Basilar Artery Bifurcation Aneurysm: Rupture of a So-Far Undiagnosed Basilar Artery Bifurcation Aneurysm in an Adolescent, Resulting in Intravital Brain Death; Establishing Brain Death Diagnosis by Imaging

2020 ◽  
pp. 1-6
Author(s):  
Hans Henkes ◽  
Sören Wagner ◽  
Christian Melville ◽  
Ali Khanafer ◽  
Oliver Ganslandt ◽  
...  
Keyword(s):  
Brain Death ◽  
Basilar Artery ◽  
Aneurysm Rupture ◽  
Brain Death Diagnosis ◽  
Bifurcation Aneurysm

Abstract 22: Outcome Of Patients With Basilar Artery Bifurcation Aneurysm Who Underwent With Endovascular Approach

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Yahia M Lodi ◽  
Khalid Sethi ◽  
Dan Gaylon ◽  
Syed Bajwa
Keyword(s):  
Clinical Outcome ◽  
Basilar Artery ◽  
Endovascular Repair ◽  
Thromboembolic Event ◽  
Negative Impact ◽  
Outcome Measurement ◽  
Aneurysm Rupture ◽  
Bifurcation Aneurysm ◽  
Endovascular Approach ◽  
Intraoperative Rupture

Background: Due to a high surgical risk, endovascular repair of the basilar artery (BA) aneurysm is considered the primary option for most of the cases. However, procedure related complications, clinical outcome and rate of recurrence in BA bifurcation aneurysms are not specifically addressed. Objectives: is to describe the incidence of endovascular procedure related complications, recurrence of aneurysm and long-term clinical outcome of BA aneurysm. Methods: Consecutive patients who underwent endovascular repair of BA bifurcation aneurysm were enrolled from 2007 to 2010. Patient’s demographics including the Hunt & Hess (H&H) grade, Fished scale, and size of aneurysm were collected. Complications including aneurysm rupture, intracranial hemorrhage or thromboembolic event were recorded. Additionally, 90-days outcome measurement was obtained using Glasgow Outcome Scale (GOS). Results: 36 patients with a mean age of 50 plus-minus 14 years required 48 successful procedures to treat 36 BA bifurcation aneurysms. Ruptured aneurysm was present in 20 cases (H&H I in 6, II in 4, III in 4 and IV in 6). 30 patients (83%) had wide neck aneurysm, 25 (69%) of which required stent in order to secure the aneurysm. There was no intraoperative rupture of aneurysm or thromboembolic event. However, one patient developed diplopia with visual incoordination on day one and other developed diplopia due to a small pontine stroke while stopping clopidogrel on post operative day 30 of stent-assisted repair. Both patients recovered completely with no disability. Ten patients (28%) had recurrence of aneurysm and required subsequent procedure. In recurrent aneurysms, repeat procedures had no negative impact on the clinical outcome. One patient died (GOS 1) who initially presented with H&H IV and never recovered. Good outcome was observed in 32 (89%) patients (GOS 5 in 31, GOS 4 in 1) including all unruptured cases and 3 of 5 ruptured BA aneurysm patients who presented with H&H of IV. Poor outcome was observed in 3 (8%) patients (GOS 3 in 3, 2 of which presented with H&H IV). Conclusion: Endovascular repair of the BA bifurcation aneurysms are associated with good clinical outcome despite requirement of multiple procedures to complete the treatment. However, the recurrence of aneurysm is very high. Therefore, a very close angiographic follow-up is necessary.

The First Description of a Basilar Artery Aneurysm Rupture in 1836

2013 ◽  
Vol 74 (S 01) ◽  
Author(s):  
Andreas Demetriades ◽  
Takashi Horiguchi ◽  
James Goodrich ◽  
Takeshi Kawase
Keyword(s):  
Basilar Artery ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Basilar Artery Aneurysm

scholarly journals An autopsy report of basilar artery aneurysm flow diversion complicated by postoperative day 3 hemorrhage from vessel rupture

2018 ◽  
Vol 11 (1) ◽  
pp. e014511 ◽  
Author(s):  
Azeem A Rehman ◽  
Ryan C Turner ◽  
Stephanie Wright ◽  
SoHyun Boo ◽  
Ansaar T Rai
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Basilar Artery ◽  
Artery Aneurysm ◽  
Symptomatic Improvement ◽  
Aneurysm Rupture ◽  
Flow Diversion ◽  
Atheromatous Plaque ◽  
Parent Artery ◽  
Autopsy Report ◽  
Complete Procedure

A middle-aged patient presented with posterior circulation symptoms attributable to a large eccentric basilar trunk aneurysm. The planned treatment was flow diversion with loose coil packing which was successfully performed using a Pipeline Flex device deployed from the basilar to the left posterior cerebral artery. The complete procedure including live biplane fluoroscopy was digitally recorded. The patient had symptomatic improvement postoperatively and was discharged on day 1. The patient suffered a cardiac arrest on postoperative day 3 secondary to massive intraventricular and subarachnoid hemorrhage. An aneurysm rupture was suspected; however, postmortem examination showed an intact aneurysm sac. The hemorrhage was attributed to a small focal rent in the distal basilar artery next to an atheromatous plaque. The Pipeline device was visible through the rent. This is an autopsy report documenting an injury to the parent artery and not the aneurysm as a source of fatal delayed subarachnoid hemorrhage following flow diversion.

Brain Death Diagnosis for Potential Organ Donors During the Covid-19 Pandemic

2021 ◽  
Vol 69 (4) ◽  
pp. 995
Author(s):  
GirijaP Rath ◽  
Siddharth Chavali ◽  
Deep Sengupta ◽  
SuryaK Dube
Keyword(s):  
Brain Death ◽  
Organ Donors ◽  
Brain Death Diagnosis

Brain Death: Diagnosis and Imaging Techniques

2018 ◽  
Vol 39 (5) ◽  
pp. 515-529 ◽  
Author(s):  
Tanvir Rizvi ◽  
Prem Batchala ◽  
Sugoto Mukherjee
Keyword(s):  
Brain Death ◽  
Imaging Techniques ◽  
Brain Death Diagnosis

scholarly journals Brain-Dead and Coma Patients Exhibit Different Serum Metabolic Profiles: A Novel Diagnostic Approach in Neurocritical Care

2021 ◽  
Author(s):  
Tomasz Dawiskiba ◽  
Wojciech Wojtowicz ◽  
Badr Qasem ◽  
Marceli Łukaszewski ◽  
Karolina Anna Mielko ◽  
...  
Keyword(s):  
Brain Death ◽  
Neurocritical Care ◽  
Clinical Symptoms ◽  
Proton Nuclear Magnetic Resonance ◽  
Sample Collection ◽  
Serum Samples ◽  
Multivariate Statistical ◽  
Brain Death Diagnosis ◽  
Brain Dead ◽  
Metabolomic Approach

Abstract There is a clear difference between severe brain damage and brain death. However, in clinical practice, the differentiation of these states can be challenging. Currently, there are no laboratory tools that facilitate brain death diagnosis. The aim of our study was to evaluate the utility of serum metabolomic analysis in differentiating coma patients (CP) from individuals with brain death (BD). Serum samples were collected from 23 adult individuals with established diagnosis of brain death and 24 patients in coma with Glasgow Coma Scale 3 or 4, with no other clinical symptoms of brain death for at least 7 days after sample collection. Serum metabolomic profiles were investigated using proton nuclear magnetic resonance (NMR) spectroscopy. The results obtained were examined by univariate and multivariate data analysis (PCA, PLS-DA, and OPLS-DA). Metabolic profiling allowed us to quantify 43 resonance signals, of which 34 were identified. Multivariate statistical modeling revealed a highly significant separation between coma patients and brain-dead individuals, as well as strong predictive potential. The findings not only highlight the potential of the metabolomic approach for distinguishing patients in coma from those in the state of brain death but also may provide an understanding of the pathogenic mechanisms underlying these conditions.

scholarly journals Evaluation of Patients with Brain Death Diagnosis and Investigation of the Effect of New Regulation on the Duration of Diagnosis

2019 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Savaş Altınsoy ◽  
Elif Şule Özdemir ◽  
İlkay Baran ◽  
Fatma Kavak Akelma ◽  
Mukaddes Tuğba Arslan ◽  
...  
Keyword(s):  
Brain Death ◽  
Brain Death Diagnosis
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