Mycotic Aneurysm of the Internal Carotid Artery Presenting with Multiple Cerebral Septic Emboli

Vascular ◽  
2007 ◽  
Vol 15 (4) ◽  
pp. 215-220 ◽  
Author(s):  
Spyros Papadoulas ◽  
Petros Zampakis ◽  
Alexandros Liamis ◽  
Panagiotis A. Dimopoulos ◽  
Ioannis A. Tsolakis
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Mycotic Aneurysm ◽  
Internal Carotid ◽  
Computed Tomographic Angiography ◽  
Septic Emboli ◽  
Computed Tomographic ◽  
Staphylococcus Aureus Bacteremia ◽  
Septic Embolization ◽  
The Brain

Mycotic aneurysms of the extracranial carotid artery are uncommon and always warrant surgical treatment to prevent eventual rupture and death. Septic embolization to the brain is an even rarer complication of these aneurysms. We present a case of a 79-year-old male with an extracranial internal carotid artery mycotic aneurysm during Staphylococcus aureus bacteremia. He presented with hemiparesis owing to brain embolism from multiple septic emboli originating from the aneurysm. Multidetector computed tomographic angiography contributed to the diagnosis. Resection of the aneurysm and restoration of arterial supply to the brain by vein graft interpositioning was the therapeutic procedure along with long-term antibiotic treatment. A high index of suspicion is required for the diagnosis of a mycotic carotid aneurysm and aggressive treatment is always needed to prevent lethal complications.

scholarly journals Anomalous left anterior cerebral artery with hypoplastic right anterior cerebral artery

2018 ◽  
Vol 7 (1) ◽  
pp. 1138-1140
Author(s):  
A Mahajan ◽  
G Goel ◽  
B Das
Keyword(s):  
Computed Tomography ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Anterior Cerebral Artery ◽  
Computed Tomographic Angiography ◽  
Anterior Communicating Artery ◽  
Computed Tomographic ◽  
Tomographic Angiography

We report an extremely rare anomalous variation of left anterior cerebral artery arising from the contralateral Paraclinoid Internal carotid artery with Hypoplastic right Anterior cerebral artery in a 56 years old female which was incidentally detected on computed tomographic angiography of cerebral vessels. Angiographic identification and characterisation of this anomaly is very important in developing a differential diagnosis and when planning a surgery and endovascular procedure.Keywords: Anterior cerebral artery, Paraclinoid Internal carotid artery, Anterior communicating artery Computed tomography angiography

BLISTER-LIKE ANEURYSMS OF THE ANTERIOR COMMUNICATING ARTERY

Neurosurgery ◽  
2008 ◽  
Vol 62 (4) ◽  
pp. 807-811 ◽  
Author(s):  
Norberto Andaluz ◽  
Mario Zuccarello
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Digital Subtraction Angiography ◽  
Internal Carotid ◽  
Computed Tomographic Angiography ◽  
Anterior Communicating Artery ◽  
Digital Subtraction ◽  
Computed Tomographic ◽  
Tomographic Angiography

Abstract OBJECTIVE Blood blister-like aneurysms are small hemispherical bulges from the dorsomedial wall of the internal carotid artery that resemble berry aneurysms but differ in their clinical and surgical features. On the basis of our literature review, blister-like aneurysms have been reported to occur only at nonbranching sites of the dorsomedial internal carotid artery. In this report on our series of five patients, we describe blister-like aneurysms of the anterior communicating artery (AComA) and discuss important diagnostic and therapeutic aspects unique to them. METHODS In our retrospective review of 719 patients with nontraumatic subarachnoid hemorrhage admitted to our service from 1998 to 2003, 181 (25.17%) patients harbored AComA aneurysms. Five (2.76%) patients (four women, one man) had blister-like aneurysms that were recognized at the time of surgery. RESULTS Initial digital subtraction angiography was diagnostic in only one patient. A second digital subtraction angiogram was diagnostic in one patient but failed to reveal an aneurysm in the remaining three patients; these were eventually diagnosed by computed tomographic angiography. All aneurysms were clipped. At the time of surgery, the aneurysms arose from the horizontal portion of the AComA without any involvement of the branches of the anterior cerebral artery. All presented as blister-like aneurysms that were thin-walled and lacking a surgical neck. On dissection, two of the lesions ruptured. All lesions were treated with straight fenestrated clips through the A1–AComA junction, thus remodeling the AComA. No delayed rupture was noted at the time of the last follow-up evaluation. At the time of discharge, outcomes were good in two patients, fair in two, and poor in the remaining patient. CONCLUSION Blister-like aneurysms constitute technically challenging lesions that may occur at the AComA. Computed tomographic angiography is valuable in diagnosis. Blister-like aneurysms should be suspected when digital subtraction angiography findings are negative for subarachnoid hemorrhage.

Progressive Hydrocephalus as a Complication of Cervical Internal Carotid Artery Occlusion in a 4-Year-Old Child

Neurosurgery ◽  
1981 ◽  
Vol 8 (4) ◽  
pp. 466-468
Author(s):  
Richard J. Lister ◽  
John K. Vries
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Internal Carotid Artery Occlusion ◽  
Diagnosis And Management ◽  
Computed Tomographic ◽  
Cervical Internal Carotid Artery

Abstract A case of progressive hydrocephalus as a complication of spontaneous cervical internal carotid artery occlusion in a child is presented. This problem has not been reported previously. The diagnosis and management of this condition are greatly facilitated by computed tomographic scanning.

Blood-brain barrier transport of neuropeptides: analysis with a metabolically stable dermorphin analogue

1994 ◽  
Vol 267 (1) ◽  
pp. E124-E131 ◽  
Author(s):  
A. Samii ◽  
U. Bickel ◽  
U. Stroth ◽  
W. M. Pardridge
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Intravenous Injection ◽  
Internal Carotid ◽  
Lipid Solubility ◽  
Permeability Surface ◽  
Bbb Permeability ◽  
The Brain ◽  
Artery Perfusion ◽  
Internal Carotid Artery Perfusion

To avoid the confounding effect of metabolic degradation, the stable mu-opioid peptide agonist [D-Arg2,Lys4]-dermorphin analogue (DALDA) was used to quantitate blood-brain barrier (BBB) permeability by intravenous injection and internal carotid artery perfusion techniques. With intravenous injection, the BBB permeability-surface area products for [3H]DALDA (0.84 +/- 0.13 microliters.min-1.g-1) and [14C]sucrose (0.39 +/- 0.05 microliters.min-1.g-1) correlated with the lipid solubility of the two molecules: the 1-octanol-Ringer partition coefficient for DALDA was approximately 2 log orders greater than that for sucrose. The brain delivery of [3H]DALDA at 30 min after intravenous administration was 0.019 +/- 0.002% of the injected dose per gram, and analgesia was induced with a 5-mg/kg dose administered systemically. In contrast to the result after intravenous injection, the BBB permeability-surface area product for DALDA estimated with the internal carotid artery perfusion technique was manyfold greater. This was due to nonspecific absorption of the peptide into the cerebral microvasculature, which precluded use of the capillary depletion technique to study transcytosis through the BBB after internal carotid artery perfusion. The present studies show that the brain delivery of a metabolically stable peptide, such as DALDA, is comparable to that for sucrose, correlates with lipid solubility, and is mediated by a nonsaturable mechanism, probably free diffusion.

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