Ruptured MCA Aneurysm Mimicking MCA Territory Ischemic Stroke: A Case Report and Review of the Literature

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0040-1720995 ◽

2021 ◽

Author(s):

Ignazio De Trizio ◽

Michael Reinert ◽

Thomas Robert

Keyword(s):

Ischemic Stroke ◽

Case Report ◽

Subarachnoid Hemorrhage ◽

Intracerebral Hemorrhage ◽

Middle Cerebral Artery ◽

Time Dependent ◽

Review Of The Literature ◽

Neurosurgical Department ◽

Aneurysmal Rupture ◽

Mca Aneurysm

AbstractIntracerebral hemorrhage (ICH) can be considered one of the major neurologic and neurosurgical emergencies that need a time-dependent diagnosis and treatment. On rare occasions, an aneurysmal rupture may also present with isolated ICH without subarachnoid hemorrhage. We present the case of a 48-year-old woman presenting in our neurosurgical department with ICH and a right middle cerebral artery (MCA) occlusion that, 6 weeks after the initial surgical management, unveiled a large MCA aneurysm treated with a clipping. In this study, we discuss our hypothesis about the etiology and the pathophysiology of this rare phenomenon in the light of the literature in the field.

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Endovascular and Surgical Options for Ruptured Middle Cerebral Artery Aneurysms: Review of the Literature

Stroke Research and Treatment ◽

10.1155/2014/315906 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

David R. Santiago-Dieppa ◽

Jeffrey S. Pannell ◽

Alexander A. Khalessi

Keyword(s):

Subarachnoid Hemorrhage ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Review Of The Literature ◽

Surgical Options ◽

Mca Aneurysm ◽

Middle Cerebral Artery Aneurysms

Middle cerebral artery (MCA) aneurysms are common entities, and those of the bifurcation are the most frequently encountered sublocation of MCA aneurysm. MCA bifurcation (MBIF) aneurysms commonly present with subarachnoid hemorrhage (SAH), are devastating, and are often lethal. At the present time, the treatment of ruptured MBIF aneurysms entails either endovascular or open microneurosurgical methods to permanently secure the aneurysm(s). The purpose of this report is to review the current available data regarding the relative superiority of endovascular versus open microneurosurgical clipping for the treatment of ruptured middle cerebral artery bifurcation aneurysms.

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Is It Safe to Proceed with Thrombolytic Therapy for Acute Ischemic Stroke in a Patient with Cardiac Myxoma Case Report and Review of the Literature

European Neurology ◽

10.1159/000340019 ◽

2012 ◽

Vol 68 (3) ◽

pp. 185-186 ◽

Cited By ~ 9

Author(s):

Ivan Rocha Ferreira da Silva ◽

Gabriel R. de Freitas

Keyword(s):

Ischemic Stroke ◽

Case Report ◽

Thrombolytic Therapy ◽

Acute Ischemic Stroke ◽

Cardiac Myxoma ◽

Review Of The Literature

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Recurrent Perimesencephalic Nonaneurysmal Subarachnoid Hemorrhage: Case Report and Review of the Literature

World Neurosurgery ◽

10.1016/j.wneu.2017.08.079 ◽

2017 ◽

Vol 107 ◽

pp. 877-880 ◽

Cited By ~ 4

Author(s):

Yuan Hong ◽

Yuanjian Fang ◽

Ting Chen ◽

Jianmin Zhang

Keyword(s):

Case Report ◽

Subarachnoid Hemorrhage ◽

Review Of The Literature ◽

Nonaneurysmal Subarachnoid Hemorrhage

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Rete Middle Cerebral Artery Anomaly Presenting with a Large Intracerebral Hemorrhage: A Case Report

Journal of Clinical Interventional Radiology ISVIR ◽

10.1055/s-0041-1732846 ◽

2021 ◽

Author(s):

Chandra Dev Sahu ◽

Nishant Bhargava ◽

Debabrata Sahana ◽

Sanjeev Kumar

Keyword(s):

Case Report ◽

High Risk ◽

Intracerebral Hemorrhage ◽

Middle Cerebral Artery ◽

Single Channel ◽

Correct Diagnosis ◽

Rare Condition ◽

Haemorrhagic Stroke ◽

Unilateral Involvement ◽

Is Failure

AbstractRete MCA anomaly is extremely rare and has been seldomly discussed in literature. Embryologically MCA develops by fusion of multiple twigs which form a single channel. If there is failure to fuse a plexiform network of vessels persists known as rete MCA. This web like network of vessels is at high risk of haemorrhagic stroke and therefore for patients presenting incidentally correct diagnosis is paramount. Here we report a case of rete MCA anomaly in a 35-year-old gentle man who presented with a large haemorrhagic stroke in emergency. DSA showed unilateral involvement of proximal MCA, and otherwise normal intra-cranial vasculature. With this report we aim to correctly diagnose this rare condition and avoid misdiagnosis leading to unnecessary treatments.

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Unexpected Rupture of a Giant Lobulated Thrombotic Middle Cerebral Artery Aneurysm and Emergency Surgical Treatment With Thrombectomy: A Case Report and Review of the Literature

Iranian Red Crescent Medical Journal ◽

10.5812/ircmj.30608 ◽

2016 ◽

Vol 18 (8) ◽

Cited By ~ 1

Author(s):

Vaner Koksal ◽

Selim Kayaci

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Artery Aneurysm ◽

Review Of The Literature ◽

Middle Cerebral Artery Aneurysm ◽

Cerebral Artery Aneurysm

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Multiple Cerebral Angiomas and Rendu-Osler-Weber Disease: Case Report

Neurosurgery ◽

10.1227/00006123-199110000-00020 ◽

1991 ◽

Vol 29 (4) ◽

pp. 599-602 ◽

Cited By ~ 16

Author(s):

B. Aesch ◽

E. Lioret ◽

B. de Toffol ◽

M. Jan

Keyword(s):

Case Report ◽

Subarachnoid Hemorrhage ◽

Surgical Treatment ◽

Arteriovenous Malformations ◽

Review Of The Literature ◽

Disease Case

Abstract A 25-year-old man was hospitalized after suffering a subarachnoid hemorrhage. Arteriograms disclosed two arteriovenous malformations, one of which was asymptomatic. Rendu-Osler-Weber disease was suspected because of the concomitant existence of cutaneous telangiectases, Review of the literature shows that in 12 previously published cases involving multiple arteriovenous malformations, this diagnosis was established five times. The indications for surgical treatment are discussed.

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Neonatal intracranial aneurysms: case report and review of the literature

Journal of Neurosurgery Pediatrics ◽

10.3171/2017.10.peds17226 ◽

2018 ◽

Vol 21 (5) ◽

pp. 471-477 ◽

Cited By ~ 3

Author(s):

Jeewaka E. Mohotti ◽

Nicole S. Carter ◽

Victor Jia Wei Zhang ◽

Leon T. Lai ◽

Christopher Xenos ◽

...

Keyword(s):

Subarachnoid Hemorrhage ◽

Endovascular Treatment ◽

Intracranial Aneurysms ◽

Time Of Flight ◽

Review Of The Literature ◽

Microsurgical Treatment ◽

Enhanced Mri ◽

Contrast Enhanced ◽

Mca Aneurysm ◽

Contrast Enhanced Mri

Intracranial aneurysms in the neonate, presenting in the first 4 weeks of life, are exceedingly rare. They appear to have characteristics, including presentation and location, that vary from those found in adults. The authors present a case of a 28-day-old neonate with a ruptured distal middle cerebral artery (MCA) aneurysm. Initial noninvasive imaging with transfontanelle ultrasound and CT confirmed intraparenchymal and subarachnoid hemorrhage. Contrast-enhanced MRI revealed a 14-mm ruptured fusiform MCA aneurysm that was not identified on time-of-flight magnetic resonance angiography (MRA). Microsurgical treatment was performed with partial neurological recovery. A comprehensive review of the literature from 1949 to 2017 revealed a total of 40 aneurysms in 37 neonates, including the present case. The most common presenting symptom was seizure. Although subarachnoid hemorrhage was the most common form of hemorrhage, 40% had intraparenchymal hemorrhage. The median aneurysm size was 10 mm (range 2–30 mm) and the most common location was the MCA, with two-thirds of cases involving the distal intracranial vasculature. Over the last 10 years, there has been a trend of increasing noninvasive diagnosis of ruptured cerebral aneurysms in neonates, with CT angiography and contrast-enhanced MRI being the most useful diagnostic modalities. The use of contrast-enhanced MRI may improve sensitivity over time-of-flight MRA. Microsurgical treatment was the most common treatment modality overall, with increased use of endovascular treatment in the last decade. Most patients underwent microsurgical vessel ligation or endovascular parent vessel occlusion. There were high rates of neurological recovery after microsurgical or endovascular treatment, particularly for patients with distal aneurysms.

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Lethal Vertebral Artery Dissection in Pregnancy: A Case Report and Review of the Literature

Archives of Pathology & Laboratory Medicine ◽

10.5858/2006-130-533-lvadip ◽

2006 ◽

Vol 130 (4) ◽

pp. 533-535 ◽

Cited By ~ 1

Author(s):

Madalina Tuluc ◽

Daniel Brown ◽

Bruce Goldman

Keyword(s):

Case Report ◽

Pregnant Woman ◽

Subarachnoid Hemorrhage ◽

Vertebral Artery ◽

Fatal Outcome ◽

Vertebral Artery Dissection ◽

Rare Event ◽

Artery Dissection ◽

Review Of The Literature ◽

In Pregnancy

Abstract Subarachnoid hemorrhage represents a rare event in pregnancy with a high mortality rate. We present the case of a 39-year-old pregnant woman who developed right vertebral artery dissection with subsequent massive subarachnoid hemorrhage with fatal outcome. The macroscopic and microscopic autopsy findings are described. A review of the literature with a discussion of the varied predisposing factors for vertebral artery dissection and subarachnoid hemorrhage and the rarity of these events in pregnancy is provided.

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Association between Apolipoprotein E Polymorphism and Clinical Outcome after Ischemic Stroke, Intracerebral Hemorrhage, and Subarachnoid Hemorrhage

Cerebrovascular Diseases ◽

10.1159/000520053 ◽

2021 ◽

pp. 1-10

Author(s):

Wen Pan ◽

Min Zhang ◽

Zhenping Guo ◽

Wenfeng Xiao ◽

Chao You ◽

...

Keyword(s):

Ischemic Stroke ◽

Subarachnoid Hemorrhage ◽

Clinical Outcome ◽

Intracerebral Hemorrhage ◽

Apolipoprotein E ◽

Functional Outcomes ◽

Fixed Effects ◽

Meta Analysis ◽

Fixed Effects Models ◽

Increased Risk

Backgrounds: Previous studies reported inconsistent results regarding associations between apolipoprotein E (APOE) polymorphism and clinical outcomes after ischemic stroke (IS), intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH). Thus, the study was designed to make a systematic review and meta-analysis regarding the association between APOE polymorphism and clinical outcome after IS, ICH, and SAH. Methods: To identify studies eligible for this meta-analysis, we searched for articles published before August 2021 in the databases (PubMed, Web of Science, and Google Scholar). We used STATA 12.0 software to compute hazard ratios (HRs) and their 95% confidence intervals (CIs) regarding APOE polymorphism and clinical outcome after IS, ICH, and SAH. Results: Meta-analysis showed no significant association between APOE polymorphism and functional outcome after IS with fixed effects models (ε4 carrier vs. non-ε4 carrier: HR, 1.00; 95% CI: 0.83–1.21, I2 = 29.4%, p = 0.183; ε2 carrier vs. non-ε2 carrier: HR, 0.92; 95% CI: 0.72–1.16, I2 = 15.6%, p = 0.307). Meta-analysis showed that ICH patients carrying ε4 allele have increased risk of poor outcome in Caucasian population with fixed effects models (ε4 carrier vs. non-ε4 carrier: HR, 1.75; 95% CI: 1.19–2.57, I2 = 0.0%, p = 0.543). Meta-analysis showed no significant association between APOE polymorphism and functional outcomes after SAH with random effects models (ε4 carrier vs. non-ε4 carrier: HR, 1.51; 95% CI: 0.80–2.84, I2 = 57.1%, p = 0.022). Conclusions: In conclusion, the present study demonstrated APOE ε4 carriers show worse functional outcomes after ICH, but not after IS or SAH. More large-scale studies were critical to explore the association between APOE polymorphism and clinical outcome after IS, ICH, and SAH.

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