• Title/Summary/Keyword: intracranial aneurysm

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Postoperative Vasospasm in Unruptured Intracranial Aneurysm

  • Lee, Suk-In;Park, Cheol-Wan;Hong, Won-Jin;Park, Chan-Woo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.131-134
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    • 2006
  • The cerebral vasospasm after clipping surgery of unruptured aneurysm is uncommon. A 44-year-old man with unruptured left middle cerebral artery[MCA] aneurysm had clipping surgery. From the third postoperative day, he presented with drowsy mentality, dysphasia and right hemiparesis. Computed tomographic scans showed low density area in frontotemporal lobe and midline shift. Transfemoral cerebral angiography revealed severe vasospasm in supraclinoid internal carotid artery, anterior cerebral artery, and MCA on the operative side. We performed left frontotemporoparietal craniectomy and hypertensive-hypervolemic therapy. He recovered without neurological deficits but for dysphasia. Neurosurgeon should be alert to the possibility of vasospasm after clipping surgery even in case of unruptured cerebral aneurysm.

Acute Subdural Hematoma Associated with Ruptured Intracranial Aneurysm: Diagnosis and Emergent Aneurysm Clipping

  • Kim, Jung-Min;Hur, Jin-Woo;Lee, Jong-Won;Kim, Myoung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.37 no.5
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    • pp.375-379
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    • 2005
  • Rarely, rupture of a cerebral aneurysm causes an acute subdural hematoma(SDH) in addition to subarachnoid hemorrhage(SAH). We report clinical and radiological characteristics of five cases, as well as potential pitfalls in the diagnosis and the treatment of this life-threatening condition. The patients ranged in age from 42 to 76 years. The Hunt-Hess grade on admission was grade III in one patient, grade IV in two, and grade V in two. All five patients un-derwent one-stage operation (both SDH evacuation and clipping of the aneurysm). The outcome was good recovery in two patients, persistent vegetative state in two, and death in one. Patients with a good outcome had a better Hunt-Hess grade on admission, with less amount of SDH.

Ruptured mirror DACA aneurysm: A rare case report and review of literature

  • Deepak Kumar Singh;Prevesh Kumar Sharma;Arun Kumar Singh;Vipin Kumar Chand
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.3
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    • pp.340-346
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    • 2023
  • Bilateral distal anterior cerebral artery (DACA) aneurysms also called "kissing aneurysms" or "mirror aneurysm" are extremely rare, accounting for only 0.2% of all intracranial aneurysms. There have only been a few examples of mirror DACA aneurysms reported in the literature. Here, we report a rare case of mirror DACA aneurysm in a middle aged female with its successful clipping. Patient was admitted with severe headache and altered sensorium. Computed tomography (CT) head was suggestive of anterior inter-hemispheric hematoma. Digital subtraction angiography (DSA) was done which was suggestive of two distal anterior cerebral artery aneurysms located at same anatomical position. It was treated through microsurgical clipping. Mirror image DACA aneurysms are rare occurrence. All patients with ruptured DACA aneurysms should have angiography with 3D reconstruction studies. This aids in determining the aneurysm's morphology and planning treatment accordingly.

Retreatment of a recurrent giant aneurysm of the internal carotid artery after treatment with a flow-diverting stent

  • Ginam Kim;Junhyung Kim;Sang Kyu Park;Joonho Chung
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.2
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    • pp.208-213
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    • 2023
  • Flow-diverting stents (FDSs) have proven advantageous for the treatment of large, fusiform, and dissecting aneurysms that are otherwise difficult to treat. Retreatment strategies for recurrent large or giant aneurysms after FDSs are limited to overlapping implantation of an additional FDS or definitive occlusion of the parent vessel. We report a recurrent giant aneurysm that was initially treated with an FDS with coils and was successfully treated with an additional FDS. Visual symptoms due to the mass effect of the recurrent aneurysm were completely resolved, and follow-up digital subtraction angiography revealed complete obliteration of the aneurysm. Additional FDS implantation for the retreatment of incompletely occluded aneurysms after the initial FDS treatment may be feasible and safe. Further studies are required to validate these results.

Successful Obliteration of Unclippable Large and Giant Middle Cerebral Artery Aneurysms Following Extracranial-Intracranial Bypass and Distal Clip Application

  • Yoon, Won-Ki;Jung, Young-Jin;Ahn, Jae-Sung;Kwun, Byung-Duk
    • Journal of Korean Neurosurgical Society
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    • v.48 no.3
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    • pp.259-262
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    • 2010
  • Large to giant middle cerebral artery aneurysm is a challenging disease, especially when incorporating important perforating arteries. Surgical risk increases by perforator infarction and anatomical complexity. In this clinical setting, extensive consideration of surgical options is needed. The two cases described here were unruptured and had rather stable wall. Because of their large and giant size, hardness and incorporated arteries, it was not affordable to isolate them by means of clipping or trapping. The procedure as the alternative to conventional treatment modalities, extracranial-intracranial bypass followed by clipping of only the efferent artery successfully treated the aneurysms.

The Clinical Comparative Investigation of Endovascular Treatment Using GDC and Neurosurgical Operation's Decision for Intracranial Aneurysm (뇌동맥류에 대한 방사선학적 중재적 시술과 신경외과학적 수술 선택의 임상적 비교 고찰)

  • Kim Sang Jin;Go Jung Seok;You Sang Jae;Kim Gyeong Sul;Choi Kwang Nam;Lee Yong Woo
    • Journal of The Korean Radiological Technologist Association
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    • v.28 no.1
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    • pp.90-96
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    • 2002
  • Purpose : The purpose of this study is to compare and analyze matters related to procedure such as characteristics and conditions etc. of intracranial aneurysm of patients who were treated GDC(Guglielmi Detachable Coil : Endovascular Treatment) and patien

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Surgical Informed Consent Process in Neurosurgery

  • Park, Jaechan;Park, Hyojin
    • Journal of Korean Neurosurgical Society
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    • v.60 no.4
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    • pp.385-390
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    • 2017
  • The doctrine of informed consent, as opposed to medical paternalism, is intended to facilitate patient autonomy by allowing patient participation in the medical decision-making process. However, regrettably, the surgical informed consent (SIC) process is invariably underestimated and reduced to a documentary procedure to protect physicians from legal liability. Moreover, residents are rarely trained in the clinical and communicative skills required for the SIC process. Accordingly, to increase professional awareness of the SIC process, a brief history and introduction to the current elements of SIC, the obstacles to patient autonomy and SIC, benefits and drawbacks of SIC, planning of an optimal SIC process, and its application to cases of an unruptured intracranial aneurysm are all presented. Optimal informed consent process can provide patients with a good comprehension of their disease and treatment, augmented autonomy, a strong therapeutic alliance with their doctors, and psychological defenses for coping with stressful surgical circumstances.

Flow diverter stenting for intracranial aneurysms in the pediatric population: Two case reports and literature review

  • Akram M Eraky;Christina Feller;Hatem Tolba;Mokshal Porwal;Raphael H. Sacho;Hirad Hedayat
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.26 no.1
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    • pp.58-64
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    • 2024
  • The Pipeline Embolization Device (PED) is a flow-diverting intraluminal device that is approved for use in adults 18 years or older with internal carotid artery aneurysms. However, it can also be used off-label in pediatric patients with aneurysms that cannot be resolved with traditional endovascular treatments. Herein, we present two cases of flow diversion in the pediatric population with complete obliteration of the aneurysm and excellent outcomes. Flow diversion has been shown to be a safe endovascular option in treating complex aneurysms in children. Larger-sized, multicenter trials are encouraged to compare outcomes between flow diversion and other aneurysm treatment options given the rarity of pediatric aneurysms.