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Brain aneurysm

Z Y Jia, L B Zhao, D H Lee
BACKGROUND AND PURPOSE: Segmental intracranial dolichoectasia of the distal ICA is a feature of PHACE syndrome or a sporadic phenomenon. We evaluated the relationship between intracranial dolichoectasia of the distal ICA and PHACE syndrome and illustrated the characteristic radiologic findings of the lesions. MATERIALS AND METHODS: Intracranial dolichoectasia of the distal ICA was identified in 20 patients at our institution from 2005 to 2016 through a review of diagnostic cerebral angiography results...
March 15, 2018: AJNR. American Journal of Neuroradiology
Min-Qing Wang, Xu Zhao, Xiao-Fei Wang, Chao Han, De-Guang Xing, Cheng-Wei Wang
BACKGROUND: The purpose of this study was to assess the outcomes in aggressively treated patients with aneurysmal intracerebral hematoma (ICH) and signs of brain herniation, and to investigate possible predictive factors. METHODS: This retrospective study included 43 patients with aneurysmal ICH who presented with brain herniation at emergency department (ED) admission and received aggressive surgical treatment between 2008 and 2016. Emergency surgical clipping, removal of hematoma, and external decompression were combined as an aggressive surgical treatment...
March 12, 2018: World Neurosurgery
Melissa L Kirkwood, Gary M Arbique, Jeffrey B Guild, Katie Zeng, Yin Xi, John Rectenwald, Jon A Anderson, Carlos Timaran
OBJECTIVE: Radiation to the interventionalist's brain during fluoroscopically guided interventions (FGIs) may increase the incidence of cerebral neoplasms. Lead equivalent surgical caps claim to reduce radiation brain doses by 50% to 95%. We sought to determine the efficacy of the RADPAD (Worldwide Innovations & Technologies, Lenexa, Kan) No Brainer surgical cap (0.06 mm lead equivalent at 90 kVp) in reducing radiation dose to the surgeon's and trainee's head during FGIs and to a phantom to determine relative brain dose reductions...
March 12, 2018: Journal of Vascular Surgery
Yu V Pilipenko, An N Konovalov, Sh Sh Eliava, O B Belousova, D N Okishev, I A Sazonov, T F Tabasaranskiy
In recent years, the so-called primary or preventive decompressive craniectomy (DC) has been increasingly used in patients with aneurysmal subarachnoid hemorrhage (SAH). The main goal of the technique is prevention of refractory intracranial hypertension (ICH) and its consequences. PURPOSE: The study purpose was to define the CT criteria for reasonability and efficacy of DC as well as clarification of the indications for preventive DC in patients with SAH after microsurgical aneurysm exclusion...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Wataro Tsuruta, Tetsuya Yamamoto, Go Ikeda, Masayuki Sato, Yoshiro Ito, Tomoji Takigawa, Aiki Marushima, Yasunobu Nakai, Yuji Matsumaru, Akira Matsumura
BACKGROUND: Endovascular surgery for vertebral artery dissections (VADs) carries the risk of spinal cord infarction (SCI). Although SCI in the region of the anterior spinal artery (ASA) has been reported, SCI in the region of the posterior spinal artery (PSA) is rare. OBJECTIVE: To investigate PSA infarction after endovascular surgery for VAD. METHODS: Infarction in the region of the PSA after endovascular surgery for VADs carried out in consecutive 21 cases was investigated...
March 9, 2018: Operative Neurosurgery (Hagerstown, Md.)
Hsiu-An Lee, Chun-Yu Lin, Yung-Chang Chen, Shao-Wei Chen, Yu-Yun Nan, Kuo-Sheng Liu, Meng-Yu Wu, Yu-Sheng Chang, Jaw-Ji Chu, Pyng-Jing Lin, Feng-Chun Tsai
The feasibility and durability of mitral valve (MV) repair in active infective endocarditis (IE) has been reported, but proper management of perioperative neurological complications and surgical timing remains uncertain and may crucially affect the outcome.In this single-center retrospective observational study, patients who underwent isolated MV surgery for active native IE in our institution between August 2005 and August 2015 were reviewed and analyzed. Patients who were operated on for healed IE or who required combined procedures were excluded from this study...
March 2018: Medicine (Baltimore)
Guangming Wang, Jinlu Yu
INTRODUCTION: Chronic subdural hematoma(CSDH) can be treated by a relatively simple burr hole surgery. Acute subarachnoid hemorrhage (SAH) occurring after surgery for CSDH has been reported as a rare but severe complication. CASE REPORT: An 88-year-old female complained of progressive headache and dizziness for one month. A right fronto-temporo-parietal CSDH with a shift in the midline structures and lateral ventricle compression was shown by computed tomography (CT) scans...
March 3, 2018: International Journal of Surgery Case Reports
Fikret Şahintürk, Hamiyet Demirkaya, Ümit Akın Dere, Erkin Sönmez, Nur Altınörs, Gökhan Moray, Mehmet Haberal
Neurologic complications after solid-organ transplant reveal a great spectrum of pathologies. Intracranial hemorrhages, cerebral ischemic lesions, infarctions, lymphoproliferative disorders, and infections, including aspergillosis, have been observed after liver transplant. Fungi constitute nearly 5% of all central nervous system infections, mainly occurring in immunocompromised patients. The most common causative agent is Aspergillus species. It presents either as maxillary sinusitis or pulmonary infection...
March 2018: Experimental and Clinical Transplantation
Okihiro Onishi, Kazuya Ikoma, Ryo Oda, Tetsuro Yamazaki, Hiroyoshi Fujiwara, Shunji Yamada, Masaki Tanaka, Toshikazu Kubo
Although treatment protocols are available, patients experience both acute neuropathic pain and chronic neuropathic pain, hyperalgesia, and allodynia after peripheral nerve injury. The purpose of this study was to identify the brain regions activated after peripheral nerve injury using functional magnetic resonance imaging (fMRI) sequentially and assess the relevance of the imaging results using histological findings. To model peripheral nerve injury in male Sprague-Dawley rats, the right sciatic nerve was crushed using an aneurysm clip, under general anesthesia...
March 7, 2018: Neuroscience Letters
Mio Takayama, Brian Waters, Hiroshi Fujii, Kenji Hara, Masayuki Kashiwagi, Aya Matsusue, Natsuki Ikematsu, Shin-Ichi Kubo
Based on a prospective case-control study of forensic autopsies, the causes of cocaine (COC)-related sudden death (SD) are cardiovascular events in 62.0% of cases, cerebrovascular events in 14.0%, and others. A forensic autopsy of a male in his early forties revealed subarachnoid hemorrhage (SAH) at the base of the brain. A cerebral arterial aneurysm was not detected even though hemorrhage was clearly observed in the anterior cerebral artery (ACA) bifurcation area. The brain weighed 1488 g and was edematous...
March 2, 2018: Legal Medicine
Hugo Alberto Rojas, Karla Simone da Silva Fernandes, Mariana Rodrigues Ottone, Kênia Cristina S Fonseca de Magalhães, Lucas Alverne Albuquerque, Julio Leonardo Barbosa Pereira, Gerival Vieira Júnior, José Lopes Sousa-Filho, Bruno Silva Costa, Valéria Cristina Sandrim, Marcos Dellaretti, Renata Toscano Simões
BACKGROUND: Intracranial aneurysms are arterial anomalies affecting 2% to 3% of the general population in the world and these ruptures are associated with a high mortality. Some risk factors, such as age, gender, smoking, alcohol, hypertension and familial history are associated with the number of aneurysms and their size. In addition, inflammatory processes within the blood vessels of the brain can activate matrix metalloproteinase-9 (MMP-9), which degrades various components of the extracellular matrix, such as elastin...
March 5, 2018: Clinical Biochemistry
P Bhogal, O Ganslandt, H Bäzner, H Henkes, M Aguilar Perez
BACKGROUND: The region of the brain supplied by the anterior choroidal artery (AChoA) is exquisitely eloquent. Aneurysms arising at or close to the origin of the vessel are not uncommon and damage or occlusion to the vessel can result in devastating consequences. The optimal treatment strategy is yet to be determined. OBJECTIVE: We sought to determine the efficacy of flow diversion for the treatment of unruptured AChoA aneurysms. METHOD: A retrospective review of our prospectively maintained database was performed to identify all patients with unruptured aneurysms of the AChoA between March 2009 and May 2017...
March 7, 2018: Clinical Neuroradiology
Jing Yu, Ning Xu, Ying Zhao, Jinlu Yu
The anterior choroidal artery (AChA) is a critical artery in brain physiology and function. The AChA is involved in many diseases, including aneurysm, brain infarct, Moyamoya disease (MMD), brain tumor, arteriovenous malformation (AVM), etc. The AChA is vulnerable to damage during the treatment of these diseases and is thus a very important vessel. However, a comprehensive systematic review of the importance of the AChA is currently lacking. In this study, we used the PUBMED database to perform a literature review of the AChA to increase our understanding of its role in neurophysiology...
2018: International Journal of Medical Sciences
Biljana Milatović, Jovica Saponjski, Haris Huseinagić, Mirza Moranjkić, Svetlana Milošević Medenica, Ivan Marinković, Igor Nikolić, Slobodan Marinkovic
BACKGROUND: Identification and anatomic features of the feeding arteries of the arteriovenous malformations (AVMs) is very important due to neurologic, radiologic, and surgical reasons. MATERIALS AND METHODS: Seventy-seven patients with AVMs were examined by using a digital subtraction angiographic (DSA) and computerized tomographic (CT) examination, including 3D reconstruction of the brain vessels. In addition, the arteries of 4 human brain stems and 8 cerebral hemispheres were microdissected...
March 3, 2018: Folia Morphologica (Warsz)
Bruno Zanotti, Nicola Zingaretti, Angela Verlicchi, Alex Alfieri, Pier Camillo Parodi
When a cranioplasty implant becomes infected, standard operating procedure dictates its removal and the initiation of a long course of antibiotic therapy. However, removing such a prosthesis can have a series of adverse consequences, including delayed cognitive and motor recovery, lack of brain tissue protection, unsightly deformity, and the need for two additional surgical procedures, not to mention the additional costs involved. To maintain the advantages of cranioplasty, we opted for a conservative approach (levofloxacin and rifampicin every 24 hours for 8 weeks) in a 68-year-old woman whose custom-made porous hydroxyapatite implant, fitted following aneurysm clipping, had become infected...
March 1, 2018: Journal of Craniofacial Surgery
Joan Margaret O'Donnell, Michael Kerin Morgan, Maurizio Manuguerra
OBJECTIVE Few studies have examined patients' ability to drive and quality of life (QOL) after microsurgical repair for unruptured intracranial aneurysms (uIAs). However, without a strong evidentiary basis, jurisdictional road transport authorities have recommended driving restrictions following brain surgery. In the present study, authors examined the outcomes of the microsurgical repair of uIAs by measuring patients' perceived QOL and cognitive abilities related to driving. METHODS Between January 2011 and January 2016, patients with a new diagnosis of uIA were prospectively enrolled in this study...
March 2, 2018: Journal of Neurosurgery
Avanish Bhardwaj, Hemant Bhagat, Vinod Kumar Grover, Nidhi Bidyut Panda, Kiran Jangra, Seelora Sahu, Navneet Singla
PURPOSE: Surgery for aneurysmal clipping after subarachnoid haemorrhage (SAH) poses a unique anaesthetic challenge. However, data on the influence of anaesthetic agents in these patients are lacking. The study aims to evaluate the superiority of propofol over desflurane for postanaesthetic morbidity in patients undergoing surgery following aneurysmal SAH. METHODS: Seventy World Federation of Neurosurgeons Grade I and II patients were randomized into propofol (n = 35) and desflurane groups (n = 35)...
March 1, 2018: Journal of Anesthesia
Syuhei Domoto, Manzo Suzuki, Shinpei Suzuki, Hiroyasu Bito
Background: Subdural hematoma (SDH) after accidental dural puncture (ADP) is rare but may be lethal. We experienced a patient who developed SDH after combined spinal and epidural anesthesia without a headache. Case presentation: A 41-year-old parturient female with an unruptured cerebral aneurysm, was scheduled to undergo elective cesarean delivery. Cerebrospinal fluid leakage was identified during puncture of the epidural space, and a catheter was placed after re-puncture...
2018: JA Clin Rep
Raluca Pascalau, Vlad Adrian Padurean, Dana BARTOș, Adrian BARTOș, Bianca Aurora Szabo
AIM: Anatomical variants of the circle of Willis are diverse and frequent and, although they are not a direct cause of cerebrovascular diseases, they are risk factors for impaired collateral perfusion and wall shear stress. This study aimed to correlate the anatomical variants with their effects on the hemodynamic and geometrical parameters responsible for the pathogenesis of neurological diseases. MATERIAL AND METHODS: The circle of Willis and the proximal segments of the main arteries were dissected and measured on ten formalin-fixed human brains...
February 7, 2018: Turkish Neurosurgery
Toshio Baba, Kiyofumi Morishita, Tooru Mawatari, Masami Shingaki, Tsuyoshi Shibata, Kouhei Narayama, Koudai Tsuruta
A 19-year-old male patient was admitted to our hospital after developing infectious endocarditis associated with methicillin-sensitive bovine Staphylococcus aureus septicemia. Brain magnetic resonance imaging confirmed occipital lobe cerebral bleeding. An echocardiogram showed severe mitral regurgitation with vegetation on the posterior mitral leaflet. We performed mitral valve replacement. However, a hepatic artery aneurysm and a ruptured splenic artery aneurysm was found on the 5th postoperative day and coil embolization was accordingly performed...
February 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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