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https://www.readbyqxmd.com/read/28168068/treatment-challenges-of-a-primary-vertebral-artery-aneurysm-causing-recurrent-ischemic-strokes
#1
Davide Strambo, Luca Peruzzotti-Jametti, Aurora Semerano, Giovanna Fanelli, Franco Simionato, Roberto Chiesa, Enrico Rinaldi, Vittorio Martinelli, Giancarlo Comi, Marco Bacigaluppi, Maria Sessa
Background. Extracranial vertebral artery aneurysms are a rare cause of embolic stroke; surgical and endovascular therapy options are debated and long-term complication may occur. Case Report. A 53-year-old man affected by neurofibromatosis type 1 (NF1) came to our attention for recurrent vertebrobasilar embolic strokes, caused by a primary giant, partially thrombosed, fusiform aneurysm of the left extracranial vertebral artery. The aneurysm was treated by endovascular approach through deposition of Guglielmi Detachable Coils in the proximal segment of the left vertebral artery...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28157751/inherited-and-uncommon-causes-of-stroke
#2
Jennifer Juhl Majersik
PURPOSE OF REVIEW: This article is a practical guide to identifying uncommon causes of stroke and offers guidance for evaluation and management, even when large controlled trials are lacking in these rarer forms of stroke. RECENT FINDINGS: Fabry disease causes early-onset stroke, particularly of the vertebrobasilar system; enzyme replacement therapy should be considered in affected patients. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), often misdiagnosed as multiple sclerosis, causes migraines, early-onset lacunar strokes, and dementia...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28149097/magnetic-resonance-imaging-findings-of-isolated-abducent-nerve-palsy-induced-by-vascular-compression-of-vertebrobasilar-dolichoectasia
#3
Hidetaka Arishima, Ken-Ichiro Kikuta
If the origin of isolated abducent nerve palsy cannot be found on neuroradiological examinations, diabetes mellitus is known as a probable cause; however, some cases show no potential causes of isolated abducent nerve palsy. Here, we report a 74-year-old male who suffered from diplopia due to isolated left abducent nerve palsy. Magnetic resonance angiography and fast imaging employing steady-state acquisition imaging clearly showed a dolichoectasic vertebrobasilar artery compressing the left abducent nerve upward and outward...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28133560/endoscopic-resection-of-skull-base-teratoma-in-klippel-feil-syndrome-through-use-of-combined-ultrasonic-and-bipolar-diathermy-platforms
#4
Justin A Edward, Alkis J Psaltis, Ryan A Williams, Gregory W Charville, Robert L Dodd, Jayakar V Nayak
Klippel-Feil syndrome (KFS) is associated with numerous craniofacial abnormalities but rarely with skull base tumor formation. We report an unusual and dramatic case of a symptomatic, mature skull base teratoma in an adult patient with KFS, with extension through the basisphenoid to obstruct the nasopharynx. This benign lesion was associated with midline palatal and cerebral defects, most notably pituitary and vertebrobasilar arteriolar duplications. A multidisciplinary workup and a complete endoscopic, transnasal surgical approach between otolaryngology and neurosurgery were undertaken...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28117210/cryptic-recanalization-of-chronic-vertebral-artery-occlusion-by-head-rotation
#5
Kenji Yagi, Hiroshi Nakagawa, Hideo Mure, Shinya Okita, Shinji Nagahiro
BACKGROUND: Chronic vertebral artery occlusion (VAO) can be associated with ischemic stroke, as thrombi formed under blood flow stagnation around the stump of the VAO may migrate into the brain. We report a new mechanism of chronic VAO-associated ischemic stroke and a patient with cryptic recanalization of chronic VAO by head rotation. CASE DESCRIPTION: A 74-year-old man presented with chronic right VAO and repeated ischemic embolic stroke in the posterior circulation despite antiplatelet therapy...
January 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28100981/isolated-left-subclavian-artery-complete-atrioventricular-block-and-tricuspid-atresia-in-a-neonate
#6
Kanupriya Chaturvedi, Deepa Prasad, Ravi Ashwath, James P Strainic, Christopher S Snyder
Isolated left subclavian artery is one of the rarer aortic arch anomalies. It has been associated with other congenital heart diseases, typically tetralogy of Fallot, double-outlet right ventricle, and atrial and ventricular septal defects. Its significant clinical implications include a left-to-right shunt from the vertebrobasilar system, which causes pulmonary overcirculation and subclavian steal. We present an unusual case of a premature infant who was diagnosed prenatally with congenital complete atrioventricular block and tricuspid atresia and was found to have an isolated left subclavian artery postnatally...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28089985/giant-cell-arteritis-related-stroke-a-retrospective-multicenter-case-control-study
#7
Hubert de Boysson, Eric Liozon, Delphine Larivière, Maxime Samson, Jean-Jacques Parienti, Jonathan Boutemy, Gwénola Maigné, Nicolas Martin Silva, Kim Ly, Emmanuel Touzé, Bernard Bonnotte, Achille Aouba, Karim Sacré, Boris Bienvenu
OBJECTIVE: Our aim was to describe patients with giant cell arteritis (GCA)-related stroke and to compare them with a control group of GCA patients without stroke. METHODS: We created a retrospective multicenter cohort of patients with (1) GCA diagnosed according to the American College of Rheumatology criteria between 1995 and 2015, and (2) stroke occurring at the time of GCA diagnosis or occurring within 4 weeks of starting GCA therapy. The control group consisted of GCA patients without stroke...
January 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28059620/persistent-trigeminal-artery-communicating-with-a-fetal-posterior-communicating-artery-a-case-report
#8
Florence L Chiang, Abdul M Zafar, Carlos Bazan
A persistent trigeminal artery (PTA) is the most common carotid-vertebrobasilar anastomosis. PTA variants terminating on cerebellar arteries instead of the basilar artery have been reported previously. We present the first case of a PTA communicating with a fetal posterior communicating artery identified on a magnetic resonance angiogram. An understanding of these anatomical variants is important to clarify pathological processes that can help guide neurosurgical and endovascular procedures.
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28029608/higher-stroke-risk-with-lower-blood-pressure-in-hemodynamic-vertebrobasilar-disease-analysis-from-the-veritas-study
#9
Sepideh Amin-Hanjani, Tanya N Turan, Xinjian Du, Dilip K Pandey, Linda Rose-Finnell, DeJuran Richardson, Mitchell S V Elkind, Gregory J Zipfel, David S Liebeskind, Frank L Silver, Scott E Kasner, Philip B Gorelick, Fady T Charbel, Colin P Derdeyn
BACKGROUND: Despite concerns regarding hypoperfusion in patients with large-artery occlusive disease, strict blood pressure (BP) control has become adopted as a safe strategy for risk reduction of stroke. We examined the relationship between BP control, blood flow, and risk of subsequent stroke in the prospective Vertebrobasilar Flow Evaluation and Risk of Transient Ischemic Attack and Stroke (VERiTAS) study. METHODS: The VERiTAS study enrolled patients with recent vertebrobasilar (VB) transient ischemic attack or stroke and ≥50% atherosclerotic stenosis or occlusion of vertebral or basilar arteries...
February 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28007277/random-finding-of-a-ruptured-kommerell-aneurysm-after%C3%A2-stroke
#10
Iannis Ben Abdallah, Salma El Batti, Pierre Julia, Jean-Marc Alsac
The random finding of a ruptured Kommerell aneurysm (rKA) is exceptional. We report the case of a 74-year-old man who received an incidental diagnosis of a contained rKA involving an aberrant right subclavian artery after a stroke. He underwent successful hybrid repair with the use of thoracic endovascular aortic repair associated with cervical debranching of the left subclavian artery and vascular plug occlusion of both subclavian artery origins. Whereas no early adverse event was reported, the patient experienced a vertebrobasilar insufficiency once he had recovered, requiring an additional right carotid-to-subclavian bypass...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27979795/differential-interstrain-susceptibility-to-vertebrobasilar-dolichoectasia-in-a-mouse-model
#11
Y-Q Zhu, H Xing, D Dai, D F Kallmes, R Kadirvel
BACKGROUND AND PURPOSE: Vetebrobasilar dolichoectasia is characterized by arterial elongation, dilation, and tortuosity and leads to high risks of ischemic stroke. Our aim was to investigate the differential susceptibility to elastase-induced vertebrobasilar dolichoectasia induction in 2 different mouse strains. MATERIALS AND METHODS: Elastase (25 mU) was injected into the cisterna magna in C57BL/6J (n = 36) and 129/SvEv (SV129) (n = 36) mice. Control animals were injected with heat-inactivated elastase (n = 12 for each strain)...
December 15, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27932747/-a-rare-case-of-metastatic-brain-tumors-in-the-bilateral-cerebellopontine-angles
#12
Yasuhiro Node, Naoyuki Harada, Hiroyuki Masuda, Kosuke Kondo, Masaaki Nemoto, Nobuo Sugo
We encountered a rare case of metastatic brain tumors in the bilateral cerebellopontine angles. The patient was a 61-year-old man, who visited an otorhinolaryngology clinic with complaints of rapidly progressing bilateral hearing impairment and facial palsy. The patient was referred to our hospital because tumorous lesions were suspected in the bilateral cerebellopontine angles on brain magnetic resonance imaging. Regarding tumor markers, the patient's cancer antigen 19-9 and carcinoembryonic antigen levels were high, which suggested metastasis...
December 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27903481/hybrid-repair-of-complex-left-subclavian-artery-injury-with-partial-transection-and-complete-thrombosis-in-an-unstable-patient-following-blunt-trauma
#13
Ilitch Diaz-Gutierrez, Muhammad A Rana, Barkat Ali, John M Marek, Mark Langsfeld
Blunt subclavian artery injuries are rare and are associated with high morbidity and mortality. Several case reports have suggested that endovascular repair is safe with short operative times and minimal blood loss. We report a case of a 20-year-old male patient involved in a high speed motor vehicle collision that resulted in partial transection of left subclavian artery with complete luminal thrombosis. Patient also had a left main-stem bronchus avulsion along with major intra-abdominal injuries and multiple spine and long bone fractures...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27856952/clinical-outcomes-of-posterior-versus-anterior-circulation-infarction-with-low-national-institutes-of-health-stroke-scale-scores
#14
Joon-Tae Kim, Man-Seok Park, Kang-Ho Choi, Beom Joon Kim, Moon-Ku Han, Tai Hwan Park, Sang-Soon Park, Kyung Bok Lee, Byung-Chul Lee, Kyung-Ho Yu, Mi Sun Oh, Jae Kwan Cha, Dae-Hyun Kim, Hyun-Wook Nah, Jun Lee, Soo Joo Lee, Youngchai Ko, Jae Guk Kim, Jong-Moo Park, Kyusik Kang, Yong-Jin Cho, Keun-Sik Hong, Jay Chol Choi, Dong-Eog Kim, Wi-Sun Ryu, Dong-Ick Shin, Min-Ju Yeo, Wook-Joo Kim, Juneyoung Lee, Ji Sung Lee, Hee-Joon Bae, Jeffrey L Saver, Ki-Hyun Cho
BACKGROUND AND PURPOSE: We compared baseline characteristics and outcomes at 3 months between patients with minor anterior circulation infarction (ACI) versus minor posterior circulation infarction (PCI), including the influence of large vessel disease on outcomes. METHODS: This study is an analysis of a prospective multicenter registry database in South Korea. Eligibility criteria were patients with ischemic stroke admitted within 7 days of stroke onset, lesions in either anterior or posterior circulation, and National Institutes of Health Stroke Scale score of ≤4 at baseline...
January 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27854084/impacts-of-cigarette-smoking-and-basilar-artery-flow-on-1-year-recovery-in-3-month-survivors-of-intracranial-vertebrobasilar-artery-dissection-related-ischemic-stroke
#15
Chih-Ping Chung, Feng-Chi Chang, Hui-Chi Huang, Jui-Yao Tsai, Yung-Yang Lin
OBJECTIVE: Intracranial vertebrobasilar artery dissection (iVBD) is an important etiology for posterior circulation ischemic stroke (PCS); however, its long-term functional outcome has been seldom reported. The present study aimed to elucidate the functional outcomes and the predictors of poor functional recovery at 1-year after iVBD-caused PCS. METHODS: Patients with iVBD-caused PCS who had been recruited in the Stroke Registry of Taipei Veterans General Hospital between January 1, 2012 to February 28, 2014 were included...
September 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/27852380/-clinical-analysis-of-endovascular-strategies-in-the-treatment-of-vertebrobasilar-dissecting-aneurysms
#16
Y Z Zang, Z G Wang, C W Wang, Y Zhang, X Ding, X F Wang
Objective: To evaluate the efficacy and safety of endovascular strategies for vertebrobasilar dissecting aneurysm (VBDA) and analyze advantages and disadvantages of different endovascular methods for the treatment of VBDA through long-term follow-up. Methods: Retrospectively analyzing was used for the clinical information of 45 cases of vertebrobasilar dissecting aneurysms treated with endovascular methods in our department from January 2007 to December 2015. The treatment modalities were classified into reconstructive surgery and destructive surgery that were based on parent artery preservation...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27836994/treatment-of-posterior-circulation-non-saccular-aneurysms-with-flow-diverters-a-single-center-experience-and-review-of-56-patients
#17
REVIEW
P Bhogal, M Aguilar Pérez, O Ganslandt, H Bäzner, H Henkes, S Fischer
BACKGROUND AND PURPOSE: Non-saccular aneurysms of the posterior fossa are an uncommon pathology with no clear treatment strategy. The use of flow-diverting stents (FDS) has had mixed results. We sought to evaluate our experience of FDS for the treatment of this pathology. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated only with flow diversion for an unruptured non-saccular aneurysm of the posterior circulation between February 2009 and April 2016...
November 11, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27831484/dynamic-respiratory-tortuosity-of-the-vertebral-artery-ostium
#18
Xiaobin Tang, Feng Tang, Chang Hu, Qian Wang, Whitney Long, Lei Li
PURPOSE: To determine the prevalence of dynamic respiratory tortuosity (DRT) of the vertebral artery ostium (VAO) as well as to evaluate its correlation with in-stent restenosis (ISR) and stent fracture. METHODS: From March 2012 to June 2015, 178 consecutive patients (mean age 65.2±5.8 years; 124 men) with symptoms of atherosclerotic vertebrobasilar ischemia underwent angiography prior to stent implantation in the vertebral, subclavian, and/or carotid arteries...
February 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27801397/-tactics-of-surgical-treatment-of-patients-with-unruptured-asymptomatic-cerebral-aneurysms
#19
A S Kheireddin, Sh Sh Eliava, S B Yakovlev, Yu M Filatov, A N Kaftanov, O B Belousova, I A Sazonov, S R Arustamyan, K G Mikeladze, E Yu Bukharin, P S Dorokhov
AIM: To clarify the indications for surgical treatment and the principles for choosing a surgical technique for patients with unruptured asymptomatic aneurysms (UAAs) based on the results of direct and endovasal operations performed at the Burdenko Neurosurgical Institute and on the literature data. MATERIAL AND METHODS: The study included 694 UAA patients (481 females (69.3%) and 213 males (30.7%)) operated on at the Burdenko Neurosurgical Institute from 1997 to 2013...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27801396/-results-of-deconstructive-endovascular-surgery-in-treatment-of-large-and-giant-intracranial-aneurysms
#20
S R Arustamyan, S B Yakovlev, A R Shakhnovich, I V Krasnoperov, O B Sazonova, A V Bocharov, E Yu Bukharin, O B Belousova, A N Kaftanov
AIM: To clarify the indications for deconstructive endovascular surgery in patients with large and giant intracranial aneurysms and to evaluate short-term and long-term postoperative outcomes. MATERIAL AND METHODS: The study was based on a retrospective analysis of the treatment results in 50 patients with large (15-25 mm) and giant (more than 25 mm) intracranial aneurysms, aged from 18 to 75 years, who were treated at the Burdenko Neurosurgical Institute in 2002-2014...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
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