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https://www.readbyqxmd.com/read/27913802/combined-use-of-a-pconus-and-a-solitaire-stent-report-of-two-cases
#1
Pervinder Bhogal, Marta Aguilar Pérez, Rosa Martinez Moreno, Marcin Miś, Maciej Miś, Hans Henkes
OBJECTIVE: The aim of this study was to report our initial experience of the use of the pCONus neck protection device in conjunction with the Solitaire AB stent to assist in the endovascular management of complex intracranial aneurysms with arteries arising from both the neck and the dome of the aneurysm. METHODS: Two patients with unruptured aneurysms underwent elective endovascular management of their aneurysms, one arising from the middle cerebral artery bifurcation and one from the anterior communicating artery...
December 2, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27911237/size-and-location-of-ruptured-intracranial-aneurysms-consecutive-series-of-1993-hospital-admitted-patients
#2
Miikka Korja, Riku Kivisaari, Behnam Rezai Jahromi, Hanna Lehto
OBJECTIVE Large consecutive series on the size and location of ruptured intracranial aneurysms (RIAs) are limited, and therefore it has been difficult to estimate population-wide effects of size-based treatment strategies of unruptured intracranial aneurysms. The authors' aim was to define the size and location of RIAs in patients diagnosed with subarachnoid hemorrhage due to aneurysm rupture in a high-volume academic center. METHODS Consecutive patients admitted to a large nonprofit academic hospital with saccular RIAs between 1995 and 2009 were identified, and the size, location, and multiplicity of RIAs were defined and reported by patient sex...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27906765/hemodynamic-disturbances-in-the-early-phase-after-subarachnoid-hemorrhage-regional-cerebral-blood-flow-studied-by-bedside-xenon-enhanced-ct
#3
Henrik Engquist, Anders Lewén, Tim Howells, Ulf Johnson, Elisabeth Ronne-Engström, Pelle Nilsson, Per Enblad, Elham Rostami
BACKGROUND: The mechanisms leading to neurological deterioration and the devastating course of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) are still not well understood. Bedside xenon-enhanced computerized tomography (XeCT) enables measurements of regional cerebral blood flow (rCBF) during neurosurgical intensive care. In the present study, CBF characteristics in the early phase after severe SAH were explored and related to clinical characteristics and early clinical course outcome...
November 30, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27903923/stent-assisted-coil-embolization-of-a-recurrent-posterior-cerebral-artery-aneurysm-following-surgical-clipping
#4
Tomonori Takeshita, Tomoaki Nagamine, Kohei Ishihara, Yasuhiko Kaku
Posterior cerebral artery (PCA) aneurysms are rare, and direct surgery of these is considered difficult. Coil embolization of PCA aneurysms is becoming popular. However, it is difficult to completely obliterate the aneurysm while preserving the flow of the parent artery in large or giant PCA aneurysms with a wide neck with this technique. We report a case of a large and wide-necked PCA aneurysm with multiple recurrences following successful surgical clipping and coil embolization.A 77-year-old man with a large unruptured right PCA (P2) aneurysm was successfully treated by surgical clipping...
November 30, 2016: Neuroradiology Journal
https://www.readbyqxmd.com/read/27903019/osteochondroma-presenting-as-a-calcified-mass-in-the-sellar-region-and-review-of-the-literature
#5
Kazuya Sekiguchi, Satoshi Tsutsumi, Sho Arai, Senshu Nonaka, Takamoto Suzuki, Hisato Ishii, Hiroshi Izumi, Yukimasa Yasumoto
Objective Osteochondroma (OC) is the most common benign bone neoplasm. It infrequently occurs in the cranial cavity as a calcified lesion and very rarely presents in the sellar region. The present study summarizes the knowledge about OCs of the sellar region. Methods We searched the literature search for the clinical appearance of OCs and other calcified pathologies occurring in the sellar region. Results A total of 21 English-language articles published from 1961 to 2015 documented cases of calcified lesions in the sellar region including cerebral aneurysm, chondroid chordoma, chondroma, craniopharyngioma, OC, odontome, osteoma, pituitary adenoma, pituitary stone, Rathke cleft cyst, retinoblastoma, schwannoma, and xanthogranuloma...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27900535/evaluation-of-cerebral-circulation-during-retrograde-perfusion-by-laser-speckle-flowgraphy
#6
Fumiaki Kimura, Hirotsugu Kanda, Yuki Toyama, Takayuki Kunisawa, Taiji Nagaoka, Akitoshi Yoshida, Hiroto Kitahara, Hiroyuki Kamiya
Laser speckle flowgraphy (LSFG) is an ophthalmologic equipment that qualitatively detects the blood flow of the optic nerve head, which is known to be related with cerebral microcirculation. LSFG can also measure the mean blur rate, which quantitatively calculates the blood flow. We aimed to assess the utility of LSFG in the evaluation of cerebral perfusion during aortic surgery under hypothermic circulatory arrest with retrograde and antegrade cerebral perfusion. Two patients underwent total arch replacement for aneurysm...
November 29, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27898547/bilateral-congenital-iris-sphincter-agenesis-diagnosed-after-massive-bleeding-episode-during-repair-of-aneurysmal-dilation-of-patent-ductus-arteriosus
#7
Tomohiro Yamamoto, Martin Schmidt-Niemann, Ehrenfried Schindler
We report a rare case of an infant with both an aneurysmal dilation of the patent ductus arteriosus (PDA) and bilateral congenital iris sphincter agenesis. Her mydriasis without pupillary light reflex was first noted after a massive intraoperative bleeding episode during the PDA ligation. The assumption that the mydriasis was a sign of cerebral ischemia led to additional examinations and intensive medical therapies that in retrospect were unnecessary. This is the first reported case of combined aneurysmal dilation of a PDA and congenital iris sphincter agenesis in the anesthesia literature...
November 28, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27895300/thsd1-thrombospondin-type-1-domain-containing-protein-1-mutation-in-the-pathogenesis-of-intracranial-aneurysm-and-subarachnoid-hemorrhage
#8
Teresa Santiago-Sim, Xiaoqian Fang, Morgan L Hennessy, Stephen V Nalbach, Steven R DePalma, Ming Sum Lee, Steven C Greenway, Barbara McDonough, Georgene W Hergenroeder, Kyla J Patek, Sarah M Colosimo, Krista J Qualmann, John P Hagan, Dianna M Milewicz, Calum A MacRae, Susan M Dymecki, Christine E Seidman, J G Seidman, Dong H Kim
BACKGROUND AND PURPOSE: A ruptured intracranial aneurysm (IA) is the leading cause of a subarachnoid hemorrhage. This study seeks to define a specific gene whose mutation leads to disease. METHODS: More than 500 IA probands and 100 affected families were enrolled and clinically characterized. Whole exome sequencing was performed on a large family, revealing a segregating THSD1 (thrombospondin type 1 domain containing protein 1) mutation. THSD1 was sequenced in other probands and controls...
December 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27891172/vortex-analysis-of-intra-aneurismal-flow-in-cerebral-aneurysms
#9
Kevin Sunderland, Christopher Haferman, Gouthami Chintalapani, Jingfeng Jiang
This study aims to develop an alternative vortex analysis method by measuring structure ofIntracranial aneurysm (IA) flow vortexes across the cardiac cycle, to quantify temporal stability of aneurismal flow. Hemodynamics were modeled in "patient-specific" geometries, using computational fluid dynamics (CFD) simulations. Modified versions of known λ2 and Q-criterion methods identified vortex regions; then regions were segmented out using the classical marching cube algorithm. Temporal stability was measured by the degree of vortex overlap (DVO) at each step of a cardiac cycle against a cycle-averaged vortex and by the change in number of cores over the cycle...
2016: Computational and Mathematical Methods in Medicine
https://www.readbyqxmd.com/read/27890755/predictors-of-shunt-insertion-in-aneurysmal-subarachnoid-hemorrhage
#10
Rouzbeh Motiei-Langroudi, Nimer Adeeb, Paul M Foreman, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Beverly C Walters, Shane R Tubbs, Mohammadali M Shoja, Justin M Moore, Raghav Gupta, Christopher S Ogilvy, Ajith T Thomas, Christoph J Griessenauer
OBJECTS: Hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage (aSAH) requiring permanent cerebrospinal fluid (CSF) diversion in up to two thirds of patients. Factors that predict permanent CSF diversion are not well established. METHODS: An exploratory analysis of 149 patients enrolled in the Cerebral Aneurysm Renin Angiotensin System (CARAS) study was performed in an effort to identify factors predictive of permanent CSF diversion following aSAH; only the 135 patients surviving the initial hospitalization were included in the present study...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27890754/endovascular-treatment-of-spontaneous-intracranial-fusiform-and-dissecting-aneurysms-outcomes-related-to-imaging-classification-of-309-cases
#11
Yisen Zhang, Zhongbin Tian, Binbin Sui, Yang Wang, Jian Liu, Miao Li, Youxiang Li, Chuhan Jiang, Xinjian Yang
OBJECTIVE: This study aimed to propose a modified classification of spontaneous intracranial dissecting aneurysms (IDAs) and to guide the treatment for IDAs. METHODS: Between January 2010 and December 2015, 3183 consecutive patients were referred to our department for endovascular treatment of a cerebral aneurysm and 309 patients harboring 323 spontaneous IDAs were identified from them. Based on a modified imaging classification, spontaneous IDAs were classified into four subtypes: classic dissecting aneurysm, segmental ectasia, dolichoectatic dissecting aneurysm, and large mural bleeding ectasia...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27890748/small-unruptured-intracranial-aneurysm-%C3%A2-5mm-associated-with-epilepsy-report-of-2-cases-and-literature-review
#12
Fuxin Lin, Hui Wan, Dezhi Kang, Yuanxiang Lin
BACKGROUND: Due to the continuing improvements in imaging technology, an increasing number of epileptogenic small (≤5mm) unruptured intracranial aneurysms (sUIA) are being diagnosed since 2000. However, they are not systematically described and reviewed until now. CASE DESCRIPTION AND THE LITERATURE REVIEW: We reported 2 patients with sUIA who initially presented with complex partial seizures (CPS). Scalp electroencephalography (EEG) showed the seizures activity arising from the mesial temporal/frontal areas, but conventional magnetic resonance imaging (MRI) scans were normal in both patients...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27888225/use-of-the-pipeline-embolization-device-for-recurrent-and-residual-cerebral-aneurysms-a-safety-and-efficacy-analysis-with-short-term-follow-up
#13
Anna Luisa Kühn, Katyucia de Macedo Rodrigues, J Diego Lozano, David E Rex, Francesco Massari, Takamitsu Tamura, Mary Howk, Christopher Brooks, Jenna L'Heureux, Matthew J Gounis, Ajay K Wakhloo, Ajit S Puri
OBJECTIVE: Evaluation of the safety and efficacy of the Pipeline embolization device (PED) when used as second-line treatment for recurrent or residual, pretreated ruptured and unruptured intracranial aneurysms (IAs). METHODS: Retrospective review of our database to include all patients who were treated with a PED for recurrent or residual IAs following surgical clipping or coiling. We evaluated neurological outcome and angiograms at discharge, 6- and 12-months' follow-up and assessed intimal hyperplasia at follow-up...
November 25, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27886800/beh%C3%A3-et-s-disease-how-to-diagnose-and-treat-vascular-involvement
#14
REVIEW
Emire Seyahi
Behçet's disease is a multisystem disorder with unknown etiology and a unique geographic distribution. The disease is characterized by recurrent skin-mucosa lesions and sight-threatening panuveitis. Vascular involvement, which is more common and more severe among males, has also equally characteristic features such as affecting mostly veins, having a significant tendency for thrombosis, and running a relapsing course. Lower extremity vein thrombosis (LEVT) is the most frequent manifestation, followed by vena cava inferior thrombosis...
April 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27882440/hemodynamic-changes-in-a-middle-cerebral-artery-aneurysm-at-follow-up-times-before-and-after-its-rupture-a-case-report-and-a-review-of-the-literature
#15
A Sejkorová, K D Dennis, H Švihlová, O Petr, G Lanzino, A Hejčl, D Dragomir-Daescu
Hemodynamic parameters play a significant role in the development of cerebral aneurysms. Parameters such as wall shear stress (WSS) or velocity could change in time and may contribute to aneurysm growth and rupture. However, the hemodynamic changes at the rupture location remain unclear because it is difficult to obtain data prior to rupture. We analyzed a case of a ruptured middle cerebral artery (MCA) aneurysm for which we acquired imaging data at three time points, including at rupture. A patient with an observed MCA aneurysm was admitted to the emergency department with clinical symptoms of a subarachnoid hemorrhage...
November 24, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/27881343/-surgical-management-of-proximal-anterior-cerebral-artery-a1-aneurysms
#16
Hua-Wei Wang, Zhe Xue, Yu-Dong Ma, Wen-Xin Wang, Chen Wu, Zheng-Hui Sun
OBJECTIVE: To review our experience in surgical management of proximal anterior cerebral artery (A1) aneurysms in 23 patients. METHODS: Between January, 2004 and December, 2014, 23 patients (1.6%) with A1 aneurysms diagnosed by CTA or DSA were treated surgically. The "3H" therapy was adopted for postoperative prevention of cerebrovascular spasm. All the patients were followed up and examined with cerebrovascular CTA at 6, 12, 48 and 60 months after the operation with their Glasgow Outcome Scale score recorded...
November 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27880805/feasibility-of-quantification-of-intracranial-aneurysm-pulsation-with-4d-cta-with-manual-and-computer-aided-post-processing
#17
Till Illies, Dennis Saering, Manabu Kinoshita, Toshiyuki Fujinaka, Maxim Bester, Jens Fiehler, Noriyuki Tomiyama, Yoshiyuki Watanabe
BACKGROUND AND PURPOSE: The analysis of the pulsation of unruptured intracranial aneurysms might improve the assessment of their stability and risk of rupture. Pulsations can easily be concealed due to the small movements of the aneurysm wall, making post-processing highly demanding. We hypothesized that the quantification of aneurysm pulsation is technically feasible and can be improved by computer-aided post-processing. MATERIALS AND METHODS: Images of 14 cerebral aneurysms were acquired with an ECG-triggered 4D CTA...
2016: PloS One
https://www.readbyqxmd.com/read/27879289/remote-multifocal-bleeding-points-producing-a-sylvian-subpial-hematoma-during-endovascular-coiling-of-an-acutely-ruptured-cerebral-aneurysm
#18
Christopher Alan Hilditch, Hemant Sonwalkar, Siddhartha Wuppalapati
Subpial hematoma is a rare type of intracranial hemorrhage with a poor prognosis. A new mechanism to explain subpial Sylvian hematoma formation in acute post-aneurysmal subarachnoid hemorrhage (SAH) was observed during coiling of a posterior communicating artery aneurysm. Multiple small bleeding points from pial branches of the left middle cerebral artery, which were remote from the ruptured aneurysm, were observed on conventional angiography. This bleeding led to the formation of a large expanding subpial Sylvian hematoma...
November 22, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27875190/combined-visualization-of-vessel-deformation-and-hemodynamics-in-cerebral-aneurysms
#19
Monique Meuschke, Samuel Voss, Oliver Beuing, Bernhard Preim, Kai Lawonn
We present the first visualization tool that combines patient-specific hemodynamics with information about the vessel wall deformation and wall thickness in cerebral aneurysms. Such aneurysms bear the risk of rupture, whereas their treatment also carries considerable risks for the patient. For the patient-specific rupture risk evaluation and treatment analysis, both morphological and hemodynamic data have to be investigated. Medical researchers emphasize the importance of analyzing correlations between wall properties such as the wall deformation and thickness, and hemodynamic attributes like the Wall Shear Stress and near-wall flow...
January 2017: IEEE Transactions on Visualization and Computer Graphics
https://www.readbyqxmd.com/read/27873519/use-of-three-dimensional-curved-multiplanar-reconstruction-images-for-sylvian-dissection-in-microsurgery-of-middle-cerebral-artery-aneurysms
#20
Taek Kyun Nam, Yong Sook Park, Jun Soo Byun, Seung Won Park, Jeong Taik Kwon
PURPOSE: The purpose of this study was to introduce a method of using three-dimensional (3D) curved-multiplanar reconstruction (MPR) images for sylvian dissection during microsurgical treatment of middle cerebral artery (MCA) aneurysms. MATERIALS AND METHODS: Forty-nine patients who had undergone surgery for MCA aneurysms were enrolled. We obtained the 3D curved-MPR images along the sphenoid ridge using OsiriX MD™ imaging software, compared sylvian dissection time according to several 3D MPR image factors, and investigated the correlations between these images and intraoperative findings...
January 2017: Yonsei Medical Journal
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