scholarly journals Integration of Fetal Middle Cerebral Arterial (MCA) Ultrasonography in Acute Fetal-Maternal Hemorrhage

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Jessian L. Munoz ◽  
Maria Schleicher ◽  
Natalie Bowersox
Keyword(s):  
Decision Making ◽  
Cesarean Section ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Labor And Delivery ◽  
Additional Testing ◽  
Emergent Cesarean Section

Here we present a case of maternal-fetal hemorrhage characterized by intermittently reassuring fetal testing. Additional testing performed with ultrasound, including middle cerebral artery (MCA) doppler waveforms, confirmed fetal hemorrhage followed by emergent cesarean section. This report highlights the acute usage of MCA dopplers in obstetric decision making. The Newborn required transfusion but otherwise recovered well. MCA may be a useful tool for fetal assessment in Labor and Delivery units.

scholarly journals Surgical Clipping for Complex Middle Cerebral Artery Aneurysm: Decision-Making Tree With Tailored Bypass Strategy

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Jumpei Oda ◽  
Ichiro Nakahara ◽  
Shoji Matsumoto ◽  
Yoshio Suyama ◽  
Akiko Hasebe ◽  
...  
Keyword(s):  
Decision Making ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Bypass Surgery ◽  
Superficial Temporal Artery ◽  
Artery Aneurysm ◽  
Operative Strategy ◽  
Mca Aneurysm ◽  
In Situ Bypass

Abstract INTRODUCTION Bypass surgery is important as an effective strategy for complex middle cerebral artery (MCA) aneurysms. Various bypass techniques were reported, but some of them were challenging and difficult to understand. The aim of this report was to propose our simple and flexible method for selecting ideal bypass option and its outcome. METHODS The strategy of bypass surgery is modified by a consideration of the anatomical situation as follows: Is it possible to make a flow our route? Is the amount of bypass flow sufficient? How is the location of lateral lenticulostriate artery (LSA)? Is the preservation of M2 branches possible? Modality of bypass surgery consists of (1) standard superficial temporal artery (STA)-middle cerebral artery (MCA) bypass (single/double, M3/4), (2) STA-proximal MCA (single/double, M1/2), (3) high flow bypass, (4) in-situ bypass (MCA-MCA parallels), and (4) interposition bypass. Operative strategy is selected based on our decision making tree. RESULTS Between 2015 and 2018, we experienced 280 cases (70 ruptured, 210 unruptured) of direct surgery for cerebral aneurysms. Of these cases, the MCA aneurysm accounted for 40% (112 cases). Among these, revascularization was required in 10 cases of complex anatomy. Strategy of bypass surgery included the following: STA-proximal MCA (M1) single bypass: 1 case, STA-proximal MCA (M2) single bypass: 3 cases, STA-proximal MCA (M2) double bypass: 3 cases, STA-distal MCA (M3-4): 1 case, and MCA-MCA in situ bypass: 2 cases (include combination bypass). Patency of bypass was 96% and neurological worsening that caused by surgery was 20% with no operative mortality. CONCLUSION Our decision-making tree with tailored bypass strategy is reasonable and will help select an optimal strategy for the complex MCA aneurysm surgery.

Ruptured Middle Cerebral Artery Aneurysm Presenting with Hematoma

2019 ◽  
pp. 47-60
Author(s):  
Joseph M. Zabramski
Keyword(s):  
Decision Making ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Aneurysm ◽  
Mass Effect ◽  
Operative Management ◽  
Surgical Emergencies ◽  
Middle Cerebral Artery Aneurysms ◽  
Cerebral Artery Aneurysm ◽  
Clot Evacuation

Abstract: This chapter reviews the surgical management of ruptured middle cerebral artery aneurysms associated with hematoma. Ruptured middle cerebral artery aneurysms occasionally present with mass effect from a large subarachnoid and/or intraparenchymal hematoma. In the case of significant hematoma size, midline shift, or increased intracranial pressure, these lesions are surgical emergencies. They can present significant management challenges because the presence of the hematoma makes operative management more difficult. Given the large and functionally critical territory supplied by the middle cerebral artery, preservation of the both the afferent and efferent branches is critical. Decision-making regarding the timing and strategy of clot evacuation is discussed.

An ultrastructural analysis of the sympathetic innervation of the rabbit ear artery and middle cerebral artery and their branches

1992 ◽  
Vol 50 (1) ◽  
pp. 934-935
Author(s):  
John T. Dodge ◽  
John A. Bevan
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Sympathetic Innervation ◽  
Electrical Field Stimulation ◽  
Rabbit Ear Artery ◽  
Electrical Field ◽  
Functional Differences ◽  
Ear Artery ◽  
Rabbit Ear ◽  
Vascular Beds

Unlike many peripheral vascular beds, the sympathetic nervous system exerts little control on cerebral blood flow. The contractile response of isolated rabbit middle cerebral artery (MCA) segments to electrical field stimulation of its intramural nerves is less than in a similar-sized artery from the ear. This study was undertaken to characterize and compare the perivascular neuromuscular relationships and innervation density of similar-sized arteries varying in diameter from these two different regional arterial beds to see if there were structural correlates for these functional differences.

Expression of neurocan after transient middle cerebral artery occlusion in adult rat brain

2005 ◽  
Vol 25 (1_suppl) ◽  
pp. S217-S217
Author(s):  
Kentaro Deguchi ◽  
Mikiro Takaishi ◽  
Takeshi Hayashi ◽  
Atsuhiko Oohira ◽  
Shoko Nagotani ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Rat Brain ◽  
Middle Cerebral Artery Occlusion ◽  
Cerebral Artery ◽  
Artery Occlusion ◽  
Adult Rat ◽  
Adult Rat Brain ◽  
Cerebral Artery Occlusion
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