BACKGROUND AND PURPOSE: Clinical features of nontraumatic dissecting aneurysms of intracranial carotid circulation remain unclear because investigation of this disease has been limited to case reports. The aim of this study was to investigate the clinical features of this disease through the use of cooperatively collected cases. METHODS: The cases ...

Rupture of an intracranial aneurysm generally has a poor outcome, though perioperative treatments have improved. At the present time, the important factors in the management of intracranial aneurysm surgery appear to be the maintenance of adequate cerebral perfusion pressure and the avoidance of hyperglycemia. Relevant features of the anesthetic management ...

OBJECTIVE AND IMPORTANCE: Herein we describe two cases of extracranial-intracranial vein graft bypasses for the treatment of giant intracranial aneurysms in prepubertal pediatric patients. One patient is, we think, the youngest patient reported in the literature to have been successfully treated in such a manner, with a good long-term outcome. ...

Beginning in the 1960s, neurosurgeons and radiologists have made attempts to treat intracranial aneurysms using nonclip techniques. The evolution of such therapy has included acrylics, metallic particles, balloons, electric current, and nondetachable and detachable coils. This article will chronologically review these various techniques and the papers that reported their results ...

We present CT and MR features of a large intracranial lipoma located in the left sphenocavernosal region in a patient with a history of spinal intradural lipoma excision. The lipomatous lesion surrounded the internal carotid artery and trigeminal nerve and extended extracranially into the infratemporal region through a smoothly dilated ...

Proper assessment of intracranial arteries by transcranial Doppler sonography (TCD) in patients with intracranial stenoses is occasionally made difficult by an insufficient temporal bone window, an unfavourable insonation angle, or low flow velocity or volume. This condition is frequently found in Chinese. In these cases, echocontrast could be helpful. We ...

Transcranial Doppler (TCD) sonography is a new imaging technique allowing for non-invasive evaluation of the intracranial vascular anatomy and cerebral hemodynamics. The recent introduction of echographic contrast agents has significantly increased the sensitivity of TCD for the diagnosis of intracranial vascular lesions. We report a case of giant AComA aneurysm, ...

Summary: For evaluation of intracranial cerebral aneurysms, three-dimensional (3D) digital subtraction angiography (DSA) and 3D-computed tomographic angiography (CTA) were demonstrated in fifteen patients. The diagnostic accuracy of preoperative 3D-CTA is equal to that of 3D-DSA except for the case with a dissecting aneurysm. The virtual images of 3D-CTA were well ...

Summary: With the advancement of molecular genetics, the deletion of the TSC2/PKD1 gene at chromosome 16p13.3 has been discovered to be responsible for the tuberous sclerosis complex sharing some of the clinical manifestations of autosomal dominant adult polycystic kidney disease such as multiple renal cysts and intracranial aneurysms. The unruptured ...

Intracranial aneurysms (ICA) are a well-known feature of autosomal dominant polycystic kidney disease. There is only one report about ICA in an adult patient with autosomal recessive polycystic kidney disease (ARPKD). We observed a 2-year, 6-month old girl with ARPKD and multiple ICA. The family history is negative for kidney ...

OBJECTIVE AND IMPORTANCE: Painful oculomotor palsy can result from enlargement or rupture of intracranial aneurysms. The IIIrd cranial nerve dysfunction in this setting, whether partial or complete, is usually fixed or progressive and is sometimes reversible with surgery. We report an unusual oculomotor manifestation of a posterior carotid artery wall ...

A 27-year-old female rhesus macaque (Macaca mulatta) developed anisocoria. The left pupil was dilated and unresponsive to light. The macaque was euthanized because of unrelated reasons and the body was submitted for necropsy. On gross examination, a berry aneurysm of the right middle cerebral artery causing marked compression of the ...

Here we report about a 35-year-old electrical engineer who was found dead in his study. Postmortem examination revealed that death resulted because of subarachnoid and intraventricular hemorrhage caused by the rupture of an intracranial aneurysm. Right hand and left cheek revealed electrical marks with metallizations on skin, an electric shock ...

BACKGROUND AND PURPOSE: Neurofibromatosis type I (NF1) is an autosomal dominant, hereditary, neurocutaneous syndrome purported to be associated with intracranial aneurysms. To study the relationship between NF1 and intracranial aneurysms, we have analyzed all intracranial autopsies of NF1 patients performed at our institution from 1889 to 1999 and analyzed all ...

BACKGROUND AND PURPOSE: Atherosclerosis occurs later and is less extensive in intracranial arteries than in extracranial arteries. However, the mechanisms responsible are poorly understood. A previous study has suggested a better antioxidant protection of intracranial arteries. METHODS: To assess the influence of age on arterial activity of antioxidant enzymes and ...

OBJECT: Applanation tonometry is a noninvasive method of assessing both peripheral and central arterial blood pressure (BP) profiles. In this study the authors examine whether there are differences in these profiles in patients with intracranial aneurysms when compared with age-matched controls. METHODS: Carotid artery (CA) and derived aortic BP waveforms ...

The use of transcranial duplex sonography in documenting additional findings by measuring vasospasm and visualising aneurysms in neurosurgical patients is described. Daily measurement of vasospasm using this method enables reassessment of the status of the lesion in the context of the patient's clinical condition. This offers a practical alternative to ...

Infective intracranial aneurysms are relatively uncommon. They develop due to septic embolisation of the vasa vasorum or lumen of the artery, with resultant focal arteritis and necrosis, leading to aneurysm formation. They are an important cause for intracranial haemorrhage. Six cases of infective aneurysms are described. A focus of infection ...

OBJECTIVE AND IMPORTANCE: Perimedullary arteriovenous fistulae (AVFs) do not commonly present with subarachnoid hemorrhage or intracranial venous drainage causing neurological symptoms. We present a case with both of these features. The patient was inadvertently treated for an unruptured intracranial aneurysm before his true problem was recognized. CLINICAL PRESENTATION: A 65-year-old ...

Dilation and inflammation of cephalic arteries and intracranial extra cerebral arteries cause the migraine headache. The migraine-associated symptoms result from the activation of the sympathetic nervous system caused by the pain. The migraine aura is caused by the neurophysiological phenomenon of spreading excitation/depression. The various mechanisms are tied together in ...

A patient is described with a vertebrobasilar aneurysm who was erroneously thought to have myasthenia gravis on the basis of the clinical presentation and investigations, which were interpreted as supportive of a disorder of the neuromuscular junction. Despite the correct diagnosis being made at a late stage the patient made ...

Cerebral revascularization offers an important adjunct to parent-vessel ligation in the treatment of large and otherwise inaccessible intracranial aneurysms. Good or excellent outcomes can be expected in approximately 80% of patients. Poor outcomes and ischemic complications were highest in posterior circulation lesions. Cranial neuropathies from mass effect associated with giant ...

In 1985, the International Study of Extracranial-to-Intracranial Arterial Anastomosis demonstrated no benefit from extracranial-to-intracranial arterial bypass operations in treatment of patients with extensive cerebrovascular disease including those with occlusions of the internal carotid artery. Interest in the potential use of extracranial-to-intracranial arterial bypass operations, however, has been rekindled by evidence ...

Abciximab was administered intravenously to three patients to treat thrombus associated with atherosclerotic stenosis of a supra-aortic artery. In two cases, the thrombi had been identified on a previous angiography more than a week before treatment. Successful thrombolysis was achieved with abciximab in all three cases. In this small series, ...

BACKGROUND AND PURPOSE: We sought to perform a large, prospective, multicenter, blinded study comparing power transcranial color duplex sonography (power TCDS) with intra-arterial digital subtraction angiography (IADSA) in the detection of intracranial aneurysms. METHODS: Contemporaneous TCDS and IADSA examinations were performed in 171 subjects with suspected intracranial aneurysm. Via the ...

Most intracranial saccular aneurysms remain asymptomatic until rupture. Yet, some unruptured lesions present with various symptoms, often related to the compression of a nerve or other intracranial tissue. An obvious question, therefore, is whether or not symptomatic unruptured lesions necessarily have a greater rupture-potential than asymptomatic ones. In this paper, ...

An anterior cerebral artery traumatic aneurysm in a 15-month-old infant is described. The diagnosis was confirmed by computed tomographic angiography. The patient recovered fully after successful clipping of the aneurysm. As the signs of traumatic intracranial aneurysm may be subtle especially in young children, a high degree of suspicion is ...

An 11-year-old boy with hemoglobin sickle disease (HbSD), bilateral stenosis of the intracranial carotid arteries, and moyamoya syndrome had recurrent ischemic strokes with aphasia and right hemiparesis. His parents (Jehovah's Witnesses) refused blood transfusions. After bilateral extracranial-intracranial (EC-IC) bypass surgery, hydroxyurea treatment increased hemoglobin F (HbF) levels to more than ...

Polyarteritis nodosa (PAN) is a necrotizing vasculitis involving small and medium-sized arteries and it affects multiple organ systems in the body Central nervous system (CNS) involvement appears less frequently, and usually develops after the disease is established. Although aneurysms are common in visceral arteries in PAN, intracranial aneurysms are uncommon ...

BACKGROUND AND PURPOSE: Approximately 6% of human beings harbor an unruptured intracranial aneurysm. Each year in the United States, >30 000 people suffer a ruptured intracranial aneurysm, resulting in subarachnoid hemorrhage. Despite the high incidence and catastrophic consequences of a ruptured intracranial aneurysm and the fact that there is considerable ...

Hallucinations are defined as sensory phenomena in the absence of external sensory stimuli. Auditory hallucinations have been shown to arise from many different intracranial lesions, but seizures manifesting as musical hallucinations triggered by unruptured intracranial aneurysms are rare. We present a case of persistent, episodic musical hallucinations associated with seizures ...

Branchio-oto-dysplasia is characterized by abnormalities of embryonic branchial arch system and deafness inherited as autosomal dominant with variable gene expression. We present a rare case of multiple intracranial aneurysms associated with branchio-oto-dysplasia. A 40-yr-old man with severe headache presented as spontaneous subarachnoid hemorrhage on brain computed tomographic scan. The patient ...

We describe a case of aneurysm of the vein of Galen (AVG), which was diagnosed by intrauterine US, MRI and MRA. The baby girl was born at 35 weeks' gestation. She had severe clinical symptoms at birth and died at 29 h of age from intractable congestive heart failure. Intrauterine ...

Intracranial vascular abnormalities such as intracranial aneurysms, carotid-cavernous fistulas, AVMs, and cavernous malformations commonly produce neuro-ophthalmologic symptoms and signs. Unruptured aneurysms can compress the third cranial nerve and anterior visual pathways. Subarachnoid hemorrhage from ruptured aneurysms can result in Terson's syndrome and papilledema. Direct and indirect carotid-cavernous fistulas most commonly ...

OBJECTIVE: An excruciating headache of instantaneous onset is known as a thunderclap headache. A subarachnoid hemorrhage is the prototypical cause, but other serious disorders may also present with a thunderclap headache, including cerebral venous sinus thrombosis, carotid artery dissection, and pituitary apoplexy. We report a group of patients with thunderclap ...

BACKGROUND: Cellulose acetate polymer (CAP) is a new liquid embolic material that has been used experimentally in intravascular treatment of intracranial aneurysms. But this compound is still controversial in some aspects such as safety, efficiency, and histological changes. In this study, we re-evaluated the material with regard to intravascular treatment ...

Intracranial aneurysmal hemorrhage is a common but devastating condition associated with significant morbidity and mortality. Epidemiologic studies have identified risk factors associated with this condition. Genetic factors involve family history and the presence of certain heritable connective tissue disorders such as Ehlers-Danlos syndrome, Marfan's syndrome, neurofibromatosis, and polycystic kidney disease. ...

The expression of polycystin-1 in the vascular smooth muscle cells (VSMC) of elastic and large distributive arteries suggests that some vascular manifestations of autosomal-dominant polycystic kidney disease (ADPKD) result directly from the genetic defect. Intracranial aneurysms have been reported in PKD2, as well as in PKD1 families. To determine whether ...

Intracranial fibromuscular dysplasia (FMD) is a vascular disease of unknown origin occurring predominantly in young women. The internal carotid artery is most often involved, but other cerebral arteries may also be affected. We report the case of a young woman presenting with an unusual angiographic appearance of intracranial FMD of ...

Crescendo transient ischaemic attacks (TIAs) should be regarded as a medical emergency. Patients require hospitalisation with urgent assessment and symptom control with anticoagulant therapy. We report on three patients, all of whom had atherosclerotic aneurysmal disease of the extracranial arterial circulation who presented with crescendo TIAs. The possibility of extracranial ...

Summary: Concerning to the embolization for the intracranial aneurysms, the underlying theme of the discussion is presented with our experiences.

OBJECTIVE AND IMPORTANCE: Intravascular papillary endothelial hyperplasia (IPEH) is an atypical proliferation of endothelium that results in abnormal organization for thrombus formation. Intracranial IPEH is a rare entity and has not been reported to arise from within an intracranial aneurysm. Furthermore, the elapsed time during which acquired intracranial IPEH develops ...

Intracranial aneurysms are a common complication of sickle cell disease. The management of a patient with multiple intracranial aneurysms and sickle cell disease is described. The English language literature is reviewed. Neuroanesthetic management has traditionally been based on the avoidance of factors said to lead to erythrocyte sickling; however neuropathology ...

We describe the development and design of a database for auditing patients with intracranial aneurysms and their endovascular treatment. The database has been used since 1992. Our department's version now contains records of over 800 patients and well over 1,000 aneurysms. The advantages of a relational database for this type ...

Mechanical heart valves are associated with a risk of thromboembolism and anticoagulation is generally recommended. However, this is inevitably associated with a risk of intracranial bleeding. The case of a patient who sustained an intracranial bleed while taking warfarin for a prosthetic aortic valve and a further two intracranial bleeds ...

BACKGROUND AND PURPOSE: Despite prominent neurological symptoms reported in Takayasu arteritis (TA), a complete evaluation of the cerebral circulation has not been consistently performed. The purpose of this study is to describe MR angiography (MRA), color Doppler flow imaging, and transcranial Doppler (TCD) findings in the extracranial and intracranial cerebral ...

PURPOSE: Intracranial aneurysms are known to complicate autosomal dominant polycystic kidney disease. We assess the value of magnetic resonance angiography to detect intracranial aneurysms early in patients with autosomal dominant polycystic kidney disease. MATERIALS AND METHODS: We evaluated 15 patients with asymptomatic autosomal dominant polycystic kidney disease treated at our ...

Intracranial fibromuscular dysplasia is a nonatheromatous angiopathy that most commonly affects adult women and is rarely recognized in children. Symptoms include stroke and headache, although the vasculopathy may be asymptomatic. Diagnosis is based on angiographic appearance, commonly described as a "string of beads." The etiology of intracranial fibromuscular dysplasia is ...

The formation and rupture of aneurysms is a significant medical problem, but is not clearly understood. Most intracranial aneurysm are located in the circle of Willis. We consider a nonlinear mathematical model that simulates the blood flow inside the aneurysm, one of the relevant factors in the evolution of an ...

OBJECTIVES: Ultrasound of the brain supplying arteries is a standard diagnostic procedure in patients with suspected and definite acute and chronic cerebrovascular occlusive disease. Anatomical and pathological limitations led to the development of echocontrast agents which are able to survive pulmonary and capillary transit and improve the echogenicity of the ...