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Cerebral Aneurysm

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5361. Effect of calcitonin-gene-related peptide in patients with delayed postoperative cerebral ischaemia after aneurysmal subarachnoid haemorrhage. European CGRP in Subarachnoid Haemorrhage Study Group. (Abstract)

Effect of calcitonin-gene-related peptide in patients with delayed postoperative cerebral ischaemia after aneurysmal subarachnoid haemorrhage. European CGRP in Subarachnoid Haemorrhage Study Group. The finding that the carotid vascular beds are sensitive to the potent vasodilator calcitonin-gene-related peptide (CGRP) suggested that the drug might help to prevent ischaemic deterioration after surgery for aneurysmal subarachnoid haemorrhage (SAH). The results of a preliminary study were (...) encouraging, so we have carried out a randomised multicentre single-blind comparison of CGRP and standard best management in patients with ischaemic deficits after surgery for ruptured intracranial aneurysms. Patients aged 18-70 years in whom a focal neurological deficit developed or who had a reduction of 2 or more points on the Glasgow coma scale (GCS) after surgery entered the study after computed tomography had excluded non-ischaemic causes for the neurological deficit. 62 patients were randomly

1992 Lancet Controlled trial quality: uncertain

5362. what investigation do we need to do in a 34 yr old worried of aneurysm due to a f/h of aneurysms- dad with abdominal and grand dad cerebral aneurysm.

what investigation do we need to do in a 34 yr old worried of aneurysm due to a f/h of aneurysms- dad with abdominal and grand dad cerebral aneurysm. what investigation do we need to do in a 34 yr old worried of aneurysm due to a f/h of aneurysms- dad with abdominal and grand dad cerebral aneurysm. - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT (...) of aneurysms- dad with abdominal and grand dad cerebral aneurysm. We have interpreted this question to mean should a 34 year old patient with a family history of aneurysms be screened and by which method. In order to answer this question, we sought assistance from the NLH Specialist Library for Screening which undertook a literature search on our behalf. A study by Kim et al examined the familial aggregatin of both aortic and cerebral aneurysms and concluded: “This study, which represents the largest

2006 TRIP Answers

5363. Effect of fasudil hydrochloride, a protein kinase inhibitor, on cerebral vasospasm and delayed cerebral ischemic symptoms after aneurysmal subarachnoid hemorrhage. (Abstract)

Effect of fasudil hydrochloride, a protein kinase inhibitor, on cerebral vasospasm and delayed cerebral ischemic symptoms after aneurysmal subarachnoid hemorrhage. The efficacy and safety of fasudil hydrochloride, a novel protein kinase inhibitor, were evaluated for the treatment of cerebral vasospasm and associated cerebral ischemic symptoms in patients with ruptured cerebral aneurysm. This randomized open trial with nimodipine as the control included 72 patients who underwent subarachnoid (...) hemorrhage surgery for ruptured cerebral aneurysm of Hunt and Hess grades I to IV. For 14 days following surgery, patients were administered either 30 mg of fasudil hydrochloride by intravenous injection over a period of 30 minutes three times a day or 1 mg/hr of nimodipine by continuous intravenous infusion. Fasudil hydrochloride and nimodipine both showed inhibitory effects on cerebral vasospasm. The incidence of symptomatic vasospasm was five of 33 patients in the fasudil group and nine of 32 patients

2006 Neurologia medico-chirurgica Controlled trial quality: uncertain

5364. Vasospasm probability index: a combination of transcranial doppler velocities, cerebral blood flow, and clinical risk factors to predict cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Full Text available with Trip Pro

Vasospasm probability index: a combination of transcranial doppler velocities, cerebral blood flow, and clinical risk factors to predict cerebral vasospasm after aneurysmal subarachnoid hemorrhage. The goal in this study was to create an index (vasospasm probability index [VPI]) to improve diagnostic accuracy for vasospasm after subarachnoid hemorrhage (SAH).Seven hundred ninety-five patients in whom aneurysmal SAH was demonstrated by computed tomography, and in whom one or more intracranial (...) aneurysms had been diagnosed, underwent transcranial Doppler (TCD) studies between April 1998 and January 2000. In 154 patients angiography was performed within 24 hours of the TCD examination, and in 75 133Xe cerebral blood flow (CBF) studies were obtained the same day. Seven cases were excluded because of a limited sonographic window. Forty-one women (60.3%) and 27 men (39.7%) between the ages of 35 and 84 years (58.0 +/- 13.2 years [mean +/- standard deviation]) were included. Clinical

2007 Journal of Neurosurgery

5365. A Rare Embryologic Variation: Anterior Communicating Artery Aneurysm Associated with Carotid—Anterior Cerebral Artery Anastomosis or Infraoptic Course of the Anterior Cerebral Artery Full Text available with Trip Pro

A Rare Embryologic Variation: Anterior Communicating Artery Aneurysm Associated with Carotid—Anterior Cerebral Artery Anastomosis or Infraoptic Course of the Anterior Cerebral Artery Aneurysms of the complex of the anterior cerebral artery are frequently associated with anatomic variations of the circle of Willis. We describe a case of aneurysmal rupture of the anterior communicating artery, a variant of the anterior cerebral artery. The aneurysm appeared to be situated on this vessel (...) proximal to the infered site of the AcoA. Surgery was performed at the 6th day after hemorrhage. The anterior communicating artery aneurysm was clipped. The post operative course was unventful, with complete recovery. In our case, an extremely rare variation of the proximal tract of the anterior cerebral artery, i.e. an infraoptic course of the proximal precommunicating tract under the optic nerve, with the distal A1 tract anterior to the chiasm and positioned between the optic nerves, is presented.

2008 Clinical medicine. Case reports

5366. Early Treatment for Ruptured Cerebral Aneurysms: Location of Aneurysms and Choice of Treatments Full Text available with Trip Pro

Early Treatment for Ruptured Cerebral Aneurysms: Location of Aneurysms and Choice of Treatments The purpose of this study was to evaluate the effect of endovascular treatment with Guglielmi detachable coils (GDC) on the outcomes of subarachnoid haemorrhage (SAH) patients of poor grades and high ages for each location of aneurysms. Between 1990 and 2003, 529 SAH cases underwent angiograghy as candidates of early aggressive treatment in our hospital. For the 299 cases in 1990-96 (Group 1 (...) patients with anterior communicating artery aneurysm (A-Comm An), the high age patients with internal carotid artery aneurysm (IC An) and all patients with Basilar bifurcation aneurysm (BA-Top An), and has contributed to improvement of their outcomes. To the poor grade patients with middle cerebral artery aneurysm (MCA An), GDC embolization was hardly indicated, because haematoma evacuation concomitantly performed with aneurysm occlusion would be necessary for those patients. In conclusion, results

2008 Interventional Neuroradiology

5367. Retreatment of ruptured cerebral aneurysms in patients randomized by coiling or clipping in the International Subarachnoid Aneurysm Trial (ISAT). Full Text available with Trip Pro

Retreatment of ruptured cerebral aneurysms in patients randomized by coiling or clipping in the International Subarachnoid Aneurysm Trial (ISAT). Because the long-term security of endovascular treatments remains uncertain, a follow-up study of the patients treated in the International Subarachnoid Aneurysm Trial was performed to compare the frequency, timing, and consequences of aneurysm recurrence.Patient data were reclassified by actual treatment performed. Aneurysm and patient

2007 Stroke Controlled trial quality: uncertain

5368. Relation between aneurysm volume, packing, and compaction in 145 cerebral aneurysms treated with coils. Full Text available with Trip Pro

Relation between aneurysm volume, packing, and compaction in 145 cerebral aneurysms treated with coils. To assess the relation between aneurysm volume, packing, and compaction in cerebral aneurysms treated with coils.The volumes of 145 aneurysms that were treated with coils were calculated with biplanar angiographic images and a custom-designed method. Partially thrombosed aneurysms were excluded. Packing was defined as the ratio between the volume of the inserted coils and the volume (...) with volumes of less than 200 mm(3), compaction did not occur when packing was above 20%.The common practice of inserting as many coils as possible in cerebral aneurysms is sensible in trying to avoid compaction. In aneurysms with packing of 24% or more, no compaction occurred at 6-month angiographic follow-up. In aneurysms with a volume of more than 600 mm(3), high packing could not be achieved, which resulted in compaction in the majority of aneurysms.Copyright RSNA, 2004

2004 Radiology

5369. Reliability of cobalt-chromium alloy aneurysm clips after long-term implantations in patients with cerebral aneurysms. Full Text available with Trip Pro

Reliability of cobalt-chromium alloy aneurysm clips after long-term implantations in patients with cerebral aneurysms. Aneurysm clip reliability after long-term implantation in vivo has not been examined. In this study the authors evaluated the mechanical properties and surface elemental composition of Co-Cr alloy aneurysm clips implanted for more than 10 years in patients with cerebral aneurysms.Five aneurysm clips implanted for ruptured or unruptured intracranial aneurysms were retrieved (...) and examined. New aneurysm clips were applied to the regrown aneurysms. The implantation period ranged from 11 to 20 years. Four new and unused aneurysm clips were also examined as controls. The mechanical properties of the clips were tested by measuring their closing force and bending strength. The surface elemental composition of the aneurysm clips was evaluated using x-ray photoelectron spectroscopy. The closing force of the retrieved clips exceeded the minimum force requirement at the time

2006 Journal of Neurosurgery

5370. Simulation of the natural history of cerebral aneurysms based on data from the International Study of Unruptured Intracranial Aneurysms. Full Text available with Trip Pro

Simulation of the natural history of cerebral aneurysms based on data from the International Study of Unruptured Intracranial Aneurysms. Despite recent publications of large-scale study data, controversy over the management of unruptured cerebral aneurysms continues. The low rupture rates in the International Study of Unruptured Intracranial Aneurysms (ISUIA) apparently contradicted surgeons' experiences with ruptured aneurysms. In the present study, based on data from the ISUIA, a mathematical (...) model describing the natural history of cerebral aneurysms was developed. With this model, the author aimed to examine the validity of data from the ISUIA and to provide a better treatment guideline for unruptured aneurysms.The author made a computer simulation of the natural history of cerebral aneurysms that was used to calculate such figures as the prevalence of unruptured aneurysms, incidence of subarachnoid hemorrhage (SAH), and age and size distribution of both unruptured and ruptured

2006 Journal of Neurosurgery

5371. Microsurgical removal of previously placed aneurysm clips and application of new clips for recurrent cerebral aneurysms. Technical note. (Abstract)

Microsurgical removal of previously placed aneurysm clips and application of new clips for recurrent cerebral aneurysms. Technical note. A technique is described for removing previously placed aneurysm clips and applying new aneurysm clips for the treatment of regrown or reruptured cerebral aneurysms in patients more than 10 years after the original clipping of the aneurysm neck. The adherent tissue covering previously placed clips is cut just on and alongside the clips themselves using a small (...) procedure for treatment of regrown or reruptured cerebral aneurysms occurring a significantly long time after initial clipping of an aneurysm neck.

2007 Journal of Neurosurgery

5372. Predictors of Rehemorrhage After Treatment of Ruptured Intracranial Aneurysms. The Cerebral Aneurysm Rerupture After Treatment (CARAT) Study. Full Text available with Trip Pro

Predictors of Rehemorrhage After Treatment of Ruptured Intracranial Aneurysms. The Cerebral Aneurysm Rerupture After Treatment (CARAT) Study. The primary purpose of intracranial aneurysm treatment is to prevent rupture. Risk factors for rupture after aneurysm treatment have not been clearly established, and the need to completely occlude aneurysms is debated.The Cerebral Aneurysm Rerupture After Treatment (CARAT) study is an ambidirectional cohort study of all patients with ruptured (...) intracranial aneurysms treated with coil embolization or surgical clipping at 9 high-volume centers in the United States from 1996 to 1998. All subjects were followed through 2005, and all potential reruptures were adjudicated by a panel of 3 specialists without knowledge of the initial treatment or aneurysm characteristics. Degree of aneurysm occlusion post-treatment was evaluated as a predictor of nonprocedural rerupture in univariate Kaplan-Meier analysis (log-rank test) and in a Cox proportional

2007 Stroke

5373. Bilobed Wide Neck Posterior Cerebral Artery Aneurysm Associated with Fusiform Basilar Aneurysm, Subarachnoid Hemorrhage and Chronic Renal Failure: A Case Report* Full Text available with Trip Pro

Bilobed Wide Neck Posterior Cerebral Artery Aneurysm Associated with Fusiform Basilar Aneurysm, Subarachnoid Hemorrhage and Chronic Renal Failure: A Case Report* A 56 year-old woman presented with a ruptured bilobed wide neck aneurysm of the P2 segment of the PCA, atherosclerotic fusiform basilar artery aneurysm, subarachnoid bleeding with negative CT scan and chronic renal failure. She was managed by a cooperative approach involving neurosurgeons, neuroradiologist, neurointensivist, emergency (...) room physicians, nurses and technicians. She underwent operation by proximal clipping for the aneurysm of the PCA. Postoperative neurological deficits include homonymous hemianopsia and ipsilateral third nerve palsy. The operation was performed through asubtemporal approach. At surgery, the aneurysm was located in the distal of the P2 segment of PCA, bilobed up and down, no definitive neck with small distal branches, and was treated by proximal clipping of the PCA aneurysm. The fusiform basilar

2004 Interventional Neuroradiology

5374. Experimental cerebral aneurysms in the female heterozygous Blotchy mouse Full Text available with Trip Pro

Experimental cerebral aneurysms in the female heterozygous Blotchy mouse The Blotchy mouse is characterized by an X-linked inherited disorder of connective tissue synthesis. The susceptibility to aneurysm formation in the cerebral arteries of the circle of Willis was compared in female heterozygous 'Blotchy' and control mice subjected to unilateral carotid artery ligation either alone or associated with hypertension. Cerebral aneurysms developed only in hypertensive Blotchy mice (6/31 vs. 0/30 (...) in parallel to the occurrence of aneurysms in all the different arterial sites. Thus, in an apparently normally viable animal, the presence of a mutated gene which indirectly leads to defective elastin and collagen fibre synthesis, favours the formation of both peripheral and cerebral aneurysms. However, the development of cerebral aneurysms requires the addition of an increase in haemodynamic stress.

1999 International journal of experimental pathology

5375. Transverse aortic arch aneurysm: improved results of treatment employing new modifications of aortic reconstruction and hypothermic cerebral circulatory arrest. Full Text available with Trip Pro

Transverse aortic arch aneurysm: improved results of treatment employing new modifications of aortic reconstruction and hypothermic cerebral circulatory arrest. The results of graft replacement for aneurysms involving the entire transverse aortic arch have lagged far behind that achieved for similar lesions located elsewhere. For example, prior to the study reported here, the mortality rate of the former, in our experience, was 25%, whereas it was only 8% for the most extensive forms (...) of thoracoabdominal aortic aneurysms. The difference had been due to limitations and complications of methods employed for cerebral and myocardial protection. The high mortality rate in our patients was due to the deficiencies of temporary bypass graft and cardiopulmonary bypass, and separate brachiocephalic perfusion employed for this purpose. This report is concerned with the use of profound hypothermia for cerebral protection and the application of graft inclusion and direct brachiocephalic arterial

1981 Annals of Surgery

5376. Central conduction time following surgery for cerebral aneurysm. Full Text available with Trip Pro

Central conduction time following surgery for cerebral aneurysm. Somatosensory evoked potentials have been recorded serially in 21 patients following aneurysm surgery. Central conduction time correlated reasonably well within the patient's clinical state at the time of testing, but it did not act as a useful predictor of clinical deterioration.

1984 Journal of neurology, neurosurgery, and psychiatry

5377. Dissecting aneurysm of middle cerebral artery following resection of meningioma. Full Text available with Trip Pro

Dissecting aneurysm of middle cerebral artery following resection of meningioma. 2732748 1989 07 27 2018 11 13 0022-3050 52 5 1989 May Journal of neurology, neurosurgery, and psychiatry J. Neurol. Neurosurg. Psychiatry Dissecting aneurysm of middle cerebral artery following resection of meningioma. 683 Heye N N Iglesias J R JR Henkes H H Ferzst R R Maier-Hauff K K eng Case Reports Letter England J Neurol Neurosurg Psychiatry 2985191R 0022-3050 IM Aneurysm, Dissecting etiology Cerebral Arterial

1989 Journal of neurology, neurosurgery, and psychiatry

5378. Fusiform aneurysm of the proximal anterior cerebral artery. Full Text available with Trip Pro

Fusiform aneurysm of the proximal anterior cerebral artery. 3361342 1988 06 09 2018 11 13 0022-3050 51 3 1988 Mar Journal of neurology, neurosurgery, and psychiatry J. Neurol. Neurosurg. Psychiatry Fusiform aneurysm of the proximal anterior cerebral artery. 451 Shigemori M M Kawaba T T Yoshitake Y Y Miyagi J J Kuramoto S S eng Case Reports Letter England J Neurol Neurosurg Psychiatry 2985191R 0022-3050 IM Cerebral Angiography Humans Intracranial Aneurysm diagnostic imaging surgery Male Middle

1988 Journal of neurology, neurosurgery, and psychiatry

5379. Cerebral haemorrhage and berry aneurysm: evidence from a family for a pattern of autosomal dominant inheritance. Full Text available with Trip Pro

Cerebral haemorrhage and berry aneurysm: evidence from a family for a pattern of autosomal dominant inheritance. Although families with several members suffering a cerebral haemorrhage have been reported previously, a family history of this stroke sub-type has not yet been firmly established as a risk factor for the disease. A family in whom cerebral haemorrhage has been clearly documented in five members, spanning three generations, is reported. In three a berry aneurysm was detected (...) . There was no evidence of hypertension among any of the five cases. A sixth member of the family probably died of a cerebral haemorrhage but no necropsy was performed. By using established incidence rates for cerebral haemorrhage in the population, the probability of five such unrelated events arising in any family of similar size and longevity was calculated to be 4.9 x 10(-10). This family strengthens the case that an underlying genetic susceptibility does exist for a proportion of patients who have a cerebral

1991 Journal of neurology, neurosurgery, and psychiatry

5380. Infective endocarditis complicated by ruptured cerebral mycotic aneurysm. Full Text available with Trip Pro

Infective endocarditis complicated by ruptured cerebral mycotic aneurysm. 1774755 1992 03 05 2018 11 13 0141-0768 84 12 1991 Dec Journal of the Royal Society of Medicine J R Soc Med Infective endocarditis complicated by ruptured cerebral mycotic aneurysm. 746-7 Patel R L RL Department of Cardiothoracic Surgery, St Thomas' Hospital, London. Richards P P Chambers D J DJ Venn G G eng Case Reports Journal Article England J R Soc Med 7802879 0141-0768 IM Adult Aneurysm, Infected complications (...) diagnostic imaging Cerebral Angiography Endocarditis, Bacterial complications Hemiplegia diagnostic imaging etiology Humans Intracranial Aneurysm complications diagnostic imaging Male Rupture, Spontaneous Tomography, X-Ray Computed 1991 12 1 1991 12 1 0 1 1991 12 1 0 0 ppublish 1774755 PMC1295527 J Neurosurg. 1978 Mar;48(3):369-82 580294 Medicine (Baltimore). 1978 Jul;57(4):329-43 580794 Arch Intern Med. 1968 Oct;122(4):349-52 5695573 J Neurosurg. 1966 Aug;25(2):189-93 5911365 J Neurosurg. 1972 May;36(5

1991 Journal of the Royal Society of Medicine

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