Clinical observation of surgical treatment of arterial aneurysm of the anterior communicating artery of the brain complicated by intraventricular hemorrhage and obstructive hydrocephalus

Abstract We describe an orbitofrontotemporobasal craniotomy technique that allows excellent access to anterior communicating artery aneurysms. This orbitocraniobasal approach is particularly useful for the surgical treatment of ruptured aneurysms in the acute stage of subarachnoid hemorrhage, when retraction of the brain needs to be kept to a minimum. With this approach, retraction of the orbital contents decreases the amount of retraction of the brain to such an extent that a brain spatula is not necessary for access to the anterior communicating artery complex. The procedure is described, as is a modification of the approach for removal of large tumors on the skull base.

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An unusual variation in the anterior communicating artery of the circle of Willis in the human brain - a case report

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401582 ◽

2016 ◽

Vol 05 (01) ◽

pp. 039-043

Author(s):

Farheen A Karim ◽

J D Sarma ◽

K L Talukdar

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Human Brain ◽

Cerebral Artery ◽

Anterior Cerebral Artery ◽

Circle Of Willis ◽

Anterior Communicating Artery ◽

Interpeduncular Cistern ◽

The Right ◽

The Brain

AbstractThis report highlights an unusual variation of Anterior communicating artery of the circle of Willis found during dissection for studying circle of Willis. The brain was carefully extracted out of the skull so that arteries forming the circle of Willis do not get tom. The circle of Willis was identified in the interpeduncular cistern. Fine dissection was done to identify any variations. In this specimen there were double anterior communicating arteries joined in the midline by a short longitudinal segment of artery. Length and external diameters of both the Anterior communicating arteries were measured using Vernier calipers. Also, a medial striate artery (recurrent artery of Heubner) was seen originating from the right anterior cerebral artery just between the junctions of the proximal and distal Anterior communicating arteries with the right Anterior cerebral artery. Knowledge of this variation is valuable to neurosurgeons in planning surgical treatment and has clinical significance in relation to stroke.

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Surgical treatment of aresorbtive hydrocephalus in remote period after rupture of the brain arterial aneurysm

Ukrainian Neurosurgical Journal ◽

10.25305/unj.47490 ◽

2014 ◽

Vol 0 (3) ◽

pp. 37-41

Author(s):

Maksim Yeleynik ◽

Svetlana Litvak

Keyword(s):

Surgical Treatment ◽

Arterial Aneurysm ◽

The Brain

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Pelvic schwannoma

GYNECOLOGY ◽

10.26442/20795696.2020.5.200216 ◽

2020 ◽

Vol 22 (5) ◽

pp. 84-86

Author(s):

Sergei P. Sinchikhin ◽

Sarkis G. Magakyan ◽

Oganes G. Magakyan

Keyword(s):

Auditory Nerve ◽

World Literature ◽

Morphological Study ◽

Clinical Observation ◽

Nerve Trunk ◽

Practical Case ◽

Surgical Volume ◽

The World ◽

Brain And Spinal Cord ◽

The Brain

Relevance.A neoplasm originated from the myelonic sheath of the nerve trunk is called neurinoma or neurilemmoma, neurinoma, schwannoglioma, schwannoma. This tumor can cause compression and dysfunction of adjacent tissues and organs. The most common are the auditory nerve neurinomas (1 case per 100 000 population per year), the brain and spinal cord neurinomas are rare. In the world literature, there is no information on the occurrences of this tumor in the pelvic region. Description.Presented below is a clinical observation of a 30-year-old patient who was scheduled for myomectomy. During laparoscopy, an unusual tumor of the small pelvis was found and radically removed. A morphological study allowed to identify the remote neoplasm as a neuroma. Conclusion.The presented practical case shows that any tumor can hide under a clinical mask of another disease. The qualification of the doctor performing laparoscopic myomectomy should be sufficient to carry out, if necessary, another surgical volume.

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Aetiologies and anatomy of confabulation

10.1093/oso/9780198789680.003.0004 ◽

2017 ◽

Author(s):

Armin Schnider

Keyword(s):

Brain Damage ◽

Limbic Encephalitis ◽

Artery Aneurysm ◽

Anterior Communicating Artery ◽

Brain Areas ◽

Anatomical Basis ◽

Korsakoff Syndrome ◽

Hypoxic Brain ◽

Degenerative Dementia ◽

The Brain

What diseases cause confabulations and which are the brain areas whose damage is responsible? This chapter reviews the causes, both historic and present, of confabulations and deduces the anatomo-clinical relationships for the four forms of confabulation in the following disorders: alcoholic Korsakoff syndrome, traumatic brain injury, rupture of an anterior communicating artery aneurysm, posterior circulation stroke, herpes and limbic encephalitis, hypoxic brain damage, degenerative dementia, tumours, schizophrenia, and syphilis. Overall, clinically relevant confabulation is rare. Some aetiologies have become more important over time, others have virtually disappeared. While confabulations seem to be more frequent after anterior brain damage, only one form has a distinct anatomical basis.

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Early Inflammatory Cytokine Expression in Cerebrospinal Fluid of Patients with Spontaneous Intraventricular Hemorrhage

Biomolecules ◽

10.3390/biom11081123 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1123

Author(s):

Wendy C. Ziai ◽

Adrian R. Parry-Jones ◽

Carol B. Thompson ◽

Lauren H. Sansing ◽

Michael T. Mullen ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Intraventricular Hemorrhage ◽

Inflammatory Responses ◽

Obstructive Hydrocephalus ◽

External Ventricular Drainage ◽

Enzyme Linked Immunosorbent Assay ◽

Injury Reduction ◽

Positive Correlations ◽

Factor Α ◽

Perihematomal Edema

We investigated cerebrospinal fluid (CSF) expression of inflammatory cytokines and their relationship with spontaneous intracerebral and intraventricular hemorrhage (ICH, IVH) and perihematomal edema (PHE) volumes in patients with acute IVH. Twenty-eight adults with IVH requiring external ventricular drainage for obstructive hydrocephalus had cerebrospinal fluid (CSF) collected for up to 10 days and had levels of interleukin-1α (IL-1α), IL-1β, IL-6, IL-8, IL-10, tumor necrosis factor-α (TNFα), and C-C motif chemokine ligand CCL2 measured using enzyme-linked immunosorbent assay. Median [IQR] ICH and IVH volumes at baseline (T0) were 19.8 [5.8–48.8] and 14.3 [5.3–38] mL respectively. Mean levels of IL-1β, IL-6, IL-10, TNF-α, and CCL2 peaked early compared to day 9–10 (p < 0.05) and decreased across subsequent time periods. Levels of IL-1β, IL-6, IL-8, IL-10, and CCL2 had positive correlations with IVH volume at days 3–8 whereas positive correlations with ICH volume occurred earlier at day 1–2. Significant correlations were found with PHE volume for IL-6, IL-10 and CCL2 at day 1–2 and with relative PHE at days 7–8 or 9–10 for IL-1β, IL-6, IL-8, and IL-10. Time trends of CSF cytokines support experimental data suggesting association of cerebral inflammatory responses with ICH/IVH severity. Pro-inflammatory markers are potential targets for injury reduction.

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Unilateral mydriasis in a child with a ventriculoperitoneal shunt for obstructive hydrocephalus: a diagnostic dilemma

BMJ Case Reports ◽

10.1136/bcr-2020-237257 ◽

2020 ◽

Vol 13 (12) ◽

pp. e237257

Author(s):

Monidipa Banerjee ◽

Eiman Haj Ahmed ◽

Kathryn Foster ◽

Arundoss Gangadharan

Keyword(s):

Ipratropium Bromide ◽

Obstructive Hydrocephalus ◽

Sudden Onset ◽

Unique Case ◽

Diagnostic Dilemma ◽

Vp Shunt ◽

Life Threatening ◽

Unilateral Mydriasis ◽

The Brain ◽

Rule Out

There are several causes for sudden onset unilateral mydriasis, however impending transtentorial uncal herniation needs to be ruled out. This unique case highlights an uncommon adverse response to a common mode of treatment that leads to a diagnostic dilemma. A 3-year-old boy with a ventriculoperitoneal (VP) shunt for an obstructive hydrocephalus presented with an acute respiratory distress. He developed unilateral mydriasis with absent light reflex during treatment with nebulisers. An urgent CT scan of the brain did not show any new intracranial abnormality. A case of pharmacological anisocoria was diagnosed that resolved completely within 24 hours of discontinuation of ipratropium bromide. Although ipratropium-induced anisocoria has been reported in children, but to our knowledge none in a child with VP shunt for hydrocephalus. This emphasises the urgency in evaluating unilateral mydriasis to rule out life-threatening conditions. Clinicians should remember that ipratropium administered through ill-fitting face masks could cause this completely reversible adverse effect.

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