Venous loop mimicking middle cerebral artery bifurcation aneurysm on computed tomographic angiography—case report

2006 ◽  
Vol 66 (5) ◽  
pp. 524-526 ◽  
Author(s):  
Jae Hoon Kim ◽  
Jin Hwan Cheong ◽  
Koang Hum Bak ◽  
Choong Hyun Kim ◽  
Jae Min Kim
Keyword(s):  
Case Report ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Bifurcation Aneurysm ◽  
Tomographic Angiography

scholarly journals Collateral status evaluation coupled with time window by dynamic axial computed tomographic angiography with a focus on the middle cerebral artery for mechanical thrombectomy

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takahisa Mori ◽  
Kazuhiro Yoshioka ◽  
Wataru Mori ◽  
Yuhei Tanno
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Mechanical Thrombectomy ◽  
Time Window ◽  
Computed Tomographic Angiography ◽  
Ct Scanner ◽  
Computed Tomographic ◽  
Upper Limit ◽  
Mca Occlusion ◽  
Tomographic Angiography

Abstract Background Dynamic axial computed tomographic angiography (dynax–CTA), covering a thin width, with a focus on the bilateral middle cerebral artery (MCA), can quickly visualize the internal carotid artery (ICA) or MCA occlusion. We aimed to investigate whether dynax–CTA appropriately evaluated the collateral status coupled with the upper limit of the onset-to-reperfusion (OtR) time to achieve a major neurological improvement (MNI) at a 24-h follow-up examination after mechanical thrombectomy (MT). Methods We included acute ischemic stroke patients admitted from 2018 to 2020 who underwent dynax–CTA on admission and emergent MT for ICA or MCA occlusion. We performed dynax–CTA using an 80-row CT scanner and acquired 25 volume scans, consisting of 40 images of 1-mm thickness and 4-cm width. We classified the collateral status as good, intermediate, and poor based on MCA branch opacification. We evaluated the collateral status and the upper OtR time limit to achieve MNI. Results Forty-eight patients met our inclusion criteria. Dynax–CTA findings demonstrated MCA and ICA occlusion in 30 and 18 patients, respectively. The collateral status was good, intermediate, and poor in four, 25, and 19 patients, respectively. The upper limits of the OtR time for MNI were 3.63, 8.08, and 8.67 h in patients with poor, intermediate, and intermediate or good collateral status, respectively. Conclusions Dynax–CTA appropriately evaluated the collateral status coupled with the upper limit of the OtR time before performing MT.

A New, More Accurate Classification of Middle Cerebral Artery Aneurysms

Neurosurgery ◽  
2013 ◽  
Vol 73 (1) ◽  
pp. 94-102 ◽  
Author(s):  
Ahmed Elsharkawy ◽  
Martin Lehečka ◽  
Mika Niemelä ◽  
Romain Billon-Grand ◽  
Hanna Lehto ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Computed Tomographic Angiography ◽  
Group Classification ◽  
Intracerebral Hematoma ◽  
Computed Tomographic ◽  
Common Location ◽  
Lenticulostriate Artery ◽  
Tomographic Angiography

Abstract BACKGROUND: Classification of middle cerebral artery (MCA) aneurysms is sometimes difficult because the identification of the main MCA bifurcation, the key for accurate classification of MCA aneurysms, is inconsistent and somewhat subjective. OBJECTIVE: To use the meeting point of the M1 and M2 trunks as an objective, generally accepted, and angiographically evident hallmark for identification of MCA bifurcation and more accurate classification of MCA aneurysms. METHODS: We reviewed the computed tomographic angiography data of 1009 consecutive patients with 1309 MCA aneurysms. The M2 trunks were followed proximally until their meeting with the M1 trunk at the main MCA bifurcation. The aneurysms were classified according to their relative location: proximal, at, or distal to the MCA bifurcation. The M1 aneurysms were further subgrouped into M1 early cortical branch aneurysms and M1 lenticulostriate artery aneurysms, extending the classic 3-group classification of MCA aneurysms into a 4-group classification. RESULTS: The main MCA bifurcation was the most common location for MCA aneurysms, harboring 829 aneurysms (63%). The 406 M1 aneurysms comprised 242 M1 early cortical branch aneurysms (60%) and 164 M1 lenticulostriate artery aneurysms (40%). We found 106 MCA aneurysms (8%) at the origin of large early frontal branches simulating M2 trunks liable to be misclassified as MCA bifurcation aneurysms. Even though 51% of the 407 ruptured MCA aneurysms were associated with an intracerebral hematoma, this did not affect the classification. CONCLUSION: Studying MCA angioarchitecture and applying the 4-group classification of MCA aneurysms is practical and facilitates the accurate classification of MCA aneurysms, helping to improve surgical outcome.

scholarly journals Rare case of a ruptured distal middle cerebral artery fusiform aneurysm: a neurosurgical challenge.

2018 ◽  
Vol 5 (2) ◽  
pp. 3550-3552
Author(s):  
Jagminder Singh ◽  
Amit Mittal ◽  
Rakesh Kumar Kaushal ◽  
Rupinder Kaur ◽  
Simran Kaur ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Surgical Intervention ◽  
Computed Tomographic Angiography ◽  
Fusiform Aneurysm ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Middle Cerebral Artery Aneurysms ◽  
Distal Middle Cerebral Artery ◽  
Early Surgical Intervention

Distal ruptured fusiform middle cerebral artery (MCA) M4 segment aneurysms are rare and their management is a challenge to the neurosurgeon. Fusiform aneurysm of M4 part of is even rarer. Patient usually presents with headache or neurological deficit. Computed tomographic angiography helps to confirm diagnosis. Treatment involves micro-neurosurgical clipping or trapping and excision of aneurysm. Early surgical intervention of distal middle cerebral artery aneurysms favours better outcome. We report a case of 20 year old female patient who presented with complaint of severe headache. Neuroimaging was suggestive of right M4 middle cerebral artery fusiform aneurysm with intracerebral haemorrhage. Patient was managed by trapping and excision of aneurysm and recovered well. 

scholarly journals Clip reconstruction of a large right MCA bifurcation aneurysm. Case report

2014 ◽  
Vol 21 (2) ◽  
pp. 163-167
Author(s):  
A. Giovani ◽  
Angela Neacsu ◽  
Ana Gheorghiu ◽  
R.M. Gorgan
Keyword(s):  
Case Report ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Neurological Deficit ◽  
Sylvian Fissure ◽  
Pterional Craniotomy ◽  
Bifurcation Aneurysm ◽  
Temporary Clip

Abstract We report a case of complex large middle cerebral artery (MCA) bifurcation aneurysm that ruptured during dissection from the very adherent MCA branches but was successfully clipped and the MCA bifurcation reconstructed using 4 Yasargill clips. Through a right pterional craniotomy the sylvian fissure was largely opened as to allow enough workspace for clipping the aneurysm and placing a temporary clip on M1. The pacient recovered very well after surgery and was discharged after 1 week with no neurological deficit. Complex MCA bifurcation aneurysms can be safely reconstructed using regular clips, without the need of using fenestrated clips or complex by-pass procedures.

scholarly journals Mechanical Thrombectomy of Primary Distal Anterior Cerebral Artery Occlusion: A Case Report

2019 ◽  
Vol 11 (3) ◽  
pp. 265-270 ◽  
Author(s):  
Hironori Haruyama ◽  
Junji Uno ◽  
Kenta Takahara ◽  
Yosuke Kawano ◽  
Naoki Maehara ◽  
...  
Keyword(s):  
Case Report ◽  
Cerebral Artery ◽  
Mechanical Thrombectomy ◽  
Anterior Cerebral Artery ◽  
Rare Condition ◽  
Computed Tomographic Angiography ◽  
Artery Occlusion ◽  
Sudden Onset ◽  
Neurological Deficits ◽  
Computed Tomographic

Objective: Primary anterior cerebral artery (ACA) occlusion is a rare condition and sometimes leads to significant neurological deficits. We herein report on the efficacy of mechanical thrombectomy (MT) in treating the distal ACA occlusion in a clinical setting. Case Presentation: A 76-year-old woman presented with a sudden onset of right hemiparesis. Computed tomographic angiography and perfusion imaging and subsequent analysis with RAPID software revealed acute left ACA occlusion with salvageable penumbra. The patient obtained a score of 11 on the National Institutes of Health Stroke Scale. MT was performed for occlusion of the left ACA (A4), and successful reperfusion (Thrombolysis in Cerebral Infarction score of 3) was achieved on the first attempt using a stent retriever. The patient’s recovery progressed well, and she was discharged 13 days after admission with a modified Rankin Scale score of 1. Conclusion: This case report demonstrates the clinical efficacy, safety, and favorable clinical outcome of treating a primary distal ACA occlusion with MT.

Sign in / Sign up

Export Citation Format

Share Document