A rare abnormality of the A1 segment of the anterior cerebral artery (ACA) is reported. The right ACA bifurcated into two parts at the middle point of the A1 segment, and these segments did not rejoin. The superior right A1 segment connected with the left A1 and formed a single ...

Physiologic cerebral monitoring has become an important part of our cardiovascular surgical unit. We recently encountered an unusual variant of aortic atresia that was first suggested by physiologic cerebral monitoring and required modification of our operative technique. We describe and discuss the anatomy, its translation into cerebral monitor findings, and ...

BACKGROUND AND OBJECTIVE: Neurological dysfunction is a common problem after cardiac surgery with cardiopulmonary bypass (CPB). Cerebral ischaemia associated with the use of CPB may result in a release of neuronal-ischaemic markers and a subsequent cerebral inflammatory response which may additionally release inflammatory cytokines. In order to locate the origin ...

The superficial temporal artery to middle artery bypass is a technique that allows the blood supply from the extracranial carotid circulation to be routed to the distal middle cerebral artery branches. The procedure allows blood flow to bypass proximal lesions of the intracranial vasculature. The performance of this bypass requires ...

A new technique for selective spin labeling of individual arteries is presented. It is based on continuous arterial spin labeling (CASL) with an amplitude-modulated control experiment. Precessionary motion of the labeling gradient about the axis of the artery, combined with an appropriate frequency modulation of the labeling RF pulse, restricts ...

Astasia, inability to stand unsupported despite good strength, resembles the marked balance impairment of patients with vestibulocerebellar disease. We describe a patient with unilateral thalamic infarct that presented with astasia. A 76-year-old hypertensive woman was admitted to our hospital because of marked unsteadiness. On neurological examination, she could not stand ...

A 9-year-old girl presented with an acute right-sided hemiparesis. Initially, the clinical presentation and stable vasculopathic abnormalities on MR and conventional angiography were suspicious of a so-called "transient cerebral arteriopathy". Mild but persistent pleocytosis and an elevated CSF IgG index led to an extensive search for infectious and immunological causes ...

OBJECTIVE: The objective was to examine the microsurgical anatomy basic to the microsurgical and endovascular management of lesions involving the dural arteries. METHODS: Adult cadaveric heads and skulls were examined using the magnification provided by the surgical microscope to define the origin, course, and distribution of the individual dural arteries. ...

OBJECTIVE: Although previous reports have described patients with both cerebral and aortic aneurysms, any association was believed to be coincidental. In this study, we provide evidence that aortic and cerebral aneurysm formation may share a common genetic predisposition in some families. METHODS: A prospective enrollment of consecutive patients treated for ...

OBJECT: The formation of cerebral aneurysms involves complex processes and little is known about the mechanisms by which they originate, grow, and rupture. The purpose of this study was to identify early ultrastructural morphological changes that lead to the formation of experimental cerebral aneurysms. METHODS: Twenty male Sprague-Dawley rats were ...

Left atrial myxoma commonly leads to cerebral embolic ischemic stroke. The subsequent formation of cerebral aneurysms due to myxomatous emboli is a phenomenon that may lead to severe neurologic complications such as intracerebral hemorrhage. In addition to the formation of aneurysms in cerebral arteries, we report here the unique picture ...

Transcranial Doppler (TCD) was carried out to determine the resistive index (RI) values of normal canine cerebral arteries and its reproducibility and to evaluate the change of cerebral vascular resistance following diuretics administration. RI values of rostral cerebral artery (RCA) were compared between fontanelle window and temporal window. Normal ranges ...

Cerebral aneurysm rupture and subarachnoid hemorrhage (SAH) inflict disability and death on thousands of individuals each year. In addition to vasospasm in large diameter arteries, enhanced constriction of resistance arteries within the cerebral vasculature may contribute to decreased cerebral blood flow and the development of delayed neurological deficits after SAH. ...

BACKGROUND AND PURPOSE: Anatomic evaluation of the lenticulostriate arteries (LSAs) is important, especially in cases of surgical or endovascular treatment, but biplanar angiography provides limited information. We analyzed the LSAs with rotational angiography (RA) and 3D reconstruction and compared the findings with those of previous autopsy studies. METHODS: We retrospectively ...

Almost all diseases affect blood vessel attributes (vessel number, radius, tortuosity, and branching pattern). Quantitative measurement of vessel attributes over relevant vessel populations could thus provide an important means of diagnosing and staging disease. Unfortunately, little is known about the statistical properties of vessel attributes. In particular, it is unclear ...

Moyamoya syndrome, a vasculopathy characterized by chronic progressive stenosis at the apices of the intracranial internal carotid arteries, is an increasingly recognized entity which is associated with cerebral ischemia. Diagnosis is made on the basis of clinical and radiographic findings, including a characteristic stenosis of the internal carotid arteries in ...

OBJECTIVE: Although the necessity of craniotomy for an unruptured cerebral aneurysm (UCA) is controversial, surgery is warranted if surgical risks are less than the risks of natural history. In this study, we investigated the need for craniotomy for UCAs on the basis of surgical risk. METHODS: History of cerebrovascular disorders, ...

A 53-year-old man was admitted with diplopia, right ptosis, left lid retraction, mild left sided weakness and involuntary movements. Neurological examination revealed plus-minus lid and Benedikt's syndromes together. Magnetic resonance imaging (MRI) showed two distinct mesencephalic infarctions in territories of paramedian and pedincular perforating arteries. Magnetic resonance angiography (MRA) showed ...

OBJECTIVE: Spontaneous intracranial haemorrhage constitutes 18-40% of all stroke cases. Indications for cerebral angiography to find underlying potentially treatable vascular abnormalities are not clear. This study determined which intracranial haemorrhage patients need cerebral angiography by correlating computed tomography (CT) findings, age and hypertension history with cerebral angiography findings. METHODS: A ...

BACKGROUND: Assess the accuracy of transcranial color-coded sonography (TCCS) for detecting middle cerebral artery (MCA) stem occlusion and compare it with cerebral angiography. METHODS: This study enrolled a series of patients who received TCCS and cerebral angiography at the Department of Neurology in Chang Gung Memorial Hospital, Linkou Medical Center, ...

OBJECTIVE: Dynamic MR perfusion imaging can detect cerebral perfusion deficits resulting from severe internal carotid artery (ICA) stenosis. It is unknown, however, whether moderate ICA stenosis (50-69%) also causes haemodynamic disturbance. We investigated whether cerebral perfusion deficits were detectable in patients with moderate ICA stenosis. METHODS: Eighteen patients underwent T2* ...

OBJECTIVE: To evaluate by MR diffusion weighted image (DWI-MR) the presence of new ischemic cerebral lesions after carotid artery stenting (CAS) and distal cerebral protection, in patients with internal carotid artery (ICA) stenosis >70. METHODS: Sixty-seven CAS were performed under cerebral protection with a distal filter. Mean age of the ...

OBJECTIVE: To describe techniques of reconstruction for unclippable and uncoilable middle cerebral artery aneurysms. METHODS: A retrospective review was performed of seven patients who underwent eight operations during a 9-year period to treat complex middle cerebral artery bifurcation aneurysms not amenable to direct clipping or endovascular coiling. All preoperative and ...

This article presents a method of analysis of variation in the cortical branching of the posterior cerebral artery (PCA). The method takes account of previous observations and reflects various symptoms of such variation. Of 100 cerebral hemispheres into whose vessels a contrast medium was injected, 94 hemispheres have been qualified ...

OBJECT: Revascularization is an important component of treatment for complex aneurysms, skull base tumors, and vertebrobasilar ischemia in the posterior circulation. In this study, the authors examined the microsurgical anatomy related to cerebral revascularization in the posterior circulation and demonstrate various procedures for bypass surgery. METHODS: The microsurgical anatomy of ...

BACKGROUND: The causes of the common dementias remain unknown. Paradoxical embolisation of the cerebral circulation by venous thrombi passing through venous to arterial shunts (v-aCS) in the heart or pulmonary circulation is known to occur in cryptogenic stroke and post-operative confusion following hip replacement. OBJECTIVES: To explore the role of ...

We previously posited that impaired washout of emboli was an important mechanism of brain infarction in patients with cerebral hypoperfusion. Hyperviscosity and hypoperfusion enhance thrombus formation promoting embolization of fresh thrombi. Hypoperfusion also reduces dissolution of emboli due to reduced flow velocity leading to classic hemodynamic patterns of stroke. To ...

BACKGROUND: The precentral gyrus (PG) is the primary motor area and is one of the most eloquent brain regions of neurosurgical interest. Although the arterial supply to the PG is generally known, contributions from different arterial branches such as the anterior cerebral artery (ACA), posterior cerebral artery (PCA), and middle ...

In this paper a method to extract cerebral arteries from computed tomographic angiography (CTA) is proposed. Since CTA shows both bone and vessels, the examination of vessels is a difficult task. In the upper part of the brain, the arteries of main interest are not close to bone and can ...

OBJECTIVE: Stroke studies in animals showed that aortic obstruction increases cerebral blood flow (CBF) and reduces infarct size. In this study we evaluate the safety and efficacy of a device providing partial and transitory aortic obstruction. METHODS: We report the results in 24 selected patients with symptomatic vasospasm by aneurysmal ...

The superficial temporal artery-to-middle cerebral artery bypass represents the mainstay of bypass operations for cerebral revascularization. The role of this operation in the setting of cerebrovascular occlusive disease, with compromised cerebral hemodynamic reserve, is a topic of current investigation. In this report, we describe technical nuances to avert potential pitfalls ...

OBJECTIVE: To see whether swine provide a suitable animal model for cerebral ischemia research projects related to apoptosis. Swine angiograms had not been obtained previously in our institution. METHODS: We performed angiography on an anesthetized pig. A right femoral artery cannulation was carried out, and angiographic images of the right ...

Several important modifications have been introduced in the intraoperative management of neonates with hypoplastic left heart syndrome during first-stage palliation. Among these, utilization of selective antegrade cerebral perfusion and interposition of a conduit between the right ventricle and pulmonary artery are currently favored by many centers. We briefly describe our ...

Environmental reduplication or reduplicative paramnesia is one of the content-specific delusions (CSD) which is characterized by reduplication of places. CSD has been reported in focal and diffuse cerebral disorders. A focal lesion such as frontal lobes and the right hemispheric lesion have been documented The authors describe a 66 year-old ...

BACKGROUND AND PURPOSE: To identify if the stroke-prone spontaneously hypertensive rat (SHRSP) exhibits impaired functional recovery after stroke compared with its normotensive reference strain, the Wistar Kyoto rat (WKY). METHODS: In study 1, a 2-mm distal middle cerebral artery occlusion (middle cerebral artery occlusion) was performed in both strains and ...

We report a case of mechanical thrombectomy in which a new device, the Retriever, was used for acute cerebral ischemia in the setting of extensive occlusion of the left internal carotid and middle cerebral arteries. Excellent radiographic and clinical results were obtained. The Retriever is currently approved and available for ...

A 53-year-old man presented with cerebral infarction associated with a dissecting aneurysm of the left middle cerebral artery (MCA), with enlargement and fluid collection. Anticoagulant therapy was performed as the first stage treatment for cerebral infarction. Serial magnetic resonance imaging showed that the dissecting aneurysm had enlarged and fluid collection ...

A 62-year-old man presented with a 2-month history of right occipito-parietal headache and worsening ipsilateral ptosis. CT scan and cerebral angiography revealed a large fusiform aneurysm of the P2 segment of the right posterior cerebral artery (PCA). The aneurysm was successfully trapped and subsequently excised via sub temporal approach leaving ...

OBJECTIVE: To analyse the topography of cerebral microbleeds (CMBs) visualized by T2*-weighted gradient-echo MR imaging in the supratentorial brain area, based on the anatomical classification of the regions and the arterial territories. BACKGROUND: CMBs are associated with hypertension and the risk of intracerebral hemorrhage; however, little is known about the ...

BACKGROUND: An arteriotomy on a branch of the middle cerebral artery (MCA) is required in the procedure of the direct anastomosis for the treatment of moyamoya disease, and the artery comes to be collapsed after blood is washed out. The phenomenon makes the microsurgical procedure difficult during direct anastomosis. METHODS: ...

OBJECTIVES: To assess the value of middle cerebral artery Doppler indices obtained from different sampling sites in predicting umbilical cord gases at delivery in prolonged pregnancies. METHODS: This was a prospective study of consecutive pregnant women referred for prolonged-pregnancy surveillance. The predictive value of distal and proximal middle cerebral artery ...

The present study evaluated the effect of wogonin, a flavonoid originated from the root of Scutellaria baicalensis GEORGI, on focal ischemic brain injury in rats. Focal brain ischemia was induced by the permanent occlusion of middle cerebral artery (pMCAO) for 24 h with a silicone rubber cylinder inserted through the ...

Summary: We report a case of thromboembolic occlusion of the middle cerebral artery after endovascular treatment of a ruptured anterior communicating artery aneurysm. When fibrinolytic therapy failed to recanalize the occluded vessel, an emergency extracranial-to-intracranial bypass was performed. This intervention rescued our patient from cerebral infarction. This case demonstrates the ...

Although many cerebral vascular anomalies are widely recognized, others are less well known or unclassified. Accessory middle cerebral artery (MCA) and duplicated MCA are among uncommon anomalies. We present a very rare case of subarachnoid haemorrhage due to rupture of a saccular aneurysm arising from a duplicated middle cerebral artery ...

A 29-year-old man presented with lethargy, headache, high fever, and visual disturbance. Neurological examination showed mydriatic pupil, ptosis, diminished light reflex, and ophthalmoplegia on the left. Magnetic resonance (MR) imaging showed the typical findings of pituitary apoplexy, and cerebral angiography disclosed mild narrowing of the A1 segment of the left ...

A 35-year-old man with neurofibromatosis type 1 (NF1) had a left ophthalmic artery occlusion that caused no light perception OS 28 years after having been treated with external beam radiation therapy for a presumed glioma of the right optic nerve and chiasm. Clinical and imaging findings were consistent with radiation-induced ...

Bithalamic infarcts are usually attributed to thromboembolism of the top of the basilar artery. However, in some cases, deep cerebral venous thrombosis and thrombosis of cerebral venous sinuses was proved to be the cause. The case of a 47-year-old female with ischemic thalamic and mesencephalic lesions is reported, that was ...

OBJECTIVE: We sought to examine the influence on the brain, with or without old infarction, of pH management during antegrade selective cerebral perfusion in a canine model. METHODS: A cerebral infarct canine model was created by injecting a cylindrical silicone embolus. Dogs that had obvious neurologic deficits and had survived ...

Moyamoya disease is vaso-occlusive disease involving the arteries of the circle of Willis that is accompanied by a compensatory recruitment of a vascular network. The pathological and immunohistochemical findings of an autopsy case of hemorrhagic moyamoya disease in a 69-year-old woman are described in the present report. The autopsy findings ...

Although the intraluminal thread technique has been used to induce focal cerebral ischaemia in rabbits, its success rate is not high. We, therefore, attempted to improve the stability and reproducibility of this method by using thread tips of appropriate diameter as determined from the anatomical characteristics of the carotid and ...