15,276 results match your criteria Brain Aneurysm Imaging


Severe Aneurysmal Subarachnoid Hemorrhage after Warning Headache during Pregnancy: A Case Report.

J Nippon Med Sch 2020 ;87(3):162-165

Department of Neurological Surgery, Nippon Medical School.

Background: Aneurysmal subarachnoid hemorrhage is a rare but important cause of maternal death during pregnancy.

Case Description: A 34-year-old primigravida (31 weeks of pregnancy) with acute headache but no neurological deficits or neck stiffness was prescribed medication and returned home. Four weeks later she presented with severe headache and consciousness disturbance. Read More

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http://dx.doi.org/10.1272/jnms.JNMS.2020_87-308DOI Listing
January 2020

Abnormal Flow Dynamics Result in Low Wall Shear Stress and High Oscillatory Shear Index in Abdominal Aortic Dilatation: Initial in vivo Assessment with 4D-flow MRI.

Magn Reson Med Sci 2020 Jul 13. Epub 2020 Jul 13.

MR Applications and Workflow, GE Healthcare Japan.

Purpose: To characterize the non-laminar flow dynamics and resultant decreased wall shear stress (WSS) and high oscillatory shear index (OSI) of the infrarenal abdominal aortic dilatation, cardiac phase-resolved 3D phase-contrast MRI (4D-flow MRI) was performed.

Methods: The prospective single-arm study was approved by the Institutional Review Board and included 18 subjects (median 67.5 years) with the dilated infrarenal aorta (median diameter 35 mm). Read More

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http://dx.doi.org/10.2463/mrms.mp.2019-0188DOI Listing

Pathophysiology of Intracranial Aneurysms: COX-2 Expression, Iron Deposition in Aneurysm Wall, and Correlation With Magnetic Resonance Imaging.

Stroke 2020 Jul 10:STROKEAHA120030590. Epub 2020 Jul 10.

Department of Neurosurgery, University Hospital Essen, Germany. (J.R., B.C., D.P., P.D., M.D.O., Y.Z., R.J., U.S., K.H.W.).

Background And Purpose: The pathophysiology of development, growth, and rupture of intracranial aneurysms (IAs) is only partly understood. Cyclooxygenase 2 (COX-2) converts arachidonic acid to prostaglandin H, which, in turn, is isomerized to prostaglandin E. In the human body, COX-2 plays an essential role in inflammatory pathways. Read More

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http://dx.doi.org/10.1161/STROKEAHA.120.030590DOI Listing
July 2020
5.723 Impact Factor

Head Repositioning during Neurointerventional Procedures to Optimize Biplanar Imaging.

J Neuroimaging 2020 Jul 8. Epub 2020 Jul 8.

Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC.

Background And Purpose: Head positioning is an important aspect for surgical planning in any cranial procedure. However, in neurointerventional cases, this is an afterthought due to advances in biplane imaging. We aim to present that the concept of head positioning may be applied to neurointerventional procedures to obtain optimal working projections to aide in the treatment of neurovascular pathology. Read More

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http://dx.doi.org/10.1111/jon.12750DOI Listing

Paramedian thalamic infarction caused by cisternal drain placement in open clipping for aneurysmal subarachnoid hemorrhage: Two case reports.

Surg Neurol Int 2020 27;11:164. Epub 2020 Jun 27.

Department of Neurosurgery, NTT Medical Center Tokyo, Shinagawa, Tokyo.

Background: Some complications associated with cisternal drainage have been reported; however, there are few reports on direct vascular injury caused by cisternal drain. We experienced two rare cases of thalamic infarction caused by cisternal drain placement during open clipping for a ruptured anterior communicating artery (AcomA) aneurysm through an anterior interhemispheric approach.

Case Description: Two cases of ruptured AcomA aneurysm were treated by surgical clipping through an anterior interhemispheric approach, and then a cisternal drain was inserted from opticocarotid space toward prepontine cistern. Read More

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http://dx.doi.org/10.25259/SNI_47_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332699PMC

Experience With the Pipeline Embolization Device for Posterior Circulations Aneurysms: A Multicenter Cohort Study.

Neurosurgery 2020 Jul 6. Epub 2020 Jul 6.

Departments of Medical Imaging & Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

Background: The Pipeline Embolization Device (PED; Medtronic) has been used off-label for the treatment of challenging posterior circulation aneurysms. Data on this modality are primarily limited to small retrospective single-center series.

Objective: To assess safety and efficacy of this treatment by establishing an international, multicenter collaboration. Read More

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http://dx.doi.org/10.1093/neuros/nyaa277DOI Listing

Bailouts in neurointervention; Novel techniques in tackling coil migration and premature intravascular detachment of microcatheter tip.

World Neurosurg 2020 Jun 29. Epub 2020 Jun 29.

Department of Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy. Electronic address:

Intracranial vascular malformations are increasingly being treated via the endovascular route. Though generally safe, a multitude of intraprocedural complications may arise, that potentially could lead to disastrous clinical outcomes. It is crucial for the operators to be well versed with the various techniques that are available to overcome any procedure-specific complications. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.06.190DOI Listing

SAFETY AND EFFICACY OF THE SILK FLOW DIVERTER: INSIGHT FROM THE DIVERSION PROSPECTIVE COHORT STUDY.

J Neuroradiol 2020 Jun 29. Epub 2020 Jun 29.

Department of Neuroradiology, University Hospital of Bordeaux, France. Electronic address:

Background And Purpose: Flow diverters are considered as an essential tool in the stent-based treatment of complex intracranial aneurysms. We report here a subgroup analysis of the nationwide prospective DIVERSION study to investigate the safety and efficacy of the Silk flow diverter at 12 months follow-up.

Methods: We performed a subgroup analysis of patients included in the DIVERSION, a national prospective cohort study including all flow diverters placement between 2012 and 2014 in France, and treated with the Silk. Read More

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http://dx.doi.org/10.1016/j.neurad.2020.06.006DOI Listing

Clinical data on rare case of spontaneous disappearance of intracranial Aneurysm.

Data Brief 2020 Aug 18;31:105874. Epub 2020 Jun 18.

Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan.

The data contained within this paper are related to another paper entitled "Rare Spontaneous disappearance of intracranial aneurysm" (Yokoya et al., 2020). Spontaneous disappearance of an unruptured non-giant aneurysm of the anterior circulation is very rare. Read More

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http://dx.doi.org/10.1016/j.dib.2020.105874DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316999PMC

Dynamic contrast-enhanced MRI analysis for prognosis of intracranial dissecting aneurysm with intramural haematoma after endovascular treatment: an observational registry study.

Stroke Vasc Neurol 2020 Jul 1. Epub 2020 Jul 1.

Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Beijing, China

Background And Purpose: Intracranial dissecting aneurysm (IDA) with intramural haematoma (IMH) is an intractable cerebrovascular disease. The outcome of IDA with IMH after endovascular treatment varies across different individuals: some IMHs stop growing after endovascular treatment, while others continue to grow, even after embolisation of the parent artery. Currently, the mechanism for the continuous growth of IMH after endovascular treatment is still unclear. Read More

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http://dx.doi.org/10.1136/svn-2020-000326DOI Listing

Endovascular flow-diversion of visceral and renal artery aneurysms using dual-layer braided nitinol carotid stents.

CVIR Endovasc 2020 Jun 28;3(1):33. Epub 2020 Jun 28.

Interventional Radiology Unit - Monash Imaging, Monash Health, Melbourne, Australia.

Background: Visceral and renal artery aneurysms (VRAAs) are uncommon but are associated with a high mortality rate in the event of rupture. Endovascular treatment is now first line in many centres, but preservation of arterial flow may be difficult in unfavourable anatomy including wide necked aneurysms, parent artery tortuosity and proximity to arterial bifurcations. Endovascular stenting, and in particular flow-diversion, is used in neurovascular intervention to treat intracranial aneurysms but is less often utilised in the treatment of VRAAs. Read More

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http://dx.doi.org/10.1186/s42155-020-00125-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321844PMC

Ruptured Vertebral Artery Dissecting Aneurysm in a Patient with Recurrent Bacterial Meningitis.

World Neurosurg 2020 Jun 22. Epub 2020 Jun 22.

Department of Neurosurgery, University of Louisville, Louisville, KY.

Background: Intracranial mycotic aneurysms are uncommon, it can occur due extravascular extension or intravascular seeding of the vessel wall. It often results subarachnoid hemorrhage (SAH) with poor prognosis. We present a rare case of ruptured proximal anterior inferior cerebellar artery- posterior inferior cerebellar artery (AICA-PICA) mycotic aneurysm after an episode of bacterial meningitis. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.06.090DOI Listing

Simultaneous subdural, subarachnoideal and intracerebral haemorrhage after rupture of a peripheral middle cerebral artery aneurysm.

Ideggyogy Sz 2020 05;73(05-06):213-216

Department of Neurosurgery, Szent János Hospital, Budapest.

The cause of intracerebral, subarachnoid and subdural haemorrhage is different, and the simultaneous appearance in the same case is extremely rare. We describe the case of a patient with a ruptured aneurysm on the distal segment of the middle cerebral artery, with a concomitant subdural and intracerebral haemorrhage, and a subsequent secondary brainstem (Duret) haemorrhage. The 59-year-old woman had hypertension and diabetes in her medical history. Read More

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http://dx.doi.org/10.18071/isz.73.0213DOI Listing

Pivotal Trial of the Neuroform Atlas Stent for Treatment of Anterior Circulation Aneurysms: One-Year Outcomes.

Stroke 2020 Jul 17;51(7):2087-2094. Epub 2020 Jun 17.

Cooper University Hospital, Camden (B.T.J.).

Background And Purpose: Stent-assisted coil embolization using the new generation Neuroform Atlas Stent System has shown promising safety and efficacy. The primary study results of the anterior circulation aneurysm cohort of the treatment of wide-neck, saccular, intracranial, aneurysms with the Neuroform Atlas Stent System (ATLAS trial [Safety and Effectiveness of the Treatment of Wide Neck, Saccular Intracranial Aneurysms With the Neuroform Atlas Stent System]) are presented.

Methods: ATLAS IDE trial (Investigational Device Exemption) is a prospective, multicenter, single-arm, open-label study of wide-neck (neck ≥4 mm or dome-to-neck ratio <2) intracranial aneurysms in the anterior circulation treated with the Neuroform Atlas Stent and approved coils. Read More

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http://dx.doi.org/10.1161/STROKEAHA.119.028418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306258PMC

Haemodynamics in a patient-specific intracranial aneurysm according to experimental and numerical approaches: A comparison of PIV, CFD and PC-MRI.

Technol Health Care 2020 Jun 19. Epub 2020 Jun 19.

Institute of Fluid Science, Tohoku University, Sendai, Miyagi, Japan.

Background: The haemodynamics determined by different approaches for studying fluid dynamics - i.e. computational fluid dynamics (CFD), particle image velocimetry (PIV), and phase-contrast magnetic resonance imaging (PC-MRI) - have rarely been thoroughly compared; nor have the factors that affect accuracy and precision in each method. Read More

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http://dx.doi.org/10.3233/THC-202252DOI Listing

Contemporaneous Clipping of Unruptured Anterior Cerebral Artery Proximal A1 Segment Aneurysm and Resection of Dural-Based Brain Tumor.

Cureus 2020 May 18;12(5):e8183. Epub 2020 May 18.

Neurological Surgery, University of Louisville School of Medicine, Louisville, USA.

The coexistence of brain tumors and unruptured intracranial aneurysms is uncommon, so there is limited data regarding management strategies for these cases. Tumor, aneurysm, and patient factors must be considered in the decision-making process. We present a case of a dural-based left temporal brain tumor with an incidental ipsilateral unruptured anterior cerebral artery (ACA) proximal A1 segment aneurysm. Read More

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http://dx.doi.org/10.7759/cureus.8183DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301418PMC

Difference in imaging biomarkers between transient and permanent neurological deficits after endovascular treatment of cerebrovascular aneurysms.

J Neurosurg 2020 Jun 19:1-10. Epub 2020 Jun 19.

Departments of1Neurological Surgery and.

Objective: The literature suggests that blood-brain barrier disruption (BBBD) plays a significant role in the development of neurological events in patients with diffusion-weighted imaging (DWI) that is negative for lesions. In this prospective, single-center cohort study, the authors compared the imaging characteristics of patients suffering transient neurological events (TNEs) with those in patients suffering permanent neurological events (PNEs) after having undergone elective embolization of unruptured intracranial aneurysms.

Methods: This prospective cohort study was conducted between July 2016 and June 2019. Read More

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http://dx.doi.org/10.3171/2020.4.JNS192718DOI Listing
June 2020
3.737 Impact Factor

Ventriculitis after emergent arch aneurysm surgery.

J Card Surg 2020 Jun 19. Epub 2020 Jun 19.

Division of Internal Medicine, Tokyo-Shinagawa Hospital, Tokyo, Japan.

A 72-year-old man was referred to our institution because of an arch aneurysm and acute aortic dissection (thrombosed Stanford type A). Anti-impulse therapy was initiated. He developed a high fever after admission. Read More

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http://dx.doi.org/10.1111/jocs.14720DOI Listing

Reduced 2-year aneurysm retreatment and costs among patients treated with flow diversion versus non-flow diversion embolization: A Premier Healthcare Database retrospective cohort study.

PLoS One 2020 18;15(6):e0234478. Epub 2020 Jun 18.

Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, United States of America.

Introduction: The use of endovascular treatments, including Pipeline embolization devices (PEDs) and coiling approaches (non-PEDs), has played an increasingly important role in the treatment of intracranial aneurysms. Despite multiple studies evaluating PEDs, a real-world evaluation of follow-up outcomes and costs remains to be completed.

Methods: The Premier Healthcare Database (PHD), 2010-2017, was queried to identify patients with unruptured intracranial aneurysms treated endovascularly. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234478PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302520PMC

Endovascular sacrifice of the proximal posterior inferior cerebellar artery for treatment of ruptured intracranial aneurysms.

J Neurointerv Surg 2020 Aug 16;12(8):777-782. Epub 2020 Jun 16.

Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA

Background: Ruptured aneurysms of the intracranial vertebral artery (VA) or posterior inferior cerebellar artery (PICA) are challenging to treat as they are often dissecting aneurysms necessitating direct sacrifice of the diseased segment, which is thought to carry high morbidity due to brainstem and cerebellar stroke. However, relatively few studies evaluating outcomes following VA or proximal PICA sacrifice exist. We sought to determine the efficacy and outcomes of endovascular VA/PICA sacrifice. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-016261DOI Listing

Treatment of a giant complicated distal posterior inferior cerebellar artery aneurysm: A case report and literature review.

Exp Ther Med 2020 Jul 7;20(1):395-400. Epub 2020 May 7.

Department of Neurosurgery, Wuxi Clinical College of Anhui Medical University, 904th Hospital of Joint Logistic Support Force of PLA, Wuxi, Jiangsu 214044, P.R. China.

Giant intracranial aneurysms, especially giant aneurysms of the distal posterior inferior cerebellar artery (PICA), remain the most difficult and challenging cerebrovascular lesions for neurosurgeons to treat. The morbidity and mortality rates of microsurgical clipping are relatively high, and endovascular embolization is also associated with many complications. In the present report, the case of a 46-year-old female patient who presented with headache and dizziness for 3 years, which was aggravated and combined with limb weakness for 1 day, is presented. Read More

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http://dx.doi.org/10.3892/etm.2020.8724DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7281963PMC

Early experience treating intracranial aneurysms using Accero: a novel, fully visible, low profile braided stent with platinum-nitinol composite wire technology.

J Neurointerv Surg 2020 Jun 10. Epub 2020 Jun 10.

Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK.

Background: Accero is an innovative, fully visible, self-expanding braided stent with platinum-nitinol composite wire technology, produced by Acandis.

Objective: To assess the technical success and safety of this new stent by evaluating the intraprocedural behavior and complication rate, and the short-term follow-up results.

Methods: Forty-one consecutive patients suitable for stent-assisted coiling were selected for the use of Accero in an 11-month period. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-015918DOI Listing

Transradial intracranial aneurysm treatment via an aberrant right subclavian artery.

BMJ Case Rep 2020 Jun 9;13(6). Epub 2020 Jun 9.

Neurological Imaging and Interventional Service of Western Australia, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.

We report two cases of successfully treated intracranial saccular aneurysms via transradial access with aberrant right subclavian artery anatomy. Two patients aged 74 and 82 years with anterior communicating artery aneurysms deemed suitable for endovascular treatment and anomalous aortic arch anatomy (aberrant right subclavian artery) underwent successful treatment with transradial access. Transradial access was obtained in both patients, in the first patient, without prior knowledge of the aortic arch anatomy. Read More

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http://dx.doi.org/10.1136/bcr-2019-234078DOI Listing

Determinants of the Presence and Size of Intracranial Aneurysms in the General Population: The Rotterdam Study.

Stroke 2020 Jul 10;51(7):2103-2110. Epub 2020 Jun 10.

Department of Neurology (T.Y.C., D.W.J.D., B.R.), Erasmus MC - University Medical Center, Rotterdam, the Netherlands.

Background And Purpose: The prevalence of unruptured intracranial aneurysms (UIAs) in the adult population is ≈3%. Rupture of an intracranial aneurysm can have devastating consequences, which emphasizes the importance of identification of potentially modifiable determinants for the presence and size of UIAs. Our aim was to study the association of a broad spectrum of potential determinants with the presence and size of UIAs in a general adult population. Read More

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http://dx.doi.org/10.1161/STROKEAHA.120.029296DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306261PMC
July 2020
5.723 Impact Factor

Fusion of subarachnoid hemorrhage data and computed tomography angiography data is helpful to identify the rupture source in patients with multiple intracranial aneurysms.

Neurosurg Rev 2020 Jun 6. Epub 2020 Jun 6.

Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China.

Determining the rupture source is imperative in patient with aneurysmal subarachnoid hemorrhage (SAH). About one third of SAH cases with multiple intracranial aneurysms cannot be certain of the rupture source according to the hemorrhage pattern. This study aims to identify of the rupture source in patients with multiple intracranial aneurysms by fusing SAH data and computed tomography angiography (CTA) data. Read More

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http://dx.doi.org/10.1007/s10143-019-01221-1DOI Listing
June 2020
1.861 Impact Factor

Posterior cerebral artery stroke by reverse flow embolism in thoracic outlet syndrome - a case report.

BMC Neurol 2020 Jun 4;20(1):229. Epub 2020 Jun 4.

Department of neurology and stroke center, Versailles Mignot Hospital, 78150, Le Chesnay, France.

Background: Arterial thoracic outlet syndrome is a rare condition characterized by a subclavian artery pathology associated with a bone abnormality. It is rarely associated with thromboembolic stroke. The mechanism of cerebral embolism associated with thoracic outlet syndrome have rarely been demonstrated. Read More

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http://dx.doi.org/10.1186/s12883-020-01797-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271554PMC

Endovascular Management of Symptomatic Intracranial Pseudoaneurysm and Intimal Flow-Limiting Dissection with a Single Device.

World Neurosurg 2020 May 31;141:72. Epub 2020 May 31.

Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois, USA.

The natural history of unruptured dissections of the intracranial vertebral artery (VA) is not well delineated. The dissected VA may heal spontaneously or may be associated with ischemic events. The literature on medical management for intracranial VA dissections is also limited. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.05.229DOI Listing

Lower complication rates associated with transradial versus transfemoral flow diverting stent placement.

J Neurointerv Surg 2020 Jun 2. Epub 2020 Jun 2.

Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA

Background: Currently, there are no large-scale studies in the neurointerventional literature comparing safety between transradial (TRA) and transfemoral (TFA) approaches for flow diversion procedures. This study aims to assess complication rates in a large multicenter registry for TRA versus TFA flow diversion.

Methods: We retrospectively analyzed flow diversion cases for cerebral aneurysms from 14 institutions from 2010 to 2019. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-015992DOI Listing

Diagnosis and treatment of pure arterial malformation: Three case reports and literature review.

Medicine (Baltimore) 2020 May;99(21):e20229

Department of Neurosurgery, the First Hospital of Jilin University, Changchun, China.

Rationale: The incidence of pure arterial malformations is relatively low, and few cases have been reported. Only 2 cases with pure arterial malformation have been reported to receive surgery or endovascular treatment.

Patient Concerns: We report 3 cases and review the relevant literatures. Read More

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http://dx.doi.org/10.1097/MD.0000000000020229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249948PMC

Ruptured cerebral mycotic aneurysm in a left ventricular assist device patient with bacteremia.

Int J Artif Organs 2020 May 30:391398820925493. Epub 2020 May 30.

Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

A 50-year-old male with a history of nonischemic dilated cardiomyopathy presented in cardiogenic shock and ultimately underwent durable left ventricular assist device implantation. He recovered well initially but developed persistent bacteremia. His indwelling pacemaker leads were extracted due to evidence of vegetation. Read More

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http://dx.doi.org/10.1177/0391398820925493DOI Listing

Wall enhancement characteristics of vertebrobasilar nonsaccular aneurysms and their relationship to symptoms.

Eur J Radiol 2020 Aug 19;129:109064. Epub 2020 May 19.

Department of Radiology and Biomedical Imaging, University of California San Francisco, 4150 Clement St., San Francisco, CA 94121, USA.

Purpose: This study aims to explore wall enhancement characteristics of vertebrobasilar nonsaccular aneurysms (VBNAs) and their relationship to clinical symptoms.

Methods: We retrospectively analyzed VBNAs in the high resolution MR vessel wall imaging (HR-VWI) databases at two institutions. The aneurysmal basic characteristics and wall enhancement characteristics, were evaluated by two radiologists. Read More

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http://dx.doi.org/10.1016/j.ejrad.2020.109064DOI Listing
August 2020
2.369 Impact Factor

Radiological classification of azygos anterior cerebral artery and evaluation of the accompanying vascular anomalies.

Surg Radiol Anat 2020 May 29. Epub 2020 May 29.

Department of Radiology, Niğde Ömer Halisdemir University Faculty of Medicine, Niğde, Turkey.

Purpose: There is not a classification of azygos anterior cerebral artery (ACA) based on anatomical branching levels in the literature. In the present study, a classification of azygos ACA was made based on radiological imaging for a common terminology, and frequency, accompanying vascular anomalies and malformations were investigated.

Methods: A total of 4913 cases who had brain CTA, MRA, contrast-enhanced MRI and DSA in January 2010-January 2020 period were screened for the study. Read More

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http://dx.doi.org/10.1007/s00276-020-02509-4DOI Listing

Long-Term Rupture Risk in Patients with Unruptured Intracranial Aneurysms Treated with Endovascular Therapy: A Systematic Review and Meta-Analysis.

AJNR Am J Neuroradiol 2020 Jun 28;41(6):1043-1048. Epub 2020 May 28.

From the Department of Radiology (A.R., S.M.S., M.A., R.K., W.B., D.F.K.).

Background: Surveillance imaging of previously unruptured, coiled aneurysms remains routine even though reports of rupture of these aneurysms are extremely rare.

Purpose: We performed meta-analysis to examine long-term rupture risk over ≥1-year follow-up duration in patients with unruptured intracranial aneurysm who underwent endovascular therapy.

Data Sources: Multiple databases were searched for relevant publications between 1995 and 2018. Read More

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http://dx.doi.org/10.3174/ajnr.A6568DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342755PMC

Longitudinal Monitoring of Flow-Diverting Stent Tissue Coverage After Implant in a Bifurcation Model Using Neurovascular High-Frequency Optical Coherence Tomography.

Neurosurgery 2020 May 28. Epub 2020 May 28.

Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts.

Background: Tissue growth over covered branches is a leading cause of delayed thrombotic complications after flow-diverter stenting (FDS). Due to insufficient resolution, no imaging modality is clinically available to monitor this phenomenon.

Objective: To evaluate high-frequency optical coherence tomography (HF-OCT), a novel intravascular imaging modality designed for the cerebrovascular anatomy with a resolution approaching 10 microns, to monitor tissue growth over FDS in an arterial bifurcation model. Read More

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http://dx.doi.org/10.1093/neuros/nyaa208DOI Listing
May 2020
3.620 Impact Factor

Safety and effectiveness of endoscopic endonasal intracranial aneurysm clipping: a systematic review.

Neurosurg Rev 2020 May 26. Epub 2020 May 26.

Department of Neurological Surgery, The Ohio State University, Wexner Medical Center, Columbus, OH, USA.

Once considered far-fetched, endoscopic endonasal clipping (EEC) has been reported as a feasible alternative route for treating intracranial aneurysms located in the midline. Appropriately, debates regarding EEC applicability have arisen amongst the neurosurgical community. We aim to define the safety, effectiveness, and current state-of-art in the use of EEC for intracranial aneurysms. Read More

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http://dx.doi.org/10.1007/s10143-020-01316-0DOI Listing
May 2020
1.861 Impact Factor

Unruptured Intracranial Aneurysms- Pathogenesis and Individualized Management.

Dtsch Arztebl Int 2020 Apr;117(14):235-242

Department of Neurosurgery, UMC Mannheim, Medical Faculty, Ruprecht-Karls-Universität Heidelberg; Department of Neuroradiology, University Hospital Erlangen, University of Erlangen-Nuremberg; Department of Neurology, Center of Neurology and Neurosurgery, Universitätsklinikum Goethe- Universität Frankfurt.

Background: About 2 million adults in Germany harbor an unruptured intracranial aneurysm (IA). Rupture can lead to a life-threatening subarachnoid hemorrhage. If an IA is detected incidentally in cranial imaging, it must be decided how to proceed. Read More

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http://dx.doi.org/10.3238/arztebl.2020.0235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264289PMC

A Pregnant Woman with Cranial Aneurysm Rupture in the Second Trimester of Pregnancy.

World Neurosurg 2020 May 11;140:229-232. Epub 2020 May 11.

Department of Neurosurgery, Acıbadem University Atakent Hospital, Istanbul, Turkey.

Background: Reports of cerebral aneurysm and aneurysm rupture during pregnancy are rare in the literature. Aneurysms might rupture and cause intracranial hemorrhage during or after pregnancy. Aneurysmal subarachnoid hemorrhage during pregnancy presents a challenge regarding treatment and management. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.04.238DOI Listing

Practical value of three-dimensional high resolution magnetic resonance Vessel Wall imaging in identifying suspicious intracranial vertebrobasilar dissecting aneurysms.

BMC Neurol 2020 May 20;20(1):199. Epub 2020 May 20.

New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, No. 16 Xinjiekouwai Street, Xicheng District, Beijing, 100088, China.

Background: Direct evidence of intimal flaps, double lumen and intramural haematomas (IMH) is difficult to detect on conventional angiography in most intracranial vertebrobasilar dissecting aneurysms (VBDAs). Our purpose was to assess the value of three-dimensional high-resolution magnetic resonance vessel wall imaging (3D HRMR VWI) for identifying VBDAs.

Methods: Between August 2013 and January 2016, consecutive patients with suspicious VBDAs were prospectively enrolled to undergo catheter angiography and VWI (pre- and post-contrast). Read More

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http://dx.doi.org/10.1186/s12883-020-01779-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238595PMC

Antiplatelet Drugs for Neurointerventions: Part 1 Clinical Pharmacology.

Clin Neuroradiol 2020 May 18. Epub 2020 May 18.

Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Victoria, Australia.

The development of endovascular treatment for intracranial aneurysms has established new techniques such as balloon and stent-assistance, flow diversion and endosaccular occlusion devices. Antiplatelet treatment is an important aspect to reduce risk of thrombus formation on microcatheters and implanted devices when utilizing these methods. It is particularly relevant for flow diverting stents to prevent early and late stent thrombosis. Read More

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http://dx.doi.org/10.1007/s00062-020-00910-5DOI Listing
May 2020
1.615 Impact Factor

Increased contrast enhancement of the parent vessel of unruptured intracranial aneurysms in 7T MR imaging.

J Neurointerv Surg 2020 May 18. Epub 2020 May 18.

Neurological Surgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

Background: Inflammation of the arterial wall may lead to aneurysm formation. The presence of aneurysm enhancement on high-resolution vessel wall imaging (HR-VWI) is a marker of wall inflammation and instability. We aim to determine if there is any association between increased contrast enhancement in the aneurysmal wall and its parent artery. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-015915DOI Listing

Immediate Postoperative Angiographic Stagnation of Contrast Media and T2-Weighted Magnetic Resonance Imaging Features within Aneurysmal Sac Are Associated with Early Regression of Large or Giant Aneurysm After Flow Diversion Only.

World Neurosurg 2020 May 12. Epub 2020 May 12.

Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.

Background: We hypothesized that the immediate postoperative imaging features would be associated with early regression of flow-diverted aneurysms. We compared the imaging features from digital subtraction angiography and spin echo T2-weighted magnetic resonance imaging between those with early total regression and partial regression.

Methods: A total of 30 consecutive patients with large and giant aneurysms were treated with pipeline embolization devices and divided into 2 groups according to the follow-up angiographic findings at 3-6 months. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.05.047DOI Listing
May 2020
2.417 Impact Factor

Ruptured Intracranial Aneurysm in a Neonate: Case Report and Review of the Literature.

World Neurosurg 2020 May 12;140:219-223. Epub 2020 May 12.

Department of Neurosurgery, Rouen University Hospital, Rouen, France; Department of Interventional Neuroradiology, Rouen University Hospital, Rouen, France; University of Limoges CNRS XLIM UMR 7252, Limoges, France; Laboratory of Microvascular Endothelium and Neonate Brain Lesions, Normandie University, UNIROUEN, INSERM U1245, Rouen, France. Electronic address:

Background: Intracranial aneurysms (IAs) are exceptional in neonates accounting for less than 2% of all IAs occurring during the first decade of life. Little is known about this pathology in this specific population. Because of its scarcity and this specific age at onset, the treatment of IA in neonates is challenging. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.05.018DOI Listing

Increased Wall Enhancement During Follow-Up as a Predictor of Subsequent Aneurysmal Growth.

Stroke 2020 Jun 13;51(6):1868-1872. Epub 2020 May 13.

Department of Neuroradiology, Université Paris-Descartes-Sorbonne-Paris-Cité, IMABRAIN-INSERM-UMR1266, DHU-Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France (W.B.H., G.B., D.T., L.L., C.R.-R., C.O., O.N., M.E.).

Background and Purpose- Absence of arterial wall enhancement (AWE) of unruptured intracranial aneurysms (UIA) has shown promise at predicting which aneurysms will not rupture. We here tested the hypothesis that increased enhancement during follow-up (increased intensity, extension, or thickness or appearance of de novo enhancement), assessed using vessel wall magnetic resonance imaging, was associated with higher rates of subsequent growth. Methods- Patients with UIA were included between 2012 and 2018. Read More

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http://dx.doi.org/10.1161/STROKEAHA.119.028431DOI Listing

Does Systemic Lupus Erythematosus Increase the Risk of Procedure-Related Complication in Endovascular Treatment of Intracranial Aneurysm?

Yonsei Med J 2020 May;61(5):441-444

Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea.

Cerebral aneurysms associated with systemic lupus erythematosus (SLE) are more likely to grow rapidly and rupture, compared to those found in the general population. The main underlying pathology of intracranial aneurysm and its rupture is presumed to be SLE-related intracranial vasculitis and fragility of blood vessels due to prolonged use of steroid. For these reasons, both surgical and endovascular options are challenging. Read More

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http://dx.doi.org/10.3349/ymj.2020.61.5.441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214111PMC

Anterior communicating artery complex fenestration combined with tandem aneurysm: a case report and literature review.

Medicine (Baltimore) 2020 May;99(19):e20013

Department of Neurosurgery, Fuzong Clinical Medical College of Fujian Medical University, 900th Hospital.

Introduction: Clinically, anterior communicating artery complex fenestration combined with fenestration-related aneurysms is rare, and combination of this condition with tandem aneurysms is even rarer.

Patient Concerns: A case of a 43-year-old man with spontaneous subarachnoid hemorrhage.

Diagnosis: A computed tomography angiography examination revealed a fenestrated anterior communicating artery complex combined with 2 aneurysms. Read More

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http://dx.doi.org/10.1097/MD.0000000000020013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220171PMC

Henle fibre layer haemorrhage: clinical features and pathogenesis.

Br J Ophthalmol 2020 May 6. Epub 2020 May 6.

Retina Department, Vitreous Retina Macula Consultants of New York, New York, New York, USA.

Background: To describe the clinical presentation and characteristic imaging features of deep retinal haemorrhages primarily located in the Henle fibre layer (HFL) of the macula. The spectrum of aetiologies and a comprehensive theory of pathogenesis are presented.

Methods: This is a retrospective, multicentre case series evaluating eyes with retinal haemorrhage in HFL. Read More

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http://dx.doi.org/10.1136/bjophthalmol-2019-315443DOI Listing

Prediction of Unruptured Intracranial Aneurysm Evolution: The UCAN Project.

Neurosurgery 2020 Jul;87(1):150-156

CHU Nantes, Neuroradiology Department, Nantes, France.

Background: Management of small (<7 mm) unruptured intracranial aneurysms (UIA) remains controversial. Retrospective studies have suggested that post gadolinium arterial wall enhancement (AWE) of UIA on magnetic resonance imaging (MRI) may reflect aneurysm wall instability, and hence may highlight a higher risk of UIA growth. This trial aims at exploring wall imaging findings of UIAs with consecutive follow-up to substantiate these assumptions. Read More

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http://dx.doi.org/10.1093/neuros/nyaa093DOI Listing

Clipping of Basilar and Middle Cerebral Artery Aneurysms: 2-dimensional operative video.

Oper Neurosurg (Hagerstown) 2020 May 4. Epub 2020 May 4.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Careful preoperative planning for patients with multiple intracranial aneurysms is paramount given the importance of an appropriate trajectory and exposure for each aneurysm that will be clipped. The general principle is to clip aneurysms in a retrograde manner, such that more distal aneurysms are clipped earlier, and more superficial aneurysms are clipped later. This patient had unruptured middle cerebral artery (MCA) and basilar artery (BA) apex aneurysms and elected for surgical clipping of both lesions. Read More

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http://dx.doi.org/10.1093/ons/opaa116DOI Listing

Development and validation of machine learning prediction model based on computed tomography angiography-derived hemodynamics for rupture status of intracranial aneurysms: a Chinese multicenter study.

Eur Radiol 2020 Apr 29. Epub 2020 Apr 29.

Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu, China.

Objectives: To build models based on conventional logistic regression (LR) and machine learning (ML) algorithms combining clinical, morphological, and hemodynamic information to predict individual rupture status of unruptured intracranial aneurysms (UIAs), afterwards tested in internal and external validation datasets.

Methods: Patients with intracranial aneurysms diagnosed by computed tomography angiography and confirmed by invasive cerebral angiograph or clipping surgery were included. The prediction models were developed based on clinical, aneurysm morphological, and hemodynamic parameters by conventional LR and ML methods. Read More

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http://dx.doi.org/10.1007/s00330-020-06886-7DOI Listing