1/764. "Kissing" bilateral large carotid-ophthalmic aneurysms. A case report.A case of unruptured bilateral large carotid-ophthalmic aneurysms, which appear to be adjoining and "kissing" each other when visualized by three-dimensional computed tomographic angiography (3-D CTA), is reported. Although bilateral carotid-ophthalmic aneurysms are not rare, bilateral large ones are quite rare, and direct imaging of "kissing aneurysms" of this portion has not been reported. Since 3-D CTA is becoming a useful tool for the diagnosis of cerebral aneurysms, we propose that these and similar bilateral large carotid-ophthalmic aneurysms are good candidates for the term "kissing aneurysms".- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/764. A large anomalous anterior choroidal artery associated with internal carotid artery-posterior communicating artery aneurysm. Case report.A case of a large anomalous anterior choroidal artery (AchA) associated with internal carotid artery-posterior communicating artery aneurysm is reported. At surgery, the large anomalous AchA mimicked the PcomA. Therefore, we initially mistook the large anomalous AchA for the PcomA, and the ICA-PcomA aneurysm for the dorsal ICA aneurysm arising at a location of other than an arterial division. This is a rare case of an anomaly of the AchA with an associated aneurysm found at surgery. Anatomical and surgical considerations are made.- - - - - - - - - - ranking = 0.8keywords = aneurysm (Clic here for more details about this article) |
3/764. Surgical treatment of internal carotid artery anterior wall aneurysm with extravasation during angiography--case report.A 54-year-old female presented subarachnoid hemorrhage from an aneurysm arising from the anterior (dorsal) wall of the internal carotid artery (ICA). During four-vessel angiography, an extravasated saccular pooling of contrast medium emerged in the suprasellar area unrelated to any arterial branch. The saccular pooling was visualized in the arterial phase and cleared in the venophase during every contrast medium injection. We suspected that the extravasated pooling was surrounded by hard clot but communicated with the artery. Direct surgery was performed but major premature bleeding occurred during the microsurgical procedure. After temporary clipping, an opening of the anterior (dorsal) wall of the ICA was found without apparent aneurysm wall. The vessel wall was sutured with nylon thread. The total occlusion time of the ICA was about 50 minutes. Follow-up angiography demonstrated good patency of the ICA. About 2 years after the operation, the patient was able to walk with a stick and to communicate freely through speech, although left hemiparesis and left homonymous hemianopsia persisted. The outcome suggests our treatment strategy was not optimal, but suture of the ICA wall is one of the therapeutic choices when premature rupture occurs in the operation.- - - - - - - - - - ranking = 0.6keywords = aneurysm (Clic here for more details about this article) |
4/764. Treatment of symptomatic cervical carotid dissections with endovascular stents.OBJECTIVE: Symptomatic dissections of the cervical carotid artery (CCA) can be spontaneous or secondary to trauma and may be associated with pseudoaneurysms. Surgical treatment is often difficult or unavailable. We report the successful use of endovascular stents in the treatment of symptomatic dissection of the CCA. methods: Five consecutive patients with symptomatic CCA dissection were seen at our institution. There were four female patients and one male patient, ranging in age from 19 to 56 years. One dissection was spontaneous. The others were secondary to a gunshot wound (one patient), blunt neck trauma (two patients), and endovascular treatment of atherosclerotic carotid bifurcation disease (one patient). Balloon-expandable and self-expanding stents were placed via a transfemoral approach. RESULTS: Success in restoring the carotid lumen with two to five stents in each patient was angiographically demonstrated. There were no procedure-related complications. All patients experienced significant clinical improvement within the first 24 hours and complete long-term recovery. CONCLUSION: Symptomatic dissections of the CCA can be successfully treated by using endovascular stents.- - - - - - - - - - ranking = 0.11798408081529keywords = aneurysm, pseudoaneurysm (Clic here for more details about this article) |
5/764. De novo formation of familial cerebral aneurysms: case report.OBJECTIVES: The factors regulating the formation and growth of cerebral aneurysms are poorly understood. We report the case of a patient whose grandfather had a cerebral aneurysm and who developed numerous de novo aneurysms of varying size 9 years after the treatment of a first aneurysm. This observation sheds light on the cause and growth of cerebral aneurysms in familial cases that may be pertinent to sporadic cases. CLINICAL PRESENTATION: A 58-year-old man was admitted to the Montreal Neurological Institute in 1956 for an ultimately fatal, autopsy-proven, ruptured internal carotid artery aneurysm. His granddaughter was first admitted to the same institution in 1984 after suffering a subarachnoid hemorrhage from a ruptured right terminal internal carotid artery aneurysm that was successfully treated. Four-vessel cerebral angiography did not reveal other aneurysms. The granddaughter was readmitted to the hospital 9 years later after a new, lumbar puncture-proven subarachnoid hemorrhage occurred. cerebral angiography demonstrated that the previously clipped aneurysm did not fill. However, five new aneurysms were present. INTERVENTION: An anterior communicating artery aneurysm, thought to be the one that bled, was surgically clipped, and a large right posterior communicating artery aneurysm was coiled endovascularly. The remaining, smaller aneurysms were left untreated. CONCLUSION: The appearance of five new aneurysms during a 9-year interval suggests that there may be a genetic factor operating in the development of cerebral aneurysms in families and that this may produce a more widespread cerebral arteriopathy than is generally appreciated. patients with treated cerebral aneurysms from families in which two or more individuals have cerebral aneurysms, and perhaps their first and second degree relatives who have had negative angiograms, should be considered for periodic follow-up cerebrovascular imaging to rule out the subsequent development of de novo aneurysms.- - - - - - - - - - ranking = 2.2keywords = aneurysm (Clic here for more details about this article) |
6/764. Bilateral fibromuscular hyperplasia in the internal carotid arteries with aneurysm formation.A patient with bilateral fibromuscular hyperplasia in the carotid arteries with development of aneurysms is reported. The patient had no symptoms except for a palpable mass on one side and a bruit on both sides. Surgery was carried out bilaterally, using direct end-to-end suture on one side and a reconstruction with an autologous vein on the other side. It is suggested that fibromuscular hyperplasia may be the cause of some of the internal carotid artery aneurysms reported as congenital or with uncertain etiology. Reconstructive surgery of the carotid artery is recommended due to the obvious hazards of the condition.- - - - - - - - - - ranking = 0.6keywords = aneurysm (Clic here for more details about this article) |
7/764. Treatment of an intracranial aneurysm using a new three-dimensional-shape Guglielmi detachable coil: technical case report.OBJECTIVE AND IMPORTANCE: Coil embolization of wide-necked aneurysms is currently difficult, when using a conventional endovascular approach without resorting to complex adjunctive techniques. CLINICAL PRESENTATION: A 41-year-old woman with a history of systemic lupus erythematosus and hypertension refractory to treatment presented with an unruptured right ophthalmic segment aneurysm of the internal carotid artery having an unfavorable neck-to-fundus ratio. INTERVENTION: A new type of Guglielmi detachable coil (Target therapeutics, Fremont, CA), consisting of a series of omega loops, spontaneously forms a three-dimensional cage after deployment and was used to successfully treat the aneurysm, which was angiographically stable at the 3-month follow-up. CONCLUSION: The new Guglielmi detachable coil may be useful in the embolization of aneurysms having an unfavorable geometry, which would otherwise not be amenable to endovascular treatment without adjunctive techniques.- - - - - - - - - - ranking = 0.8keywords = aneurysm (Clic here for more details about this article) |
8/764. Carotid ligation for carotid aneurysms.Thirty patients with subarachnoid haemorrhage due to rupture of a carotid aneurysm were treated by ligation of the common carotid artery. Two patients died as a result of the procedure, two patients developed persisting hemisphere deficit. Eight of the ten patients who developed cerebral ischemia after the operation were operated within ten days after the bleeding. At present out aim is to guide the patient safely through the first ten days after his haemorrhage and perform ligation at the end of the second week. After a follow up period of 1-8 years recurrent haemorrhage did not occur. Common carotid ligation, preferably with control of carotid artery end pressure, cerebral blood-flow and EEG is considered to be a valuable method to treat ruptured intracranial carotid aneurysm.- - - - - - - - - - ranking = 0.6keywords = aneurysm (Clic here for more details about this article) |
9/764. Direct cervical internal carotid access for GDC treatment of an ophthalmic origin carotid aneurysm.The use of detachable coils in the treatment of intracranial aneurysms continues to evolve since its introduction in 1991 [1-5]. Although not well described in the literature, technical considerations in gaining and maintaining access to intracranial aneurysms play a pivotal role in any successful endovascular treatment. Tortuosity and looping of the cervical internal carotid artery (ICA) is one problem occasionally encountered. These unusual loops, in addition to the normal turns of the carotid siphon result in less control of the microcatheter tip. This problem culminated in this case where an ophthalmic origin carotid aneurysm could not be successfully treated from the standard femoral approach due to the presence of multiple ICA turns, with the presence of a proximal cervical ICA turn being particularly bothersome. This problem was circumvented by use of direct surgical access to the cervical ICA above the cervical ICA turn, allowing for successful endovascular aneurysm treatment with detachable coils.- - - - - - - - - - ranking = 0.8keywords = aneurysm (Clic here for more details about this article) |
10/764. An aneurysm of the petrous internal carotid artery.Internal carotid artery aneurysms are a rare cause of pulsatile tinnitus and conductive hearing loss but should be borne in mind when there is a suspected diagnosis of glomus jugulare or high-riding jugular bulb. Most cases are congenital. We present a case of otorrhagia which was initially thought to be a glomus jugulare, the diagnosis of internal carotid artery aneurysm was made at angiography and treated by balloon embolization.- - - - - - - - - - ranking = 0.6keywords = aneurysm (Clic here for more details about this article) |
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