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Cerebral Aneurysm

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5321. Cerebral aneurysm associated with an intracranial tumour: staged endovascular and surgical treatment in two cases. (Abstract)

Cerebral aneurysm associated with an intracranial tumour: staged endovascular and surgical treatment in two cases. Two cases are reported in which an anterior communicating artery aneurysm was associated with an intracranial tumour. The tumour was a suprasellar meningioma in one case and an optic chiasm/hypothalamic astrocytoma in the other. In both cases, the aneurysm was successfully embolized using Guglielmi detachable coils. Subsequently craniotomy was performed with complete excision (...) of the meningioma and subtotal removal of the astrocytoma. Endovascular techniques can be employed to make the surgical excision of an intracranial tumour co-existing with an incidental aneurysm safer.

2004 British Journal of Neurosurgery

5322. The interleukin-6 gene -174G>C and -572G>C promoter polymorphisms are related to cerebral aneurysms. Full Text available with Trip Pro

The interleukin-6 gene -174G>C and -572G>C promoter polymorphisms are related to cerebral aneurysms. An important part is played by inflammation in intracranial aneurysm formation. The hypothesis that there is an association of the proinflammatory cytokine interleukin-6 (IL-6) genotypes (-572G>C and -174G>C) with intracranial aneurysms was tested.IL-6 genotypes were determined in 91 Caucasian patients with aneurysms and compared with 2720 healthy UK controls.For both polymorphisms (...) , the distribution of the genotypes and estimated allele frequency were different between the control group and the aneurysm group. For -572G>C, a higher frequency of the C allele (p = 0.001) and more people homozygous for the C allele were found among those with aneurysms than among the controls (4.4% v 0.3%, p = 0.001). For -174G>C, more people homozygous for the C allele were found among the controls than among those with aneurysm (18% v 7%, p = 0.007). The 572C/174G haplotype was associated with an increased

2006 Neurosurgery and Psychiatry

5323. Early circulating levels of endothelial cell activation markers in aneurysmal subarachnoid haemorrhage: associations with cerebral ischaemic events and outcome. Full Text available with Trip Pro

Early circulating levels of endothelial cell activation markers in aneurysmal subarachnoid haemorrhage: associations with cerebral ischaemic events and outcome. To investigate the relation of endothelial cell activation with delayed cerebral ischaemia (DCI) and outcome after subarachnoid haemorrhage (SAH).Concentrations of soluble (s) intercellular adhesion molecule-1, sE-selectin, sP-selectin, ED1-fibronectin, von Willebrand Factor (vWf), and vWf propeptide were measured within three days (...) of SAH onset. The associations with poor outcome were investigated at three months in 106 patients. In 90 patients in whom the occurrence of cerebral ischaemia could be dated accurately, two analyses were undertaken: one for all ischaemic events (n = 32), including those related to treatment, and another for spontaneous DCI (n = 11). Concentrations of markers were dichotomised at their medians. The associations of endothelial cell activation markers with outcome were expressed as odds ratios

2006 Neurosurgery and Psychiatry

5324. Does the method of treatment of acutely ruptured intracranial aneurysms influence the incidence and duration of cerebral vasospasm and clinical outcome? Full Text available with Trip Pro

Does the method of treatment of acutely ruptured intracranial aneurysms influence the incidence and duration of cerebral vasospasm and clinical outcome? Cerebral vasospasm remains the leading cause of death and permanent disability after subarachnoid haemorrhage. This study determined whether the method of aneurysm treatment plays an important role in determining the incidence of cerebral vasospasm and its clinical consequences.Admission data, cranial computed tomography (CT), treatment details (...) , transcranial Doppler (TCD) results, and clinical outcomes of patients who had surgical or endovascular management of their ruptured aneurysm were recorded and subject to multivariate analysis.Between January 1995 and December 1999, 292 eligible patients (206 female, 86 male) had definitive aneurysm treatment at our unit. 212 patients were clipped, 80 coiled. There was no significant difference in patient age, pre-treatment neurological grade, Fisher grade, or timing of treatment in the two groups. 48.3

2004 Neurosurgery and Psychiatry

5325. Intracranial aneurysm and arachnoid cyst: a rare association between two cerebral malformations. (Abstract)

Intracranial aneurysm and arachnoid cyst: a rare association between two cerebral malformations. Intracranial aneurysms and arachnoid cysts are cerebral disorders of a high prevalence. However, association between both malformations is a rare finding. The aim was to analyse this association with regard to the different clinical presentations according to the haemorrhage types, as well as the pathogenesis of this association. We searched the English language literature in MEDLINE database (...) middle cerebral artery in three cases, internal carotid artery bifurcation in two cases, posterior communicating segment of carotid artery in two cases, anterior communicating artery in one case and azygos pericallosal artery in one case. Clinical presentation was related to aneurysmal rupture in six cases (subarachnoid haemorrhage in four, subdural haematoma in one and intracystic haematoma in two) and related to arachnoid cysts in three cases, where the most common symptoms were seizures

2007 British Journal of Neurosurgery

5326. Wrapping and coating of cerebral aneurysms: history, evolution and surgical management after a re-bleed. (Abstract)

Wrapping and coating of cerebral aneurysms: history, evolution and surgical management after a re-bleed. Wrapping or coating of ruptured cerebral aneurysms was an acceptable method of surgical treatment until the 1980s. Occasionally, patients still present with a re-bleed. Management of these patients can be challenging. The author describes his experience of surgically treating ruptured aneurysms that have been previously wrapped. Technical issues in the surgical treatment are discussed (...) with three illustrative cases of aneurysms at different locations encountered from 1999 to 2003. Despite operative difficulties satisfactory surgical results can be accomplished in the majority of these cases.

2004 British Journal of Neurosurgery

5327. A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons. Full Text available with Trip Pro

A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons. To assess communication between vascular neurosurgeons and their patients with unruptured cerebral aneurysms about treatment options and expected outcomes.Vascular neurosurgeons and their patients with cerebral aneurysms were surveyed immediately following outpatient appointments in a neurosurgery clinic. Data collected included how well the patient understood their aneurysm treatment options, the risks (...) = 0.040; and nopatient 63% v neurosurgeon 25%, p<0.001).Following consultation with a vascular neurosurgeon, many patients with cerebral aneurysms have an inaccurate understanding of their aneurysm treatment plan and an exaggerated sense of the risks of aneurysmal disease and treatment.

2005 Neurosurgery and Psychiatry

5328. Treatment Options for Unruptured Cerebral Aneurysm. (Abstract)

Treatment Options for Unruptured Cerebral Aneurysm. The management of unruptured cerebral aneurysm is controversial. Because the natural history of unruptured cerebral aneurysm is not well defined, the best management strategy is unclear. The current consensus on the management of unruptured cerebral aneurysm includes observation, microsurgical clipping, and endovascular treatment. The methodologies used to follow up a known unruptured aneurysm are controversial and may be dependent (...) on the preferences of the treating physician. Most aneurysms are managed by the neurosurgeons and interventional neuroradiologists, but neurologists often are the first to discover the unruptured aneurysms when screening the patients for other neurologic disorders. Therefore, the knowledge on when to screen patients for and how to best manage an unruptured aneurysm will have a direct impact on their daily practices. Unruptured aneurysms often cause other neurologic symptoms including ischemic events, seizures

2004 Current Treatment Options in Neurology Controlled trial quality: uncertain

5329. A comparison of bispectral index and entropy monitoring, in patients undergoing embolization of cerebral artery aneurysms after subarachnoid haemorrhage. Full Text available with Trip Pro

A comparison of bispectral index and entropy monitoring, in patients undergoing embolization of cerebral artery aneurysms after subarachnoid haemorrhage. Processed EEG monitoring of anaesthetic depth could be useful in patients receiving general anaesthesia following subarachnoid haemorrhage. We conducted an observational study comparing performance characteristics of bispectral index (BIS) and entropy monitoring systems in these patients.Thirty-one patients of the World Federation (...) of Neurosurgeons grades 1 and 2, undergoing embolization of cerebral artery aneurysms following acute subarachnoid haemorrhage, were recruited to have both BIS and entropy monitoring during general anaesthesia. BIS and entropy indices were matched to clinical indicators of anaesthetic depth. Anaesthetists were blinded to the anaesthetic depth monitoring indices. Analysis of data from monitoring devices allowed calculation of prediction probability (P(K)) constants, and receiver operating characteristic (ROC

2006 British Journal of Anaesthesia

5330. Development of torsade de pointes caused by exacerbation of QT prolongation during clipping of cerebral artery aneurysm in a patient with subarachnoid haemorrhage. Full Text available with Trip Pro

Development of torsade de pointes caused by exacerbation of QT prolongation during clipping of cerebral artery aneurysm in a patient with subarachnoid haemorrhage. We report the case of a 79-yr-old woman with subarachnoid haemorrhage (SAH) in whom torsade de pointes (TdP) caused by worsening the QT prolongation occurred during clipping of cerebral artery aneurysm. This patient shows a potential risk of occurrence of life-threatening tachyarrhythmia, TdP by prolonging the QT interval during

2006 British Journal of Anaesthesia

5331. Moderate hypothermia for 359 operations to clip cerebral aneurysms. Full Text available with Trip Pro

Moderate hypothermia for 359 operations to clip cerebral aneurysms. Experimental data have suggested that hypothermia (32-34 degrees C) may improve outcome after cerebral ischaemia, but its efficacy has not yet been established conclusively in humans. In this study we examined the feasibility and safety of deliberate moderate perioperative hypothermia during operations for subarachnoid aneurysms.A total of 359 operations for intracranial cerebral aneurysms were included in this prospective (...) correlation between the occurrence of complications and the severity of the underlying neurological disease as assessed by the Hunt and Hess score.Moderate hypothermia accomplished within 1 h of induction of anaesthesia and maintained during surgery for subarachnoid aneurysms appears to be a safe method as far as the risks of peri/postoperative complications such as circulatory instability, coagulation abnormalities and infections are concerned.

2004 British Journal of Anaesthesia

5332. Angiographic analysis of blood flow modification in cerebral aneurysm models with a new asymmetric stent Full Text available with Trip Pro

Angiographic analysis of blood flow modification in cerebral aneurysm models with a new asymmetric stent We have built new asymmetric stents for minimally invasive endovascular treatment of cerebral aneurysms. Each asymmetric stent consists of a commercial stent with a micro-welded circular mesh patch. The blood flow modification in aneurysm-vessel phantoms due to these stents was evaluated using x-ray angiographic analysis. However, the density difference between the radiographic contrast (...) and the blood gives rise to a gravity effect, which was evaluated using an initial optical dye-dilution experiment. For the radiographic evaluations, curved-vessel phantoms instead of simple straight side-wall aneurysm phantoms were used in the characterization of meshes/stents. Six phantoms (one untreated, one treated with a commercial stent, and four treated with different asymmetric stents) with similar morphologies were used for comparison. We calculated time-density curves of the aneurysm region

2004 Proceedings of SPIE--the International Society for Optical Engineering

5333. MTI (Dendron) Variable Detachable Coils: Preliminary Clinical Experience in Cerebral Aneurysms in Glasgow Full Text available with Trip Pro

MTI (Dendron) Variable Detachable Coils: Preliminary Clinical Experience in Cerebral Aneurysms in Glasgow We present our initial clinical experience of Dendron Variable Detachable System (VDS) coils, now Sapphire VDS from MTI, in the endovascular treatment of cerebral aneurysms. VDS coils, uniquely, can be detached at variable points along their length, allowing placement of as much or as little as desired of the coil within the aneurysm. Our ten patients formed part of a multicentre (...) feasibility study. VDS coils were successfully deployed in all but one aneurysm. The electrolytic detachment mechanism with practice is both simple to use and reliable. The coils are however slightly stiffer than standard coils limiting their use in small aneurysms. This remains a technology in evolution.

2004 Interventional Neuroradiology

5334. The Role of GDC Embolization as a Second Choice in the Treatment of Ruptured Cerebral Aneurysm: Retrospective Analysis from Mid-Term Outcome Full Text available with Trip Pro

The Role of GDC Embolization as a Second Choice in the Treatment of Ruptured Cerebral Aneurysm: Retrospective Analysis from Mid-Term Outcome We investigated the role of GDC embolization as a second choice for the treatment of ruptured cerebral aneurysm. From september 1997 to may 2001, 139 ruptured aneurysms out of 151 consecutive ruptured aneurysms transferred to our hospital were treated by clipping (first choice) or GDC embolization (second choice). Patient selection was decided by more than (...) -paraclinoid Ans, BA-VA Ans, and ruptured VA dissections. Because of the good clinical outcome gained in the GDC group, GDC treatment would be the first choice of treatment for such aneurysms as geometrically suitable for coiling.

2004 Interventional Neuroradiology

5335. Cortical Venous Aneurysm Isolated Cerebral Varix Full Text available with Trip Pro

Cortical Venous Aneurysm Isolated Cerebral Varix Venous aneurysms so-called isolated cerebral varix, are known as a related pathology in arteriovenous malformations (AVM) due to the arterial pressure on venous drainage (16). They are also observed in combination with developmental venous anomalies (DVA) (2,4,8,15). However, isolated varix is a rare entity (1,7,11,13). They appear in most cases without neurological deficits. Some of the cases mimic a meningioma due to their manifestation in CT

2004 Interventional Neuroradiology

5336. Distal Middle Cerebral Artery Aneurysms: Endovascular Treatment Results with Literature Review Full Text available with Trip Pro

Distal Middle Cerebral Artery Aneurysms: Endovascular Treatment Results with Literature Review Intracranial aneurysms of the distal intracranial arteries are uncommon lesions which are difficult to treat with surgical techniques. Distal middle cerebral artery (MCA) aneurysms constitute approximately 5% of all MCA aneurysms.We report the results of our coil embolization for the treatment of distal MCA aneurysms. Eleven patients (four men and seven women, average age 37 years) with distally (...) located MCA aneurysms were treated. Four of the aneurysms were fusiform in shape and the remainder were saccular. Seven of the aneurysms were in the dominant hemisphere. Four of the seven patients who had saccular aneurysms were treated with selective aneurysm embolization. The remaining seven patients were treated with aneurysmal sac and parent artery coiling. All patients had good retrograde flow into the peripheral branches of the occluded artery. All the procedures were completed successfully

2004 Interventional Neuroradiology

5337. Liver resection in a patient with concomitant thoraco-abdominal and cerebral aneurysms Full Text available with Trip Pro

Liver resection in a patient with concomitant thoraco-abdominal and cerebral aneurysms Surgical resection remains the only curative procedure for liver metastases but even in expert hands it has appreciable morbidity and mortality rates. The presence of a concomitant aortic aneurysm greatly increases these risks.A 66-year-old woman who was known to have large aneurysms of the thoraco-abdominal aorta and middle cerebral artery presented with colorectal liver metastases. After detailed (...) preoperative assessment, she underwent resection of segments V and VI of the liver. The surgical procedure was uneventful. She made a good initial recovery, but on day 7 she suddenly became hypotensive and died from a cardiorespiratory arrest. Post-mortem examination revealed a ruptured thoracic portion of the thoraco-abdominal aortic aneurysm.Despite careful control of perioperative blood pressure and the lack of abdominal complication, intrathoracic aneurysmal rupture on day 7 highlights the risk

2005 HPB : the official journal of the International Hepato Pancreato Biliary Association

5338. Subarachnoid Haemorrhage from a Large Cerebral Aneurysm Visible only on Repeat Angiography Full Text available with Trip Pro

Subarachnoid Haemorrhage from a Large Cerebral Aneurysm Visible only on Repeat Angiography We report the case of a 49-year-old woman with a massive subarachnoid haemorrhage in conjunction with trauma. The initial cerebral angiography was normal. Three weeks later she had a second subarachnoid haemorrhage. A repeat angiography demonstrated an eight mm aneurysm of the internal carotid artery bifurcation, a region clearly normal in the previous angiography.

2005 Interventional Neuroradiology

5339. A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons Full Text available with Trip Pro

A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons 15774429 2005 05 10 2017 11 14 0022-3050 76 4 2005 Apr Journal of neurology, neurosurgery, and psychiatry J. Neurol. Neurosurg. Psychiatry A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons. 467 Leys D D Lejeune J-P JP Pruvo J-P JP eng Comment Editorial England J Neurol Neurosurg Psychiatry 2985191R 0022-3050 IM J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):550-4 15774444 (...) Carotid Stenosis surgery Communication Decision Making Disclosure Humans Informed Consent Intracranial Aneurysm surgery Neurosurgery Neurosurgical Procedures methods Patient Education as Topic Physician-Patient Relations Postoperative Complications 2005 3 19 9 0 2005 5 11 9 0 2005 3 19 9 0 ppublish 15774429 76/4/467 10.1136/jnnp.2004.054460 PMC1739573

2005 Journal of neurology, neurosurgery, and psychiatry

5340. Recurrent or New Symptomatic Cerebral Aneurysm after Previous Treatment Full Text available with Trip Pro

Recurrent or New Symptomatic Cerebral Aneurysm after Previous Treatment With the establishment of endovascular coiling as a successful treatment for symptomatic cerebral aneurysms, attention is now being directed at the durability of this treatment. If this is to be accurately done it will be important to understand the causes of symptomatic aneurysm presentation after previous treatment. In order to assess this we undertook a retrospective review, covering the four year period from 2000 (...) to 2004, of all patients re-presenting with a symptomatic saccular aneurysm after previous treatment. Seven patients were identified, six presenting with subarachnoid haemorrhage (SAH) and one with a third cranial nerve palsy. Three patients had incomplete clipping of their aneurysms and all presented within months of their initial treatment. The other four patients presented between five and 20 years after primary treatment and all were felt to have new cerebral aneurysms. Two of these patients had

2006 Interventional Neuroradiology

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