1/29. A giant dissecting aneurysm mimicking serpentine aneurysm angiographically. Case report and review of the literature.Intracranial dissecting and giant serpentine aneurysms are rare vascular anomalies. Their precise cause has not yet been completely clarified, and the radiological appearance of such lesions can be different in each case according to the effect of hemodynamic stress on a pathologic vessel wall. For berry aneurysms, available evidence overwhelmingly favors their causation by hemodynamically induced degenerative vascular disease and there is an obvious need to determine the hemodynamic parameters most likely to induce the precursor atrophic lesions. In this study, a case of a giant dissecting aneurysm angiographically mimicking serpentine aneurysm of the right ophthalmic artery is reported and the relevant literature is reviewed to investigate the pathological characteristics and pathogenesis of this lesion. In the present case, radiological investigation of the lesion suggested a serpentine aneurysm, but the diagnosis was corrected to dissecting aneurysm subsequent to the pathological examination of the resected aneurysm. A giant dissecting aneurysm angiographically mimicking serpentine aneurysm and developing as the result of a circumferential dissection located between the internal elastic lamina and media is of particular interest when the etiology of these aneurysms is considered. To our knowledge this is the first report on intracranial dissecting aneurysm mimicking serpentine aneurysm angiographically. Our case illustrates the importance of careful serial section studies for a better understanding of the vascular pathology underlying the processes involved in intracranial serpentine aneurysms. We conclude that serpentine, dissecting and berry aneurysms may all arise by way of similar pathophysiological mechanisms.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/29. De novo formation of an aneurysm in a case of unusual intracranial fibromuscular dysplasia.Intracranial fibromuscular dysplasia (FMD) is a vascular disease of unknown origin occurring predominantly in young women. The internal carotid artery is most often involved, but other cerebral arteries may also be affected. We report the case of a young woman presenting with an unusual angiographic appearance of intracranial FMD of the internal carotid artery (ICA) that could not be categorized into any type of the Osborn-Anderson classification. During follow up the patient presented with an intracerebral and subarachnoid hemorrhage. Repeated angiography revealed multiple aneurysms in the pathologic segment of the vessel. The patient underwent surgical treatment with clipping of the aneurysms, wrapping of the pathologic segment of the ICA and biopsy of the superficial temporal artery. Histopathological sections revealed FMD of the intimal type. alpha(1)-antitrypsin blood levels were normal. Cases of intracranial FMD previously reported in the literature are reviewed and various aspects of this rare disease are discussed.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
3/29. Cerebral aneurysmal dilatation in an infant with perinatally acquired hiv infection and HSV encephalitis.Although most children with human immunodeficiency virus (hiv) infection have neurological dysfunction, in childhood the incidence of symptomatic cerebrovascular disease is low. Cerebral aneurysmal arteriopathy in childhood AIDS has been reported in the past and considered to have a relatively long latency following the primary infection. We report a 1 month-old infant with congenitally acquired hiv infection, and herpes encephalitis; she presented a sudden cardiorespiratory arrest followed by coma and was found to have a giant saccular aneurysm of the left basilar artery. literature review showed that cerebral aneurysmal artheriopathy is an unusual manifestation in newborns and infants and this case is possibly the youngest patient reported with aneurysma, herpes encephalitis and AIDS. The role of hiv and herpes simplex infections in the pathogenesis of this lesion is discussed.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
4/29. Brainstem infarction after delayed thrombosis of a stented vertebral artery fusiform aneurysm: case report.OBJECTIVE AND IMPORTANCE: Recent technological advances have provided clinicians with stents that can be navigated throughout the tortuous proximal vessels of the posterior intracranial circulation. There have been few reports of fusiform and wide-necked aneurysms treated with stents. Of the known risks involved in stent placement in the intracranial circulation, delayed stent thrombosis has not been well described. CLINICAL PRESENTATION: A 34-year-old man who experienced the sudden onset of a severe headache with increasing lethargy was found on computed tomographic imaging to have a subarachnoid hemorrhage. angiography revealed a left vertebral artery fusiform aneurysm that incorporated the posteroinferior cerebellar artery origin. INTERVENTION: A low-porosity magic Wallstent (boston Scientific, Natick, MA) was placed in the left vertebral artery across the aneurysm and the origin of the posteroinferior cerebellar artery. angiography performed 9 days later revealed significant reduction in filling of the aneurysm. The patient returned 3 months after stent placement with severe neurological deterioration from a brainstem infarction caused by complete thrombotic occlusion of the left vertebral artery at the stented segment of the vessel. CONCLUSION: Stenting of fusiform aneurysms has provided an alternative to surgical clipping or parent vessel reconstruction. With the increasing frequency of intracranial stent placement for various cerebrovascular disease entities, we must become aware of potential complications associated with these procedures. Such awareness may influence decision-making processes regarding treatment and follow-up care.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
5/29. Clinics in diagnostic imaging (75). hiv encephalopathy and cerebral aneurysmal arteriopathy.A six-year-old girl with vertically-transmitted hiv infection had hyperreflexia. MR imaging showed diffuse prominence of the subarachnoid spaces and ventricles caused by hiv encephalopathy. Fusiform dilatation of the supraclinoid segment of the right internal carotid artery was also noted. MR angiography confirmed cerebral aneurysmal arteriopathy. Imaging findings of the various cerebral manifestations and complications found in children with AIDS coming from the primary effects of hiv, opportunistic infections, tumours, and vascular disease are discussed.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
6/29. Hemodynamic analysis of an adult vein of Galen aneurysm malformation by use of 3D image-based computational fluid dynamics.We applied computational fluid dynamic (CFD) analysis on the numerical grid of a 3D rotational digital subtraction angiogram obtained in a 22-year-old male patient, with an accidentally discovered vein of Galen malformation associated with single feeder aneurysm, to understand the flow pattern through the two aneurysms and improve our general understanding of hemodynamic characteristics of this variety of fusiform aneurysm. This technical note provides a good example of the application of CFD to 3D digital subtraction angiography for studying the flow pattern in patients with cerebrovascular disease.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
7/29. Intracerebral abscess formation following embolisation of an internal carotid artery aneurysm using Guglielmi detachable coils.Infection following endovascular therapy for cerebrovascular disease is a potential but rare complication. A 70-year-old lady in whom an intracranial abscess formed secondary to GDC embolisation of a giant right internal carotid artery aneurysm is reported. Computed tomography (CT) showed the abscess and staphylococcus aureus was cultured from the cerebrospinal fluid and blood. The abscess was successfully treated by antibiotic therapy. Infected Guglielmi detachable coils (GDC) may result in abscess formation in the presence of underlying cerebral ischaemia.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
8/29. aneurysm in the skin: arterial fibromuscular dysplasia.We describe a pulsatile aneurysm in the skin of 16-year-old boy that was found to be a sign of a systemic vascular disease, that is, arterial fibromuscular dysplasia. The patient had aneurysms in the renal, cerebral, coronary, and other arteries; he developed renovascular hypertension and had a cerebrovascular accident and acute myocardial infarction at 17 years of age. This disease has not been previously reported in the dermatologic literature.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
9/29. Computational simulation of therapeutic parent artery occlusion to treat giant vertebrobasilar aneurysm.We applied computational fluid dynamics (CFD) analysis to assess 3D digital subtraction angiography findings in a patient with a giant vertebrobasilar aneurysm to simulate and compare the consequences of left and right vertebral artery occlusion. The balloon occlusion test suggested that occlusion of the right vertebral artery is the better way to treat this patient's aneurysm from the point of view of aneurysmal thrombosis and isolation from the circulation. The computer simulation supported this conclusion, at the same time indicating that from the point of view of pressure distribution on the wall of the aneurysm, the right vertebral occlusion may be also accompanied by an undesirable effect. A high-pressure area on the aneurysm wall in systole was revealed. This high pressure potentially could lead to subsequent aneurysmal growth, which indeed occurred, as was revealed by a follow-up examination 6 months later. This study is a good example of possible future applications of CFD in patients with cerebrovascular disease before therapeutic intervention.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
10/29. pregnancy and subarachnoid hemorrhage: a case report.Cerebrovascular diseases are rare in pregnancy and mostly caused by rupture of an arterial aneurysm. We present the case of a pregnant woman at 36 weeks of gestation who had a subarachnoid hemorrhage resulting from rupture of an unknown aneurysm, and who underwent a cesarean section and an endovascular treatment to embolize the aneurysm.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
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