1/14. Giant brain aneurysm--difficulties in diagnosis and treatment. Case report.Aneurysms of diameter above 25 mm, determined as giant aneurysms, are thought to be surgically difficult. The most common symptom of the presence of aneurysm is subarachnoidal hemorrhage. Giant aneurysm may cause focal neurological symptoms, very rarely may show symptoms of intracranial hypertension. In the presented case a 47-year old woman after the first epilepsy attack the dominated symptoms were those of intracranial hypertension. CT suggested brain tumour of 70 mm diameter. brain angiography revealed giant aneurysm of the left middle cerebral artery. After having considered differed method of therapeutic management, microsurgical operative technique was applied in general anesthesia with brain protection.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/14. Late detection of supraclinoid carotid artery aneurysm after traumatic subarachnoid hemorrhage and occlusion of the ipsilateral cervical internal carotid artery.BACKGROUND AND PURPOSE: We report the first case of traumatic aneurysm of the supraclinoid internal carotid artery (ICA), which we speculate may have developed or grown after traumatic occlusion of the ipsilateral cervical ICA. CASE DESCRIPTION: A 26-year-old man presented with severe traumatic subarachnoid hemorrhage (SAH) and occlusion of the right cervical ICA after a motor vehicle accident. Three-dimensional CT angiography on admission showed no aneurysm. However, cerebral angiography 3 weeks after the injury showed a large aneurysm of the right supraclinoid ICA. The aneurysm was trapped, and pathological examination showed that it was a traumatic aneurysm. CONCLUSIONS: In this case we cannot be sure that the aneurysm was not present on admission. In view of the significant SAH, a lesson of this case may be to suspect such an aneurysm early on and perform early diagnostic cerebral angiography.- - - - - - - - - - ranking = 1.375keywords = aneurysm (Clic here for more details about this article) |
3/14. anterior cerebral artery dissections manifesting as cerebral hemorrhage and infarction, and presenting as dynamic angiographical changes--case report.A 65-year-old woman presented with multiple dissecting aneurysms of the anterior cerebral artery (ACA) manifesting as hemiparesis on the right with dominance in the lower extremity. Computed tomography revealed hematoma in the left frontal lobe, corresponding to the area perfused by the callosomarginal artery. Initial angiography showed string sign and occlusion in the distal portion of the left callosomarginal artery and abnormal feeding suggesting double lumen of the A2 portion of the left ACA. The patient was treated conservatively under a diagnosis of multiple spontaneous dissecting aneurysms of the left ACA. Repeat angiography on Day 8 showed improvement of the string sign and occlusion in the left callosomarginal artery, and change of the double lumen of the A2 portion into string sign. Further angiography on Day 36 showed normalization of the left callosomarginal artery and improvement of the string sign in the A2 portion. Multiple spontaneous dissecting aneurysms of the ACA are extremely rare. Serial angiography beginning in the early stage will be important for correct diagnosis.- - - - - - - - - - ranking = 0.375keywords = aneurysm (Clic here for more details about this article) |
4/14. Cranial nerve pareses following wrapping of a ruptured dissecting vertebral artery aneurysm: a possible complication of cyanoacrylate glue--case report.A 51-year-old female with a ruptured dissecting vertebral artery aneurysm underwent an uneventful wrapping technique using Biobond-soaked gauze through a unilateral suboccipital transcondyle approach. On the 3rd postoperative day, she developed pareses of the ipsilateral VII through XII cranial nerves. Daily intravenous administration of 300 mg of hydrocortisone was started. This treatment was continued and dosage was tapered until the 10th postoperative day. The cranial nerve pareses deteriorated until the 8th postoperative day, but slowly resolved by 3 weeks after surgery. The patient was discharged with slight hoarseness and dysphasia 5 weeks after surgery. She had only slight hoarseness at 6 months. This complication was probably due to a neural toxic response to the Biobond.- - - - - - - - - - ranking = 0.625keywords = aneurysm (Clic here for more details about this article) |
5/14. Cerebral gnathostomiasis as a cause of an extended intracranial bleeding.This is a report of a fourteen year old Thai-girl who presented with acute hemiparesis because of intracranial haemorrhage six weeks after immigrating to germany. Marked blood eosinophilia and raised IgE in serum in comparison with her origin led to the suspected diagnosis of parasitosis. Angiography showed mycotic aneurysm typical for cerebral gnathostomiasis one of the major causes of intracranial haemorrhage in children in thailand. This diagnosis was confirmed by detecting specific antibodies against gnathostoma spinigerum in serum and CSF by Western blot. Therapy was started with albendazole and dexamethasone and the girl made a complete recovery. In case of intracranial haemorrhage cerebral gnathostomiasis should be considered if the patient originates from an endemic area.- - - - - - - - - - ranking = 0.125keywords = aneurysm (Clic here for more details about this article) |
6/14. Gas embolism: an exceptional complication of radial arterial catheterization.BACKGROUND: We report a rare complication of radial arterial catheterization in a 74-year-old man who had undergone retroperitoneal surgery for an infra-renal aortic aneurysm. A right subclavian venous catheter and a right radial artery catheter were inserted for hemodynamic monitoring. RESULTS: The patient suddenly went into a coma, with dyspnea and bradycardia, 1 day postsurgery, as a result of a cerebral gas embolism produced by the accidental entry of pressurized air into the artery via the arterial catheter. Cerebral magnetic resonance imaging revealed multiple, diffuse brain lesions. Six months later the patient still had a left hemiparesis and a cognitive deficit. He walks with assistance. CONCLUSION: Misuse of an arterial catheter can lead to a severe gas embolism. The infusion system used to flush arterial catheters should be checked regularly to ensure it contains no gas.- - - - - - - - - - ranking = 0.125keywords = aneurysm (Clic here for more details about this article) |
7/14. pupil-sparing, painless compression of the oculomotor nerve by expanding basilar artery aneurysm: a case of ocular pseudomyasthenia.BACKGROUND: oculomotor nerve paresis may have relatively benign but also life-threatening causes. Distinguishing between these is of great clinical importance. OBJECTIVE: To reveal a potential pitfall of the clinical evaluation of oculomotor nerve paresis. PATIENT: Single case observation. RESULTS: A 56-year-old man had fluctuating diplopia and fatigable ptosis, promptly relieved by intravenous edrophonium, leading to the diagnosis of ocular myasthenia gravis. His pupillary function was intact. A few days after the initial diagnosis, he suffered a subarachnoid hemorrhage secondary to the rupture of a basilar artery aneurysm. His ocular symptoms were related to aneurysmal oculomotor nerve compression. CONCLUSION: patients with oculomotor nerve dysfunction need more detailed evaluation because the underlying cause cannot be safely determined on a clinical basis.- - - - - - - - - - ranking = 0.75keywords = aneurysm (Clic here for more details about this article) |
8/14. Behcet's disease, associated with subarachnoidal heamorrhage due to intracranial aneurysm.Behcet's disease is an unusual medical condition in central europe and north america, however more common in turkey and japan. It was originally described in turkey, characterized by recurrent oral ulcers, genital ulcers and also uveitis. A variety of vascular lesions such as venous occlusions, arterial aneurysms and varices account for the high rate of morbidity and mortality with this disease. Arterial aneurysms most commonly occur in the abdominal aorta, femoral arteries and in the pulmonary arteries.To our knowledge there have been seventeen documented reports of patient's with Behcet's disease combined with aneurysms of cerebral arteries. We describe a patient with Behcet's disease and subarachnoid haemorrhage due to a ruptured cerebral aneurysm.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
9/14. Transclival decompression of brainstem from a compressing coiled aneurysm of the midbasilar artery.The authors present the case of a young woman, suffering from progressive tetraplegia, cranial nerve dysfunction, respiratory failure and lethargy due to radiographically demonstrated increased brainstem compression after coil embolization of an aneurysm of the midportion of the basilar artery. The patients condition improved dramatically after transclival decompression. The importance of understanding the effects of a rigid endovascular mass on adjacent neural structures is emphasized.- - - - - - - - - - ranking = 0.625keywords = aneurysm (Clic here for more details about this article) |
10/14. A saccular-like dissecting aneurysm of the anterior cerebral artery that developed 2 years after an ischemic event.BACKGROUND: A rare case of a growing dissecting aneurysm, which was located at the horizontal (A1) segment of the anterior cerebral artery (ACA), is reported. CASE DESCRIPTION: A 53-year-old woman experienced left hemiparesis and alien hand syndrome. A computerized tomography scan showed an infarction in the right frontal lobe, and cerebral angiography revealed a false lumen and intimal flap at the A1 segment of the ACA. magnetic resonance angiography demonstrated that the stenosis progressed 6 months later and improved 1 year later. cerebral angiography showed a saccular-like aneurysm 2 years later. The surgery was planned for prevention of aneurysmal rupture. The aneurysm, which was cocoon shaped, was exposed surgically and was resected. Histological examination of the aneurysm showed arterial dissection. The postoperative course was uneventful without additional neurological deficits. CONCLUSION: This is the first case report of A1 dissecting aneurysm presenting with an ischemic event in the literature. The sequential change of the configuration was curious to develop aneurysmal dilatation in 2 years. Long-term follow-up is necessary even after disappearance of the arterial dissection.- - - - - - - - - - ranking = 1.375keywords = aneurysm (Clic here for more details about this article) |
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