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https://www.readbyqxmd.com/read/29331948/lvis-blue-as-a-low-porosity-stent-and-coil-adjuvant
#1
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
#2
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/29325471/intracranial-subarachnoid-hemorrhage-following-cervical-laminoplasty-a-report-of-two-cases
#3
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
#4
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/29320313/acute-radiologic-manifestations-of-america-s-opioid-epidemic
#5
David D B Bates, Katherine Gallagher, HeiShun Yu, Jennifer Uyeda, Akira M Murakami, Bindu N Setty, Stephan W Anderson, Mariza O Clement
The United States is in the midst of an opioid use epidemic, which has severe medical, social, and economic consequences. Addictions to and abuse of prescription and illicit opioids are increasing, and emergency department radiologists are increasingly being faced with the task of examining patients who present with opioid-related complications. These complications may be the result of direct drug toxicity or nonsterile injection of the drugs. Neurologic, musculoskeletal, cardiopulmonary, genitourinary, and gastrointestinal complications may be evident at diagnostic imaging in emergent settings...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29310957/revascularization-for-aplastic-or-twiglike-middle-cerebral-artery-a-case-report
#6
Yuki Matsunaga, Tsuyoshi Izumo, Yoichi Morofuji, Nobutaka Horie, Kentaro Hayashi, Takayuki Matsuo
An aplastic or twiglike middle cerebral artery (Ap/T-MCA) is a congenital anomaly related to interference of normal embryonic development of the middle cerebral artery (MCA). This condition may cause ischemic and hemorrhagic strokes as a result of hypoperfusion, vulnerable collateral circulation, and associated aneurysms. We reported a case of Ap/T-MCA with transient ischemic attack, which was successfully treated with revascularization. A 19-year-old woman with a history of transient left upper limb hemiparesis, dysesthesia, and headache visited our hospital...
January 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29309735/diagnostic-accuracy-of-simulated-low-dose-perfusion-ct-to-detect-cerebral-perfusion-impairment-after-aneurysmal-subarachnoid-hemorrhage-a-retrospective-analysis
#7
Saif Afat, Carolin Brockmann, Omid Nikoubashman, Marguerite Müller, Kolja M Thierfelder, Marc A Brockmann, Konstantin Nikolaou, Martin Wiesmann, Jong Hyo Kim, Ahmed E Othman
Purpose To evaluate diagnostic accuracy of low-dose volume perfusion (VP) computed tomography (CT) compared with original VP CT regarding the detection of cerebral perfusion impairment after aneurysmal subarachnoid hemorrhage. Materials and Methods In this retrospective study, 85 patients (mean age, 59.6 years; 62 women) with aneurysmal subarachnoid hemorrhage and who were suspected of having cerebral vasospasm at unenhanced CT and VP CT (tube voltage, 80 kVp; tube current-time product, 180 mAs) were included, 37 of whom underwent digital subtraction angiography (DSA) within 6 hours...
January 8, 2018: Radiology
https://www.readbyqxmd.com/read/29309312/the-link-between-cerebrovascular-hemodynamics-and-rehabilitation-outcomes-after-aneurysmal-subarachnoid-hemorrhage
#8
Forrest A Brooks, Uvieoghene Ughwanogho, Galen V Henderson, Randie Black-Schaffer, Farzaneh A Sorond, Can Ozan Tan
OBJECTIVE: To assess the relation between cerebrovascular function early after aneurysmal subarachnoid hemorrhage (SAH) onset and functional and rehabilitation outcomes. DESIGN: Observational cohort study of SAH patients (n=133) admitted to rehabilitation (n=49), discharged home (n=52), or died before discharge (n=10). Hemodynamic markers of cerebral autoregulatory function obtained from blood flow velocities in the middle cerebral artery and arterial pressure waveforms, recorded daily on days 2-4 after symptom onset, and functional independence measure (FIM™) scores and FIM efficiency for those admitted to acute rehabilitation...
January 5, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29309289/anesthesia-for-same-day-discharge-after-craniotomy-review-of-a-single-center-experience
#9
Veena Sheshadri, Lashmi Venkatraghavan, Pirjo Manninen, Mark Bernstein
Same day discharge or outpatient surgery for intracranial procedures has become possible with the advent of image-guided minimally invasive approaches to surgery and availability of short-acting anesthetic agents. In addition, patient satisfaction and the benefits of avoiding hospital stay have resulted in the evolution of neurosurgical day surgery. We reviewed our experience and the available literature to determine the perioperative factors involved which have promoted and will improve this concept in the future...
January 5, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29307023/successful-microsurgical-treatment-of-intracranial-aneurysms-in-infants-a-retrospective-study-and-literature-review
#10
Yanming Ren, Shuzhen Zhao, Lunxin Liu, Hong Sun, Yi Liu, Hao Li, Lu Ma, Min He, Chao You, Jin Li
OBJECTIVE: Intracranial aneurysms are extremely rare in infants, especially less than 1 year old. This study aimed to analyze the frequency of infantile intracranial aneurysm in our department and investigate the clinical characteristics, treatment strategies, and outcomes of this disease. METHODS: Six infants under 1 year old in 4350 patients with intracranial aneurysms were retrospectively analyzed from January 2010 to December 2016. RESULTS: The patients (5 females and 1 male) ranged in age from 2 to 11 (mean age, 4...
January 6, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29307022/fluorescein-videoangiography-during-extracranial-to-intracranial-bypass-surgery-preliminary-results
#11
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/29306602/alpha-2-antiplasmin-arg407lys-polymorphism-and-cryptogenic-ischemic-cerebrovascular-events-association-with-neurological-deficit
#12
Joanna Wzorek, Marek Karpiński, Ewa Wypasek, Michał Michalski, Andrzej Szczudlik, Krzysztof Piotr Malinowski, Anetta Undas
OBJECTIVE: Genetic background of cryptogenic ischemic stroke (IS) and transient ischemic attack (TIA) remains uncertain. Alpha-2-antiplasmin (α2AP) Arg407Lys polymorphism has been shown to be less common in patients with abdominal aortic aneurysm (AAA) compared with healthy controls. We investigated associations of α2AP Arg407Lys polymorphism with cryptogenic IS and TIA. METHODS: We studied 165 consecutive Caucasian patients who experienced cryptogenic IS (n=123) or TIA (n=42)...
December 26, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29305915/intraventricular-hemorrhage-due-to-subarachnoid-hemorrhage-does-the-severity-matter
#13
Marvin Darkwah Oppong, Oliver Gembruch, Annika Herten, Roman Frantsev, Mehdi Chihi, Philipp Dammann, Nicolai El Hindy, Michael Forsting, Ulrich Sure, Ramazan Jabbarli
OBJECT: Aneurysm rupture might be accompanied by intraventricular hemorrhage (IVH) that is associated with poor outcome of subarachnoid hemorrhage (SAH). The aim of this study was to analyze risk factors and clinical impact of IVH severity. MATERIAL AND METHODS: 995 consecutive SAH patients treated at our institution between January 2003 and June 2016 were eligible for this study. Clinical and radiological findings were correlated with the presence and severity of IVH assessed with the original Graeb score...
January 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29305756/on-aneurysmal-rupture-and-rerupture
#14
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/29304062/phase-contrast-mri-versus-numerical-simulation-to-quantify-hemodynamical-changes-in-cerebral-aneurysms-after-flow-diverter-treatment
#15
Sergey Sindeev, Philipp Georg Arnold, Sergey Frolov, Sascha Prothmann, Dieter Liepsch, Andrea Balasso, Philipp Berg, Stephan Kaczmarz, Jan Stefan Kirschke
Cerebral aneurysms are a major risk factor for intracranial bleeding with devastating consequences for the patient. One recently established treatment is the implantation of flow-diverters (FD). Methods to predict their treatment success before or directly after implantation are not well investigated yet. The aim of this work was to quantitatively study hemodynamic parameters in patient-specific models of treated cerebral aneurysms and its correlation with the clinical outcome. Hemodynamics were evaluated using both computational fluid dynamics (CFD) and phase contrast (PC) MRI...
2018: PloS One
https://www.readbyqxmd.com/read/29303459/multimodal-treatment-approach-in-a-patient-with-multiple-intracranial-myxomatous-aneurysms
#16
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/29301972/presence-of-anterior-communicating-artery-aneurysm-is-associated-with-age-bifurcation-angle-and-vessel-diameter
#17
Xue-Jing Zhang, Bu-Lang Gao, Wei-Li Hao, Song-Shi Wu, Dong-Hai Zhang
BACKGROUND AND PURPOSE: The anterior communicating artery (Acom) aneurysm is the most complex in all cerebral aneurysms, and wider vascular bifurcation angles are considered to be associated with aneurysm formation. The objective of this study was to investigate association of the Acom aneurysm formation with patient age and vascular bifurcation morphology. METHODS: Three-dimensional angiographic data of 665 patients were used in this study, including 160 patients with Acom aneurysms, 66 with non-Acom aneurysms, and 439 control subjects with no aneurysms...
January 4, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29301051/antiplatelet-premedication-for-stent-assisted-coil-embolization-of-intracranial-aneurysms-low-dose-prasugrel-vs-clopidogrel
#18
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/29300738/hemodynamics-in-a-giant-intracranial-aneurysm-characterized-by-in-vitro-4d-flow-mri
#19
Omid Amili, Daniele Schiavazzi, Sean Moen, Bharathi Jagadeesan, Pierre-François Van de Moortele, Filippo Coletti
Experimental and computational data suggest that hemodynamics play a critical role in the development, growth, and rupture of cerebral aneurysms. The flow structure, especially in aneurysms with a large sac, is highly complex and three-dimensional. Therefore, volumetric and time-resolved measurements of the flow properties are crucial to fully characterize the hemodynamics. In this study, phase-contrast Magnetic Resonance Imaging is used to assess the fluid dynamics inside a 3D-printed replica of a giant intracranial aneurysm, whose hemodynamics was previously simulated by multiple research groups...
2018: PloS One
https://www.readbyqxmd.com/read/29299821/brain-protection-in-aortic-arch-aneurysm-antegrade-or-retrograde
#20
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
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