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Waleed Brinjikji, Bongjae Chung, Ding Yong-Hong, John T Wald, Fernando Mut, Ramanathan Kadirvel, David F Kallmes, Aymeric Rouchaud, Giuseppe Lanzino, Juan R Cebral
BACKGROUND AND PURPOSE: Vertebrobasilar dolichoectatic and fusiform aneurysms (VBDAs) are known to have a poor natural history, with high rates of growth, rupture, and stroke. The purpose of this study was to identify hemodynamic characteristics that differ between VBDAs associated with growth, rupture, and stroke. MATERIALS AND METHODS: VBDAs with CT angiography or MR angiography followed longitudinally without treatment were studied. Unstable aneurysms were defined as those that grew or ruptured during follow-up...
March 16, 2018: Journal of Neurointerventional Surgery
Mehmet Akif Cakar, Ersun Tatli, Alptug Tokatli, Harun Kilic, Huseyin Gunduz, Ramazan Akdemir
INTRODUCTION: Percutaneous endovascular therapy is an accepted and preferred procedure for symptomatic subclavian artery disease. However, the technical feasibility and effectiveness of treating chronic total occlusion of the subclavian artery with this approach is uncertain. We aimed to evaluate the initial and mid-term results of endovascular therapy for patients with symptomatic chronic total occlusion of the left subclavian artery. METHODS: Consecutive patients who underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery between January 2010 and February 2014 were included...
March 16, 2018: Singapore Medical Journal
Chenhui Mao, Jing Gao, Liri Jin, Bin Peng, Yupu Guo
Neurosyphilis occurs in the late stage of systemic syphilis infection; early diagnosis and treatment are crucial to the prognosis. We review 3 autopsy cases with different subtypes of neurosyphilis, that is cases with meningovascular, general paresis, and a combination of the 2, respectively. We investigated the gross morphology and leptomeninges, vessels, cerebral cortex, white matter, brainstem, cerebellum, olfactory bulb and spinal cord microscopically. We found that meningovascular inflammation exists in both early and late phases of neurosyphilis, not only in the meningovascular subtype...
March 12, 2018: Journal of Neuropathology and Experimental Neurology
Vladimir Nakov, Toma Spiriev, Evgeni Stavrev
BACKGROUND: Vertebrobasilar junction aneurysms occur rarely, but have a higher rupture rate than supratentoral aneurysms, and higher morbidity and mortality. Their location ventral to the neuroaxis makes them a challenging surgical lesion. METHODS: In this paper, we share our experience with the surgical technique for the management of these complex aneurysms. CONCLUSION: An in-depth understanding of the anatomy of these aneurysms, careful preoperative planning, and a meticulous surgical technique, including knowledge of every detail of the procedure-positioning, an advanced skull base technique, and careful aneurysm dissection and clipping-is essential for a successful outcome of the surgery...
March 14, 2018: Acta Neurochirurgica
Xinmiao Zhang, Jing Jing, Kehui Dong, Yilong Wang, Yongjun Wang
No abstract text is available yet for this article.
March 13, 2018: Neurology
Cen Zhang, John A Detre, Scott E Kasner, Brett Cucchiara
Objective: The objective of this study is to determine whether structural features of the vertebrobasilar arterial system are related to migraine. Background: Alterations in cerebral vascular structure and function have been associated with migraine, possibly mediated by hypoperfusion and/or endothelial dysfunction triggering cortical spreading depression. Vessel tortuosity, in particular, has been associated with both altered hemodynamics and endothelial function...
2018: Frontiers in Neurology
David Z Cai, Ryan P Roach, John P Weaver, Gerald T McGillicuddy, Zachary M Mansell, Jonathan P Eskander, Mark S Eskander
This is a case report of a 48-year-old man with multiple transient ischemic attacks and a known hypoplastic right vertebral artery (VA) who presented after a syncopal event while turning his head to the left. The objective of this study is to demonstrate the necessity of proper diagnosis and management of cerebrovascular pathology including imaging and surgical intervention in patients with known anatomical anomalies. This study was conducted at Massachusetts, United States of America. Our patient's history was significant for a hypoplastic right VA and a stenotic segment of the right VA at the C3-C4 junction...
January 2018: Asian Journal of Neurosurgery
P L Anufriev, A N Evdokimenko, T S Gulevskaya
AIM: to obtain more specific information on the morphology and pathogenesis of cerebral infarctions occurring in vertebrobasilar artery (VBA) atherosclerosis. MATERIAL AND METHODS: Macro- and microscopic investigations of the brain, its arterial system, and heart were conducted in 69 autopsy cases with infarctions located in the vertebrobasilar system (VBS) in atherosclerosis. RESULTS: 69 cases were found to have 206 VBA infarctions of various extent and locations...
2018: Arkhiv Patologii
Deena M Nasr, Kelly D Flemming, Giuseppe Lanzino, Harry J Cloft, David F Kallmes, Mohammad Hassan Murad, Waleed Brinjikji
BACKGROUND AND PURPOSE: Vertebrobasilar non-saccular and dolichoectatic aneurysms (VBDA) are a rare type of aneurysm and are generally associated with poor prognosis. In order to better characterize the natural history of VBDAs, we performed a systematic review and meta-analysis of the literature to determine rates of mortality, growth, rupture, ischemia, and intraparenchymal hemorrhage. MATERIALS AND METHODS: We searched the literature for longitudinal natural history studies of VBDA patients reporting clinical and imaging outcomes...
February 13, 2018: Cerebrovascular Diseases
Luísa Panadés-de Oliveira, Antonio Méndez-Guerrero, Roberto López-Blanco, Elena Salvador Álvarez, Juan Ruiz Morales, Jesús González de la Aleja
No abstract text is available yet for this article.
February 6, 2018: Neurology
Bum Joon Kim, Kyung Mi Lee, Hyun Young Kim, Young Seo Kim, Seong-Ho Koh, Sung Hyuk Heo, Dae-Il Chang
BACKGROUND AND PURPOSE: Subclinical atherosclerotic plaques are common in patients with pontine infarctions (PIs) but without basilar artery (BA) stenosis. We hypothesized that BA plaque locations may differ by PI type and vertical location as well as vertebrobasilar artery geometry. METHODS: Ninety-six patients with PI but without BA stenosis on magnetic resonance imaging (MRI) and magnetic resonance angiography were enrolled. PIs were classified by type (paramedian, deep, or lateral) and vertical location (rostral, middle, or caudal)...
January 2018: Journal of Stroke
Xiaohui Li, Menghui Liu, Yu Zhang, Ziqing Li, Dawei Wang, Xia Yan
BACKGROUND: Vertebrobasilar insufficiency vertebrobasilar (VBIV) is a serious nerve disease and many old people suffer from it. Acupuncture has been widely applied in the treatment of VBIV. However, to our knowledge, there has been no systematic review or meta-analysis of randomized controlled trails regarding the effectiveness of this treatment. Here, we provide a protocol to evaluate the effectiveness and safety of acupuncture for VBIV. METHODS: Relevant randomized controlled trials in 5 databases (EMBASE, PubMed, the Cochrane Central Register of Controlled Trials [Cochrane Library], Chinese Biomedical Literature Database [CBM], China National Knowledge Infrastructure [CNKI]) will be comprehensively searched by 2 researchers in December 2017...
December 2017: Medicine (Baltimore)
Takuya Kameda, Koji Otani, Takamitsu Tamura, Shinichi Konno
Beauty parlor stroke syndrome (BPSS) is a rare condition characterized by mechanical impingement of a vertebral artery (VA) during neck rotation and/or hyperextension followed by vertebrobasilar insufficiency. However, there have been no reports of BPSS in which the cause of mechanical impingement was identified and no cases for which surgical treatment was reported. The authors report the case of a 56-year-old Japanese man who presented with presyncope that occurred during cervical extension. Given the possibility of vertebrobasilar insufficiency, digital subtraction angiography and CT angiography were performed...
January 26, 2018: Journal of Neurosurgery. Spine
Yi-Bin Fang, Amy Lin, Alex Kostynskyy, Ronit Agid, Mike Tymianski, Ivan Radovanovic, Timo Krings, Vitor Mendes Pereira
PURPOSE: To compare the safety and efficacy of endovascular parent artery occlusion (PAO) and flow diverter (FD) treatment in treating vertebrobasilar dissecting aneurysms (VBDAs). METHODS: A review of a prospective aneurysm database at our institution was performed to identify all consecutive patients with intracranial VBDAs managed with endovascular treatment, which were either PAO or FD. Clinical and imaging findings were compared between the two groups. RESULTS: A total of 25 consecutive patients with 27 VBDAs were included...
February 2018: European Journal of Radiology
Yuji Kanazawa, Kazuo Funabiki, Akiko Taura, Takumi Imai, Hiroko Torii, Hideaki Ogita, Takayuki Okano, Juichi Ito, Koichi Omori
OBJECTIVE: To investigate whether our original method can precisely evaluate the angle between slow and quick phases of nystagmus (vector angle) and to determine whether vector angle analysis is helpful in differentiating between horizontal nystagmus and mixed nystagmus with horizontal and vertical components. METHODS: We included 20 healthy volunteers, 17 patients with horizontal nystagmus, and 15 patients with mixed nystagmus. Caloric nystagmus was recorded in healthy volunteers; positional nystagmus was recorded in each patient...
January 21, 2018: Acta Oto-laryngologica
I Kopolovets, P Štefanič, V Rusyn, Š Tóth, V Mashura, P Berek
To date in patients with subclavian steal syndrome diagnosis is only grade of stenosis or localization of occlusion described. Authors recommend to take into account also type of a collateral compensation of cerebral circulation for selection of an optimal treatment The objective of the research was to study the features of formation of collateral circulation in patients with subclavian steal syndrome. The authors described changes in the direction of blood flow in the extracranial vessels of 42 patients with subclavian steal syndrome...
December 2017: Georgian Medical News
Eike Immo Piechowiak, Jan Gralla
No abstract text is available yet for this article.
January 2018: Neurology India
Yaoling Liu, Xiangen Shi, K I Singh K C, Yuming Sun, Fangjun Liu, Hai Qian, Jie Zhang
BACKGROUND: There has been a massive shift in the balance toward endovascular therapy for basilar artery (BA) aneurysms in the modern era. METHODS: The authors retrospectively reviewed clinical and radiological data from patients with BA aneurysms who were treated in a single medical center during a 10-year period from August 2006 to May 2016. RESULTS: Thirty-five consecutive patients with 46 aneurysms during the 10-year period were included...
January 6, 2018: World Neurosurgery
Reza Mohammadian, Ali Tarighatnia, Mehran Naghibi, Evin Koleini, Nader D Nader
Cerebral ischemia because of vertebrobasilar insufficiency (VBI) rarely presents as an initial sign within the systemic lupus erythematosus (SLE) population, and there are very few case reports supporting this manifestation. This report details 3 different patients with SLE who experienced VBI as an initial manifestation. Patient 1 was a 24-year-old female who developed a bilateral pontine lesion as a consequence of basilar artery stenosis. Patient 2 was a 34-year-old male with an acute ischemic lesion on the right side of his cerebellum and pons because of significant stenosis in the distal segment of the right vertebral artery...
January 3, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Matthew D Alexander, Jeffrey M Rebhun, Steven W Hetts, Matthew R Amans, Fabio Settecase, Robert J Darflinger, Christopher F Dowd, Van V Halbach, Randall T Higashida, Daniel L Cooke
Background: Atherosclerotic disease of the vertebrobasilar system causes significant morbidity and mortality. All lesions require aggressive medical management, but the role of endovascular interventions remains unsettled. This study examines such endovascular interventions for vertebrobasilar atherosclerosis. Methods: Retrospective review was performed of prospectively maintained procedure logs at three hospitals with comprehensive neurointerventional services...
2017: Surgical Neurology International
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