scholarly journals Deep Cerebral Perforators: Anatomical Distribution and Clinical Symptoms: An Overview

Stroke ◽  
2021 ◽  
Author(s):  
Valerie Vogels ◽  
Ruben Dammers ◽  
Martine van Bilsen ◽  
Victor Volovici
Keyword(s):  
Clinical Symptoms ◽  
Imaging Techniques ◽  
Published Data ◽  
Comprehensive Overview ◽  
Large Variability ◽  
Anatomical Distribution ◽  
Anatomic Distribution ◽  
Anterior Choroidal ◽  
Near Future ◽  
Choroidal Artery

The anatomic distribution of the deep cerebral perforators is considered either a given or subject to enormous variability. Most published overviews on this topic only report findings from a limited number of anatomic dissections, and no attempt has been made to date to provide a comprehensive overview of all published data. A comprehensive literature search was performed on MEDLINE, Embase, and Google Scholar with the help of an information specialist. Three types of studies were included: (1) articles that described the anatomy and distribution territories of perforator groups arising from the arteries of the circle of Willis; (2) studies that evaluated the anatomy of the deep cerebral perforators using imaging techniques; and (3) studies that evaluated either microsurgically or radiologically confirmed perforator occlusion and reported the (magnetic resonance imaging–confirmed) distribution territory of the infarction together with a description of the clinical symptoms associated as a result of the infarction. A total of 2715 articles were screened and 53 were included. Of these, 40 dealt with the anatomic and imaging anatomy of perforator groups (37 reported results of dissections and 3 results of imaging studies), with a total of 2421 hemispheres investigated. Another 13 articles with 680 patients were included that evaluated perforator infarction territories. The deep cerebral perforator distribution shows large variability with poor concordance rates among reported studies, with the exception of the posterior communicating and anterior choroidal artery perforators. Despite the assumption that cerebral perforator anatomy is a given, studies show large variability in the anatomic distribution of various perforator groups. Perforator anatomy and relationships between perforator groups, as well as potential collateral circulation in these territories should be prioritized as a research topic in cerebrovascular disease in the near future.

scholarly journals Patency of the anterior choroidal artery covered with a flow-diverter stent

2015 ◽  
Vol 123 (6) ◽  
pp. 1540-1545 ◽  
Author(s):  
Hiroaki Neki ◽  
Jildaz Caroff ◽  
Pakrit Jittapiromsak ◽  
Nidhal Benachour ◽  
Cristian Mihalea ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Clinical Symptoms ◽  
Flow Diverter ◽  
Anterior Choroidal Artery ◽  
Parent Vessel ◽  
Flow Diverter Stent ◽  
Anterior Choroidal ◽  
Long Course ◽  
Choroidal Artery

OBJECT The concept of the flow-diverter stent (FDS) is to induce aneurysmal thrombosis while preserving the patency of the parent vessel and any covered branches. In some circumstances, it is impossible to avoid dangerously covering small branches, such as the anterior choroidal artery (AChA), with the stent. In this paper, the authors describe the clinical and angiographic effects of covering the AChA with an FDS. METHODS Between April 2011 and July 2013, 92 patients with intracranial aneurysms were treated with the use of FDSs in the authors’ institution. For 20 consecutive patients (21.7%) retrospectively included in this study, this involved the unavoidable covering of the AChA with a single FDS during endovascular therapy. AChAs feeding the choroid plexus were classified as the long-course group (14 cases), and those not feeding the choroid plexus were classified as the short-course group (6 cases). Clinical symptoms and the angiographic aspect of the AChA were evaluated immediately after stent delivery and during follow-up. Neurological examinations were performed to rule out hemiparesis, hemihypesthesia, hemianopsia, and other cortical signs. RESULTS FDS placement had no immediate effect on AChA blood flow. Data were obtained from 1-month clinical follow-up in all patients and from midterm angiographic follow-up in 17 patients (85.0%), with a mean length of 9.8 ± 5.4 months. No patient in either group complained of transient or permanent symptoms related to an AChA occlusion. In all cases, the AChA remained patent without any flow changes. CONCLUSIONS The results of this study suggest that when impossible to avoid, the AChA may be safely covered with a single FDS during intracranial aneurysm treatment, irrespective of anatomy and anastomoses.

The anterior choroidal artery

1978 ◽  
Vol 14 (2) ◽  
pp. 160
Author(s):  
SY Rho ◽  
SH Cha ◽  
WH Lee ◽  
JS Kim
Keyword(s):  
Anterior Choroidal Artery ◽  
Anterior Choroidal ◽  
Choroidal Artery

Potential Role of Cytokines in Children with Acute Appendicitis and Acute Mesenteric Lymphadenitis

2011 ◽  
Vol 11 (1) ◽  
pp. 130-133
Author(s):  
Astra Zviedre ◽  
Arnis Engelis ◽  
Mohit Kakar ◽  
Aigars Pētersons
Keyword(s):  
Early Detection ◽  
Acute Appendicitis ◽  
Inflammatory Mediators ◽  
Potential Role ◽  
Clinical Symptoms ◽  
Future Research ◽  
Mesenteric Lymphadenitis ◽  
Proper Diagnosis ◽  
Near Future

Potential Role of Cytokines in Children with Acute Appendicitis and Acute Mesenteric Lymphadenitis Although, AAP and AML have different etiological factors, clinical symptoms are very much similar but treatment tactics in both the disease differ a lot. In case of AML, treatment is more conservative and does not require hospitalization while in case of AAP immediate hospitalization and maybe further surgery can be mandatory. With the identification of group of cytokines serum inflammatory mediators IL-8, IL-10, IL-12[p70], IL-17, TNF-a and MCP-1, it is believed early and proper diagnosis of AAP in the near future. Research of cytokines-serum inflammatory mediators has opened new opportunities for an early detection and differentiation of these two diseases in children.

scholarly journals Paracentral homonymous hemianopic scotoma caused by anterior choroidal artery infarction

QJM ◽  
2021 ◽  
Author(s):  
A Mitsutake ◽  
Y Nagashima ◽  
H Mori ◽  
H Sawamura ◽  
T Toda
Keyword(s):  
Anterior Choroidal Artery ◽  
Anterior Choroidal ◽  
Choroidal Artery

Management of an Uncommon Complication: Anterior Choroidal Artery Occlusion by Posterior Clinoid Process Detected Through Intraoperative Monitoring After Clipping of Paraclinoid Aneurysm: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Walter Marani ◽  
Francisco Mannará ◽  
Kosumo Noda ◽  
Tomomasa Kondo ◽  
Nakao Ota ◽  
...  
Keyword(s):  
Intraoperative Monitoring ◽  
Motor Evoked Potential ◽  
Japanese Woman ◽  
Motor Deficits ◽  
Anterior Choroidal Artery ◽  
Diffusion Weighted Images ◽  
Ct Angiogram ◽  
Paraclinoid Aneurysms ◽  
Anterior Choroidal ◽  
Choroidal Artery

Abstract Despite technological advances in endovascular therapy, surgical clipping of paraclinoid aneurysms remains an indispensable treatment option and has an acceptable profile risk. Intraoperative monitoring of motor and somatosensory evoked potentials has proven to be an effective tool in predicting and preventing postoperative motor deficits during aneurysm clipping.1,2 We describe the case of a 61-yr-old Japanese woman with a history of hypertension and smoking. During follow-up for bilateral aneurysms of ophthalmic segment of the internal carotid artery (ICA), left-sided aneurysm growth was detected. A standard pterional approach with extradural clinoidectomy was used to approach the aneurysm. After clipping, a significant intraprocedural change in motor evoked potential (MEP) amplitude was observed despite native vessel patency was confirmed through micro-Doppler and indocyanine green video angiography.3-5 After extensive dissection of the sylvian fissure and exposure of the communicating segment of ICA, the anterior choroidal artery was found to be compressed and occluded by the posterior clinoid because of an inadvertent shift of the ICA after clip application and removal of brain retractors. Posterior clinoidectomy was performed intradurally with microrongeur and MEP amplitude returned readily to baseline values. Computed tomography (CT) angiogram demonstrated complete exclusion of the aneurysm, and magnetic resonance imaging (MRI) was negative for postoperative ischemic lesions on diffusion weighted images. The patient tolerated the procedure well and was discharged home on postoperative day 3 with modified Rankin Scale (mRS) 0. The patient signed the Institutional Consent Form to undergo the surgical procedure and to allow the use of her images and videos for any type of medical publications.

scholarly journals A Case of Anterior Choroidal Artery Occlusion and Stroke Secondary to External Compression

2021 ◽  
pp. 369-374
Author(s):  
Satya Narayana Patro ◽  
Khawaja Hassan Haroon ◽  
Khansabegum Tamboli ◽  
Abdulaziz Zafar ◽  
Suhail Hussain ◽  
...  
Keyword(s):  
Medial Temporal Lobe ◽  
Optic Tract ◽  
Internal Capsule ◽  
Cerebral Peduncle ◽  
Anterior Choroidal Artery ◽  
Vessel Occlusion ◽  
External Compression ◽  
Posterior Limb ◽  
Anterior Choroidal ◽  
Choroidal Artery

The anterior choroidal artery (AChA) is a small artery commonly arising from the supraclinoid segment of the internal carotid artery (ICA). The significance of the AChA is related to its strategic supply to various important structures of the brain, such as the optic tract, the posterior limb of the internal capsule, the cerebral peduncle, the lateral geniculate body, medial temporal lobe, medial area of pallidum, and the choroid plexus [<i>J Neurol</i>. 1988;235:387–91]. The AChA syndrome in its complete form consists of the triad of hemiplegia, hemisensory loss, and hemianopia. However, incomplete forms are more frequent in clinical practice [<i>Stroke</i>. 1994;25:837–42]. Isolated infarction in the AChA territory is relatively rare. The presumed pathogenic mechanisms of AChA infarction are cardiac emboli, large-vessel atherosclerosis, dissection of the ICA, small-vessel occlusion, or other determined or undetermined causes [<i>Stroke</i>. 1994;25:837–42 and <i>J Neurol Sci</i>. 2009;281:80–4].

Whole brain atlas-based diffusion kurtosis imaging parameters for evaluation of minimal hepatic encephalopathy

2021 ◽  
pp. 197140092110269
Author(s):  
Prateek Gupta ◽  
Sameer Vyas ◽  
Teddy Salan ◽  
Chirag Jain ◽  
Sunil Taneja ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Imaging Techniques ◽  
Clinical Stage ◽  
Minimal Hepatic Encephalopathy ◽  
Brain Atlas ◽  
Diffusion Kurtosis Imaging ◽  
Whole Brain ◽  
Diffusion Kurtosis

Background and purposes Minimal hepatic encephalopathy (MHE) has no recognizable clinical symptoms, but patients have cognitive and psychomotor deficits. Hyperammonemia along with neuroinflammation lead to microstructural changes in cerebral parenchyma. Changes at conventional imaging are detected usually at the overt clinical stage, but microstructural alterations by advanced magnetic resonance imaging techniques can be detected at an early stage. Materials and methods Whole brain diffusion kurtosis imaging (DKI) data acquired at 3T was analyzed to investigate microstructural parenchymal changes in 15 patients with MHE and compared with 15 age- and sex-matched controls. DKI parametric maps, namely kurtosis fractional anisotropy (kFA), mean kurtosis (MK), axial kurtosis (AK) and radial kurtosis (RK), were evaluated at 64 white matter (WM) and gray matter (GM) regions of interest (ROIs) in the whole brain and correlated with the psychometric hepatic encephalopathy score (PHES). Results The MHE group showed a decrease in kFA and AK across the whole brain, whereas MK and RK decreased in WM ROIs but increased in several cortical and deep GM ROIs. These alterations were consistent with brain regions involved in cognitive function. Significant moderate to strong correlations (–0.52 to –0.66; 0.56) between RK, MK and kFA kurtosis metrics and PHES were observed. Conclusion DKI parameters show extensive microstructural brain abnormalities in MHE with minor correlation between the severity of tissue damage and psychometric scores.

scholarly journals Novel mutation in the TGFBI gene in a Moroccan family with atypical corneal dystrophy: a case report

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yahya Benbouchta ◽  
Imane Cherkaoui Jaouad ◽  
Habiba Tazi ◽  
Hamza Elorch ◽  
Mouna Ouhenach ◽  
...  
Keyword(s):  
Exome Sequencing ◽  
Whole Exome Sequencing ◽  
Clinical Symptoms ◽  
Age Of Onset ◽  
Novel Mutation ◽  
Corneal Dystrophy ◽  
Heterozygous Mutation ◽  
Large Variability ◽  
Whole Exome ◽  
Moroccan Family

Abstract Background Corneal dystrophies (CDs) are a heterogeneous group of bilateral, genetically determined, noninflammatory bilateral corneal diseases that are usually limited to the cornea. CD is characterized by a large variability in the age of onset, evolution and visual impact and the accumulation of insoluble deposits at different depths in the cornea. Clinical symptoms revealed bilateral multiple superficial, epithelial, and stromal anterior granular opacities in different stages of severity among three patients of this family. A total of 99 genes are involved in CDs. The aim of this study was to identify pathogenic variants causing atypical corneal dystrophy in a large Moroccan family and to describe the clinical phenotype with severely different stages of evolution. Case presentation In this study, we report a large Moroccan family with CD. Whole-exome sequencing (WES) was performed in the three affected members who shared a phenotype of corneal dystrophy in different stages of severity. Variant validation and familial segregation were performed by Sanger sequencing in affected sisters and mothers and in two unaffected brothers. Whole-exome sequencing showed a novel heterozygous mutation (c.1772C > A; p.Ser591Tyr) in the TGFBI gene. Clinical examinations demonstrated bilaterally multiple superficial, epithelial and stromal anterior granular opacities in different stages of severity among three patients in this family. Conclusions This report describes a novel mutation in the TGFBI gene found in three family members affected by different phenotypic aspects. This mutation is associated with Thiel-Behnke corneal dystrophy; therefore, it could be considered a novel phenotype genotype correlation, which will help in genetic counselling for this family.

The Perforating Branches of the Internal Carotid Artery: The Microsurgical Anatomy of Their Extracerebral Segments

Neurosurgery ◽  
1990 ◽  
Vol 26 (3) ◽  
pp. 472-479 ◽  
Author(s):  
Slobodan V. Marinkovié ◽  
Milan M. Milisavljevié ◽  
Zorica D. Marinkovié
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Cerebral Aneurysms ◽  
Microsurgical Anatomy ◽  
Great Care ◽  
Anterior Choroidal Artery ◽  
Frequent Site ◽  
Anterior Choroidal ◽  
Choroidal Artery

Abstract The perforating branches of the internal carotid artery (ICA) were examined in 30 forebrain hemispheres. These branches were present in all the cases studied, and varied from 1 to 6 in number (mean, 3.1). Their diameters ranged from 70 to 470 Mm (mean, 243 Mm). The perforating branches arose from the choroidal segment of the ICA, that is, from its caudal surface (52.3%), caudolateral surface (34.1%), or caudomedial surface (13.6%). They rarely originated from the bifurcation point of the ICA (10%). The distance of the remaining 90% of the perforators from the summit of the ICA measured between 0.6 and 4.6 mm. The perforating branches most often originated as individual vessels, and less frequently from a common stem with another vessel or by sharing the same origin site with another perforator or with the anterior choroidal artery. The bifurcation of the ICA, which is a frequent site for cerebral aneurysms, is surrounded by many perforating branches. Hence, great care must be taken to avoid damage to these important vessels during operations in that region.

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