14,314 results match your criteria Brain Aneurysm Imaging


Tailor-made branch reconstruction by intracranial to intracranial bypass during clipping surgery for middle cerebral artery aneurysms.

World Neurosurg 2019 Apr 14. Epub 2019 Apr 14.

Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.

Background: In clipping surgery, it is advantageous to dissect an adhered artery from the aneurysmal dome to achieve complete clipping. Bypass surgery is useful to reconstruct an adhered artery when dissection of the artery is technically difficult or risky. Here, we report the effectiveness of tailor-made intracranial (IC)-IC bypass to reconstruct an adhered artery in clipping surgery for middle cerebral artery (MCA) aneurysms. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.04.074DOI Listing
April 2019
1 Read

Distal Outflow-related Anterior Inferior Cerebellar Artery Aneurysm in Hemangioblastoma.

World Neurosurg 2019 Apr 12. Epub 2019 Apr 12.

Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University. Electronic address:

Anterior inferior cerebellar artery (AICA) aneurysm is a rare cerebral entity and its presentation in association with a hyper-vascularized tumor is even more exceptional. In this study, we presented a patient with rare coexistent pathologies in combination of a cerebellar hypervascularized tumor with an outflow related AICA aneurysm. A one-stage procedure to remove both lesions was carried out following meticulous discussion with patient. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.04.023DOI Listing

Economic Comparison Between Endovascular Coiling vs Neurosurgical Clipping for Ruptured and Unruptured Intracranial Aneurysms in Austria.

Neurosurgery 2019 May;84(5):E272-E273

Introduction: Subarachnoid hemorrhage from a ruptured intracranial aneurysm poses a significant health hazard due to its high rates of mortality and disability. The 2 most commonly used treatment modalities of intracranial aneurysms are neurosurgical clipping and endovascular coiling. Through the decision on which treatment option should be chosen in every case is made based on medical indication, nevertheless, due to high socioeconomic burden of subarachnoid hemorrhage, it is also important to compare the healthcare expenditures, caused by clipping and coiling. Read More

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https://academic.oup.com/neurosurgery/article/84/5/E272/5418
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http://dx.doi.org/10.1093/neuros/nyz001.NV1DOI Listing
May 2019
3 Reads

Clinical feasibility study of 3D intracranial magnetic resonance angiography using compressed sensing.

J Magn Reson Imaging 2019 Apr 13. Epub 2019 Apr 13.

Department of Radiology, Peking University First Hospital, Beijing, China.

Background: Compressed sensing (CS) has been widely used to improve the speed of MRI, but the feasibility of application in 3D intracranial MR angiography (MRA) needs to be evaluated in clinical practice.

Purpose: To evaluate the clinical feasibility of CS-MRA in comparison with conventional 3D-MRA (Con-MRA).

Study Type: Retrospective. Read More

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http://dx.doi.org/10.1002/jmri.26752DOI Listing
April 2019
1 Read
3.210 Impact Factor

Flow diversion for treatment of intracranial aneurysms: Mechanism and implications.

Ann Neurol 2019 Apr 11. Epub 2019 Apr 11.

Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Flow diverters are new generation stents that have recently garnered a large amount of interest for use in treatment of intracranial aneurysms. Flow diverters reduce blood flow into the aneurysm, with redirection along the path of the parent vessel. Flow stagnation into the aneurysm and neck coverage with subsequent endothelialization are the important synergistic mechanisms by which the therapy acts. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1002/ana.25484
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http://dx.doi.org/10.1002/ana.25484DOI Listing
April 2019
2 Reads

Injection of N‑butyl Cyanoacrylate Through a Dual-Lumen Balloon for Embolization of High-flow Intranidal Fistulas in Brain Arteriovenous Malformations: Technical Note.

Clin Neuroradiol 2019 Apr 10. Epub 2019 Apr 10.

Department of Neuroradiology, Pitié-Salpêtrière Hospital, 47 Boulevard de l'Hôpital, 75013, Paris, France.

Purpose: N-butyl cyanoacrylate (NBCA) glue is a valuable liquid embolic agent for the endovascular treatment of brain arteriovenous malformations (BAVM). The use of NBCA carries a risk of embolic agent reflux and distal migration with ensuing possibility of venous drainage compromise. The aim of this technical note is to describe a single center case series of high-flow intranidal fistulas embolized though a dual lumen balloon under local flow-arrest conditions. Read More

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http://dx.doi.org/10.1007/s00062-019-00780-6DOI Listing
April 2019
1 Read

Intracranial mirror aneurysm: Epidemiology, Rupture risk, New imaging, Controversies and Treatment strategies.

World Neurosurg 2019 Apr 4. Epub 2019 Apr 4.

Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao, China. Electronic address:

There are some controversies about the surgical treatment strategy of mirror aneurysms. Whether to take one-stage or two-stages surgery, bilateral or unilateral craniotomy, surgical or interventional treatment is the main points in dispute. The present review mainly introduces the different surgery strategies facing with different patients. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.03.275DOI Listing

Anatomical triangles defining routes to anterior communicating artery aneurysms: the junctional and precommunicating triangles and the role of dome projection.

J Neurosurg 2019 04 5:1-12. Epub 2019 Apr 5.

Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona.

Objective: Anterior communicating artery (ACoA) aneurysms are common intracranial aneurysms. Despite advances in endovascular therapy, microsurgical clipping remains an important treatment for aneurysms with broad necks, large size, intraluminal thrombus, complex branches, or previous coiling. Anatomical triangles identify safe corridors for aneurysm access. Read More

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http://dx.doi.org/10.3171/2018.12.JNS183264DOI Listing

A randomized 500-subject open-label phase 3 clinical trial of minimally invasive surgery plus alteplase in intracerebral hemorrhage evacuation (MISTIE III).

Int J Stroke 2019 Apr 3:1747493019839280. Epub 2019 Apr 3.

2 Division of Brain Injury Outcomes, Johns Hopkins University, Baltimore, MD, USA.

Rationale And Hypothesis: Surgical removal of spontaneous intracerebral hemorrhage may reduce secondary destruction of brain tissue. However, large surgical trials of craniotomy have not demonstrated definitive improvement in clinical outcomes. Minimally invasive surgery may limit surgical tissue injury, and recent evidence supports testing these approaches in large clinical trials. Read More

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http://journals.sagepub.com/doi/10.1177/1747493019839280
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http://dx.doi.org/10.1177/1747493019839280DOI Listing
April 2019
4 Reads

Remote ischemic preconditioning for elective endovascular intracranial aneurysm repair: a feasibility study.

Neuroradiol J 2019 Apr 3:1971400919842059. Epub 2019 Apr 3.

1 Department of Radiology, Mayo Clinic, Rochester, MN, USA.

Objectives: Remote ischemic preconditioning has been proposed as a possible potential treatment for ischemic stroke. However, neuroprotective benefits of the pre-procedural administration of remote ischemic preconditioning have not been investigated in patients undergoing an elective endovascular intracranial aneurysm repair procedure. This study investigated the safety and feasibility of remote ischemic preconditioning in patients with an unruptured intracranial aneurysm who undergo elective endovascular treatment. Read More

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http://dx.doi.org/10.1177/1971400919842059DOI Listing
April 2019
4 Reads

Constitutive activation of the PI3K-AKT pathway and cardiovascular abnormalities in an individual with Kosaki overgrowth syndrome.

Am J Med Genet A 2019 Apr 2. Epub 2019 Apr 2.

Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.

Kosaki overgrowth syndrome is a recently described syndrome characterized by distinctive facial features, brain white matter lesions, and developmental delay. Germline activating heterozygous PDGFRB mutations have been reported in this condition. Systemic connective tissue-type findings have been described in some individuals. Read More

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http://dx.doi.org/10.1002/ajmg.a.61145DOI Listing
April 2019
1 Read

[Effectiveness of Color-Coded Doppler Ultrasonography for Detecting the Trajectory in the Surgical Management of Distal ACA Aneurysms].

No Shinkei Geka 2019 Mar;47(3):321-327

Department of Neurosurgery, Tokyo Medical and Dental University.

Distal anterior cerebral artery(DACA)aneurysms are relatively rare. The detection of the surgical trajectory of DACA aneurysmal clipping is difficult because DACA aneurysms are located at various sites in the ACA. The purpose of this study was to evaluate the effectiveness of intraoperative use of color Doppler ultrasonography for the surgery of DACA aneurysms. Read More

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http://dx.doi.org/10.11477/mf.1436203937DOI Listing

Focal aneurysm wall enhancement on MRI indicates intraluminal thrombus and the rupture point.

World Neurosurg 2019 Mar 27. Epub 2019 Mar 27.

Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan; Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Background And Purpose: The precise mechanism of aneurysm wall enhancement (AWE) in ruptured intracranial aneurysms on magnetic resonance vessel wall imaging (VWI) remains unclear. We explored patterns of VWI findings and correlations with intraoperative or histopathologic aneurysm wall architecture.

Methods: Twenty-four patients were evaluated by VWI before microsurgical clipping or endovascular coiling. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.03.209DOI Listing
March 2019
1 Read

Predictors of Impaired Cerebral Perfusion After Flow Diversion Therapy.

World Neurosurg 2019 Mar 27. Epub 2019 Mar 27.

Department of Neurological Surgery, University of Wisconsin School of Medicine, Madison, WI, USA.

Introduction: Flow-diverting stents (FDS) are relatively safe and highly efficacious in treating cerebral aneurysms; however, a small subset of patients experience devastating hemorrhagic complications due to presumed alterations in local aneurysm and distal cerebral blood flow. The downstream effects of FDS on distal cerebral blood flow is not well understood but isolated reports of hyperperfusion injury have been described in the literature. We investigate the incidence and clinical factors contributing to abnormal cerebral blood flow after FDS placement. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.03.203DOI Listing

Neurological Complications of Infective Endocarditis.

Curr Neurol Neurosci Rep 2019 Mar 30;19(5):23. Epub 2019 Mar 30.

Department of Neurosciences and Mental Health, Neurology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.

Purpose Of Review: The purpose of this narrative review and update is to summarize the current knowledge and provide recent advances on the neurologic complications of infective endocarditis.

Recent Findings: Neurological complications occur in about one-fourth of patients with infective endocarditis. Brain MRI represents a major tool for the identification of asymptomatic lesions, which occur in most of the patients with infective endocarditis. Read More

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http://dx.doi.org/10.1007/s11910-019-0935-xDOI Listing
March 2019
1 Read
3.059 Impact Factor

Pipeline embolization device diameter is an important factor determining the efficacy of flow diversion treatment of small intracranial saccular aneurysms.

J Neurointerv Surg 2019 Mar 29. Epub 2019 Mar 29.

Department of Radiology, University of Maryland, Baltimore, Maryland, USA.

Objective: Flow diversion using the Pipeline embolization device (PED) has become a widely used treatment method for intracranial aneurysms. However, a subset of aneurysms will fail to occlude following treatment and the factors that influence the efficacy of flow diversion remain uncertain. As smaller diameter PEDs inherently have greater metal density than larger devices, we elected to investigate whether PED diameter influences treatment efficacy when using a single device. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014792DOI Listing
March 2019
2 Reads

Complex revascularization for idiopathic intracranial occlusive disease with unruptured, fusiform anterior cerebral artery and middle cerebral artery aneurysms.

World Neurosurg 2019 Mar 25. Epub 2019 Mar 25.

Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address:

Revascularization is an important strategy when treating cerebrovascular occlusive disease and complex aneurysms. Radial artery fascial flow-through free flaps (RAFFs) are flexible grafts that provide direct and indirect revascularization. RAFFs can be especially useful for large territory revascularization and can be combined with other direct bypasses. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.03.164DOI Listing

Cerebral foreign body reaction due to hydrophilic polymer embolization following aneurysm treatment by pipeline flow diversion device.

Interv Neuroradiol 2019 Mar 28:1591019919830767. Epub 2019 Mar 28.

2 Stanford Hospital and Clinics, Stanford, USA.

The use of flow diverting stents for wide based, intracranial aneurysms has become an invaluable treatment option. While intracranial hemorrhage and ischemic stroke from dislodged atherosclerotic emboli are common adverse events, the potential for delayed granulomatous inflammation from possible hydrophilic polymer emboli is rarely recognized. We present a unique case in which visible chipping of the pusher wire for stent placement was observed, followed by clinical and radiographic evidence suggestive of a delayed foreign body reaction to intracranial hydrophilic polymer emboli. Read More

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http://dx.doi.org/10.1177/1591019919830767DOI Listing
March 2019
1 Read

Endovascular management of a ruptured aneurysm associated with distal PICA fenestration.

Interv Neuroradiol 2019 Mar 28:1591019919838194. Epub 2019 Mar 28.

Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.

Fenestrations are rare but well-known arterial anatomic variations in which a segment of artery divides into two parallel channels that reunite distally. Although fenestrations as such are asymptomatic, they have gained clinical significance because of their association with aneurysms and other intracranial vascular pathologies. Here we present a 35-year-old woman with history of sudden severe occipital headache and vomiting. Read More

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http://dx.doi.org/10.1177/1591019919838194DOI Listing

Insurance and Flow-Alteration Superficial Temporal Artery to Middle Cerebral Artery (STA-MCA) Bypass in Management of Complex Anterior Intracranial Circulation Aneurysms in Postendovascular Era.

World Neurosurg 2019 Mar 19. Epub 2019 Mar 19.

Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

Background: Optimal management of complex anterior circulation aneurysms is an enigmatic challenge because of frequent involvement of major vessel bifurcation, choroidal vessels, and lenticulostriate/thalamostriate perforators. Cerebral ischemia associated with prolonged clipping time is a major concern pertinent to their surgical management, especially in patients with poor cross-flow. To circumvent this hurdle, single/double-barrel low-flow superficial temporal artery (STA) to middle cerebral artery (M3/M4-MCA) can be performed, which can maintain distal cerebral perfusion while facilitating safe clip reconstruction of complex MCA and supraclinoidal internal carotid artery (ICA) aneurysms involving ICA bifurcation or supraclinoidal ICA aneurysms with poor cross-circulation-insurance bypass, as well as supplement/alter blood flow after MCA aneurysm trapping-flow-alteration bypass. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.03.109DOI Listing
March 2019
2 Reads

Hippocampus subfield volumetry after microsurgical or endovascular treatment of intracranial aneurysms-an explorative study.

Eur Radiol Exp 2019 Mar 21;3(1):13. Epub 2019 Mar 21.

Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.

Background: To study hippocampus subfield volumes in patients after microsurgical clipping (MC) and/or endovascular coiling (EC) of intracranial aneurysms.

Methods: Hippocampus subfield volumetry was performed using FreeSurfer v6.0 in 51 patients (35 females, mean age 54. Read More

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http://dx.doi.org/10.1186/s41747-019-0092-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428873PMC
March 2019
3 Reads

Surgical Treatment Strategy and Perioperative Analysis of Patients With Intracranial Mirror Aneurysms.

J Craniofac Surg 2019 Mar 16. Epub 2019 Mar 16.

Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao.

Object: Intracranial mirror aneurysm is a type of multiple aneurysms, which is rare in clinical and literature. There is no unified conclusion on the treatment strategy of mirror aneurysms. Therefore, our study evaluated the surgical approach and prognosis of a series of mirror aneurysms, and explored the clinical features and treatment strategies of mirror aneurysms. Read More

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http://dx.doi.org/10.1097/SCS.0000000000005420DOI Listing
March 2019
1 Read

Disturbed flow induces a sustained, stochastic NF-κB activation which may support intracranial aneurysm growth in vivo.

Sci Rep 2019 Mar 18;9(1):4738. Epub 2019 Mar 18.

Department Bioengineering, Imperial College London, London, UK.

Intracranial aneurysms are associated with disturbed velocity patterns, and chronic inflammation, but the relevance for these findings are currently unknown. Here, we show that (disturbed) shear stress induced by vortices is a sufficient condition to activate the endothelial NF-kB pathway, possibly through a mechanism of mechanosensor de-activation. We provide evidence for this statement through in-vitro live cell imaging of NF-kB in HUVECs exposed to different flow conditions, stochastic modelling of flow induced NF-kB activation and induction of disturbed flow in mouse carotid arteries. Read More

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http://dx.doi.org/10.1038/s41598-019-40959-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426999PMC
March 2019
1 Read

Clinical features and management of traumatic ophthalmic artery aneurysm: a case report and literature review.

Br J Neurosurg 2019 Mar 20:1-5. Epub 2019 Mar 20.

a Department of Neurosurgery , Tokyo Medical University , Tokyo , Japan.

We report a 52-year-old man with progressive disturbance of visual acuity following a head injury. Magnetic resonance imaging (MRI) showed an aneurysm of the internal carotid artery. Digital subtraction angiography (DSA) 57 days after onset found that the aneurysm originated in the proximal ophthalmic artery. Read More

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https://www.tandfonline.com/doi/full/10.1080/02688697.2019.1
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http://dx.doi.org/10.1080/02688697.2019.1587382DOI Listing
March 2019
2 Reads

Application of the Willis Covered Stent in the Treatment of Ophthalmic Artery Segment Aneurysms: A Single-Center Experience.

World Neurosurg 2019 Feb 25;122:e546-e552. Epub 2018 Oct 25.

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China. Electronic address:

Objective: The purpose of this study is to introduce our initial experience with the evaluation of the feasibility of using Willis covered stents (WCSs) in the treatment of complicated ophthalmic artery (OA) segment aneurysms.

Methods: Of the 162 patients with OA segment aneurysms treated by endovascular techniques in West China Hospital from January 2015 to August 2017, a total of 26 patients treated with WCSs were included in the study.

Results: Twenty-six patients with 26 aneurysms were included (mean age, 57. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.10.098DOI Listing
February 2019
2 Reads

Management of Unruptured Intracranial Aneurysms in Older Adults: A Cost-effectiveness Analysis.

Radiology 2019 May 19;291(2):411-417. Epub 2019 Mar 19.

From the Departments of Radiology and Biomedical Imaging (A.M., X.W., H.P.F., C.C.M.), Economics (H.P.F.), Management (H.P.F.), Public Health (H.P.F.), and Neurosurgery (C.C.M.), Yale School of Medicine, 333 Cedar St, Box 208042, Tompkins East 2, New Haven, CT 06520-8042; Harvey L. Neiman Health Policy Institute, Reston, VA (D.R.H.); Department of Radiology, University of Maryland School of Medicine, Baltimore, MD (D.G.); and Department of Radiology, Northwell Health, Manhasset, NY (P.S.).

Background Unruptured intracranial aneurysms (UIAs) are relatively common and are being increasingly diagnosed, with a significant proportion in older patients (˃ 65 years old). Serial imaging is often performed to assess change in size or morphology of UIAs since growing aneurysms are known to be at high risk for rupture. However, the frequency and duration of surveillance imaging have not been established. Read More

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http://dx.doi.org/10.1148/radiol.2019182353DOI Listing
May 2019
3 Reads

Microsurgical Clip Reconstruction of a Ruptured Dissecting PICA Aneurysm: a 2D Operative Video.

World Neurosurg 2019 Mar 11. Epub 2019 Mar 11.

Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA. Electronic address:

This case is a presentation of technical tenets for the microsurgical clipping of a ruptured posterior inferior cerebellar artery (PICA) aneurysm. The patient described in this case was a 19-year old male with a history of polysubstance abuse who presented from an outside hospital after being found unresponsive and admitted for a subarachnoid hemorrhage seven days earlier. Noninvasive vascular imaging completed at the outset hospital showed no clear intracranial aneurysm except some irregularity of left PICA proximally. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.02.161DOI Listing
March 2019
3 Reads

Surgical Trapping With Revascularization of Concomitant Cervical and Petrous Internal Carotid Artery Aneurysms: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2019 Mar 14. Epub 2019 Mar 14.

Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah.

Petrous internal carotid artery (ICA) aneurysms are rare, complicated lesions to treat. The management paradigms include observation, endovascular exclusion, or surgical trapping with or without revascularization. The case described in this video involved a 67-yr-old woman with a known history of chronic lymphocytic leukemia, who presented after a mechanical ground-level fall. Read More

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http://dx.doi.org/10.1093/ons/opz022DOI Listing
March 2019
2 Reads

Acute Subdural Hematomas in Ruptured Brain Arteriovenous Malformations: Association with Distal Flow-Related Aneurysms.

Clin Neuroradiol 2019 Mar 13. Epub 2019 Mar 13.

Department of Neuroradiology, Pitié-Salpêtrière Hospital, 47 Boulevard de l'Hôpital, 75013, Paris, France.

Purpose: Non-traumatic acute subdural hematomas (SDH) are rare and have seldom been reported in ruptured brain arteriovenous malformations (BAVM). The aim of this study was to report the frequency of acute SDH in BAVM-related hemorrhage and to determine the relationship of SDHs with BAVM angioarchitectural features.

Methods: This was a retrospective monocentric study of patients admitted for BAVM rupture between 2003 and 2017. Read More

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http://dx.doi.org/10.1007/s00062-019-00771-7DOI Listing
March 2019
1 Read

Transient Complete Unilateral Oculomotor Nerve Palsy following Clipping of Ruptured Anterior Communicating Artery Aneurysm: An Abstruse Phenomenon.

Case Rep Vasc Med 2019 5;2019:3185023. Epub 2019 Feb 5.

Medical Officer, Department of Neurosurgery, College of Medical Sciences-Teaching Hospital, Bharatpur-10, Chitwan, Nepal.

Background: Aneurysmal subarachnoid hemorrhage may be associated with different cranial nerve palsies, with oculomotor nerve palsy (ONP) being the most common. ONP is especially associated with posterior communicating artery aneurysms, due to the anatomical proximity of the nerve to the aneurysmal wall. Anterior communicating artery (Acom) aneurysms are very unlikely to produce ONP due to the widely separated anatomical locations of Acom and oculomotor nerve. Read More

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http://dx.doi.org/10.1155/2019/3185023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379881PMC
February 2019
2 Reads

The Pipeline Embolization Device: Changes in Practice and Reduction of Complications in the Treatment of Anterior Circulation Aneurysms in a Multicenter Cohort.

Neurosurgery 2019 Mar 12. Epub 2019 Mar 12.

Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Background: The Pipeline Embolization Device (PED; Medtronic, Dublin, Ireland) has become an important tool for the treatment of cerebral aneurysms. Since FDA approval, there are ongoing efforts to increase aneurysm occlusion rates and reduce the incidence of complications.

Objective: To assess aneurysm occlusion and complication rates over time. Read More

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http://dx.doi.org/10.1093/neuros/nyz059DOI Listing
March 2019
3.620 Impact Factor

Periprocedural safety and technical outcomes of the new Silk Vista Baby flow diverter for the treatment of intracranial aneurysms: results from a multicenter experience.

J Neurointerv Surg 2019 Mar 9. Epub 2019 Mar 9.

Neuroradiology, Alfried Krupp Krankenhaus Ruttenscheid, Essen, Germany.

Purpose: The aim of our study was to assess the technical success and the safety of this new low-profile flow diverter Silk Vista Baby (SVB) by evaluating the intraprocedural and periprocedural complication rate.

Material/methods: Clinical, procedural, and angiographic data were analyzed.

Results: 41 consecutive patients (28 women; age average 50. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014770DOI Listing
March 2019
2 Reads

Perioperative rupture risk of unruptured intracranial aneurysms in cardiovascular surgery.

Brain 2019 Mar 8. Epub 2019 Mar 8.

Department of Anaesthesiology and Pain Medicine, Laboratory for Perioperative Outcomes Analysis and Research, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Although unruptured intracranial aneurysms are increasingly being diagnosed incidentally, perioperative rupture risk of unruptured intracranial aneurysm in patients undergoing cardiovascular surgery remains unclear. Therefore, we conducted an observational study to assess the prevalence and perioperative rupture risk of unruptured intracranial aneurysm in patients undergoing cardiovascular surgery. Adult patients (n = 4864) who underwent cardiovascular surgery between January 2010 and December 2016 were included. Read More

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http://dx.doi.org/10.1093/brain/awz058DOI Listing
March 2019
2 Reads

Pipeline Embolization Device for the Treatment of Intracranial Pseudoaneurysms.

World Neurosurg 2019 Mar 5. Epub 2019 Mar 5.

University of Miami, Department of Neurological Surgery, Florida, USA.

Background: Intracranial pseudoaneurysms (PSA) are associated with high rupture and mortality rates and have traditionally been treated by parent vessel sacrifice. There has been recent interest in utilizing flow-diverting devices for treatment of these complex lesions while preserving flow through the parent artery.

Objective: Examine the safety and efficacy of these devices in the treatment of intracranial PSA. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750193055
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http://dx.doi.org/10.1016/j.wneu.2019.02.135DOI Listing
March 2019
9 Reads

Aneurysm Remnants after Flow Diversion: Clinical and Angiographic Outcomes.

AJNR Am J Neuroradiol 2019 Apr 7;40(4):694-698. Epub 2019 Mar 7.

From the Departments of Neurointerventional Radiology and Neurosurgery (T.P.M., J.A.G., B.M.H., C.M.C., F.C.T.), Emory University School of Medicine, Atlanta, Georgia.

Background And Purpose: Flow diversion is an established method to treat complex intracranial aneurysms. The natural history of flow-diversion treatment failure resulting in aneurysm remnants is not well-defined. We aimed to delineate the clinical and angiographic features of this entity. Read More

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http://dx.doi.org/10.3174/ajnr.A6010DOI Listing

Pipeline embolisation device with shield technology for the treatment of ruptured intracranial aneurysm.

Neuroradiol J 2019 Mar 6:1971400919834692. Epub 2019 Mar 6.

1 Division of Neurosurgery, University of Toronto, Canada.

Flow diverters have emerged as a safe and effective treatment option for patients with complex unruptured cerebral aneurysms. Their utilisation in patients with ruptured aneurysms poses significant challenges, most notably the need for periprocedural dual antiplatelet medication. We describe the use of the pipeline embolisation device with shield technology in an 88-year-old patient with a complex ruptured posterior communicating artery aneurysm not amenable to microsurgical clipping or coiling alone. Read More

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http://dx.doi.org/10.1177/1971400919834692DOI Listing
March 2019
2 Reads

Unruptured intracranial aneurysm growth trajectory: occurrence and rate of enlargement in 520 longitudinally followed cases.

J Neurosurg 2019 Mar 1:1-11. Epub 2019 Mar 1.

2Department of Epidemiology, MD Anderson Cancer Center, University of Texas, Houston, Texas.

OBJECTIVEAs imaging technology has improved, more unruptured intracranial aneurysms (UIAs) are detected incidentally. However, there is limited information regarding how UIAs change over time to provide stratified, patient-specific UIA follow-up management. The authors sought to enrich understanding of the natural history of UIAs and identify basic UIA growth trajectories, that is, the speed at which various UIAs increase in size. Read More

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http://dx.doi.org/10.3171/2018.11.JNS181814DOI Listing
March 2019
8 Reads

Comprehensive analysis of perforator territory infarction on postoperative diffusion-weighted imaging in patients with surgically treated unruptured intracranial saccular aneurysms.

J Neurosurg 2019 Mar 1:1-8. Epub 2019 Mar 1.

1Department of Neurosurgery, Stroke Center, and.

OBJECTIVEPerforator territory infarction (PTI) is still a major problem needing to be solved to achieve good outcomes in aneurysm surgery. However, details and risk factors of PTI diagnosed on postoperative MRI remain unknown. The authors aimed to investigate the details of PTI on postoperative diffusion-weighted imaging (DWI) in patients with surgically treated unruptured intracranial saccular aneurysms (UISAs). Read More

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http://dx.doi.org/10.3171/2018.11.JNS181235DOI Listing
March 2019
5 Reads

Endosaccular Flow Disruption: A New Frontier in Endovascular Aneurysm Management.

Neurosurgery 2019 Mar 5. Epub 2019 Mar 5.

Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Flow modification has caused a paradigm shift in the management of intracranial aneurysms. Since the FDA approval of the Pipeline Embolization Device (Medtronic, Dublin, Ireland) in 2011, it has grown to become the modality of choice for a range of carefully selected lesions, previously not amenable to conventional endovascular techniques. While the vast majority of flow-diverting stents operate from within the parent artery (ie, endoluminal stents), providing a scaffold for endothelial cells growth at the aneurysmal neck while inducing intra-aneurysmal thrombosis, a smaller subset of endosaccular flow disruptors act from within the lesions themselves. Read More

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http://dx.doi.org/10.1093/neuros/nyz017DOI Listing
March 2019
1 Read
3.620 Impact Factor

[Efficacy analysis of LVIS and Enterprise stent assisted coil in the treatment of vertebral artery dissection aneurysm].

Zhonghua Yi Xue Za Zhi 2019 Mar;99(9):685-689

Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070 Chian.

To observe and evaluate the therapeutic efficacy of LVIS stent and Enterprise stent assisted coil in embolization of vertebral artery dissection aneurysm (VDA). Clinical data of 96 patients with VDAs treated by LVIS stent and Enterprise stent assisted coil were analyzed retrospectively between January, 2013 and June, 2017.Of all, the LVIS stent assisted coil was performed in 28 patients (LVIS-stent group) and Enterprise in 68 patients (Enterprise-stent group). Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2019.09.010DOI Listing
March 2019
1 Read

Magnetic Resonance Images of patients with acute isolyted cranial nerve palsies.

Turk Neurosurg 2018 Dec 14. Epub 2018 Dec 14.

Medipol University,Esenler Hospital.

Aim: Aim :To investigate magnetic resonance imaging (MRI) results of patients with the complaint of diplopia who found having ocular nevre palsy.

Material And Methods: Material ans Methods:Routine ophthalmic examination performed , neurology consultation requested and cranial MRI performed for all patients. The image results were grouped into four: Ischemic lesions, demyelinating disease lesions group, tumors and group who found no lesions. Read More

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http://www.turkishneurosurgery.org.tr/summary_en_doi.php3?do
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http://dx.doi.org/10.5137/1019-5149.JTN.24775-18.4DOI Listing
December 2018
6 Reads

Bypass Surgery for Complex Internal Carotid Artery Aneurysms: 39 Consecutive Patients.

World Neurosurg 2019 Feb 28. Epub 2019 Feb 28.

Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Objective: Bypass surgery is a special technique used to treat complex internal carotid artery (ICA) aneurysms. The aim of this retrospective study is to provide a comprehensive description of treatment and outcome of complex ICA aneurysms at different ICA segments (cavernous, supraclinoid, ICA bifurcation) treated with bypass procedures.

Methods: We identified 39 consecutive patients with 41 complex ICA aneurysms that were treated with 44 bypass procedures between 1998 and 2016. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.02.072DOI Listing
February 2019
3 Reads

Cardioembolic Sources in Patients With Small Single Subcortical Infarcts.

Neurologist 2019 Mar;24(2):56-58

Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL.

Transthoracic echocardiogram (TTE) is widely used as part of the work-up for ischemic stroke. However, the added utility of TTE in the management of small single subcortical infarcts (SSSI) has not been extensively evaluated. Therefore, we aimed to determine the frequency of high-risk and medium-risk cardioembolic sources diagnosed by TTE in SSSI patients, and whether the findings altered clinical management. Read More

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http://dx.doi.org/10.1097/NRL.0000000000000224DOI Listing
March 2019
3 Reads

Perineural cyst with intracystic hemorrhage following aneurysmal subarachnoid hemorrhage: A case report.

Medicine (Baltimore) 2019 Feb;98(8):e14184

Department of Rehabilitation Medicine, Dongguk University Ilsan Hospital, Goyang, Korea and Dongguk University, Seoul, Korea.

Rationale: Most perineural cysts are asymptomatic and discovered incidentally at the time of imaging. Although enlargement of the perineural cyst (PC) through a ball-valve mechanism and resultant compression of the adjacent neural or bony structures are known to be a source of pain in PCs, the reason why asymptomatic PCs become symptomatic is unclear. The authors report a case of PC, which was presumed to become symptomatic after subarachnoid hemorrhage without enlargement of the pre-existing PC. Read More

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http://dx.doi.org/10.1097/MD.0000000000014184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408090PMC
February 2019
2 Reads

Delayed development of a de novo contralateral middle cerebral artery aneurysm in a patient with hyperimmunoglobulin E syndrome: A case report.

Interv Neuroradiol 2019 Feb 25:1591019919828657. Epub 2019 Feb 25.

3 St Paul Radiology, St Paul, USA.

A 50-year-old female patient with hyperimmunoglobulin E syndrome (HIES) presented initially at the age of 48 years with subarachnoid hemorrhage (SAH) from a ruptured left middle cerebral artery (MCA) bifurcation aneurysm, which was treated successfully with coiling and microsurgical clipping. Angiography and cross-sectional imaging did not indicate evidence of any additional intracranial aneurysm. However, the patient presented two years later with SAH secondary to a new ruptured right MCA bifurcation aneurysm, which was treated successfully with microsurgical clipping. Read More

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http://dx.doi.org/10.1177/1591019919828657DOI Listing
February 2019
2 Reads

A Newly-Developed Flow Diverter (FloWise) for Internal Carotid Artery Aneurysm: Results of a Pilot Clinical Study.

Korean J Radiol 2019 Mar;20(3):505-512

Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

Objective: We report the results of a pilot clinical study that evaluated the safety and efficacy of a newly-developed, retrievable flow diverter (FloWise; Taewoong Medical) for the treatment of internal carotid artery (ICA) aneurysm.

Materials And Methods: A total of 10 patients were enrolled. Inclusion criteria were 1) unruptured aneurysm with a dome size of ≥ 8 mm and a neck size of ≥ 4 mm at the ICA, or 2) two or more unruptured aneurysms of any size able to be spanned by a single FloWise at the ICA. Read More

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http://dx.doi.org/10.3348/kjr.2018.0421DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389806PMC

The endoscopic transpterional port approach: anatomy, technique, and initial clinical experience.

J Neurosurg 2019 Feb 22:1-11. Epub 2019 Feb 22.

1Division of Neurosurgery, Toronto Western Hospital, Krembil Brain Institute, University Health Network, and Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

OBJECTIVEThe evolution of microsurgical and endoscopic techniques has allowed the development of less invasive transcranial approaches. The authors describe a purely endoscopic transpterional port craniotomy to access lesions involving the cavernous sinus and the anterolateral skull base.METHODSThrough single- or dual-port incisions and with direct endoscopic visualization, the authors performed an endoscopic transpterional port approach (ETPA) using a 4-mm straight endoscope in 8 sides of 4 formalin-fixed cadaveric heads injected with colored latex. Read More

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http://dx.doi.org/10.3171/2018.10.JNS171898DOI Listing
February 2019
2 Reads
3.737 Impact Factor

Complementary Roles of Dynamic Contrast-Enhanced MR Imaging and Postcontrast Vessel Wall Imaging in Detecting High-Risk Intracranial Aneurysms.

AJNR Am J Neuroradiol 2019 Mar 21;40(3):490-496. Epub 2019 Feb 21.

From the Department of Biomedical Engineering (H.Q., X.L., H.C.), Tsinghua University, Beijing, China

Background And Purpose: Individual assessment of the absolute risk of intracranial aneurysm rupture remains challenging. Emerging imaging techniques such as dynamic contrast-enhanced MR imaging and postcontrast vessel wall MR imaging may improve risk estimation by providing new information on aneurysm wall properties. The purpose of this study was to investigate the relationship between aneurysm wall permeability on dynamic contrast-enhanced MR imaging and aneurysm wall enhancement on postcontrast vessel wall MR imaging in unruptured intracranial aneurysms. Read More

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http://dx.doi.org/10.3174/ajnr.A5983DOI Listing

Practice Variation in the Diagnosis of Aneurysmal Subarachnoid Hemorrhage: A Survey of US and Canadian Emergency Medicine Physicians.

Neurocrit Care 2019 Feb 21. Epub 2019 Feb 21.

Department of Emergency Medicine, Stanford University Medical Center, Palo Alto, USA.

Background And Aims: Spontaneous subarachnoid hemorrhage (SAH) from a brain aneurysm, if untreated in the acute phase, leads to loss of functional independence in about 30% of patients and death in 27-44%. To evaluate for SAH, the American College of Emergency Physicians (ACEP) Clinical Policy recommends obtaining a non-contrast brain computed tomography (CT) scan followed by a lumbar puncture (LP) if the CT is negative. On the other hand, current evidence from prospectively collected data suggests that CT alone may be sufficient to rule out SAH in patients who present within 6 h of symptom onset while anecdotal evidence suggests that CT angiogram (CTA) may be used to detect aneurysms, which are the probable cause of SAH. Read More

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http://dx.doi.org/10.1007/s12028-019-00679-7DOI Listing
February 2019
2 Reads

Evaluation of the yield of post-clipping angiography and nationwide current practice.

Acta Neurochir (Wien) 2019 Apr 19;161(4):783-790. Epub 2019 Feb 19.

Department of Neurosurgery, University Medical Center Utrecht, Internal Postage: G03.124, PO-box 85500, 3584 CX, Utrecht, The Netherlands.

Background: Surgical treatment of intracranial saccular aneurysms aims to prevent (re)hemorrhage by complete occlusion of the aneurysmal lumen. It is unclear whether routine postoperative imaging, to assess aneurysmal occlusion, is necessary since intraoperative assessment by the neurosurgeon may be sufficient. We assessed routine clinical protocols for post-clipping imaging in the Netherlands and determined whether intraoperative assessment of aneurysm clippings sufficiently predicts aneurysm residuals. Read More

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http://dx.doi.org/10.1007/s00701-019-03834-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6431297PMC