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Cerebral Aneurysm

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5381. Influence of the Perianeurysmal Environment on Rupture of Cerebral Aneurysms: Preliminary Observation (Full text)

Influence of the Perianeurysmal Environment on Rupture of Cerebral Aneurysms: Preliminary Observation We evaluate the perianeurysmal environment and study parameters potentially influencing rupture of cerebral aneurysms. 101 consecutive aneurysm cases were retrospectively evaluated using radiological observation including imaging documents such as MR, CT and DSA studies. Aneurysm contact with perianeurysmal environment was classified and correlated with aneurysm shape, size, location and likely (...) rupture point. Topographic relation of the aneurysm to the cisternal compartment was studied. Presence of contact with the surrounding structures was evaluated for bone, dura, brain, cranial nerves, arteries, and veins. The aneurysm shape and likely rupture point was found to be significantly influenced by the aneurysm environment. Depending on aneurysm type, location and size, the growth pattern also exhibited signs of interaction with the environment. Overall, there was no significant difference

2001 Interventional Neuroradiology PubMed

5382. Multifocal Cerebral Fusiform Aneurysms in Children with Immune Deficiencies Report of Four Cases (Full text)

Multifocal Cerebral Fusiform Aneurysms in Children with Immune Deficiencies Report of Four Cases We describe three children infected by the human immunodeficiency virus (HIV 1), and one child suffering from familial mucocutaneous candidiasis, who all had multiple, fusiform subarachnoid intracranial aneurysms. Because infectious causative agents were never detected at the level of the lesions, a classical "mycotic" origin of these aneurysms seemed unlikely. Despite the fact that these aneurysms (...) have the same angiographic appearance, they have different etiologies (immune and infectious). These data open the discussion on the reciprocal role of an infectious or immune initial trigger acting on a vascular (endothelial) target. The specificities of the target in terms of location and response enhance specific topographic characteristics (phenotypes) of the cerebral vasculature.

2001 Interventional Neuroradiology PubMed

5383. The Accuracy of Plain Skull X-ray Examination as a Predictor of Recanalization Following Guglielmi Detachable Coil Embolisation in the Treatment of Cerebral Aneurysms (Full text)

The Accuracy of Plain Skull X-ray Examination as a Predictor of Recanalization Following Guglielmi Detachable Coil Embolisation in the Treatment of Cerebral Aneurysms We evaluated the accuracy of plain skull x-ray series as an imaging modality for the follow-up of cerebral aneurysm recanalization after Guglielmi Detachable Coil (GDC) embolisation. We retrospectively reviewed of 100 consecutive follow-up angiograms and skull x-ray examinations in 78 patients harboring 82 aneurysms and in whom 85 (...) procedures were performed. Angiography was performed between 1 and 54 months (mean: 10.8 months) after embolisation. The skull series (AP, lateral and Towne's projections) were taken at the time of follow-up angiography. Each follow-up angiogram and skull series were compared to the immediate post-coiling, correlating presence or absence of coil compaction on the skull series and recanalization of the aneurysm at angiography. In 97 (97%) examinations, skull x-ray findings correlated with the angiographic

2001 Interventional Neuroradiology PubMed

5384. Complete Thrombosis of a Giant Distal Middle Cerebral Artery Aneurysm (Full text)

Complete Thrombosis of a Giant Distal Middle Cerebral Artery Aneurysm Complete thrombosis of a giant cerebral aneurysm is rarely reported and peripheral giant middle cerebral artery (MCA) aneurysms are similarly rare. We present a case of complete spontaneous thrombosis of a giant sylvian artery aneurysm that had previously been wrapped at surgery.

2001 Interventional Neuroradiology PubMed

5385. Clearance of Subarachnoid Clots after GDC Embolization for Acutely Ruptured Cerebral Aneurysm: Comparison with Early Direct Surgery (Full text)

Clearance of Subarachnoid Clots after GDC Embolization for Acutely Ruptured Cerebral Aneurysm: Comparison with Early Direct Surgery It is apparent that subarachnoid clots play an important role in the development of delayed vasospasm that is one of the major causes of mortality and morbidity in patients with acutely ruptured cerebral aneurysm. The purpose of this study is to compare the clearance of subarachnoid clots in the acute stage after the treatment with Guglielmi detachable coils (GDC

2002 Interventional Neuroradiology PubMed

5386. 2D Fast Spoiled Gradient Echo (2D-FSPGR) Gd-DTPA Enhanced Dynamic MR Angiography in Cerebral Aneurysms after Treatment with Platinum Detachable Coils (Full text)

2D Fast Spoiled Gradient Echo (2D-FSPGR) Gd-DTPA Enhanced Dynamic MR Angiography in Cerebral Aneurysms after Treatment with Platinum Detachable Coils The purpose of this study is to evaluate the perfusional state of cerebral aneurysms treated by platinum detachable coils using three different techniques of MR angiography (MRA), and to compare the results of each MRA technique. Thirty examinations were investigated in twelve patients. They were three men and nine women, and their average age (...) was 67y.o. They were all treated by platinum detachable coils for cerebral aneurysms. We obtained three different types of MRA on the same day; 2D-FSPGR Gd-DTPA enhanced dynamic MRA, 3D-TOF MRA with and without Gd-DTPA enhancement. On 2D-FSPGR enhanced dynamic MRA, we used the first pass arterial phase for judgement that did not overlap the venous phase. In each study, we evaluated parent artery flow, branch artery flow, residual flow in coils, and residual neck. Digital subtraction angiography (DSA

2002 Interventional Neuroradiology PubMed

5387. Angiographical Follow-up Results of Cerebral Aneurysms Treated by Guglielmi Detachable Coil System (Full text)

Angiographical Follow-up Results of Cerebral Aneurysms Treated by Guglielmi Detachable Coil System To examine the long term results of endovascular treatment of cerebral aneurysms with the Guglielmi detachable coil (GDC) system, follow- up (F/U) angiography was performed at 6, 12 and 24 months after the procedure. We analyzed 45 cases, 49 procedures of GDC treated cerebral aneurysms from 1997.6. to 2000.5. Follow- up angiography was achieved at 6M 43/45 (96%), 12M 29/33 (87%) and 24M 22/25 (88 (...) treatment. In cases of side-wall aneurysm, tight packing of the inflow side of the aneurysm and small neck aneurysm were thought to be causes of the angiographical improvements. In patients with wide neck aneurysms with partial occlusion result were angiographic worsening at the F/U. Other factors of angiographical worsening were improper working angle at the procedure and improper follow-up angle at the angiography and the intraluminal clot in the case of ruptured aneurysm.

2002 Interventional Neuroradiology PubMed

5388. Natural History of Cerebral Aneurysms (Full text)

Natural History of Cerebral Aneurysms 18750473 2010 06 30 2018 11 13 0093-0415 149 3 1988 Sep The Western journal of medicine West. J. Med. Natural history of cerebral aneurysms. 326-7 Mayberg M R MR Winn H R HR eng Journal Article United States West J Med 0410504 0093-0415 1988 9 1 0 0 1988 9 1 0 1 1988 9 1 0 0 ppublish 18750473 PMC1026424 Semin Neurol. 1986 Sep;6(3):299-308 3332434 Ann Neurol. 1977 Apr;1(4):358-70 617253 J Neurosurg. 1983 Oct;59(4):642-51 6886785

1988 Western Journal of Medicine PubMed

5389. Surgical Management of Aortic Coarctation Associated With Ruptured Cerebral Artery Aneurysm (Full text)

Surgical Management of Aortic Coarctation Associated With Ruptured Cerebral Artery Aneurysm We report two patients with coarctation of the aorta who were admitted to the hospital with ruptured cerebral artery aneurysms. In both patients, we surgically treated the coarctation and later repaired the intracranial lesion. One patient, a 34-year-old woman, is alive and well after 3 years; whereas, the other, a 19-year-old man, did not survive. We discuss the sequence for surgery, which continues

1986 Texas Heart Institute Journal PubMed

5390. Clinical and Angiographic Results of Intra-Aneurysmal Embolization for Cerebral Aneurysms and Histopathological Findings in an Aneurysm Treated with GDC (Full text)

Clinical and Angiographic Results of Intra-Aneurysmal Embolization for Cerebral Aneurysms and Histopathological Findings in an Aneurysm Treated with GDC We describe follow-up clinical and angiographic results in patients with cerebral aneurysms treated with IDC or GDC. In 175 patients, 116 patients with ruptured aneurysm and 59 patients with non-ruptured aneurysm who underwent endovascular occlusion of aneurysms, there was no mortality and nine cases (4.7%) with morbidity in the periprocedural (...) of an incomplete endothelium- lined layer of connective tissue at the orifice, and no complete fibrous obliteration of the aneurysm lumen could be detected, various amounts of unorganized clot were still present in the center of the aneurysm. Coil embolization is a safe treatment for cerebral aneurysms with a lower incidence of peri-procedural morbidity, wheareas follow-up results are less satisfactory in cases involving incompletely obliterated lesions.

2004 Interventional Neuroradiology PubMed

5391. Magnitude and role of wall shear stress on cerebral aneurysm: computational fluid dynamic study of 20 middle cerebral artery aneurysms. (Full text)

Magnitude and role of wall shear stress on cerebral aneurysm: computational fluid dynamic study of 20 middle cerebral artery aneurysms. Wall shear stress (WSS) is one of the main pathogenic factors in the development of saccular cerebral aneurysms. The magnitude and distribution of the WSS in and around human middle cerebral artery (MCA) aneurysms were analyzed using the method of computed fluid dynamics (CFD).Twenty mathematical models of MCA vessels with aneurysms were created by 3 (...) of the aneurysm region (1.64+/-1.16 N/m2) was significantly lower than that of the vessel region (P<0.05). The WSSs at the tip of ruptured aneurysms were markedly low.These results suggest that in contrast to the pathogenic effect of a high WSS in the initiating phase, a low WSS may facilitate the growing phase and may trigger the rupture of a cerebral aneurysm by causing degenerative changes in the aneurysm wall. The WSS of the aneurysm region may be of some help for the prediction of rupture.

2004 Stroke PubMed

5392. Effect of nicardipine and diltiazem on internal carotid artery blood flow velocity and local cerebral blood flow during cerebral aneurysm surgery for subarachnoid hemorrhage. (PubMed)

Effect of nicardipine and diltiazem on internal carotid artery blood flow velocity and local cerebral blood flow during cerebral aneurysm surgery for subarachnoid hemorrhage. To determine the hemodynamic effects of a bolus injection of nicardipine 1 mg or diltiazem 5 mg on local cerebral blood flow (LCBF) and internal carotid blood flow velocity (ICBFV) with isoflurane anesthesia.Randomized study.Inpatient neurosurgery and anesthesia clinic at a city hospital.26 patients with subarachnoid (...) hemorrhage who were scheduled for cerebral aneurysm clipping.A bolus injection of either nicardipine or diltiazem was administered to patients whose systolic blood pressure increased to over 150 mmHg after opening of the dura.After the bolus injection, both drugs rapidly decreased arterial blood pressure. Nicardipine increased LCBF [before injection, 42.1 +/- 12.3 ml/100 g/min; after injection, 47 +/- 10.7 ml/100g/min; (p < 0.05 vs control); after recovery, 42.4 +/- 11.1 cm/sec], but diltiazem did

1994 Journal of clinical anesthesia

5393. Effects of prostaglandin E1 or trimethaphan on local cerebral blood flow and carbon dioxide reactivity during cerebral aneurysm surgery. (PubMed)

Effects of prostaglandin E1 or trimethaphan on local cerebral blood flow and carbon dioxide reactivity during cerebral aneurysm surgery. Effects of prostaglandin E1 (PGE1) or trimethaphan (TMP) on local cerebral blood flow (LCBF) and carbon dioxide (CO2) reactivity were studied in 26 patient undergoing cerebral aneurysm surgery for subarachnoid hemorrhage (SAH) under isoflurane anesthesia. Measurement of LCBF was made using a thermal gradient blood-flow meter. Hypotension was induced (...) rate (HR) did not change significantly in either group. LCBF decrease at 30 min after start of TMP administration (p < 0.05 compared with preinfusion value), whereas LCBF was unchanged during PGE1 administration. Neither PGE1 nor TMP affected CO2 reactivity during cerebral aneurysm surgery, whereas CO2 reactivity showed a close correlation with presurgical neurological status: before, rs = -0.523, p < 0.01; during, rs = -0.794, p < 0.01; after, rs = -0.643, p < 0.01. Comparison of the outcomes

1993 Journal of neurosurgical anesthesiology

5394. Cerebral perfusion before and after endovascular or surgical treatment of acutely ruptured cerebral aneurysms: a 1-year prospective follow-up study. (PubMed)

Cerebral perfusion before and after endovascular or surgical treatment of acutely ruptured cerebral aneurysms: a 1-year prospective follow-up study. To prospectively determine temporal changes in regional cerebral perfusion in patients with acutely (<72 h) ruptured cerebral aneurysms treated either endovascularly or surgically.Cerebral perfusion was measured both before and 1 week after treatment by use of a (99m)Tc-labeled ethyl-cysteine dimer and single-photon emission computed tomographic (...) side of the ruptured aneurysm. The 12-month magnetic resonance imaging of the brain revealed no significant difference in the number of ischemic deficits between the endovascular and surgical groups.Disturbances in cerebral perfusion both before and after treatment are common. Although no major differences in the findings were detected between patients treated with either clips or coils, progression of perfusion deficits was more common in the surgical group. However, the 12-month magnetic

2002 Neurosurgery

5395. Clinical study of OKY-046, a thromboxane synthetase inhibitor, in prevention of cerebral vasospasms and delayed cerebral ischaemic symptoms after subarachnoid haemorrhage due to aneurysmal rupture: a randomized double-blind study. (PubMed)

Clinical study of OKY-046, a thromboxane synthetase inhibitor, in prevention of cerebral vasospasms and delayed cerebral ischaemic symptoms after subarachnoid haemorrhage due to aneurysmal rupture: a randomized double-blind study. A double-blind study was conducted at 48 neurosurgical services in Japan to investigate the usefulness of OKY-046, an imidazole derivative and a thromboxane synthetase inhibitor, on cerebral vasospasm and cerebral ischaemic symptoms in patients with ruptured cerebral (...) aneurysms. OKY-046 was administered in two daily doses of 80 mg (L group) and 400 mg (H group), and compared with a group given a placebo (P group). The following results were obtained: the occurrence of cerebral vasospasm was significantly lower in the L group than in the P group; the development of low density area (LD) in CTs was significantly lower in both the L and H groups than in the P group; motor paralysis in the L group improved significantly sooner, and that in the H group tended to improve

1989 Neurological research

5396. Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis. (PubMed)

Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis. A well-defined complication rate of cerebral angiography in patients with subarachnoid hemorrhage (SAH), cerebral aneurysm, and arteriovenous malformation (AVM) would be useful to physicians making decisions regarding the imaging of these patients. We sought to define a statistically significant complication rate through meta-analysis of prospective studies (...) in the literature.Meta-analysis of 3 published prospective studies of complications in cerebral angiography was performed to specifically define the risk of cerebral angiography in patients presenting with SAH, cerebral aneurysm, and AVM. The complication rates for cerebral angiography in patients with SAH and AVM/aneurysm without SAH were compared with the complication rates in patients who underwent cerebral angiography for transient ischemic attack (TIA)/ischemic stroke with use of the Fisher exact test.The

1999 Stroke

5397. Aneurysm Clipping after Partial Endovascular Embolization for Ruptured Cerebral Aneurysms (Full text)

Aneurysm Clipping after Partial Endovascular Embolization for Ruptured Cerebral Aneurysms The aim of this study was to investigate the advantages and disadvantages of a two-stage treatment for ruptured cerebral aneurysms; partial embolization in acute stage followed by clipping in chronic stage of subarachnoid hemorrhage. Between April 1997 and August 1999, twenty ruptured cerebral aneurysms were initially treated endovasculary using Guglielmi detachable coils in our institution. Among them (...) reasons, and memory disturbance due to sacrifice of a perforator arising from the anterior communicating artery. In 3 cases, coil extraction was needed during the clipping, because the loops of the coil extended into the residual neck. Complications related to coil extraction were not observed in these 3 cases. Acute partial embolization of ruptured aneurysm appears to be effective for the prevention of subsequent rerupture during the subacute period, in which treatment for vasospasm should

2001 Interventional Neuroradiology PubMed

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