1/92. Computerized tomography: abnormal intracerebral collections of blood in children.Three children with unusual abnormal intracerebral collections of blood were examined by computerized tomography. These cases demonstrate the complementary relationship of this technique with other neuroradiological diagnostic methods. An intracerebral aneurysm and an arteriovenous malformation of the vein of Galen are demonstrated on computerized tomograms.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/92. Distal stump of an occluded intracranial vertebral artery at the vertebrobasilar junction mimicking a basilar artery aneurysm.The distal stump of an occluded intracranial vertebral artery (VA) can mimic a basilar artery aneurysm of the vertebrobasilar junction. Their differentiation is crucial to establishing the appropriate treatment. We report two cases with occlusion of the distal stump of the VA due to atherosclerosis and arterial dissection. Magnetic resonance images with three-dimensional constructive interference in steady state sequences are useful in revealing the occluded segment as a continuous anatomical structure from the proximal VA to the basilar artery. This information may prevent unnecessary exploratory surgery for a suspected basilar artery aneurysm.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
3/92. Intracranial aneurysms in ehlers-danlos syndrome type IV in early childhood.ehlers-danlos syndrome type IV is of special interest to neurologists because of the risk of cerebrovascular complications. We describe a 5-year-old female with ehlers-danlos syndrome type IV, demonstrating multiple intracranial aneurysms and right middle cerebral artery stenosis. The diagnosis of ehlers-danlos syndrome type IV was confirmed by electron microscopic examination of a skin biopsy. To our knowledge, this is the youngest reported patient with intracranial aneurysms associated with the ehlers-danlos syndrome type IV. ehlers-danlos syndrome type IV should be considered in the differential diagnosis of cerebrovascular disorder and stroke in early childhood.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
4/92. Takayasu's arteritis presented with subarachnoid hemorrhage: report of two cases.Takayasu's arteritis is a chronic inflammatory disease that produces a narrowing of the aorta and its major branches. fibrosis and thickening of the arterial wall often occur in later stages, resulting in a cerebrovascular accident. The authors report two young women patients who presented with subarachnoid hemorrhage (SAH) and occlusive cerebrovasular disease associated with Takayasu's arteritis. Both patients had sudden headache and hemiparesis. physical examination showed weak radial pulse, carotid bruit, and asymmetrical blood pressure. Erythrocyte sedimentation rate (ESR) was elevated in both patients. SAH was confirmed by brain computerized tomography (CT) or lumbar puncture. Occlusive cerebrovascular disease was diagnosed by brain magnetic resonance imaging (MRI), brain magnetic resonance angiography (MRA), and cerebral angiography. The findings of aortography and cerebral angiography were compatible with Takayasu's arteritis, but intracranial aneurysm was not found in either patient.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
5/92. Ipsilateral hyperperfusion after neck clipping of a giant internal carotid artery aneurysm. Case report.A 48-year-old woman exhibited hyperperfusion soon after undergoing a successful clip operation involving multiple clip placement for a giant internal carotid artery (ICA) aneurysm. Intraarterial digital subtraction angiography demonstrated a left paraclinoid giant aneurysm. Multiple clips were placed to obliterate the aneurysm during a 7-minute temporary ICA occlusion. Intraoperative Doppler ultrasound flowmetry showed that the blood flow through the ICA distal to the aneurysm increased from 71.6 ml/minute before clipping to 123.3 ml/minute after. The patient exhibited right hemiparesis and motor aphasia after the operation. Postoperative imaging studies revealed an increase in perfusion and diffuse edema in the left cerebral cortex. The symptoms and diffuse brain edema gradually resolved. In this case, increase in blood flow through the ICA distal to the aneurysm may have played an important role in the circulatory disturbance.- - - - - - - - - - ranking = 9keywords = aneurysm (Clic here for more details about this article) |
6/92. Obliteration of bilateral dissecting aneurysms of the vertebral arteries following repeated subarachnoid hemorrhage: a case report.A 51-year-old man presented with loss of consciousness when he underwent urological examination at another hospital. CT scans showed subarachnoid hemorrhage, and cerebral angiography showed bilateral dissecting aneurysms of the vertebral arteries. Following ventricular drainage, the lesion was managed conservatively with blood pressure control but again ruptured on day 8. Cerebral angiography revealed narrowing of both the dissecting aneurysms. On day 11, the right vertebral artery had been spontaneously obliterated and the right dissecting aneurysm was filled in a retrograde fashion via the left vertebral artery. Proximal occlusion of the right vertebral artery was performed to prevent recanalization. Two months later, cerebral angiography revealed that both vertebral arteries were obliterated and the basilar artery and right posterior inferior cerebellar artery were filled via the right posterior communicating artery. The present case demonstrated that the hemodynamic status of bilateral dissecting aneurysms of the vertebral artery changed variably indicating the necessity of careful angiographic observation.- - - - - - - - - - ranking = 8keywords = aneurysm (Clic here for more details about this article) |
7/92. fibromuscular dysplasia of the basilar artery. Report of a case.A case of fibromuscular dysplasia (FMD), mostly involving the basilar artery, associated with an intracranial aneurysm, is presented. Although the patient was symptomatic, the typical angiographic pattern is felt to be in this case an incidental finding. However the potential for FMD to produce severe neurological impairment is emphasized. The case is used as a basis for discussing shortly the incidence, the characteristic radiological appearance, the relationship with the presence of intracranial aneurysms and the therapeutic problems of FMD.- - - - - - - - - - ranking = 2keywords = aneurysm (Clic here for more details about this article) |
8/92. Giant aneurysms of the internal carotid artery: endovascular treatment and long-term follow-up.We report the long-term follow-up of 18 patients with giant aneurysms of the internal carotid artery (ICA) referred for endovascular occlusion of the parent vessel. There were 10 aneurysms involving the infra- and/or supraclinoid cavernous segment, six the ophthalmic segment, one the petrous segment and one the bifurcation. One patient who did not tolerate test occlusion was treated medically. Clinical and imaging follow-up were obtained in 16 patients for a mean of 30 months, range 6-80 months. Endovascular treatment led to excellent clinical outcome in 16 patients. One 34-year-old woman, who presented with subarachnoid haemorrhage (SAH), died from bilateral middle cerebral artery infarcts due to severe vasospasm 4 days after treatment. The patient treated medically died from SAH. Long-term imaging follow-up in 16 patients revealed a markedly smaller aneurysm sac in all cases.- - - - - - - - - - ranking = 7keywords = aneurysm (Clic here for more details about this article) |
9/92. Three-dimensional digital angiography: new tool for simultaneous three-dimensional rendering of vascular and osseous information during rotational angiography.Three-dimensional (3D) digital subtraction angiography (DSA) is the latest development in the neurovascular imaging armamentarium. 3D-DSA combines the anatomic resolution of DSA with 3D visualization abilities previously offered by only CT or MR angiography. 3D-DSA provides more detailed information than does DSA alone in the evaluation of neurovascular lesions, such as cerebral aneurysms. However, the inability of 3D-DSA to simultaneously image osseous and vascular structures is noted as a weakness of this technique compared with CT angiography. We describe a new 3D digital angiography reconstruction algorithm that allows the concurrent display of the cerebral vasculature and the osseous landmarks.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
10/92. stroke in a cohort of patients with homozygous sickle cell disease.Strokes occurred in 17 of 310 children with homozygous sickle cell disease who were followed from birth, representing an incidence of 7.8% by the age of 14 years. Two children had subarachnoid hemorrhage, one having resolution of symptoms after aneurysm surgery and another dying of a presumed second hemorrhage 14 days later. The remaining 15 strokes were presumed to be cerebral infarction, although autopsy, angiographic, or computed tomographic evidence was available in only 8 children. There were 6 deaths, 2 in the acute event and 4 after recurrence, which occurred in 6 (46%) of 13 patients who survived the initial episode. There were 10 recurrent episodes at a median interval of 9 months after the initial event. Steady-state hematologic data revealed significantly higher leukocyte counts than in control subjects without strokes at age 1 year and in the last study preceding the stroke. The initial stroke coincided with an acutely lowered hemoglobin value in 5 patients (3 aplastic crises, 1 acute splenic sequestration, 1 probable pulmonary sequestration) and with painful crises in another 7 patients. We conclude that a high leukocyte count and an acute decrease of hemoglobin are risk factors for stroke in patients with homozygous sickle cell disease.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
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