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Cerebral Aneurysm

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5421. Long Term Angiographical Follow-up of Cerebral Aneurysms after Coil Embolization Full Text available with Trip Pro

Long Term Angiographical Follow-up of Cerebral Aneurysms after Coil Embolization We evaluated long-term angiographical follow- up of cerebral aneurysms treated with detachable platinum coils with special reference to the long-term morphological outcomes of incompletely obliterated aneurysms. Serial long-term follow-up cerebral angiograms (> 1 year) were obtained in 47 cases out of 134 cases treated with GDCs or IDCs from 1994 to 1999. In 47 patients, intial angiographical results demonstrated (...) ten complete aneurysmal occlusion, seven aneurysms with a small neck remnant, twenty aneurysms with body filling and ten aneurysms with both of neck remnant and body filling. In the ten completely obliterated aneurysms, follow-up angiograms revealed no aneurysmal recanalization. In seven aneurysms with neck remnant, three remained unchanged, four showed enlargement of contrast filling in the part of the neck of the aneurysm. In twenty aneurysms with body filling, five had developed into complete

2002 Interventional Neuroradiology

5422. The Accuracy and Usefulness of 3D-DSA and 3D-CT Angiography for Cerebral Aneurysms Full Text available with Trip Pro

The Accuracy and Usefulness of 3D-DSA and 3D-CT Angiography for Cerebral Aneurysms For evaluation of intracranial cerebral aneurysms, three-dimensional (3D) digital subtraction angiography (DSA) and 3D-computed tomographic angiography (CTA) were demonstrated in fifteen patients. The diagnostic accuracy of preoperative 3D-CTA is equal to that of 3D-DSA except for the case with a dissecting aneurysm. The virtual images of 3D-CTA were well correlated with surgical findings. In endovascular (...) treatment of intracranial aneurysms, 3D-DSA had an obvious advantage in obtaining the best working angle of the C-arm. The major branches originating from the dome were depicted on 3D-DSA in two cases that could not be judged on 3D-CTA. The aim of the present study was to verify the difference between 3D-DSA and 3D-CTA for evaluation of intracranial aneurysms.

2002 Interventional Neuroradiology

5423. New methods of treatment for cerebral aneurysms. Full Text available with Trip Pro

New methods of treatment for cerebral aneurysms. 9830359 1998 12 17 2018 11 13 0093-0415 169 5 1998 Nov The Western journal of medicine West. J. Med. New methods of treatment for cerebral aneurysms. 286-7 Phatouros C C CC Higashida R T RT Halbach V V VV eng Journal Article United States West J Med 0410504 0093-0415 AIM IM Aneurysm, Ruptured therapy Cerebral Angiography Embolization, Therapeutic instrumentation methods Equipment Design Humans Intracranial Aneurysm diagnostic imaging therapy

1998 Western Journal of Medicine

5424. Prevalence of cerebral aneurysms in patients with fibromuscular dysplasia: a reassessment. Full Text available with Trip Pro

Prevalence of cerebral aneurysms in patients with fibromuscular dysplasia: a reassessment. The aim of this study was to determine the prevalence of cerebral saccular aneurysms in patients with carotid artery and/or vertebral artery (VA) fibromuscular dysplasia (FMD).A metaanalysis was performed using data from 17 previously reported series of patients with internal carotid artery (ICA) and/or VA FMD that included information on the prevalence of cerebral aneurysms. In addition, the authors (...) retrospectively evaluated their own series of 117 patients with ICA and/or VA FMD to determine the prevalence of cerebral aneurysms. The metaanalysis of the 17 earlier series, which included 498 patients, showed a 7.6 +/- 2.5% prevalence of incidental, asymptomatic aneurysms in patients with ICA and/or VA FMD. In the authors' series of patients with FMD, 6.3 +/- 4.9% of patients harbored an incidental, asymptomatic aneurysm. When the authors' series was combined with those included in the metaanalysis

1998 Journal of neurosurgery

5425. Cerebral aneurysm perforations complicating therapy with Guglielmi detachable coils: a meta-analysis. (Abstract)

Cerebral aneurysm perforations complicating therapy with Guglielmi detachable coils: a meta-analysis. The risk of intraprocedural aneurysm perforation in patients with previously ruptured aneurysms tends to be higher than that of patients with previously unruptured aneurysms, but a statistically significant difference has not been shown. Our purpose was to define the rates of occurrence and of morbidity and mortality associated with aneurysmal perforation associated with coil embolization.A (...) meta-analysis of the results from 17 published retrospective reports of aneurysm perforations complicating therapy with Guglielmi detachable coils (GDCs) was performed. Rates of perforation and associated morbidity and mortality in previously ruptured and unruptured aneurysms were calculated. The mechanism of perforation was noted.The risk of intraprocedural perforation was significantly higher in patients with ruptured aneurysms compared with patients with unruptured aneurysms (4.1% vs 0.5%; P

2002 AJNR. American journal of neuroradiology

5426. Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms: a meta-analysis. (Abstract)

Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms: a meta-analysis. To compare a novel diagnostic radiological technique, computed tomographic angiography (CTA), with the standard method, namely digital subtraction angiography (DSA), in the diagnosis of cerebral aneurysms.A comprehensive search of the world literature on CTA was performed. Articles that reported on prospective comparisons of CTA and DSA in the evaluation (...) of patients suspected of harboring cerebral aneurysms were selected for data extraction. Suitable statistical methods were applied to the extracted data for meta-analysis.Twenty-one references met the criteria for use in the meta-analysis. Unweighted calculations based on data for 1251 patients resulted in a sensitivity of 0.933 (93.3%; range, 75.4-100%) and a specificity of 0.878 (87.8%; range, 0-100%). When the studies were weighted for the number of patients in each study, the sensitivity decreased

2003 Neurosurgery

5427. Linear and whorled nevoid hypermelanosis with bilateral giant cerebral aneurysms. (Abstract)

Linear and whorled nevoid hypermelanosis with bilateral giant cerebral aneurysms. A 24-year-old woman presented with bilateral giant intracavernous carotid artery aneurysms manifesting as a cavernous sinus syndrome on the left side, and anisocoria, ophthalmic pain, and oculomotor paresis on the left side. Physical examination showed mild hyperextensibility of the metacarpophalangeal joints, amelogenesis imperfecta, and hyperpigmentation following Blaschko lines. Analysis of the NEMO gene (...) for incontinentia pigmenti syndrome and of collagen III for Ehlers-Danlos type IV was normal. Skewed X-inactivation patterns in blood lymphocytes were detected. To the best of our knowledge, this association of linear hyperpigmentation and cerebral aneurysms has never been previously reported.Copyright 2002 Wiley-Liss, Inc.

2002 American Journal of Medical Genetics

5428. Cerebral embolism and thrombus in a membranous interventricular septal aneurysm. (Abstract)

Cerebral embolism and thrombus in a membranous interventricular septal aneurysm. This report describes the occurrence of a thrombus in an aneurysm of the membranous interventricular septum with cerebral embolism in a young patient. We would recommend periodic echocardiography checkups in patients with aneurysm of the membranous interventricular septum with or without a small ventricular septal defect. The findings of a mass in the aneurysm, suggestive of thrombus, may justify anticoagulation

2003 Annals of Thoracic Surgery

5429. Failure to detect Chlamydia pneumoniae DNA in cerebral aneurysmal sac tissue with two different polymerase chain reaction methods. Full Text available with Trip Pro

Failure to detect Chlamydia pneumoniae DNA in cerebral aneurysmal sac tissue with two different polymerase chain reaction methods. Chlamydia pneumoniae (C pneumoniae) is a common cause of a usually mild, community acquired pneumonia. This organism, however, can spread from the respiratory tract into other parts of the body and has been detected in up to 70% of atheromatous lesions in blood vessels. Although the exact mechanism of the C Pneumoniae contribution to the pathogenesis (...) of atherosclerosis remains unknown, prophylactic antibiotic trials are planned for people at high risk for coronary disease.In this study the authors aimed to investigate C pneumoniae DNA content in the cerebral aneurysmal sac tissue with the aid of polymerase chain reaction (PCR) method. C pneumoniae DNA was searched in 15 surgically clipped and removed aneurysmal sac tissue and in two tumour (an ependymoma of the fourth ventricle and a craniofaringoma) samples by touchdown enzyme time release PCR (TETR PCR

2003 Neurosurgery and Psychiatry

5430. [Curative action of intravenous nimodipine on cerebral vasospasm after aneurysm rupture]. (Abstract)

[Curative action of intravenous nimodipine on cerebral vasospasm after aneurysm rupture]. 2955393 1987 08 21 2016 12 09 0755-4982 16 26 1987 Jul 04 Presse medicale (Paris, France : 1983) Presse Med [Curative action of intravenous nimodipine on cerebral vasospasm after aneurysm rupture]. 1286-7 Frèrebeau P P Janny P P Jomin M M Peragut J C JC Philippon J J Taquoi G G fre Clinical Trial Letter Randomized Controlled Trial Action curative de la nimodipine intraveineuse sur le vasospasme cérébral (...) après rupture anévrysmale. France Presse Med 8302490 0755-4982 57WA9QZ5WH Nimodipine IM Clinical Trials as Topic Humans Injections, Intravenous Intracranial Aneurysm complications Ischemic Attack, Transient drug therapy Nimodipine administration & dosage Rupture, Spontaneous 1987 7 4 1987 7 4 0 1 1987 7 4 0 0 ppublish 2955393

1987 Presse medicale (Paris, France : 1983) Controlled trial quality: uncertain

5431. Clinical and Angiographic Results of Intra-Aneurysmal Embolization for Cerebral Aneurysms and Histopathological Findings in an Aneurysm Treated with GDC Full Text available with Trip Pro

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

5432. Cathepsin B, K, and S Are Expressed in Cerebral Aneurysms and Promote the Progression of Cerebral Aneurysms. Full Text available with Trip Pro

Cathepsin B, K, and S Are Expressed in Cerebral Aneurysms and Promote the Progression of Cerebral Aneurysms. A cerebral aneurysm (CA) causes catastrophic subarachnoid hemorrhage. Degradation of extracellular matrix in arterial walls is a prominent feature of cerebral aneurysms. We investigated the expression and role of cysteine cathepsins, collagen- and elastin- degrading proteinases, in CA progression.CAs were induced in Sprague-Dawley rats with or without cysteine cathepsin inhibitor, NC (...) -2300. Expression of cathepsin B, K, S, and cystatin C, an endogenous inhibitor of cysteine cathepsins, in aneurysmal walls was examined in quantitative RT-PCR and immunohistochemistry. The activity of cysteine cathepsins and collagenase I and IV in aneurysmal walls was also assessed. Finally, expression of cysteine cathepsins and cystatin C in human CAs was examined.Quantitative RT-PCR and immunohistochemistry revealed upregulated expression of cathepsin B, K, and S in the late stage of aneurysm

2008 Stroke

5433. Magnitude and role of wall shear stress on cerebral aneurysm: computational fluid dynamic study of 20 middle cerebral artery aneurysms. Full Text available with Trip Pro

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

5434. Cerebral perfusion before and after endovascular or surgical treatment of acutely ruptured cerebral aneurysms: a 1-year prospective follow-up study. (Abstract)

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 Controlled trial quality: uncertain

5435. 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. (Abstract)

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 Controlled trial quality: uncertain

5436. Effects of prostaglandin E1 or trimethaphan on local cerebral blood flow and carbon dioxide reactivity during cerebral aneurysm surgery. (Abstract)

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 Controlled trial quality: uncertain

5437. Effect of nicardipine and diltiazem on internal carotid artery blood flow velocity and local cerebral blood flow during cerebral aneurysm surgery for subarachnoid hemorrhage. (Abstract)

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 Controlled trial quality: uncertain

5438. Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis. (Abstract)

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

5439. Aneurysm Clipping after Partial Endovascular Embolization for Ruptured Cerebral Aneurysms Full Text available with Trip Pro

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

5440. Cerebral hemorrhage produced by ruptured dissecting aneurysm in miliary aneurysm. (Abstract)

Cerebral hemorrhage produced by ruptured dissecting aneurysm in miliary aneurysm. This report describes, for what may be only the second time, a ruptured miliary aneurysm within a cerebral hemorrhage. The report is unique in that the aneurysm has arisen at the site of a dissection within the wall of an arteriole at a site of fibrinoid necrosis. The case not only is a unique illustration of this pathogenetic pathway to miliary aneurysm formation, but also reemphasizes the relationship between (...) fibrinoid and miliary aneurysm formation.

2003 Annals of Neurology

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