatal-remote-cerebellar-hemorrhage-after-supratentorial-unruptured-aneurysm-surgery-in-patient-with-previous-cerebellar-infarction-a-case-report
#12
Eun-Jeong Koh, Jung-Soo Park
RATIONALE: Remote cerebellar hemorrhage (RCH) is a rare complication of supratentorial and spinal surgeries, seldom requiring intervention but occasionally causing significant morbidity or even mortality. Although a number of theories have been proposed, the exact pathophysiology of RCH remains incompletely understood. PATIENT CONCERNS: We present a 62-year-old patient with RCH encountered following surgical clipping of an unruptured middle cerebral artery bifurcation aneurysm in a patient with previous cerebellar infarction...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28111312/dual-channel-endoscopic-indocyanine-green-fluorescence-angiography-for-clipping-of-cerebral-aneurysms
#13
Won-Sang Cho, Jeong Eun Kim, Hyun-Seung Kang, Eun Jin Ha, Minwoong Jung, Choonghee Lee, Il Hyung Shin, Uk Kang
OBJECTIVE: Neuroendoscopy is useful for assessing the status of perforators, parent arteries, and aneurysms beyond the straight line of microscopic view during aneurysm clipping. We aimed to evaluate the clinical usefulness of our endoscopic indocyanine green angiography (eICGA) system, which can simultaneously display both visible light and ICG fluorescent images. METHODS: A total of 16 unruptured aneurysms in 10 patients were surgically clipped via the keyhole approach...
January 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28110854/training-in-cerebral-aneurysm-clipping-using-self-made-3-dimensional-models
#14
Toshihiro Mashiko, Naoki Kaneko, Takehiko Konno, Keisuke Otani, Rie Nagayama, Eiju Watanabe
INTRODUCTION: Recently, there have been increasingly fewer opportunities for junior surgeons to receive on-the-job training. Therefore, we created custom-built three-dimensional (3D) surgical simulators for training in connection with cerebral aneurysm clipping. METHODS: Three patient-specific models were composed of a trimmed skull, retractable brain, and a hollow elastic aneurysm with its parent artery. The brain models were created using 3D printers via a casting technique...
January 16, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28108855/causes-of-poor-outcome-in-patients-admitted-with-good-grade-subarachnoid-haemorrhage
#15
Vladimír Beneš, Lubomír Jurák, Radim Brabec, Nina Nechanická, Miroslav Šercl, Ladislav Endrych, Pavel Buchvald, Petr Suchomel
BACKGROUND: Surgical risk in patients with unruptured aneurysms is well known. The relative impact of surgery and natural history of subarachnoid haemorrhage (SAH) on patients in good clinical condition (World Federation of Neurological Surgeons [WFNS] grades 1 and 2) is less well quantified. The aim of this study was to determine causes of poor outcome in patients admitted in good grade SAH. METHODS: A retrospective study of prospectively collected data among WFNS-1 and -2 patients: demographics, SAH and aneurysm-related data, surgical complications and outcome as assesed by the Glasgow Outcome Scale (GOS)...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28108577/the-efficacy-and-risk-of-cerebrospinal-fluid-drainage-for-thoracoabdominal-aortic-aneurysm-repair-a-retrospective-observational-comparison-between-drainage-and-non-drainage%C3%A2
#16
Junya Sugiura, Hideki Oshima, Tomonobu Abe, Yuji Narita, Yoshimori Araki, Kazuro Fujimoto, Masato Mutsuga, Akihiko Usui
OBJECTIVES: We reviewed our experiences with thoracoabdominal aortic aneurysm (TAAA) repair to assess the efficacy of cerebrospinal fluid drainage (CSFD) to prevent the neurological deficits and complications associated with CSFD. METHODS: Between 2002 and 2015, 118 patients underwent TAAA repair. Seventy-eight patients underwent CSFD for 2.7 ± 1.1 days after surgery. CSFD was not performed for the other 40 patients due to an urgent situation, chronic disseminated intravascular coagulation or anatomical difficulties...
January 20, 2017: Interactive Cardiovascular and Thoracic Surgery
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
#17
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
#18
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
#19
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
#20
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
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