A venographic cryptic stenosis at the junction of middle and lateral third of the transverse sinus has been observed in patients suffering from idiopathic intracranial hypertension. After reviewing the anatomical and embryological literature of the transverse sinus, 20 transverse sinuses were explored (in a pilot study of 10 human cadavers) ...

OBJECTIVE: We hypothesized that patients with intracranial cerebral aneurysms (IAs) harbor a molecular defect in the process responsible for maintaining arterial integrity (arterial homeostasis). In this study, we undertook a preliminary assessment of differential expression of key molecules involved with each phase of homeostasis: arterial flow modulation, arterial tear and ...

BACKGROUND: To analyze the co-occurrence of atherosclerotic lesions in CT angiograms of extra and intracranial arteries in patients with cerebral circulation insufficiency. MATERIAL/METHODS: Extra-and intracranial CTA was performed in 70 patients with symptoms of cerebral circulation insufficiency. Co-occurrence of atherosclerotic lesions at both levels and correlation between the degree of ...

The surgical treatment of ruptured blister-like dissecting aneurysm on the internal carotid artery (ICA) is still controversial. We report a case of this disease successfully managed by a staged treatment: GDC packing into the blister-like aneurysm in the acute stage followed by proximal occlusion in the chronic stage. The merit ...

Spontaneous subarachnoid hemorrhage accounts for 5 to 10 % of all strokes, with a worldwide incidence of 10.5 / 100000 person/year, varying in individual reports from 1.1 to 96 /100000 person/year. Angiographic and autopsy studies suggest that between 0.5% and 5% of the population have intracranial aneurysms. Approximately 30000 people ...

An intracranial aneurysm would be low on the differential diagnosis of a patient presenting with behavioral or emotional changes. Nonetheless, complex partial seizures (CPS) may cause such symptoms and result from an unruptured intracranial aneurysm. Failure to diagnose and treat this condition in a timely manner increases the patient's risk ...

The association of intracranial aneurysms and sickle cell disease (SCD) has been described in the English-language literature. Treatment strategies have included angiography and craniotomy. However, with advancement of non-operative interventions, much controversy surrounds the treatment of these patients. Endovascular embolization has been used in many patients with cerebral aneurysms, but ...

DESPITE THE CATASTROPHIC consequence of ruptured intracranial aneurysms, very little is understood regarding their pathogenesis, and there are no reliable predictive markers for identifying at-risk individuals. Given that intracranial aneurysms have a strong but complex genetic component and well-characterized modifiable risk factors, it seems likely that the most valuable approach ...

BACKGROUND: Approximately 8% of autosomal-dominant polycystic kidney disease (ADPKD) patients have intracranial aneurysms. The risk of growth and rupture of those discovered by presymptomatic screening is key to the feasibility and success of a screening program. This study was initiated to ascertain this risk. METHODS: ADPKD patients were offered screening ...

Moyamoya disease is infrequently associated with intracranial aneurysms arising from the circle of Willis vessels or from "peripheral" branches of choroidal and meningeal vessels. We present a rare case of a moyamoya-related aneurysm arising along the dural junction of multiple meningeal branches from the external carotid artery causing intracerebral hemorrhage. ...

Summary: PTA/stenting for the intracranial arteriosclerotic lesion is effective and novel treatment. Our standard technique to avoid serious complications, such as vessel rupture or acute occlusion was introduced in this paper.

Summary: The incidence of multiple intracranial aneurysms has been reported from 5% to 35%. But over four multiple aneurysms are extremely rare. Sometimes it is very difficult to draw a clear line between ruptured ones and unruptured others especially in multiple aneurysm cases with even distribution of subarachnoid haemorrhage on ...

This report involves a patient suffering from focal epilepsy caused by an unruptured, intracranial aneurysm (UIA), and her treatment using intravascular embolisation, with an excellent postoperative outcome in terms of the epilepsy. A 52 year-old, right-handed woman had been suffering for three years from focal seizures, characterized by loss of ...

BACKGROUND: Alagille syndrome (AGS) is a dominantly inherited multisystem disorder involving the liver, heart, eyes, face, and skeleton, caused by mutations in Jagged1. Intracranial bleeding is a recognized complication and cause of mortality in AGS. There are multiple case reports of intracranial vessel abnormalities and other vascular anomalies in AGS. ...

15 years ago, the treatment of incidentally discovered intracranial aneurysms was straightforward with a good evidence base behind it. When intracranial aneurysms were identified, people were referred to neurosurgeons who would offer surgical repair if the patient was in reasonable health and had a good life expectancy. Since that time, ...

The authors describe a novel approach to the management of high-output heart failure secondary to an intracranial high-flow dural arteriovenous fistula (DAVF) by using extracorporeal membrane oxygenation (ECMO). To the best of the authors' knowledge, this represents the first report of an embolization performed in conjunction with the use of ...

PHACE and PHACES are acronyms for a syndrome of variable expression comprising posterior cranial fossa malformations, facial haemangiomas, arterial anomalies, aortic coarctation and other cardiac disorders, ocular abnormalities and stenotic arterial disease. We review five girls and three boys aged 1 month-14 years with disorders from this spectrum. Six had ...

Extracranial-intracranial arterial bypass was frequently utilized in the 1970s and early 1980s to treat patients with atherosclerotic occlusive carotid arterial lesions not amenable to extracranial arterial revascularization procedures. After a large randomized trial reported in 1985 that there was no benefit of surgery in these patients, the procedure was generally ...

OBJECTIVES: To evaluate the frequency of intracranial atherosclerosis among patients with steno-occlusive extracranial carotid artery disease and to determine if there are factors related to the combined intracranial atherosclerosis. DESIGN: Cross-sectional study. SETTING: A tertiary referral hospital. Patients We studied 142 consecutive patients who had atherosclerotic steno-occlusive lesions (defined as ...

OBJECTIVE AND IMPORTANCE: The association of Graves' disease with multiple intracranial arterial stenoses is rare. CLINICAL PRESENTATION: We report on two Japanese women who experienced the concurrence of Graves' disease and cerebral ischemia attributable to multiple intracranial arterial stenoses around the circle of Willis. Clinically, these patients demonstrated hyperthyroidism, goiter, ...

Three cases of re-rupture of intracranial aneurysms during cerebral angiography (RIADCA) between June and September, 2001 are reported. All cases underwent emergency craniotomy and aneurysm clipping. The subarachnoid blood and the extravasating contrast medium were removed intraoperatively as completely as possible. There was no mortality in this series. The incidence, ...

We report 2 patients who had clinical and neuroimaging signs of spontaneous intracranial hypotension and who developed cerebral sinus venous thrombosis. This sequence of events -- known after dural puncture but not in spontaneous intracranial hypotension -- was suggested by the change in the pattern of headache, from a postural ...

Moyamoya disease is a progressive vascular disorder of unknown etiology. Theories of inflammatory and immunologic mechanisms have been proposed as the pathogeneses. We have designed a new method of administering N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP) for experimental induction of moyamoya disease using an intravascular interventional technique combined with rod-shaped embolic materials made from ...

Intracranial aneurysms are frequently present with subarachnoid hemorrhage. Less often they produce suggestive symptoms of cranial nerve dysfunction or intracranial tumor when very large. Their association with epilepsy has rarely been reported; such concurrence may not be a coincidence. When the patient presents with epileptiforme attacks the presence of an ...

BACKGROUND: Intracranial atherosclerosis accounts for 8% to 10% of all ischemic strokes, and intracranial angioplasty is increasingly performed to treat stenotic lesions. We report an autopsy case and discuss the effects of intracranial angioplasty for atherosclerotic arteries. CASE DESCRIPTION: A 77-year-old patient died 9 days after angioplasty of the left ...

OBJECTIVE: Although the cause of cerebral aneurysms remains unclear, there is clear evidence that genetic predisposition plays a role. Ten percent of patients report an aneurysm in a first-degree family member. However, studies to date have largely involved Caucasian populations. Our goal was to characterize the familial aggregation of intracranial ...

Screening patients with autosomal dominant polycystic kidney disease (ADPKD) for asymptomatic intracranial aneurysms has been proposed as a method of reducing the morbidity and mortality associated with aneurysm rupture. However, recent studies have shown lower spontaneous rupture rates of small aneurysms and higher risks of significant complications with interventions than ...

OBJECT: Intracranial stent placement combined with coil embolization is an emerging procedure for the treatment of intracranial aneurysms. The authors report their results using intracranial stents for the treatment of intracranial aneurysms. METHODS: A prospectively maintained database was reviewed to identify all patients with intracranial aneurysms that were treated with ...

OBJECTIVE: Massive intraoperative swelling (IOS) is a potential complication of intracranial surgery for traumatic hematomas. We present a novel design of dural opening to minimize the risks of IOS. METHODS: Over the last eight years, we have used and evaluated a "reversed U-shaped" durotomy incision, which leaves the dura intact ...

Summary: Traumatic intracranial aneurysms in children are rare and mostly related to skull fracture or rapid decelerating closed head injury.We report the case of an infant who developed intracranial aneurysm after minor head trauma and managed by endovascular treatment. A seven-month-old infant presented with delayed intracranial hemorrhage following minor head ...

OBJECTIVE: Chlamydia pneumoniae (C pneumoniae) is a common cause of a usually mild, community acquired pneumonia. This organism, however, can spread from the respiratory tract into other parts of the body and has been detected in up to 70% of atheromatous lesions in blood vessels. Although the exact mechanism of ...

BACKGROUND: The acronym PHACE describes a rare neurocutaneous syndrome encompassing the following features: posterior fossa brain malformation, hemangioma, arterial anomalies, coarctation of aorta and cardiac defects, and eye abnormalities. This report describes the cervico-cerebrovascular anomalies (CCVA) in 7 patients with PHACE syndrome. METHODS: The medical records of 7 children (4 ...

While the mortality rate of subarachnoid haemorrhage is very high in haemodialysis (HD) patients, the prevalence of unruptured intracranial aneurysms in HD patients has not yet been elucidated. We performed cerebral magnetic resonance angiography (MRA) on 123 HD patients who did not have symptomatic cerebrovascular disease, and on 52 control ...

Despite many reports investigating the relationship of subarachnoid haemorrhage and seasonal variation in different parts of the world, there is no clear correlation. As far as we know this subject has not been reported from Istanbul yet. The purpose of this study is to determine if there is any correlation ...

Extracranial-intracranial bypass surgery was performed prior to carotid resection in eight patients with head and neck carcinoma that involved the carotid artery near the skull base. Four patients underwent the standard one-stage extracranial-intracranial bypass procedure. A two-stage procedure was performed in the remaining four patients. The procedure first involved an ...

Summary: Formation of de novo intracranial aneurysms is rare. Their etiology is not known, but they are seen in patients with inherited collagen disorders, polycystic kidney disease, and familial history of aneurysms. Most de novo intracranial aneurysms are found 3-20 years after diagnosis of the initial aneurysm. We report the ...

We report a case of spontaneous intracranial hypotension that underwent cerebral angiography. The angiogram showed prominence of the veins and venous phase of the angiogram. This is thought to be secondary to decreased intracranial pressure and subsequent dilation of the venous system to attempt to replace the lost intracranial CSF ...

OBJECTIVE: Elevated serum levels of lipoprotein(a), a risk factor for atherosclerosis (AS), are also associated with the presence of asymptomatic intracranial aneurysms. AS is present in some aneurysms, but its contribution to aneurysm formation and growth is unclear. Apolipoprotein(a) [apo(a)], the active moiety of lipoprotein(a), is present in atherosclerotic circle ...

OBJECT: Vascular bypass is performed in neurosurgery for a variety of pathological entities, including extracranial atherosclerotic disease, extra- and intracranial aneurysms, and tumors involving the carotid artery (CA) at the skull base or cervical regions. Creation of an interposition saphenous vein graft (SVG) is the typical method of choice when ...

OBJECTIVE AND IMPORTANCE: A unique case of delayed ischemic deficit after resection of a large intracranial dermoid is presented. CLINICAL PRESENTATION: A 23-year-old woman, 36 hours after the uneventful gross total resection of a large intracranial dermoid cyst, slowly developed a progressive mixed aphasia and right hemiparesis. Magnetic resonance imaging ...

Intracranial internal carotid artery (ICA) aneurysms are frequently treated either by microsurgical clipping of the aneurysm neck, by endovascular coiling of the aneurysm sac or by balloon occlusion of the parent vessel. For some broad-based aneurysms that may not be suitable for any of these options, microsurgical wrapping of the ...

BACKGROUND: Although vasculopathy is a recognized complication during acute meningitis, to our knowledge, no previous reports have been published of this phenomenon developing months after successful treatment. OBJECTIVE: To report a unique case of a late-developing vasculopathy after pyogenic meningitis in an adult. REPORT OF A CASE: A 51-year-old woman ...

Childhood intracranial aneurysms are exceedingly uncommon. Diagnosis of intracranial aneurysms in infancy may be difficult because of their infrequency and confusing clinical presentation. Findings with routine radiographic methods may be misleading and difficult to interpret. We present a case of the rupture of an anterior communicating artery aneurysm in a ...

BACKGROUND AND PURPOSE: The clinical pattern of stroke and the angiographic distribution of cerebral atherosclerosis in the Japanese and Chinese are different from those in whites. Our purpose was to evaluate the location and distribution of severe atherosclerotic stenoses in Korean patients by using cerebral angiography. METHODS: We retrospectively reviewed ...

BACKGROUND: We aimed to prospectively assess the usefulness of computer tomographic angiography (CTA) in streamlining the management of symptomatic intracranial aneurysms in a tertiary neurosurgical unit, from admission to surgery. METHODS: We performed a prospective evaluation over a 2-year period of all symptomatic intracranial aneurysms managed according to a standardized ...

When intracranial aneurysms are deemed nonclippable, an accepted alternative neurosurgical treatment is to reinforce the aneurysm wall by wrapping or coating it with various materials, including muslin (cotton gauze). Granulomatous or "foreign-body" reactions, sometimes referred to as "muslinomas" or "gauzomas," and adhesive arachnoiditis are known but rare complications. Experience with ...

The persistent otic artery is a rare remnant of early fetal development that, to our knowledge, has been convincingly documented only once before with angiography. Other persistent vessels such as the trigeminal, hypoglossal, and proatlantal intersegmental arteries have been found to be associated with a variety of vascular anomalies. We ...

Summary: Acute subdural haematoma (ASDH) is rarely caused by an aneurysmal rupture. We report four cases of pure acute subdural haematomas caused by ruptured intracranial aneurysms. Aneurysms were localized in the posterior communicating artery in two cases, in the anterior communicating artery in one case and in the middle cerebral ...

Oculomotor palsy related to the presence of an intracranial aneurysm arising from the supraclinoid internal carotid artery (ICA) is a well known and described clinical condition. Recent microanatomical and clinical evidences seem to demonstrate that the pathophysiology of the aneurysm-related III nerve palsy could be interpreted as that of any ...

Intracranial aneurysms (IAs) are found more often in patients with aortic coarctation (AC) than in the general population and aneurysm rupture occurs much earlier in the lives of these patients when there is coexistent AC. The diagnosis of AC is frequently made only after a serious cerebrovascular complication has developed. ...