1/18. Atherosclerotic superficial temporal artery aneurysm: report of a case.We herein report a rare case of an atherosclerotic superficial temporal artery (STA) aneurysm. The patient was a 34-year-old Japanese man. He noticed a throbbing swelling just in front of his right ear, which had slowly increased in size. There was no history of trauma. Digital subtraction angiography and ultrasound revealed an aneurysm measuring 2cm in diameter fed by STA. A ligation and resection were performed under local anesthesia. The recovery period was uneventful. A microscopic examination revealed a moderate degree of atherosclerosis. We found 48 cases of STA aneurysm in the Japanese literature from 1969 to 1997, including our case. Thirty-six of these cases (75.0%) were considered to be traumatic in origin. Three cases (6.2%) occurred after a craniotomy. To date, only nine reported cases (18.8%) have been attributed to a spontaneous or congenital etiology.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/18. Ischaemic complication following obliteration of unruptured cerebral aneurysms with atherosclerotic or calcified neck.We report three cases of ischaemic complications following direct surgery of unruptured cerebral aneurysms having necks with atherosclerotic or calcified walls. Among 30 patients we treated directly for unruptured aneurysm over the last 4 years, 6 had 8 such aneurysms. Atherosclerotic or calcified neck was a major contributor to postoperative ischaemic sequelae in our recent series of unruptured aneurysms treated surgically, and common technical problems during surgery seemed to have caused ischaemic complications in the 3 patients reported here. In this report, attention is given to ischaemic complications in the treatment of such aneurysms.- - - - - - - - - - ranking = 1.2857142857143keywords = aneurysm (Clic here for more details about this article) |
3/18. pathology of a dissecting intracranial aneurysm.The pathological findings of six autopsy cases of dissecting intracranial aneurysm are studied. Clinically, all cases exhibited systemic hypertension or left ventricular hypertrophy. Macroscopically, all cases exhibited rupture of the vertebral artery and subarachnoid hemorrhage. Two types of lesion were present. First, all cases showed the formation of a dilatated pseudoaneurysm with widespread disruption of the entire arterial wall, which was composed of thin adventitia. Second, a medial disruption of the arterial wall and subadventitial dissecting hemorrhage, which formed a false lumen and stenosis of the 'true' lumen of the artery, was also found. However, these lesions were found to be connected to the site of rupture. The autopsy cases within 1 day of onset of intracranial dissecting aneurysm showed the formation of fibrin thrombus, a marked degree of leukocyte infiltration and necrosis of the arterial wall at the site of the lesion. The cases that survived more than 1 week showed smooth muscle cell proliferation, macrophage accumulation and lymphocytic infiltration. No arteriosclerosis was found in any lesion studied. These data suggest that the disruption of the entire arterial wall might initially occur and cause medial disruption and subadventitial hemorrhage. hypertension and arteriosclerosis might function as causal and protective factors in the pathogenesis of dissecting intracranial aneurysms, respectively.- - - - - - - - - - ranking = 1.1675198655284keywords = aneurysm, pseudoaneurysm (Clic here for more details about this article) |
4/18. 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 = 0.85714285714286keywords = aneurysm (Clic here for more details about this article) |
5/18. Cerebral aneurysms in the perforating artery manifesting intracerebral and subarachnoid haemorrhage--report of two cases.BACKGROUND: An arteriosclerotic aneurysm in the perforating artery has been focused on as a causative factor for hypertensive intracerebral haemorrhage. However, its pathogenesis remains unknown, and its existence is still a controversy. CASE DESCRIPTION: A 62-year-old female and a 70-year-old male with a history of hypertension suffered from intracerebral haemorrhage accompanied by subarachnoid haemorrhage. Cerebral angiograms demonstrated an aneurysm arising from the perforating artery at the central location of the haematoma in both cases. The aneurysms were confirmed as the cause of bleeding during microsurgery, and were resected. Histological examination of the surgical specimens revealed that the walls of the aneurysms lacked internal elastic lamina and consisted only of the adventitia. CONCLUSION: These findings demonstrate that the aneurysm in the perforating artery can be a causative factor for hypertensive intracerebral haemorrhage, and indicate that the loss of internal elastic lamina induced by hypertension may contribute to the formation of the aneurysm of the perforating artery.- - - - - - - - - - ranking = 1.4285714285714keywords = aneurysm (Clic here for more details about this article) |
6/18. Infra-posterior inferior cerebellar artery aneurysm arising after occlusion of the ipsilateral vertebral artery--case report.An 85-year-old woman had subarachnoid hemorrhage due to rupture of a very rare left infra-posterior inferior cerebellar artery (pica) aneurysm, a saccular aneurysm located proximally at the junction of vertebral artery (VA) and pica. Right vertebral angiography demonstrated the aneurysm since the left VA was occluded in the extracranial portion. The aneurysm projected in the opposite direction to common VA-pica aneurysms. The angiographical and intraoperative findings imply this rare aneurysm resulted from the hemodynamic changes caused by the VA occlusion. Detailed exploration of angiography is emphasized to detect such rare aneurysms among the diversity of hemodynamic patterns in elderly patients with subarachnoid hemorrhage.- - - - - - - - - - ranking = 1.5714285714286keywords = aneurysm (Clic here for more details about this article) |
7/18. Fate of branch arteries after intracranial stenting.OBJECTIVE: One concern with respect to stent procedures performed to treat patients with intracranial lesions is the fate of normal major arterial branches after stents are placed across them. Because most of these lesions occur at vessel bifurcations or at branch points, a normal major branch often arises near the lesion and may be difficult to avoid during stent positioning. The aim of this article is to describe the angiographic outcome of intracranial major branch arteries crossed by a stent in the intracranial circulation. methods: We examined the immediate postprocedural cerebral angiograms of the 40 patients who underwent intracranial stenting at the University at Buffalo, Buffalo, NY, between June 1998 and April 2000. In each of 10 patients, the stent was placed across a normal major branch artery. stents were used to treat aneurysms in seven patients and intracranial stenosis in three patients. The latest cerebral angiogram available was reviewed, and the patency of the major branch arteries was evaluated. RESULTS: The angiographic follow-up period ranged from 4 days to 35 months (mean follow-up, 10 mo). Each of the 10 major branch arteries was patent. No infarcts were associated with the territory of the major branch arteries crossed by the stents, and no patient experienced a related episode of clinical ischemia. Four patients died as a result of causes unrelated to the stenting procedure. The histology of a middle cerebral artery stent that was placed across a lenticulostriate perforator is presented. CONCLUSION: The flexible, low-profile stents used in this study had no angiographically or clinically apparent effect on the major intracranial branches across which they were placed.- - - - - - - - - - ranking = 0.14285714285714keywords = aneurysm (Clic here for more details about this article) |
8/18. Caudate hemorrhage with moyamoya-like vasculopathy from atherosclerotic disease.BACKGROUND AND PURPOSE: Caudate hemorrhage usually results from hypertension, rupture of arteriovenous malformation or aneurysm, or rarely, moyamoya disease. Moyamoya-like changes related to severe atherosclerotic occlusive disease, usually causing ischemic stroke, have been reported. CASE DESCRIPTION: A 51-year-old normotensive patient was admitted with headache due to a left caudate hematoma with ventricular extension. There was a history of smoking, leg claudication, elevated cholesterol, and coronary artery disease. angiography demonstrated complete extracranial carotid occlusion on the left and atherosclerotic stenosis at the bifurcation on the right, with supraophthalmic occlusion distally. At the base of the brain, bilateral moyamoya-like vessels, presumed to be secondary to atherosclerotic occlusion, were evident, but neither aneurysm nor arteriovenous malformation was present. Cerebral blood flow and transcranial Doppler studies indicated severely impaired cerebral perfusion that improved after bilateral extracranial-to-intracranial bypass surgery. CONCLUSIONS: Atherosclerotic occlusive carotid disease with moyamoya-like changes may be a rare cause of caudate hemorrhage. A decrease in moyamoya vessels with bypass surgery may reduce the risk of recurrent hemorrhage.- - - - - - - - - - ranking = 0.28571428571429keywords = aneurysm (Clic here for more details about this article) |
9/18. Neuroendovascular interventions for intracranial posterior circulation disease via the transradial approach: technical case report.OBJECTIVE AND IMPORTANCE: To describe our experience with the transradial approach for posterior circulation neurointerventional procedures. To the best of our knowledge, this approach has not been described previously for intracranial neuroendovascular procedures. CLINICAL PRESENTATION: The clinical and imaging characteristics as well as periprocedural outcomes of patients treated for intracranial posterior circulation disease via the transradial approach were analyzed retrospectively. INTERVENTION: Between January 1 and October 21, 2003, four patients with posterior circulation disease (aneurysm, n = 1, and atherosclerotic stenosis, n = 3) were treated via the transradial approach because of tortuous brachiocephalic anatomy. Procedural success was 100%, and there were no procedural complications. No technical difficulties were encountered. CONCLUSION: The transradial approach is an alternative to the femoral approach for posterior circulation neuroendovascular intervention. This approach has several advantages over other approaches, and the vasculature can be less tortuous than that encountered during the femoral approach. These factors can result in increased device trackability and procedural ease.- - - - - - - - - - ranking = 0.14285714285714keywords = aneurysm (Clic here for more details about this article) |
10/18. Angiographic CT in cerebrovascular stenting.We evaluated the feasibility of angiographic CT (ACT) for visualizing metallic stents in three patients who underwent intracranial (n = 2) or extracranial (n = 1) stent placement to treat atherosclerotic lesions. ACT is a new technique that provides cross-sectional CT-like images based on rotational radiography performed with a rotating C-arm-mounted flat-panel detector. ACT allowed for the clear visualization of stents in both intracranial and extracranial arteries and was superior to conventional digital subtraction angiography and digital radiography in visualizing both the stent struts and their relationships to the arterial walls and aneurysmal lumen.- - - - - - - - - - ranking = 0.14285714285714keywords = aneurysm (Clic here for more details about this article) |
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