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Cerebral embolism

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https://www.readbyqxmd.com/read/29341947/spontaneous-direct-carotid-cavernous-fistula-in-an-elderly-patient
#1
Stanimir S Sirakov, Borislav D Kitov, Kristina S Sirakova, Ivo I Kehayov
We describe the case of an 83-year-old woman with left-sided ophthalmoplegia. She had no family history of connective tissue disease. The computed tomography study found a dilated left cavernous sinus. The conventional cerebral panangiography confirmed the diagnosis - a direct carotid-cavernous fistula (CCF), with no evidence of ruptured aneurysm. The woman underwent endovascular treatment with coiling of the cavernous sinus in combination with application of the Onyx embolic agent in the fistula. During the first 48 hours after the embolization the local pain, exophthalmos and conjunctival injection of the left eye were significantly ameliorated...
December 20, 2017: Folia Medica
https://www.readbyqxmd.com/read/29331948/lvis-blue-as-a-low-porosity-stent-and-coil-adjuvant
#2
Matthew J Koch, Christopher J Stapleton, Scott B Raymond, Susan Williams, Thabele M Leslie-Mazwi, James David Rabinov, Aman B Patel
INTRODUCTION: The LVIS Blue is an FDA-approved stent with 28% metallic coverage that is indicated for use in conjunction with coil embolization for the treatment of intracranial aneurysms. Given a porosity similar to approved flow diverters and higher than currently available intracranial stents, we sought to evaluate the effectiveness of this device for the treatment of intracranial aneurysms. METHODS: We performed an observational single-center study to evaluate initial occlusion and occlusion at 6-month follow-up for patients treated with the LVIS Blue in conjunction with coil embolization at our institution using the modified Raymond-Roy classification (mRRC), where mRRC 1 indicates complete embolization, mRRC 2 persistent opacification of the aneurysm neck, mRRC 3a filling of the aneurysm dome within coil interstices, and mRRC 3b filling of the aneurysm dome...
January 13, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29327999/declining-complication-rates-with-flow-diversion-of-anterior-circulation-aneurysms-after-introduction-of-the-pipeline-flex-analysis-of-a-single-institution-series-of-568-cases
#3
Geoffrey P Colby, Matthew T Bender, Li-Mei Lin, Narlin Beaty, Justin M Caplan, Bowen Jiang, Erick M Westbroek, Bijan Varjavand, Jessica K Campos, Judy Huang, Rafael J Tamargo, Alexander L Coon
OBJECTIVE The second-generation Pipeline embolization device (PED), Flex, has several design upgrades, including improved opening and the ability to be resheathed, in comparison with the original device (PED classic). The authors hypothesized that Flex is associated with a lower rate of major complications. METHODS A prospective, IRB-approved, single-institution database was analyzed for all patients with anterior circulation aneurysms treated by flow diversion. The PED classic was used from August 2011 to January 2015, and the Pipeline Flex has been used since February 2015...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29327485/right-left-propensity-of-cardiogenic-cerebral-embolism-in-standard-versus-bovine-aortic-arch-variant
#4
Menachem Gold, Mojdeh Khamesi, Mangaiyarkkarasi Sivakumar, Vijaya Natarajan, Hooman Motahari, Nicholas Caputo
INTRODUCTION: Left-hemispheric ischemic strokes are more frequent overall and often have a worse outcome than their right-hemispheric counterparts. We hypothesized that the right-left propensity of CE cerebral infarcts differs between patients with standard and bovine arch variants. METHODS: We retrospectively identified all patients with acute stroke of the anterior circulation admitted to our primary stroke center between January 2011 and June 2017 who had moderate- to high-risk cardio-embolic sources according to the SSS-TOAST classification...
January 12, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29326378/the-casper-stent-system-for-carotid-artery-stenosis
#5
Sebastian J Mutzenbach, Katharina Millesi, Cornelia Roesler, Erasmia Broussalis, Slaven Pikija, Johann Sellner, Lukas Machegger, Christoph J Griessenauer, Monika Killer-Oberpfalzer
PURPOSE: To report the results of a retrospective analysis of prospectively collected data evaluating the safety and efficacy of a double layer stent engineered for carotid artery occlusive disease. METHODS: Between January 2014 and February 2017, 138 patients (25.4% women; median age 71 years) underwent Casper stent implantation for carotid artery stenosis. Eligibility criteria included stenosis >70% of vessel diameter (or >50% diameter with ulceration) in symptomatic patients or asymptomatic patients with >80% stenosis at the carotid bifurcation or in the proximal internal carotid artery...
January 11, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29324372/dislocation-of-a-cerebral-protection-device-component-during-carotid-stenting-a-case-report-of-favorable-outcome-from-conservative-management-after-failure-of-retrieval
#6
Ilaria Tocco-Tussardi, Caterina Kulyk, Vincenzo Vindigni, Giampiero Avruscio
INTRODUCTION: Cerebral-protection devices (CPDs) are a well-established system for reduction of embolic risk in carotid artery angioplasty and stenting (CAS). Although rare, adverse events with CPDs are unpredictable and can be associated with serious outcomes and iatrogenic sequelae. PRESENTATION OF CASE: We describe the unique case of dislocation of a FilterWire EX™ filter loop during right CAS. On trying to recapture the CPD filter at the end of the procedure, the filter loop suddenly detached from the guidewire and dislocated to the proximal middle cerebral artery...
December 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29322968/treatment-strategies-for-traumatic-cervico-cranial-pseudoaneurysms-a-single-institution-experience
#7
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/29315509/carotid-plaque-volume-in-patients-undergoing-carotid-endarterectomy
#8
S Ball, S Rogers, K Kanesalingam, R Taylor, E Katsogridakis, C McCollum
BACKGROUND: The main indication for carotid endarterectomy (CEA) is severity of carotid artery stenosis, even though most strokes in carotid disease are embolic. The relationship between carotid plaque volume (CPV) and symptoms of cerebral ischaemia, and the measurement of CPV by minimally invasive tomographic ultrasound imaging, were investigated. METHODS: The volume of the endarterectomy specimen was measured using a validated saline suspension technique in patients undergoing CEA...
January 8, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29313909/peri-operative-neurological-complications
#9
REVIEW
R Hood, A Budd, F A Sorond, C W Hogue
Brain injury from cardiac surgery is an important source of patient morbidity and mortality. The relationship between risk of brain injury and advanced age portends a rising frequency of these complications due to an increasing proportion of elderly patients undergoing cardiac surgery. This review will explore the aetiology and risk factors for peri-operative stroke, postoperative cognitive dysfunction and postoperative delirium. The prevention of each of these conditions will also be discussed, with a focus on brain protection strategies and the avoidance of cerebral embolism and hypoperfusion...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29307005/effect-of-cerebral-embolus-size-on-the-timing-of-cardiac-surgery-for-infective-endocarditis-in-patients-with-neurological-complications
#10
Yong Kyun Kim, Choong Gon Choi, Jiwon Jung, Shi Nae Yu, Ju Young Lee, Yong Pil Chong, Sung-Han Kim, Sang-Oh Lee, Sang-Ho Choi, Jun Hee Woo, Yang Soo Kim
The optimal timing of cardiac surgery remains unclear for patients with neurological complications of infective endocarditis (IE). However, neuroimaging findings may allow more refined clinical decision-making. We analyzed clinical and advanced neuroimaging data for 135 patients with IE who had preoperatively diagnosed ischemic cerebral complications (86 patients) or hemorrhagic complications (49 patients), between January 1997 and May 2013. The effect of early surgery (within 3 and 7 days of ischemic and hemorrhagic complications respectively) on in-hospital mortality and 1-year adverse outcomes (mortality, relapse, or new embolic events) was estimated...
January 6, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29305562/possible-relationship-between-antiphospholipid-antibodies-and-embolic-events-in-infective-endocarditis
#11
Christine Selton-Suty, Charles-Henry Maigrat, Jean Devignes, François Goehringer, Marie-Line Erpelding, François Alla, Carine Thivilier, Olivier Huttin, Clément Venner, Yves Juilliere, Thanh Doco-Lecompte, Thomas Lecompte
OBJECTIVE: Antiphospholipid (aPL) antibodies may activate platelets and contribute to vegetation growth and embolisation in infective endocarditis (IE). We aimed to determine the value of aPL as predictors of embolic events (EE) in IE. METHODS: We studied 186 patients with definite IE (Duke-Li criteria, all types of IE) from the Nanc-IE prospective registry (2007-2012) who all had a frozen blood sample and at least one imaging procedure to detect asymptomatic or confirm symptomatic EE...
January 5, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29304541/rationale-design-and-methodology-of-the-computerized-registry-of-patients-with-venous-thromboembolism-riete
#12
Behnood Bikdeli, David Jimenez, Mayra Hawkins, Salvador Ortíz, Paolo Prandoni, Benjamin Brenner, Hervé Decousus, Frederick A Masoudi, Javier Trujillo-Santos, Harlan M Krumholz, Manuel Monreal
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a preventable cause of in-hospital death, and one of the most prevalent vascular diseases. There is a lack of knowledge with regards to contemporary presentation, management and outcomes of patients with VTE. Many clinically important subgroups (including the elderly, those with recent bleeding and pregnant patients) have been under-represented in clinical trials. Furthermore, design of clinical trials is challenging in some scenarios, such as in those with hemodynamically unstable PE...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29303459/multimodal-treatment-approach-in-a-patient-with-multiple-intracranial-myxomatous-aneurysms
#13
David L Penn, Arianna B Lanpher, Jennifer M Klein, Harry P W Kozakewich, Kristopher T Kahle, Edward R Smith, Darren B Orbach
The most common primary cardiac tumor is myxoma, typically originating in the left atrium. Emboli to the central nervous system can cause cerebral infarction or, rarely, seed tumor growth within vessel walls, causing myxomatous aneurysms. Fewer than 60 myxomatous aneurysms have been reported, including 2 cases in children. Here, the authors describe 2 different growing myxomatous aneurysms in a child successfully managed using a combined multidisciplinary approach. A 12-year-old boy developed a sudden headache, diplopia, gait instability, and speech difficulty...
January 5, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29301051/antiplatelet-premedication-for-stent-assisted-coil-embolization-of-intracranial-aneurysms-low-dose-prasugrel-vs-clopidogrel
#14
Hyun Ho Choi, Jung Jun Lee, Young Dae Cho, Moon Hee Han, Won-Sang Cho, Jeong Eun Kim, Sang Joon An, Jong Hyeon Mun, Dong Hyun Yoo, Hyun-Seung Kang
BACKGROUND: The use of antiplatelet medications to prevent thrombosis in the treatment of cerebral aneurysms with stents has become widely emphasized. OBJECTIVE: To compare low-dose prasugrel with clopidogrel in stent-assisted coil embolization of intracranial aneurysms. METHODS: This is a retrospective review of 311 aneurysms from 297 patients who underwent stent-assisted endovascular coil embolization of unruptured intracranial aneurysm between November 2014 and March 2017...
December 29, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29299100/vascular-eagle-s-syndrome-two-cases-illustrating-distinct-mechanisms-of-cerebral-ischemia
#15
Abdulrahman Aldakkan, Marshall Dunn, Nebras M Warsi, Alireza Mansouri, Thomas R Marotta
We report two cases of Vascular Eagle's Syndrome, which demonstrate two distinct mechanisms of cerebral ischemia. In the first case, hemodynamic transient cerebral ischemia arose as a direct result of compression of the internal carotid artery (ICA). In the second, embolic large left middle cerebral artery (MCA) infarction as a result of a thrombus from a pseudoaneurysmal dilatation of the left ICA.
August 2017: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/29291536/skeletonization-method-for-vessel-delineation-of-arteriovenous-malformation
#16
D Babin, A Pižurica, L Velicki, V Matić, I Galić, H Leventić, V Zlokolica, W Philips
Cerebral arteriovenous malformation (AVM) presents a great health threat due to its high probability of rupture that can cause severe brain damage. Image segmentation alone is not sufficient to support AVM embolization procedure. In order to successfully navigate the catheter and perform embolization, the segmented blood vessels need to be classified into feeding arteries, draining veins and the AVM nidus. For this reason we address here the AVM localization and vessel decomposition problem. We propose in this paper a novel AVM localization and vessel delineation method using ordered thinning-based skeletonization...
December 19, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/29289804/endovascular-management-of-multiple-dysplastic-aneurysms-in-a-young-male-with-an-unknown-underlying-etiology-a-case-report-and-review-of-the-literature
#17
Tyler Scullen, Mansour Mathkour, Joseph Lockwood, Leah Ott, Ricky Medel, Aaron S Dumont, Peter S Amenta
BACKGROUND: Intracranial aneurysms (IA) are the leading cause of non-traumatic subarachnoid hemorrhage and are most commonly associated with the anterior cerebral artery (ACA) and anterior communicating artery complex. We describe the presentation and management of a 27-year-old male with concurrent bilateral A1-2 junction aneurysms and fusiform intraorbital ophthalmic artery (OA) aneurysms. CASE DESCRIPTION: A 27-year-old male with no past medical history presented with three months of headaches...
December 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29288212/cerebral-arterial-gas-embolism-from-attempted-mechanical-thrombectomy-recovery-following-hyperbaric-oxygen-therapy
#18
Louise Segan, Fiona Permezel, Wei Ch'ng, Ian Millar, Mark Brooks, Matt Lee-Archer, Geoffrey Cloud
Cerebral arterial gas embolism is a recognised complication of endovascular intervention with an estimated incidence of 0.08%. Its diagnosis is predominantly clinical, supported by neuroimaging. The treatment relies on alleviating mechanical obstruction and reversing the proinflammatory processes that contribute to tissue ischaemia. Hyperbaric oxygen therapy is an effective treatment and has multiple mechanisms to reverse the pathological processes involved in cerebral arterial gas embolism. Symptomatic cerebral arterial gas embolism is a rare complication of endovascular intervention for acute ischaemic stroke...
December 28, 2017: Practical Neurology
https://www.readbyqxmd.com/read/29285410/the-clinical-examination-in-the-patient-with-subarachnoid-hemorrhage-is-still-the-most-reliable-parameter-for-predicting-pathophysiological-changes
#19
Athanasios K Petridis, Kerim Beseoglu, Hans J Steiger
Background: Macrovasospasms and delayed cerebral injury are factors which correlate with high morbidity in patients suffering a subarachnoid hemorrhage. Transcranial Doppler (TCD) ultrasonography and perfusion computed tomography (PCT) are diagnostic tools used to diagnose such pathologies. However, TCD is not very reliable and PCT exposes patients to radiation and cannot be performed daily. Case Description: We present the case of a 47-year-old female with subarachnoid hemorrhage caused by rupture of an intracranial aneurysm...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29284057/computational-fluid-dynamics-cfd-using-porous-media-modeling-predicts-recurrence-after-coiling-of-cerebral-aneurysms
#20
Yasuyuki Umeda, Fujimaro Ishida, Masanori Tsuji, Kazuhiro Furukawa, Masato Shiba, Ryuta Yasuda, Naoki Toma, Hiroshi Sakaida, Hidenori Suzuki
OBJECTIVE: This study aimed to predict recurrence after coil embolization of unruptured cerebral aneurysms with computational fluid dynamics (CFD) using porous media modeling (porous media CFD). METHOD: A total of 37 unruptured cerebral aneurysms treated with coiling were analyzed using follow-up angiograms, simulated CFD prior to coiling (control CFD), and porous media CFD. Coiled aneurysms were classified into stable or recurrence groups according to follow-up angiogram findings...
2017: PloS One
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