scholarly journals Characteristics and Management of Ruptured Aneurysms Originating from the Penetrating Artery of the Distal Middle Cerebral Artery

2021 ◽  
Vol 8 (1) ◽  
pp. 7-12
Author(s):  
Yu IIDA ◽  
Kentaro MORI ◽  
Yosuke KAWAHARA ◽  
Issei FUKUI ◽  
Katsuya ABE ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Ruptured Aneurysms ◽  
Distal Middle Cerebral Artery

scholarly journals Aneurysm Arising at the Origin of a Duplicated Middle Cerebral Artery

2021 ◽  
pp. 446-450
Author(s):  
Jean Roch Alliez ◽  
Luis Manera
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Haemorrhage ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
World Federation ◽  
Treatment Procedure ◽  
3D Computed Tomography ◽  
Ruptured Aneurysms ◽  
Tomography Reconstruction ◽  
Computed Tomography Reconstruction

A duplicated middle cerebral artery (DMCA) is a common anomaly. However, aneurysms arising from the origin of a DMCA are extremely rare. A 22-year-old female was admitted to our hospital with a World Federation of Neurosurgical Societies grade 2 subarachnoid haemorrhage. Four-vessel angiography revealed a DMCA and an aneurysm arising from the origin of this artery. The aneurysm was successfully treated by embolization, and the patient was discharged 2 weeks later. Ruptured aneurysms arising from the origin of a DMCA can be successfully treated by embolization. These aneurysms are small and 3D-computed tomography reconstruction is mandatory to detect them. It is important to preserve the DMCA during the treatment procedure.

Microsurgical Repair of Ruptured Aneurysms Associated with Moyamoya-Pattern Collateral Vessels of the Middle Cerebral Artery: A Report of Two Cases

2017 ◽  
Vol 105 ◽  
pp. 1042.e5-1042.e10 ◽  
Author(s):  
Min Lang ◽  
Nina Z. Moore ◽  
Alex M. Witek ◽  
Varun R. Kshettry ◽  
Mark D. Bain
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Ruptured Aneurysms ◽  
Collateral Vessels

scholarly journals Predictive anatomical factors for rupture in middle cerebral artery mirror bifurcation aneurysms

2018 ◽  
Vol 128 (6) ◽  
pp. 1799-1807 ◽  
Author(s):  
Homajoun Maslehaty ◽  
Crescenzo Capone ◽  
Roman Frantsev ◽  
Igor Fischer ◽  
Ramazan Jabbarli ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Rupture Risk ◽  
Significance Level ◽  
Ruptured Aneurysms ◽  
Regular Shape ◽  
The Moment ◽  
The One ◽  
Aneurysm Shape

OBJECTIVEThe aim of this study was to define predictive factors for rupture of middle cerebral artery (MCA) mirror bifurcation aneurysms.METHODSThe authors retrospectively analyzed the data in patients with ruptured MCA bifurcation aneurysms with simultaneous presence of an unruptured MCA bifurcation mirror aneurysm treated in two neurosurgical centers. The following parameters were measured and analyzed with the statistical software R: neck, dome, and width of both MCA aneurysms—including neck/dome and width/neck ratios, shape of the aneurysms (regular vs irregular), inflow angle of both MCA aneurysms, and the diameters of the bilateral A1 and M1 segments and the frontal and temporal M2 trunks, as well as the bilateral diameter of the internal carotid artery (ICA).RESULTSThe authors analyzed the data of 44 patients (15 male and 29 female, mean age 50.1 years). Starting from the usual significance level of 0.05, the Sidak-corrected significance level is 0.0039. The diameter of the measured vessels was statistically not significant, nor was the inflow angle. The size of the dome was highly significant (p = 0.0000069). The size of the neck (p = 0.0047940) and the width of the aneurysms (p = 0.0056902) were slightly nonsignificant at the stated significance level of 0.0039. The shape of the aneurysms was bilaterally identical in 22 cases (50%). In cases of asymmetrical presentation of the aneurysm shape, 19 (86.4%) ruptured aneurysms were irregular and 3 (13.6%) had a regular shape (p = 0.001).CONCLUSIONSIn this study the authors show that the extraaneurysmal flow dynamics in mirror aneurysms are nonsignificant, and the aneurysmal geometry also does not seem to play a role as a predictor for rupture. The only predictors for rupture were size and shape of the aneurysms. It seems as though under the same conditions, one of the two aneurysms suffers changes in its wall and starts growing in a more or less stochastic manner. Newer imaging methods should enable practitioners to see which aneurysm has an unstable wall, to predict the rupture risk. At the moment one can only conclude that in cases of MCA mirror aneurysms the larger one, with or without shape irregularities, is the unstable aneurysm and that this is the one that needs to be treated.

scholarly journals L-Arginine Does Not Improve Cortical Perfusion or Histopathological Outcome in Spontaneously Hypertensive Rats Subjected to Distal Middle Cerebral Artery Photothrombotic Occlusion

1996 ◽  
Vol 16 (4) ◽  
pp. 612-622 ◽  
Author(s):  
Ricardo Prado ◽  
Brant D. Watson ◽  
Weizhao Zhao ◽  
Hiroshi Yao ◽  
Raul Busto ◽  
...  
Keyword(s):  
Cerebral Ischemia ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Spontaneously Hypertensive Rats ◽  
Therapeutic Potential ◽  
Focal Cerebral Ischemia ◽  
Hypertensive Rats ◽  
Spontaneously Hypertensive ◽  
Tissue Reactions ◽  
Distal Middle Cerebral Artery

The potential of nitric oxide (NO) to influence positively or negatively the outcome of mechanically induced focal cerebral ischemia is still controversial. Recent evidence suggests that NO of vascular origin, whether synthesized from exogenously administered L-arginine (L-Arg) or from NO donor compounds, is beneficial but that of neuronal origin is not. However, the therapeutic potential of NO to ameliorate stroke induced by arterial thrombosis has not been reported. We assessed the therapeutic effect of L-Arg administration in spontaneously hypertensive rats (SHR) subjected to permanent photothrombotic occlusion of the distal middle cerebral artery (dMCA). The ipsilateral carotid artery was left unligated to enhance L-Arg delivery into the putative penumbral region. Local CBF (LCBF) was assessed at 30 min by the [14C]iodoantipyrine technique (n = 9), while histological infarct volumes and index of peripheral ischemic cell change were determined at 3 days (n = 7). Rats (n = 9) given 300 mg/kg L-Arg at 18 and 3 h before photothrombotic dMCA occlusion and at 5 min afterward displayed no significant differences in LCBF compared with animals (n = 8) injected with water (the carrier vehicle) and similarly irradiated. Infarct volumes were also similar, being 37.0 ± 9.7 mm3 (SD) in the vehicle-treated and 49.1 ± 17.2 mm3 (SD) in the L-Arg-treated groups (both n = 7), as were assessments of ischemic neuronal density in the penumbra. In contrast, L-Arg administered intravenously in a dose of 300 mg/kg to nonischemic SHR (n = 5) increased cortical CBF by ∼75% during a 70-min observation period. We conclude that thrombotic processes superimposed upon cerebral ischemia may facilitate tissue reactions that offset the potentially beneficial effect of L-Arg, and this caveat must be considered when proposing L-Arg for clinical treatment of focal thrombotic stroke.

Sign in / Sign up

Export Citation Format

Share Document