Penetrating Injury Due to Bicycle Brake Handle Causing Middle Cerebral Artery Infarct

2018 ◽  
Vol 15 (02/03) ◽  
pp. 067-069
Author(s):  
Gopalakrishnan Madhavan Sasidharan ◽  
Abhishek Chauhan
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Mass Effect ◽  
Penetrating Injury ◽  
Left Middle Cerebral Artery ◽  
Computed Tomographic ◽  
Ct Angiogram ◽  
History Of ◽  
Titanium Cranioplasty

AbstractAn 8-year-old boy was brought to the emergency room with history of fall from a bicycle he was riding. On examination, he had a swelling in the left orbit with a small laceration under the medial aspect of the left eyebrow. The Glasgow coma scale was E2M5V2. An emergency computed tomographic (CT) scan showed infarct causing mass effect in the territory of the left middle cerebral artery. CT angiogram showed that a branch of the middle cerebral artery was occluded at the end of track traversed by the bicycle brake handle. The patient underwent decompressive craniectomy. Initial methylmethacrylate cranioplasty had to be removed due to infection. Later, the patient underwent titanium cranioplasty. At last follow-up, he was going to school. Hemiparesis persisted. Children are vulnerable to penetrating injury by the relatively sharp brake handle when they fall from an adult bicycle. Previous reports include fatal injury by similar mechanism. In this case, it caused injury to the middle cerebral artery without causing bleed. Bicycle manufacturers could be advised to make the vehicle safer for children by twisting the end of the brake handle.

scholarly journals Pipeline-assisted coil embolization of a large middle cerebral artery pseudoaneurysm in a 9-month-old infant: experience from the youngest flow diversion case

2018 ◽  
Vol 22 (5) ◽  
pp. 532-540 ◽  
Author(s):  
Geoffrey P. Colby ◽  
Bowen Jiang ◽  
Matthew T. Bender ◽  
Narlin B. Beaty ◽  
Erick M. Westbroek ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Coil Embolization ◽  
Pediatric Population ◽  
Flow Diversion ◽  
Left Middle Cerebral Artery ◽  
Artery Pseudoaneurysm ◽  
First Case ◽  
Aneurysm Occlusion

Intracranial aneurysms in the pediatric population are rare entities. The authors recently treated a 9-month-old infant with a 19-mm recurrent, previously ruptured, and coil-embolized left middle cerebral artery (MCA) pseudoaneurysm, which was treated definitively with single-stage Pipeline-assisted coil embolization. The patient was 5 months old when she underwent resection of a left temporal Grade 1 desmoplastic infantile ganglioglioma at an outside institution, which was complicated by left MCA injury with a resultant 9-mm left M1 pseudoaneurysm. Within a month, the patient had two aneurysmal rupture events and underwent emergency craniectomy for decompression and evacuation of subdural hematoma. The pseudoaneurysm initially underwent coil embolization; however, follow-up MR angiography (MRA) revealed aneurysm recanalization with saccular enlargement to 19 mm. The patient underwent successful flow diversion–assisted coil embolization at 9 months of age. At 7 months after the procedure, follow-up MRA showed complete aneurysm occlusion without evidence of in-stent thrombosis or stenosis. Experience with flow diverters in the pediatric population is still in its early phases, with the youngest reported patient being 22 months old. In this paper the authors report the first case of such a technique in an infant, whom they believe to be the youngest patient to undergo cerebral flow diversion treatment.

Congenital Intracerebral Pial Arteriovenous Fistula: A Case Report

2017 ◽  
Vol 79 (02) ◽  
pp. 173-176 ◽  
Author(s):  
Shun-Bao Xin ◽  
Guang-Bin Wang ◽  
Wen-Juan Liu ◽  
Qiang Liu
Keyword(s):  
Magnetic Resonance ◽  
Middle Cerebral Artery ◽  
Arteriovenous Fistula ◽  
Cerebral Artery ◽  
Mass Effect ◽  
Vascular Lesion ◽  
Left Middle Cerebral Artery ◽  
Ethylene Vinyl Alcohol ◽  
Sagittal Sinus ◽  
Pial Arteriovenous Fistula

AbstractPial arteriovenous fistula (AVF) is an extremely rare intracranial vascular lesion. The pediatric type of AVF has a high percentage of varix, leading to mass effect with symptoms. We report a 12-year-old boy who was admitted due to sudden confusion and urinary incontinence. Computed tomography, magnetic resonance imaging, and magnetic resonance angiography (MRA) confirmed the diagnosis of congenital pial AVF. Digital subtraction angiography (DSA) revealed the lesion originating from the left middle cerebral artery and draining into the superior sagittal sinus. The AVF was successfully obliterated with six microcoils and 2.5-mL ethylene vinyl alcohol copolymer using a middle cerebral artery approach. This patient was discharged without neurologic deficits. The AVF became smaller and ultimately disappeared on the DSA and MRA at follow-up.

scholarly journals Remote results of endovascular treatment of middle cerebral artery aneurysms

2015 ◽  
Vol 17 (2) ◽  
pp. 28
Author(s):  
D. V. Shcheglov
Keyword(s):  
Postoperative Complications ◽  
Endovascular Treatment ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Considerable Increase ◽  
Mass Effect ◽  
Endovascular Occlusion ◽  
Middle Cerebral Artery Aneurysms

Our objective was to study the dynamics of remote results of MCA SA endovascular occlusion. 149 patients with MCA SA were examined and operated, 127 patients were selected for 36 months follow-up, 112 patients in 1 year follow-up, 52 patients were to be examined in 23 years, 17 in 45 years and 14 patients in more than 5 years. Endovascular occlusion was carried out by means of different coils during reconstructive 138 (92.6%) and unplanned deconstructive occlusions 8 (5.4%). For planned deconstructions detachable balloons were used 3 (2%). 17 (11.4%) recurrences were diagnosed and 12 (8%) repeated operations were performed. 19 (12.8%) intra-and postoperative complications/ predictors and 18 (12.1%) complications unrelated to surgery were observed in the first 30 days and only 1 (1.1%) mass effect was identified in 36 months. After our research we were ableto trackthe dynamicsof thepatientslife quality according totheRankinscale; tomonitorthe changes in SA occlusion degree; to define the frequency of recurrences and complications/predictors of complications and to determine the amount of reoperations. We noted a considerable increase in the quantity of total occlusions after reoperations, which resulted in much better filling of the CA cavity, because the prophylaxis of the repeated hemorrhages is the main goal of SA endovascular treatment.

scholarly journals A RARE CASE OF RUPTURED ANEURYSM AT THE ORIGIN OF INFERIOR PART OF DUPLICATED MIDDLE CEREBRAL ARTERY

2021 ◽  
Vol 7 (2) ◽  
pp. 146-148
Author(s):  
Achmad Firdaus Sani ◽  
Dedy Kurniawan
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Anatomical Variation ◽  
Ruptured Aneurysm ◽  
Endovascular Coiling ◽  
Left Middle Cerebral Artery ◽  
History Of ◽  
Head Computed Tomography ◽  
Left Middle

Duplicated middle cerebral artery (DMCA) is an anomalous vessel arises from the internal carotid artery (ICA). This anatomical variation is rare. Aneurysm with this anatomical variation and unusual form was very rare. Even though this kind of aneurysm is rare, it was often ruptured. In this paper, we report a case of 40-years old female with abrupt decreased of consciousness as a chief complaint, along with severe headache one day earlier, no history of head trauma, and there was nuchal rigidity. She didn’t had history of hypertension before. Head computed tomography showed subarachnoid hemmorrhage (SAH) mostly on the left sylvian fissure with Hunt and Hess scale was 3 and Fisher scale was 2, while the cerebral angiography showed duplication of the left middle cerebral artery in which the inferior part of the MCA duplication has ruptured aneurysm at the origin. Treatment option for this aneurysm is endovascular coiling with preserved of the inferior part of duplicated MCA. Result of this treatment shows a good outcome.

A CASE OF MIDDLE CEREBRAL ARTERY INFARCT FOLLOWING UNEVENTFUL CLIPPING OF ANTERIOR COMMUNICATING ARTERY ANEURYSM

2021 ◽  
pp. 6-7
Author(s):  
T S Vasan ◽  
Rahul Vyas ◽  
Karan Mathur
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Left Middle Cerebral Artery ◽  
Middle Cerebral Artery Infarction ◽  
Anterior Communicating Artery Aneurysm ◽  
Ct Angiogram

Background: Aneurysms of the anterior communicating artery are the most frequently encountered intracerebral aneurysms in routine neurosurgical practice. Management of intracerebral aneurysm involves aneurysm clipping or endovascular coil aneurysm embolisation. However, to the best of our knowledge, there is no reported case of an isolated ipsilateral middle cerebral artery infarction following clipping of anterior communicating artery aneurysm. Case Description: A 65-year-old female with hypertension presented with a history of giddiness, fall and altered sensorium. The patient had a Glasgow Coma Scale (GCS) score of 12, and further investigation of the magnetic resonance imaging on suspicion of stroke revealed subarachnoid haemorrhage in the bilateral parietal sulcus, left Sylvain ssure, left ambient and quadrigeminal cisterns with intra-ventricular extension. The patient was subsequently referred for neurosurgery consultation. Computed tomography (CT) angiogram conrmed the presence of a ruptured anterior communicating artery aneurysm. The neurological assessment showed reduced responsiveness to verbal commands, with a Hunt and Hess score of 3. The patient underwent uneventful clipping of the aneurysm. Postoperatively, the patient did not wake up from anaesthesia and had persistently elevated blood pressure and right-sided hemiplegia. On the third day of postoperative care, a CT head scan revealed a left middle cerebral artery infarction with a midline shift. Decompressive craniotomy was performed, and following this procedure, the patient improved in sensorium with residual right-sided hemiplegia Conclusion: This case report presents an undetected new micro embolism or postoperative cerebral vasospasm as possible causes for the development of cerebral infarct in patients with subarachnoid haemorrhage following an aneurysm rupture.

Treatment of a middle cerebral artery giant aneurysm using a covered stent

2006 ◽  
Vol 104 (6) ◽  
pp. 965-968 ◽  
Author(s):  
Guglielmo Pero ◽  
Federica Denegri ◽  
Luca Valvassori ◽  
Edoardo Boccardi ◽  
Giuseppe Scialfa
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Giant Aneurysm ◽  
Covered Stent ◽  
Left Middle Cerebral Artery ◽  
Transient Ischemic Attacks ◽  
Ischemic Lesion ◽  
Mca Aneurysm ◽  
Left Middle

✓ The authors report the case of a 60-year-old man harboring a wide-necked giant aneurysm of the M1 segment of the left middle cerebral artery (MCA); his symptoms included transient ischemic attacks characterized by right hemiparesis and aphasia. The aneurysm was treated by placing a covered stent across the orifice of the aneurysm. The 18-month follow-up examination showed a very good outcome, with perfect left MCA patency, no new ischemic lesion, and minor residual aphasia and right hemiparesis. This is the first report in the literature of an MCA aneurysm treated using a covered stent.

scholarly journals Air gun orbitocranial penetrating injury: emergency endovascular treatment and surgical bypass following pellet migration to middle cerebral artery: case report

2018 ◽  
Vol 21 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Eric S. Nussbaum ◽  
Patrick Graupman ◽  
James K. Goddard ◽  
Kevin M. Kallmes
Keyword(s):  
Foreign Body ◽  
Endovascular Treatment ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Vascular Occlusion ◽  
Penetrating Injury ◽  
Left Middle Cerebral Artery ◽  
Imaging Evaluation ◽  
Foreign Body Migration ◽  
Air Gun

The authors describe a 14-year-old boy presenting with an orbitocranial penetrating injury (OPI) from a metallic air gun pellet to the left eye who developed hemiparesis and speech difficulty due to migration of the pellet to the left middle cerebral artery. They highlight the potential complications associated with both OPIs and intravascular foreign body migration and occlusion by describing the patient’s presentation, results of imaging evaluation, and the combined endovascular treatment and extracranial-intracranial bypass, which resulted in rapid restoration of blood flow and full neurological recovery with intact vision. Based on this case and a review of the literature on intracranial foreign body migration with resultant vascular occlusion, the authors recommend that complex OPIs be treated at centers that offer both neuroendovascular and neurovascular surgical capabilities on an urgent basis to manage both the primary injury and potential secondary vascular compromise.

scholarly journals Moyamoya: An Uncommon Variant Of Stroke In Childrena

2018 ◽  
Vol 08 (03) ◽  
pp. 194-196
Author(s):  
Rida Zaheer ◽  
Ayesha Ahmed ◽  
Shazia Shakoor ◽  
Shakeel Ahmed
Keyword(s):  
Middle Cerebral Artery ◽  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Conservative Therapy ◽  
Unknown Etiology ◽  
Cerebrovascular Disorder ◽  
Ct Angiogram ◽  
History Of ◽  
The Right

Moyamoya is a rare cause of stroke in children. It is an infrequent cerebrovascular disorder of unknown etiology. We are reporting a case of a 7-year-old girl who presented with an acute history of left-sided weakness. On imaging she was diagnosed with Moyamoya disease. CT Angiogram revealed an occlusion of the right middle cerebral artery typical of Moyamoya disease. The child improved with conservative therapy.

Spontaneous thrombosis in agiant middle cerebral artery aneurysm

1972 ◽  
Vol 37 (3) ◽  
pp. 361-363 ◽  
Author(s):  
R. Michael Scott ◽  
H. Thomas Ballantine
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Left Middle Cerebral Artery ◽  
Content Type ◽  
Complete Thrombosis ◽  
Cerebral Artery Aneurysm

✓ Five-year follow-up angiography in a woman with an untreated giant aneurysm of the left middle cerebral artery revealed complete thrombosis of the aneurysm. Her case suggests that certain asymptomatic giant cerebral aneurysms may be treated without surgery.

Prevention of secondary ischemic events by superficial temporal artery–middle cerebral artery bypass surgery after tuberculosis-induced vasculopathy in a 5-year-old child

2010 ◽  
Vol 6 (1) ◽  
pp. 69-72 ◽  
Author(s):  
Martin Misch ◽  
Ulrich-Wilhelm Thomale ◽  
Rolf Keitzer ◽  
Peter Vajkoczy
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Bypass Surgery ◽  
Endovascular Procedures ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Common Finding ◽  
Left Middle Cerebral Artery ◽  
Ischemic Events

Tuberculosis-related vasculopathy and resulting ischemic events are a common finding after tuberculous meningitis (TBM) in children. The authors report on a case of recurring ischemic episodes that were refractory to repetitive endovascular procedures (transluminal angioplasty, stent insertion, in-stent vessel dilation). After failure of endovascular treatment, extracranial-intracranial (EC-IC) bypass surgery was performed to prevent further ischemia. This 5-year-old girl presented with a series of ischemic events in the left middle cerebral artery (MCA) territory 12 months after her presentation with TBM. Angiography studies showed a 50% lumen reduction of the left MCA. After failure of antithrombocyte aggregation and repeated endovascular procedures to prevent new ischemia, EC-IC bypass surgery was performed. The left superficial temporal artery–MCA bypass was found to be capable of preventing new ischemic events in the 21-month follow-up period, despite a near-total MCA occlusion on follow-up conventional and MR angiography studies. Bypass surgery seems to be a reliable tool to augment cerebral blood flow in tuberculosis-related stenoocclusive changes of cerebral vasculature after the failure of endovascular procedures.

Sign in / Sign up

Export Citation Format

Share Document