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Cerebral Aneurysm

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161. Non-Ischemic Cerebral Energy Dysfunction at the Early Brain Injury Phase following Aneurysmal Subarachnoid Hemorrhage Full Text available with Trip Pro

Non-Ischemic Cerebral Energy Dysfunction at the Early Brain Injury Phase following Aneurysmal Subarachnoid Hemorrhage The pathophysiology of early brain injury following aneurysmal subarachnoid hemorrhage (SAH) is still not completely understood.Using brain perfusion CT (PCT) and cerebral microdialysis (CMD), we examined whether non-ischemic cerebral energy dysfunction may be a pathogenic determinant of EBI.A total of 21 PCTs were performed (a median of 41 h from ictus onset) among a cohort (...) of 18 comatose mechanically ventilated SAH patients (mean age 58 years, median admission WFNS score 4) who underwent CMD and brain tissue PO2 (PbtO2) monitoring. Cerebral energy dysfunction was defined as CMD episodes with lactate/pyruvate ratio (LPR) >40 and/or lactate >4 mmol/L. PCT-derived global CBF was categorized as oligemic (CBF < 28 mL/100 g/min), normal (CBF 28-65 mL/100 g/min), or hyperemic (CBF 69-85 mL/100 g/min), and was matched to CMD/PbtO2 data.Global CBF (57 ± 14 mL/100 g/min

2017 Frontiers in neurology

162. Twin Middle Cerebral Artery with Aneurysm: A Variant of Early Bifurcation or a Discrete Entity Full Text available with Trip Pro

Twin Middle Cerebral Artery with Aneurysm: A Variant of Early Bifurcation or a Discrete Entity The middle cerebral artery (MCA) usually bifurcates into a superior or frontal and inferior or temporal branch. However, it may have various branching pattern, and there may be additional arteries from the anterior circulation supplying its territory. The majority of them remain asymptomatic. Some cases may have aneurismal dilatation due to turbulent blood flow or the weak arterial wall. The surgical (...) approach in these cases may be challenging due to complex anatomical pattern of MCA. In this report, we have described a distinct pattern of left MCA with an aneurysm which was not clear in computed tomography angiogram and further confirmed on digital subtraction angiography. The different anatomical patterns of MCA and their surgical implications have also been discussed.

2017 Journal of neurosciences in rural practice

163. Intra-arterial and Intravenous Tirofiban Infusion for Thromboembolism during Endovascular Coil Embolization of Cerebral Aneurysm Full Text available with Trip Pro

Intra-arterial and Intravenous Tirofiban Infusion for Thromboembolism during Endovascular Coil Embolization of Cerebral Aneurysm Thromboembolism is the one of the most serious complications that can occur during endovascular coil embolization of cerebral aneurysm. We report on the effectiveness and safety of intra-arterial/intravenous (IA/IV) glycoprotein IIb/IIIa inhibitor (tirofiban) infusion for treating thromboembolism during endovascular coil embolization of cerebral aneurysm.We performed (...) a retrospective analysis of 242 patients with ruptured or unruptured cerebral aneurysms (n=264) who underwent endovascular coil embolization from January 2011 to June 2014. Thromboembolism occurred in 20 patients (7.4%), including 14 cases of ruptured aneurysms and 6 cases of unruptured aneurysms. The most common site of aneurysms was the anterior communicating artery (n=8), followed by middle cerebral artery (n=6). When we found an enlarged thromboembolism during coil embolization, we tried to dissolve

2017 Journal of Korean Neurosurgical Society

164. Morphological and Hemodynamic Parameters for Middle Cerebral Artery Bifurcation Aneurysm Rupture Risk Assessment Full Text available with Trip Pro

Morphological and Hemodynamic Parameters for Middle Cerebral Artery Bifurcation Aneurysm Rupture Risk Assessment To investigate the morphological and hemodynamic parameters associated with middle cerebral artery (MCA)bifurcation aneurysm rupture.A retrospective study of 67 consecutive patients was carried out based on 3D digital subtraction angiography data. Morphological and hemodynamic parameters including aneurysm size parameters (dome width, height, and perpendicular height), longest (...) dimension from the aneurysm neck to the dome tip, neck width, aneurysm area, aspect ratio, Longest dimension from the aneurysm neck to the dome tip (Dmax) to dome width, and height-width, Bottleneck factor, as well as wall shear stress (WSS), low WSS area (LSA), percentage of LSA (LSA%) and energy loss (EL) were estimated. Parameters between ruptured and un-ruptured groups were analyzed. Receiver operating characteristics were generated to check prediction performance of all significant variables.Sixty

2017 Journal of Korean Neurosurgical Society

165. Subarachnoid Hemorrhage Associated with Intratumoral Aneurysm Rupture within a Posterior Fossa Hemangioblastoma: The Importance of Continued Surveillance for Cerebral Vasospasm Full Text available with Trip Pro

Subarachnoid Hemorrhage Associated with Intratumoral Aneurysm Rupture within a Posterior Fossa Hemangioblastoma: The Importance of Continued Surveillance for Cerebral Vasospasm Cerebellar hemangioblastomas are rare tumors of the neuraxis. Only seven cases of hemangioblastoma associated with a cerebral aneurysm have been reported. We report a case of a patient who presented with acute onset headache as a result of subarachnoid hemorrhage (SAH) and hydrocephalus. Radiographic workup revealed (...) a hemangioblastoma with an intratumoral aneurysm. Preoperative cerebral angiography was performed for both embolization as well as characterization of the aneurysm. The patient underwent a suboccipital craniotomy for tumor resection. The patient's postoperative course was unexpectedly complicated by delayed ischemic neurologic deficit secondary to flow-limiting left internal carotid artery vasospasm. We present a case report, review of the literature, and management considerations for patients who present

2017 Cureus

166. Association of travel distance and cerebral aneurysm treatment Full Text available with Trip Pro

Association of travel distance and cerebral aneurysm treatment The management of cerebral aneurysms requires a significant level of expertise, and large areas of the country have limited access to such advanced neurosurgical care. The objective of this study was to examine the impact of longer travel distance on aneurysm management.Adult patients treated for cerebral aneurysms from January 1, 2013 to January 1, 2016, were retrospectively identified. Demographic data, socioeconomic data (...) aneurysms in the anterior communicating artery, anterior cerebral artery, or posterior communicating artery (P < 0.001). On multivariable analysis, longer travel distance (OR 3.288, 95% CI 1.562-6.922, P = 0.002), lower income (1.899, 95% CI 1.003-3.596, P = 0.049), and aneurysm location (P = 0.035) remained significantly associated with treatment after rupture.Patients who must travel further to receive advanced neurovascular care are more likely to receive treatment for their aneurysms only after

2017 Surgical neurology international

167. Simulation of spreading depolarization trajectories in cerebral cortex: Correlation of velocity and susceptibility in patients with aneurysmal subarachnoid hemorrhage Full Text available with Trip Pro

Simulation of spreading depolarization trajectories in cerebral cortex: Correlation of velocity and susceptibility in patients with aneurysmal subarachnoid hemorrhage In many cerebral grey matter structures including the neocortex, spreading depolarization (SD) is the principal mechanism of the near-complete breakdown of the transcellular ion gradients with abrupt water influx into neurons. Accordingly, SDs are abundantly recorded in patients with traumatic brain injury, spontaneous (...) intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage (aSAH) and malignant hemispheric stroke using subdural electrode strips. SD is observed as a large slow potential change, spreading in the cortex at velocities between 2 and 9 mm/min. Velocity and SD susceptibility typically correlate positively in various animal models. In patients monitored in neurocritical care, the Co-Operative Studies on Brain Injury Depolarizations (COSBID) recommends several variables to quantify SD occurrence

2017 NeuroImage : Clinical

168. Evidence of Asymptomatic Visual Losses after Surgical Repair of Cerebral Aneurysm Full Text available with Trip Pro

Evidence of Asymptomatic Visual Losses after Surgical Repair of Cerebral Aneurysm Deficits in visual acuity, visual field, and oculomotor function are commonly detected after repair of cerebral aneurysms. However, when these deficits are absent, it does not mean that other potential visual deficits also are absent. Here, we report three cases that after complete recover from surgical repair of cerebral aneurysms presented minimal visual acuities of about 20/20 and no visual disturbances. While (...) two of them (Cases 1 and 2) showed visual fields with no relevant central defects, two of them showed relevant impairments in spatial contrast sensitivity (Cases 2 and 3). This evidence supports that after complete recover from surgical repair of hemorrhagic cerebral aneurysms spatial contrast sensitivity can be asymptomatically impaired when visual acuity (Cases 2 and 3) and visual fields (Case 2) are not correlated with symptoms of visual disturbances. Hypothetical explanations and consequences

2017 Frontiers in neurology

169. Endovascular Biopsy: In Vivo Cerebral Aneurysm Endothelial Cell Sampling and Gene Expression Analysis Full Text available with Trip Pro

Endovascular Biopsy: In Vivo Cerebral Aneurysm Endothelial Cell Sampling and Gene Expression Analysis There is limited data describing endothelial cell (EC) gene expression between aneurysms and arteries partly because of risks associated with surgical tissue collection. Endovascular biopsy (EB) is a lower risk alternative to conventional surgical methods, though no such efforts have been attempted for aneurysms. We sought (1) to establish the feasibility of EB to isolate viable ECs (...) ) and self-organizing maps (SOMs) were performed to identify possible subpopulations of cells. ECs were collected from all aneurysms and there were no adverse events. A total of 437 ECs was collected, 94 (22%) of which were aneurysmal cells and 319 (73%) demonstrated EC-specific gene expression. Ruptured aneurysm cells, relative controls, yielded a median p value of 0.40 with five genes (10%) with p values < 0.05. The five genes (TIE1, ENG, VEGFA, MMP2, and VWF) demonstrated uniformly reduced expression

2017 Translational stroke research

170. Bazedoxifene, a selective estrogen receptor modulator, reduces cerebral aneurysm rupture in Ovariectomized rats Full Text available with Trip Pro

Bazedoxifene, a selective estrogen receptor modulator, reduces cerebral aneurysm rupture in Ovariectomized rats Estrogen deficiency is thought to be responsible for the higher frequency of aneurysmal subarachnoid hemorrhage in post- than premenopausal women. Estrogen replacement therapy appears to reduce this risk but is associated with significant side effects. We tested our hypothesis that bazedoxifene, a clinically used selective estrogen receptor (ER) modulator with fewer estrogenic side (...) effects, reduces cerebral aneurysm rupture in a new model of ovariectomized rats.Ten-week-old female Sprague-Dawley rats were subjected to ovariectomy, hemodynamic changes, and hypertension to induce aneurysms (ovariectomized aneurysm rats) and treated with vehicle or with 0.3 or 1.0 mg/kg/day bazedoxifene. They were compared with sham-ovariectomized rats subjected to hypertension and hemodynamic changes (HT rats). The vasoprotective effects of bazedoxifene and the mechanisms underlying its efficacy

2017 Journal of neuroinflammation

171. Esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case report Full Text available with Trip Pro

Esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case report Esophageal submucosal hematoma is a rare complication after endovascular surgery. We report a case of an esophageal submucosal hematoma which may have been caused by rigorous cough during extubation.A 75-year-old woman underwent endovascular treatment for unruptured cerebral aneurysm under general anesthesia. The patient received aspirin and clopidogrel

2017 Ja Clinical Reports

172. Blood free Radicals Concentration Determined by Electron Paramagnetic Resonance Spectroscopy and Delayed Cerebral Ischemia Occurrence in Patients with Aneurysmal Subarachnoid Hemorrhage Full Text available with Trip Pro

Blood free Radicals Concentration Determined by Electron Paramagnetic Resonance Spectroscopy and Delayed Cerebral Ischemia Occurrence in Patients with Aneurysmal Subarachnoid Hemorrhage Pathophysiology of delayed cerebral ischemia and cerebral vasospasm following aneurysmal subarachnoid hemorrhage is still poorly recognized, however free radicals are postulated as one of the crucial players. This study was designed to scrutinize whether the concentration of free radicals in the peripheral (...) venous blood is related to the occurrence of delayed cerebral ischemia associated with cerebral vasospasm. Twenty-four aneurysmal subarachnoid hemorrhage patients and seven patients with unruptured intracranial aneurysm (control group) have been studied. Free radicals in patients' blood have been detected by the electron paramagnetic resonance (CMH.HCl spin probe, 150 K, ELEXSYS E500 spectrometer) on admission and at least 72 h from disease onset. Delayed cerebral ischemia monitoring was performed

2017 Cell biochemistry and biophysics

173. Development of a cerebral mycotic aneurysm within 5 days Full Text available with Trip Pro

Development of a cerebral mycotic aneurysm within 5 days 29620063 2019 02 26 2163-0402 7 5 2017 Oct Neurology. Clinical practice Neurol Clin Pract Development of a cerebral mycotic aneurysm within 5 days. 449-450 10.1212/CPJ.0000000000000315 Samaniego Edgar A EA University of Iowa, Iowa City. Ortega Santiago S University of Iowa, Iowa City. Stander Leal L University of Iowa, Iowa City. Leira Enrique C EC University of Iowa, Iowa City. eng Case Reports United States Neurol Clin Pract 101577149

2017 Neurology: Clinical Practice

174. Clinical value of homodynamic numerical simulation applied in the treatment of cerebral aneurysm Full Text available with Trip Pro

Clinical value of homodynamic numerical simulation applied in the treatment of cerebral aneurysm Our objective was to evaluate the clinical value of numerical simulation in diagnosing cerebral aneurysm based on the analysis of numerical simulation of hemodynamic model. The experimental method used was the numerical model of cerebral aneurysm hemodynamic, and the numerical value of blood flow at each point was analyzed. The results showed that, the wall shear stress (WSS) value on the top of CA1 (...) , the application of cerebral aneurysm hemodynamic research can help doctors to diagnose cerebral aneurysm more precisely and to grasp the opportunity of treatment during the formulating of the treatment strategies.

2017 Experimental and therapeutic medicine

175. The efficacy of microsurgery in the treatment of cerebral aneurysm rupture and its effect on NF-κB, MCP-1 and MMP-9 Full Text available with Trip Pro

The efficacy of microsurgery in the treatment of cerebral aneurysm rupture and its effect on NF-κB, MCP-1 and MMP-9 The clinical efficacy of microsurgical neck clipping for the treatment of cerebral aneurysm rupture and its effect on serum nuclear factor κ-light-chain-enhancer of activated β cells (NF-κB), monocyte chemoattractant protein-1 (MCP-1) and matrix metalloproteinase-9 (MMP-9) levels were investigated. A total of 56 patients with first occurrence of cerebral aneurysm rupture were (...) group showed significantly lower levels for all three proteins than the control group (p<0.05). The application of early microsurgical neck clipping for the treatment of cerebral aneurysm rupture can reduce complications and improve clinical prognosis, and this may be related to a decrease in serum inflammatory response-related factors (NF-κB and MCP-1) and MMP-9.

2017 Experimental and therapeutic medicine

176. Clinical Use of Cerebral Microdialysis in Patients with Aneurysmal Subarachnoid Hemorrhage—State of the Art Full Text available with Trip Pro

Clinical Use of Cerebral Microdialysis in Patients with Aneurysmal Subarachnoid Hemorrhage—State of the Art To review the published literature on the clinical application of cerebral microdialysis (CMD) in aneurysmal subarachnoid hemorrhage (SAH) patients and to summarize the evidence relating cerebral metabolism to pathophysiology, secondary brain injury, and outcome.Study selection: Two reviewers identified all manuscripts reporting on the clinical use of CMD in aneurysmal SAH patients from (...) management of SAH patients. (3) CMD markers of ischemia may detect delayed cerebral ischemia early (up to 16 h before onset), underlining the importance of trend analysis. (4) Various CMD-derived parameters may be associated with patient outcome at 3-12 months, including CMD-lactate-to-pyruvate-ratio, CMD-glucose, and CMD-glutamate.The clinical use of CMD is an emerging area in the literature of aneurysmal SAH patients. Larger prospective multi-center studies on interventions based on CMD findings

2017 Frontiers in neurology

177. Massive Cerebrospinal Fluid Replacement Reduces Delayed Cerebral Vasospasm After Embolization of Aneurysmal Subarachnoid Hemorrhage. (Abstract)

Massive Cerebrospinal Fluid Replacement Reduces Delayed Cerebral Vasospasm After Embolization of Aneurysmal Subarachnoid Hemorrhage. BACKGROUND Delayed cerebral vasospasm (DCVS) following aneurismal subarachnoid hemorrhage (SAH) is a leading cause of poor prognosis and death in SAH patients. Effective management to reduce DCVS is needed. A prospective controlled trial was conducted to determine if massive cerebrospinal fluid (CSF) replacement (CR) could reduce DCVS occurrence and improve (...) the clinical outcome after aneurysmal SAH treated with endovascular coiling. MATERIAL AND METHODS Patients treated with endovascular coiling after aneurysmal SAH were randomly divided into a control group receiving regular therapy alone (C group, n=42) and a CSF replacement group receiving an additional massive CSF replacement with saline (CR group, n=45). CSF examination, head CT, DCVS occurrence, cerebral infarction incidence, Glasgow Outcome Scale prognostic score, and 1-month mortality were recorded

2017 Medical science monitor : international medical journal of experimental and clinical research Controlled trial quality: uncertain

178. Successful treatment with electroconvulsive therapy of a patient with bipolar disorder and a 7-mm cerebral aneurysm Full Text available with Trip Pro

Successful treatment with electroconvulsive therapy of a patient with bipolar disorder and a 7-mm cerebral aneurysm 28072662 2017 10 23 2018 11 13 1533-4112 33 1 2017 Mar The journal of ECT J ECT Successful Treatment With Electroconvulsive Therapy of a Patient With Bipolar Disorder and a 7-mm Cerebral Aneurysm. e8 10.1097/YCT.0000000000000389 Toprak Mesut M Department of PsychiatryYale School of MedicineNew Haven, CTSamuel.wilkinson@yale.edu. Wilkinson Samuel T ST Ostroff Robert B RB eng IK6 (...) RX002458 RX RRD VA United States L30 MH111000 MH NIMH NIH HHS United States T32 MH062994 MH NIMH NIH HHS United States UL1 TR001863 TR NCATS NIH HHS United States Case Reports Journal Article United States J ECT 9808943 1095-0680 IM Aneurysm, Ruptured etiology Bipolar Disorder complications therapy Electroconvulsive Therapy methods Female Humans Intracranial Aneurysm complications Middle Aged 2017 1 11 6 0 2017 10 24 6 0 2017 1 11 6 0 ppublish 28072662 10.1097/YCT.0000000000000389 PMC5315600

2017 The journal of ECT

179. Assessment of Pre- and Post-Operative Cerebral Perfusion in Anterior Circulation Intracranial Aneurysm Clipping Patients at Hospital Sungai Buloh Using CT Perfusion Scan and Correlations to Fisher, Navarro and WFNS Scores Full Text available with Trip Pro

Assessment of Pre- and Post-Operative Cerebral Perfusion in Anterior Circulation Intracranial Aneurysm Clipping Patients at Hospital Sungai Buloh Using CT Perfusion Scan and Correlations to Fisher, Navarro and WFNS Scores Intracranial aneurysms may rupture and are typically associated with high morbidity and mortality, commonly due to vasospasm after rupture. Once the aneurysm ruptures, the patient's cerebral blood flow may be disturbed during the acute phase, affecting cerebral circulation (...) ), cerebral blood volume (CBV) and mean transit time (MTT) in regions of interests (ROI) to obtain the cerebral perfusion status as well as detecting vasospasm.A total of 30 patients' data with clipped anterior circulation intracranial aneurysms admitted to the hospital between 1 January 2013 and 30 June 2014, were collected from the hospital's electronic database. The data collected included patients' admissions demographic profiles, Fisher, Navarro and WFNS scores; and their immediate pre- and post

2017 The Malaysian journal of medical sciences : MJMS

180. Aneurysm of azygos anterior cerebral artery associated with falcine meningioma: Case Report and review of the literature Full Text available with Trip Pro

Aneurysm of azygos anterior cerebral artery associated with falcine meningioma: Case Report and review of the literature The azygos anterior cerebral artery (ACA) is an uncommon intracranial vascular anomaly of the circle of Willis. Identification of aneurysm from azygos ACA with anterior falcine meningioma is an extremely rare association. The aim of the present study is to report the case of an adult female with a ruptured aneurysm from azygos ACA in association with an anterior falcine (...) meningioma.A 65-year-old female was admitted in the Emergency Department reporting sudden onset of severe headache. Computed tomography (CT) revealed an intracerebral hematoma and an expansive calcified lesion. AngioCT showed the presence of a large aneurysm in the distal portion of the azygos ACA. During the surgical procedure, it was possible to visualize the aneurysm in contact with an expansive lesion arising from the anterior third of the falx. Microsurgical clipping of the aneurysm was performed

2017 Surgical neurology international

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