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https://www.readbyqxmd.com/read/29140523/sequential-coiling-assisted-deployment-of-flow-diverter-for-treatment-of-fusiform-middle-cerebral-artery-aneurysms
#1
Abdulrahman Y Alturki, Philip G R Schmalz, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND AND IMPORTANCE: Fusiform intracranial aneurysms remain challenging lesions to treat. These aneurysms have historically required bypass procedures or clip remodeling constructs for cure. Recently, endovascular specialists have reported experience with flow diversion for complex fusiform aneurysms of the vertebrobasilar system, with mixed results. Vascular anatomy for anterior circulation fusiform aneurysms may make these lesions more amenable to flow diversion and embolization procedures; however, published experience with these techniques is lacking...
November 11, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29137102/lateral-medullary-infarction-with-similar-features-of-brown-sequard-syndrome-caused-by-vertebrobasilar-dysplasia-and-klippel-feil-syndrome-a-case-report
#2
Jingzhe Han, Duanhua Cao, Guomei Ma, Tingting Wang, Ye Ji, Zhilei Kang
RATIONALE: Patients with Klippel-Feil syndrome (KFS) are always anomaly associated with vertebrobasilar dysplasia. That may present commonly as infarction of brainstem, medulla, and cerebellum. In this article, we reported a rare case of lateral medullary infarction (LMI) with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and KFS, and the 2 rare conditions that are causally related. The case is being reported because of its unusual and rare presentation...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29130973/frequency-aetiology-and-outcome-of-small-cerebellar-infarction
#3
Zeljka Calic, Cecilia Cappelen-Smith, Ramesh Cuganesan, Craig S Anderson, Miriam Welgampola, Dennis J Cordato
BACKGROUND AND PURPOSE: Strokes due to small (<2 cm) cerebellar infarction are under-recognised, and their profile and aetiology have not been well characterised. We aimed to determine the frequency, clinical features, aetiology, and outcome of small as compared to large cerebellar infarction. METHODS: This study is a retrospective analysis of clinical and imaging features of a prospectively assessed series of 108 consecutive patients with acute cerebellar infarction admitted to Liverpool Hospital, Sydney, NSW, Australia, during 2011-2015...
November 2, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29129766/the-treatment-of-a-spontaneous-dissecting-aneurysm-in-the-extracranial-vertebral-artery-with-covered-stent-a-case-report
#4
Ning Xu, Kun Zhang, Hao Meng, Tianyi Liu, Honglei Wang
A 13-year-old boy with a spontaneous vertebrobasilar artery dissecting aneurysm (VADA) in the extracranial artery, which was only 1 mm away from the initial segment of subclavian artery, was successfully treated with a covered-stent to block the artery of the VADA. Our experience indicates that this is a fast, reliable, effective and economical technique, particularly suitable for surgeries in settings with limited resources.
November 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29123909/basi-parallel-anatomical-scanning-magnetic-resonance-imaging-for-the-diagnosis-of-reversible-cerebral-vasoconstriction-syndrome-of-the-basilar-artery-a-case-report
#5
Akitaka Yamamoto, Yukinari Omori, Akihiro Shindo, Hiroshi Imai, Hidenori Suzuki
Case: Reversible cerebral vasoconstriction syndrome (RCVS) is an increasingly recognized and important cause of thunderclap headache. Delays in diagnosis may cause deterioration of symptoms and concomitant unnecessary investigations. However, the diagnosis of RCVS in the acute stage remains difficult.A 41-year-old man was admitted to the emergency department for severe, recurrent occipital headaches. The results of initial computed tomography and magnetic resonance imaging (MRI) of the brain and cerebrospinal fluid analysis were normal...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122537/a-coil-placement-technique-to-treat-intracranial-aneurysm-with-incorporated-artery
#6
Chao-Bao Luo, Feng-Chi Chang, Chung-Jung Lin, Wan-Yuo Guo
BACKGROUND: Endovascular coil embolization is an accepted treatment option for intracranial aneurysms. However, the coiling of aneurysms with an incorporated artery (IA) poses a high risk of IA occlusion. Here we report our experience of endovascular coil placement using a technique that avoids IA occlusion in aneurysms with IAs. METHODS: Over a 6-year period, 185 patients harboring 206 intracranial aneurysms underwent endosaccular coiling. Forty-two of these patients with 45 aneurysms were treated by coil placement to avoid IAs occlusion...
November 6, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29121660/associations-between-fatty-liver-index-and-asymptomatic-intracranial-vertebrobasilar-stenosis-in-chinese-population
#7
Jing Qiu, Zhiwei Zhou, Jie Wang, Yiying Wang, Chunxing Liu, Xingxiang Liu, Yunfang Xu, Lugang Yu, Hui Zhou, Jie Lin, Zhirong Guo, Chen Dong
Metabolic diseases such as type 2 diabetes mellitus (T2DM) and metabolic syndromes (MetS) have been recognized as the important risk factors for asymptomatic intracranial vertebrobasilar stenosis (IVBS). Although fatty liver index (FLI) is significantly related with these diseases, the association between FLI and IVBS remains unclear. In the present study, 2368 participants (30-75 years) were recruited from a Chinese prospective cohort study of PMMJS. Amongst them, 2281 individuals who did not have IVBS at baseline were enrolled in the 6-year following-up study...
2017: PloS One
https://www.readbyqxmd.com/read/29114306/combined-use-of-intraoperative-indocyanine-green-and-dynamic-angiography-in-rotational-vertebral-artery-occlusion
#8
Nauman Chaudhry, Brandon Gerard Gaynor, Sudheer Ambekar, Mohamed Samy Elhammady
Rotational vertebral artery occlusion (RVAO) is a well-documented surgically amenable cause of vertebrobasilar insufficiency. Traditionally, patients have been imaged using dynamic rotational angiography. We report a case of RVAO in which intraoperative indocyanine green angiography (ICGA) was used to confirm adequate surgical decompression of the VA. A 57-year-old female who presented with multiple episodes of syncope provoked by turning her head to the right. Rotational dynamic angiography revealed a dominant right VA that became occluded at the level of C5/6 with head rotation to the right...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29098320/iatrogenic-vessel-dissection-in-endovascular-treatment-of-acute-ischemic-stroke
#9
Barbara Goeggel Simonetti, Justine Hulliger, Etienne Mathier, Simon Jung, Urs Fischer, Hakan Sarikaya, Johannes Slotboom, Gerhard Schroth, Pasquale Mordasini, Jan Gralla, Marcel Arnold
PURPOSE: Knowledge about the localization and outcome of iatrogenic dissection (ID) during endovascular treatment of acute ischemic stroke (AIS) is limited. We aimed to determine the frequency, clinical aspects and morphology of ID in endovascular AIS treatment and to identify predictors of this complication. METHODS: Digital subtraction angiography (DSA) of ID carried out during endovascular treatment between January 2000 and March 2012 have been re-evaluated. The ID localization and morphology were analyzed and related to the interventional techniques...
November 2, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29089457/predictors-of-good-outcome-after-endovascular-therapy-for-vertebrobasilar-occlusion-stroke
#10
Mehdi Bouslama, Diogo C Haussen, Amin Aghaebrahim, Jonathan A Grossberg, Gregory Walker, Srikant Rangaraju, Anat Horev, Michael R Frankel, Raul G Nogueira, Tudor G Jovin, Ashutosh P Jadhav
BACKGROUND AND PURPOSE: Endovascular therapy is increasingly used in acute ischemic stroke treatment and is now considered the gold standard approach for selected patient populations. Prior studies have demonstrated that eventual patient outcomes depend on both patient-specific factors and procedural considerations. However, these factors remain unclear for acute basilar artery occlusion stroke. We sought to determine prognostic factors of good outcome in acute posterior circulation large vessel occlusion strokes treated with endovascular therapy...
October 31, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29089415/periprocedural-heparin-use-in-acute-ischemic-stroke-endovascular-therapy-the-trevo-2-trial
#11
Melanie J Winningham, Diogo C Haussen, Raul G Nogueira, David S Liebeskind, Wade S Smith, Helmi L Lutsep, Tudor G Jovin, Bin Xiang, Fadi Nahab
BACKGROUND: The use of periprocedural heparin has previously been reported to be safe and potentially beneficial during thrombectomy with older generation devices. We aimed to evaluate the safety and clinical outcomes of heparin use in the stent retriever era. METHODS: A post hoc analysis of the TREVO 2 trial was performed comparing baseline characteristics and clinical outcomes between patients who received (HEP+) and those who did not receive periprocedural heparin (HEP-) while undergoing MERCI or TREVO clot retrieval...
October 31, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29084065/recent-advances-in-the-management-of-symptomatic-vertebral-artery-stenosis
#12
Anna M Drazyk, Hugh S Markus
PURPOSE OF REVIEW: Vertebrobasilar stenosis accounts for 20% of posterior circulation strokes and is associated with high risk of early stroke recurrence. We review data from randomized controlled trials examining whether stenting may reduce this risk, including the recently published Vertebral Artery Ischaemia Stenting Trial (VIST). RECENT FINDINGS: VIST and VAST (Vertebral Artery Stenting Trial), having recruited both intracranial and extracranial vertebral stenosis and showed a low rate of perioperative stroke for extracranial (0 and 2%, respectively), but a higher rate for intracranial stenosis (15 and 22%, respectively)...
October 27, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29075905/vertebrobasilar-dolichoectasia-causing-homonymous-hemianopia-a-case-report-and-review-of-the-literature
#13
Ladina Greuter, Jean-Yves Fournier
A 73-year-old man was diagnosed with an incidental finding of right homonymous hemianopia and presyncopal spells. Magnetic resonance imaging revealed a vertebrobasilar dolichoectasia (VBD) with compression of the left optic tract. VBD is defined as an elongation and dilatation of the basilar artery. Only a few cases have been described in the literature of VBD causing optic tract compression. So far no treatment option has been described for these cases, while surgical options exist for compressions of other cranial nerves, most commonly the trigeminal nerve...
October 26, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29074316/outcome-of-gamma-knife-radiosurgery-for-trigeminal-neuralgia-associated-with-neurovascular-compression
#14
Cheng-Siu Chang, Cheng-Wei Huang, His-Hsien Chou, Long-Yau Lin, Chuan-Fu Huang
We reviewed 130 patients from 1999 to 2012 to evaluate whether neurovascular compression (NVC) has prognostic value for pain relief in idiopathic trigeminal neuralgia (TN) treated by Gamma Knife radiosurgery (GKRS). Patients were assigned to one of the following groups based on NVC identified by MRI: no NVC, small vessel NVC, and large vessel (defined as part of the vertebrobasilar arterial system) NVC. Follow-up ranged from 4 to 14years. Primary outcome was pain graded by the Barrow Neurological Institute (BNI) pain scale...
October 23, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29058985/seven-years-follow-up-of-comparative-study-between-stenting-and-medication-for-treatment-of-symptomatic-vertebrobasilar-artery-stenosis
#15
Jun Wang, Changyang Zhong, Yan Zhang, Yingnan Wei, Huili Liu, Chunli Wu, Yongxing Yan
Objective Endovascular stent-assistant angioplasty (ESAA) is a valid treatment for symptomatic vertebrobasilar artery stenosis (SVAS), but the long-term effect and the improvement of condition compared with medication treatment are unknown. This study investigated the long-term efficacy of ESAA in patients with moderate and severe SVAS, and compared the efficacy with medication treatment. Materials and methods We conducted a retrospective analysis of clinical data of 43 patients with moderate and severe SVAS hospitalized in our department...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29040971/characteristics-and-outcomes-of-vertebrobasilar-artery-dissection-with-accompanied-atherosclerosis
#16
Chun Chien, Feng-Chi Chang, Hui-Chi Huang, Jui-Yao Tsai, Chih-Ping Chung
BACKGROUND: With the popularity of MRI use, vertebrobasilar artery dissection (VBD) has been found more frequently in patients with posterior circulation ischemic stroke (PCS). The relationship between VBD and atherosclerosis is unknown. The present study aimed to prove the hypothesis that PCS with pure VBD (p-VBD) and with VBD and accompanied cervical or cerebral artery atherosclerosis (a-VBD) have distinct manifestations. METHODS: Patients with VBD-related PCS who were prospectively enrolled in the Taipei Veterans General Hospital Stroke Registry between January 1, 2010 and August 31, 2014 were recruited for the present study...
October 17, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29039156/-vertebrobasilar-artery-dolichoectesia-and-pain-coincidence-or-etiology
#17
Murat Alemdar
Dolichoectesia is described as elongation, widening, and tortuosity of an artery. Most commonly involved vessels are the intracranial vertebral and basilar arteries. Vertebrobasilar artery dolichoectesia is usually asymptomatic. Cerebral ischemia, hemorrhage, or compression findings due to mass effect can be seen in symptomatic patients. Although there are case reports of trigeminal neuralgia due to fifth cranial nerve compression in the literature, to the best of our knowledge, neither hemicranial nor continuous facial pain secondary to vertebrobasilar artery dolichoectesia has been reported previously...
July 2017: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/29037758/the-association-of-vertebrobasilar-calcification-with-etiological-subtypes-stroke-recurrence-and-outcome-in-acute-brainstem-ischemic-stroke
#18
Elif Gökçal, Elvin Niftaliyev, Tuğçe Özdemir, Mehmet Kolukısa, Talip Asil
Arterial calcification (AC), a frequent finding on imaging studies, has been reported as a risk factor for ischemic stroke. However few studies have explored the association of AC with etiological subtypes and prognostic implications. The purpose of this study was to investigate the association of AC with demograhics, risk factors and etiological subtypes and to determine whether it predicts stroke recurrence and functional outcome in patients with acute brainstem ischemic stroke. We analyzed our database consisting of patients who were diagnosed as acute brainstem ischemic stroke admitted within 24hours of onset...
October 9, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29021679/a-rare-case-of-a-vertebrojugular-arteriovenous-fistula-a-case-report-and-review-of-literature
#19
Fanor Saavedra-Pozo, Juan Vicenty-Padilla, Rafael Rodriguez-Mercado
Vertebrojugular fistulas have been described in the literature associated with blunt or penetrating injury and iatrogenic or spontaneous development. Its presentation may be broad and may include symptoms of radiculopathy, vertebrobasilar insufficiency, tinnitus, and bruit. However, so far, no direct cardiac complications had been reported. Here, we describe a case of an 86-year-old female who suffered a C5 vertebral fracture secondary to a ground-level fall that was initially treated conservatively due to the onset of new severe atrial fibrillation...
July 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29018650/surgical-treatment-of-rotational-vertebral-artery-syndrome-induced-by-spinal-tumor-a-case-report-and-literature-review
#20
Shoichi Haimoto, Yusuke Nishimura, Masahito Hara, Yuu Yamamoto, Toshiki Fukuoka, Ryuichi Fukuyama, Toshihiko Wakabayashi, Howard J Ginsberg
Vertebrobasilar insufficiency (VBI) provoked by physiological head rotation is known as rotational vertebral artery syndrome (RVAS) or Bow Hunter syndrome. RVAS most often occurs at C1-2 level with head rotation and presents with symptoms of VBI. Several previously published studies have reported RVAS at subaxial sites (V2 segment), however, tumor-induced RVAS has never been reported. The authors report the first case of RVAS at V2 segment due to compression from a spinal tumor. A 71-year-old man presented with symptoms of dizziness provoked by head rotation or neck extension...
October 2017: NMC Case Rep J
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