scholarly journals Treatment of pediatric patient with ruptured intracranial aneurysm: Case report

2012 ◽  
Vol 65 (7-8) ◽  
pp. 331-336 ◽  
Author(s):  
Igor Meljnikov ◽  
Petar Vulekovic ◽  
Tomislav Cigic ◽  
Vladimir Borisev ◽  
Aleksandar Milojevic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Endovascular Treatment ◽  
Digital Subtraction Angiography ◽  
Intracranial Aneurysms ◽  
Good Condition ◽  
Neurological Deficits ◽  
Left Vertebral Artery ◽  
Digital Subtraction ◽  
Ruptured Intracranial Aneurysm

Introduction. Despite the contemporary diagnostics of intracranial aneurysms their treatment is still a great challenge. The decision when and if to apply a surgical or endovascular treatment of intracranial aneurysms should be made by a team of medical specialists which consists of a cerebrovascular neurosurgeon, neuro-radiologist and neuro-anesthesiologist. Case Report. We report a case of a patient aged 16 who was admitted because of a sudden intensive headache followed by sickness, vomiting, and loss of consciousness. On admission the patient was conscious but sleepy. Glasgow Coma Scale score was 14 and the World Federation of Neurological Surgeons Scale grade was I. The computed tomography scan showed a massive subarachnoid haemorrhage. The computed tomography angiography and digital subtraction angiography revealed a ruptured saccular aneurysm in the left vertebral artery. An early treatment with the coiling of the lumen of the aneurysm was performed under general anaesthesia. On the tenth day the boy was discharged in good condition and without any neurological deficits. Six months after the intervention the patient was without symptoms and the control digital subtraction angiography showed the complete occlusion of the aneurysm. Conclusion. Intracranial aneurysms in children are more common in males and are predominantly localized in the posterior circulation. In addition, they are frequently of greater size and more complex architecture and they are associated with a lower incidence of clinically manifest vasospasm. According to previous experience, endovascular treatment of intracranial aneurysms in paediatric patients has proven to be a safe and efficient method with a small number of complications.

scholarly journals Angioembolization of Scrotal Arteriovenous Malformations: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ammar Mohammad ◽  
Wael Sahyouni ◽  
Taisser Almeree ◽  
Bayan Alsaid
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Literature Review ◽  
Digital Subtraction Angiography ◽  
Acute Pain ◽  
Arteriovenous Malformations ◽  
Duplex Ultrasound ◽  
Digital Subtraction ◽  
Acute Bleeding ◽  
Scrotal Mass

Arteriovenous malformations (AVMs) of the scrotum are rare lesions, usually diagnosed incidentally during the evaluation of scrotal masses or infertility. It could be presented with acute bleeding or acute pain. We are presenting a case of painless bilateral infiltrated scrotal mass (more advanced in the left side) developed dramatically over a year, no other symptoms existed. The diagnosis was made using duplex ultrasound (DUS), computed tomography arteriography (CTA), and digital subtraction angiography (DSA). Three sessions of angioembolization were performed and followed by surgical resection of the left side of the scrotum.

Intracranial Aneurysms: Clinical Value of 3D Digital Subtraction Angiography in the Therapeutic Decision and Endovascular Treatment

Radiology ◽  
2001 ◽  
Vol 218 (3) ◽  
pp. 799-808 ◽  
Author(s):  
René Anxionnat ◽  
Serge Bracard ◽  
Xavier Ducrocq ◽  
Yves Trousset ◽  
Laurent Launay ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Digital Subtraction Angiography ◽  
Intracranial Aneurysms ◽  
Digital Subtraction ◽  
Therapeutic Decision ◽  
Clinical Value

Comparison Between CTA and Digital Subtraction Angiography in the Diagnosis of Ruptured Aneurysms

Neurosurgery ◽  
2017 ◽  
Vol 80 (5) ◽  
pp. 769-777 ◽  
Author(s):  
Lucas R. Philipp ◽  
D. Jay McCracken ◽  
Courtney E. McCracken ◽  
Sameer H. Halani ◽  
Brendan P. Lovasik ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Intracranial Aneurysms ◽  
Internal Carotid ◽  
Cerebral Aneurysms ◽  
Small Sample ◽  
Digital Subtraction ◽  
Ruptured Intracranial Aneurysm ◽  
Small Sample Sizes ◽  
Low Sensitivity ◽  
Ruptured Intracranial Aneurysms

Abstract BACKGROUND: Computerized tomography angiography (CTA) is commonly used to diagnose ruptured cerebral aneurysms with sensitivities reported as high as 97% to 100%. Studies validating CTA accuracy in the setting of subarachnoid hemorrhage (SAH) are scarce and limited by small sample sizes. OBJECTIVE: To evaluate the diagnostic accuracy of CTA in detecting intracranial aneurysms in the setting of SAH. METHODS: A single-center, retrospective cohort of 643 patients was reviewed. A total of 401 patients were identified whose diagnostic workup included both CTA and confirmatory digital subtraction angiography (DSA). Aneurysms missed by CTA but diagnosed by DSA were further stratified by size and location. RESULTS: Three hundred and thirty aneurysms were detected by CTA while DSA detected a total of 431 aneurysms. False positive CTA results were seen for 24 aneurysms. DSA identified 125 aneurysms that were missed by CTA and 83.2% of those were <5 mm in diameter. The sensitivity of CTA was 57.6% for aneurysms smaller than 5 mm in size, and 45% for aneurysms originating from the internal carotid artery. The overall sensitivity of CTA in the setting of SAH was 70.7%. CONCLUSION: The accuracy of CTA in the diagnosis of ruptured intracranial aneurysm may be lower than previously reported. CTA has a low sensitivity for aneurysms less than 5 mm in size, in locations adjacent to bony structures, and for those arising from small caliber parent vessels. It is our recommendation that CTA should be used with caution when used alone in the diagnosis of ruptured intracranial aneurysms.

scholarly journals Microsurgical Clipping of Intracranial Aneurysms following Unsuccessful Endovascular Treatment

2010 ◽  
Vol 16 (1) ◽  
pp. 23-30 ◽  
Author(s):  
J.-L. Yu ◽  
K. Xu ◽  
H.-L. Wang ◽  
B. Wang ◽  
Q. Luo
Keyword(s):  
Computed Tomography ◽  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Cranial Computed Tomography ◽  
Endovascular Coiling ◽  
Digital Subtraction ◽  
Microsurgical Clipping ◽  
Improved Outcomes ◽  
Aneurysm Coiling

The purpose of the current study was to examine the reasons for failed endovascular aneurysm coiling and to determine the outcome of immediate microsurgical clipping. From July 2006 to July 2008, 198 patients underwent endovascular coiling at our institute; among them, ten cases were unsuccessful. All of the patients were diagnosed with intracranial aneurysms (ICAs) by cranial computed tomography angiography (CTA), and all underwent endovascular treatment without digital subtraction angiography (DSA). When endovascular coiling failed, the patients were immediately transferred to the operating room for microsurgical clipping under the same anesthetic. The ten patients were divided into three groups based on the cause of endovascular failure and associated clinical features. The clinical follow-up period was between 6–12 months, and all 10 patients had good outcomes following the surgery. Taken together, the results of this study suggest that immediate microsurgical clipping after failed endovascular coiling is efficient and may provide improved outcomes by preventing rebleeding.

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