• Title/Summary/Keyword: Aneurysms

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Surgical treatment of sinus valsalva rupture -Surgical considerations and results of operation- (Valsalva형 동뇌류파열의 외과적 치료)

  • Kim, Gi-Bong;Lee, Yeong-Gyun
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.101-107
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    • 1986
  • Over the past 11 years, from Jan. 1975 through Nov. 1985, 27 consecutive patients with congenital aneurysms of sinus of Valsalva underwent corrective surgery in our department of Thoracic Surgery. 26 were suggested to arise from right coronary sinus and 1 from noncoronary sinus: among 26, 18 ruptured into right ventricle, 1 into right atrium, 1 into pulmonary artery. And 1 from noncoronary sinus into right atrium. Among 18 cases of preoperatively diagnosed as ruptured aneurysm, the fistula was repaired through the aorta in 12, although the chamber of termination was also opened in some. Recurrent fistula occurred in 2 cases in which the ruptured aneurysm was repaired through right ventricle. It appears that repair of the fistula itself is best carried out through an aortotomy, after cross-clamping.

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Surgical Treatment of Aortic Diseases (대동맥질환의 수술요법)

  • 이재원
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.455-459
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    • 1994
  • We experienced 20 cases of acquired aortic diseases during last 1 year [Sep. 1992-Aug. 1993] with newly developed surgical strategies. There were 13 cases[65%] of aortic dissections, 5 cases[25%] of aortic aneurysms and 2 cases of Takayasu arteritis with mean age of 56 + 16 years[range:5-78].In ten cases of patients requiring ascending aortic replacement, femoral artery and femoral vein &/or RA auricle were used as cannulation site. With deep hypothermic circulatory arrest and retrograde cerebral perfusion of cold oxygenated blood via SVC, we can replace the ascending aorta and part of arch if necessary. The mean duration of circulatory arrest was 30 minutes[17-45 min]. In 5 cases of patients who requiring descending and thoracoabdominal aorta replacement, we used simple aortic crossclamping under normothermia with no heparin. The mean duration of aortic crossclamping was 37 minutes[25-50 min].The results of operation were as follow:Operative mortality[2 cases, 10%], delayed cerebral infarct[1], low extremity weakness[1] and intraoperative myocardial infarct[1]. There are no delayed complication or mortality as yet.

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"Brain Stunning" Atypical Feature of tPA Thrombolysis Following Aneurysm Embolization

  • Park, Min-Woo;Yi, Hyeong-Joong;Gupta, Rishi;Horowitz, Michael B.
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.300-302
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    • 2006
  • "Stunning" represents prolonged contractile depression of any muscular component after alleviation of severe ischemia, as shown in reperfusion following acute myocardial ischemia or ischemic stroke. Clinically, it presents with no or delayed recovery past to thrombolytic therapy but its pathogenic mechanism is not fully uncovered yet. We describe a unique case of a 63-year-old woman, who was undertaken endovascular coiling for the aneurysms, deteriorated several hours later without known cause, and showed delayed clinical improvement over the next 3 days following thrombolysis. Immediate post-thrombolysis magnetic resonance imaging scan showed no apparent abnormality except for high signal intensity within the corresponding hemisphere. Reversible but delayed nature of " brain stunning" can be explained by these images and it seems to be caused by a certain type of reperfusion injury.

Pure Sylvian Fissure Arteriovenous Malformation

  • Kim, Sung-Joon;Han, Young-Min;Chung, Dong-Sup
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.471-474
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    • 2005
  • Pure sylvian fissure arteriovenous malformations[AVMs] are vascular malformations confined to the sylvian fissure without parenchymal involvement. Surgical removal is regarded as difficult because the nidus is located just lateral to important structures such as the basal ganglia and the internal capsule. Because most feeding arteries to the nidus are branches of the middle cerebral artery[MCA], differentiation between these feeders from en passant and normal vessels is of great importance in order to reduce morbidity and mortality from surgical intervention. We report a case of pure sylvian fissure AVM who presented with an intra-temporal lobe hematoma that was located around venous aneurysms distant from the nidus. The clinical characteristics of this AVM and the surgical methods employed to avoid complications are discussed.

Dissecting Aneurysm of the Anterior Cerebral Artery : Report of Two Cases

  • Choi, In-Jae;Son, Young-Je;Kim, Jeong-Eun;Han, Dae-Hee
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.465-467
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    • 2005
  • Anterior cerebral artery[ACA] dissecting aneurysms are extremely rare and optimal treatment remains unclear. The majority of cases manifest as cerebral infarction or as intracranial bleeding. The authors report two cases of ACA dissecting aneurysm, one with a large partially thrombosed gradually growing aneurysm and one with a cerebral infarction in the ACA territory. The patient with a large aneurysm was treated by trapping the aneurysm, and the patient with infarction by conservative management. We report on two cases of dissecting aneurysm of the ACA and include a review of pertinent literature.

Current Status and Future Prospect of Endovascular Neurosurgery

  • Jeon, Young-Il;Kwon, Do-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.43 no.2
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    • pp.69-78
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    • 2008
  • Recently, due to the evolution of technology, the field of neurosurgery is receiving spotlight. In particular endovascular neurosurgery has gained a great interest along with the advancement of the modern neurosurgery. The most remarkable advances were made in embolization of the cerebral aneurysms, arteriovenous malformations and intracranial stenosis during the past 10 years. These advances will further change the role of neurosurgeons in treating cerebrovascular disease. Because interventional neuroradiologists have performed most of procedures in the past, neurosurgeons have been deprived of chances to learn endovascular procedure. This article discusses the development of technological aspect of endovascular neurosurgery in chronological order. By understanding the history and current status of the endovascular surgery, the future of neurosurgery will be promising.

Large Intracranial Aneurysm after Transsphenoidal Surgery for Pituitary Macroadenoma

  • Yoon, Kyeong-Wook;Cho, Chun-Sung;Lee, Sang-Koo
    • Journal of Korean Neurosurgical Society
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    • v.55 no.3
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    • pp.160-163
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    • 2014
  • Uncontrolled cerebrospinal fluid (CSF) leakage after transsphenoidal surgery (TSS) for pituitary adenoma can lead to meningitis. Intracranial mycotic pseudoaneurysm is a rare complication in central nervous system infection. Large single pseudoaneurysm is more uncommon. Most mycotic aneurysms occur due to endocarditis. The present patient had no heart problem and was infected by CSF leakage after transsphenoidal surgery. We present a case of large ruptured mycotic pseudoaneurysm as a complication of cerebral infection after TSS for pituitary macroadenoma.

Traumatic Aneurysm of the Callosomarginal Artery-Cortical Artery Junction from Penetrating Injury by Scissors

  • Kim, Myoung Soo;Sim, Sook Young
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.222-225
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    • 2014
  • Traumatic intracranial aneurysms (TICAs) are rare and are associated with high rates of morbidity and mortality. TICAs usually result from head injuries caused by traffic accidents, industrial accidents, or gunshots. We report a traumatic aneurysm of the callosomarginal artery-cortical artery junction arising from a penetrating injury by scissors. A 51-year-old woman was admitted to our hospital after suffering a penetrating injury caused by scissors. Computed tomography (CT) and CT-angiography demonstrated a right orbital roof fracture, subarachnoid hemorrhage, frontal lobe hemorrhage, intraventricular hemorrhage, and a traumatic aneurysm of the right callosomarginal artery-cortical artery junction. We trapped the traumatic aneurysm and repositioned a galeal flap. Postoperative CT showed a small infarction in the left frontal lobe. Follow-up angiography two months later showed no residual aneurysm. We suggest that an aggressive surgical intervention be performed whenever TICA is diagnosed.

Variability of Platelet Reactivity on Antiplatelet Therapy in Neurointervention Procedure

  • Yi, Ho Jun;Hwang, Gyojun;Lee, Byoung Hun
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.3-9
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    • 2019
  • As more intracranial aneurysms and other cerebrovascular pathologies are treated with neurointervention procedure, thromboembolic events that frequently lead to serious neurological deficit or fatal outcomes are increasing. In order to prevent the thromboembolic events, antiplatelet therapy is used in most procedures including coil embolization, stenting, and flow diversion. However, because of variable individual pharmacodynamics responses to antiplatelet drugs, especially clopidogrel, it is difficult for clinicians to select the adequate antiplatelet regimen and its optimal dose. This article reviews the neurointervention literature related to antiplatelet therapy and suggests a strategy for tailoring antiplatelet therapy in individual patients undergoing neurointervention based on the results of platelet function testing.

Eighteen Years of Follow-up after Resection of a Giant Coronary Artery Aneurysm and Reconstruction with a Vein Graft

  • Kwon, Yelee;Park, Chong Bin;Kang, Pil Je;Cho, Won Chul
    • Journal of Chest Surgery
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    • v.54 no.3
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    • pp.221-223
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    • 2021
  • Giant coronary artery aneurysms are rare and challenging to treat because of variation in the presenting symptoms and the lack of established management guidelines. We report the case of a patient with a 6-cm-wide giant coronary artery aneurysm that was resected, followed by reconstruction using a saphenous vein graft and 18 years of follow-up.