scholarly journals An Analysis of Intracranial Aneurysms Presenting with Subarachnoid Haemorrhage in Manipal Teaching Hospital Pokhara

2018 ◽  
Vol 8 (1) ◽  
pp. 20-24
Author(s):  
Balgopal Karmacharya ◽  
Nikunja Yogi
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Teaching Hospital ◽  
Intracranial Aneurysms ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
High Morbidity ◽  
Anterior Circulation ◽  
Cross Sectional ◽  
Female Ratio ◽  
Spontaneous Subarachnoid Hemorrhage

Introduction: Rupture of intracranial aneurysms is the most common cause for spontaneous subarachnoid hemorrhage. It is a devastating stroke with high morbidity and mortality. This study was done to determine the frequency, location and size of aneurysms in patients presenting with spontaneous subarachnoid hemorrhage.Methods: This prospective cross sectional observational study was conducted in the Neurosurgery Unit of Manipal Teaching Hospital from January 2012 to June 2016. All patients who presented with spontaneous subarachnoid hemorrhage and had a positive angiography of brain were included in the study.Results: There were 39 patients who had positive angiographic results. Male: female ratio was 1:2.25. Mean age was 55.79 years. Nine patients had more than one aneurysms. More than 50% of patients were of age group 50-70 years. Anterior circulation aneurysms were found in 90% of patients. Anterior communicating artery was the commonest location of aneurysms. Most of the aneurysms had neck size less than 4 mm.Conclusion: Anterior communicating artery aneurysm was the commonest location of ruptured aneurysms.  23.07% of patients had multiple aneurysms. 

scholarly journals Surgical treatment of intracranial aneurysms: six-year experience in Belo Horizonte, MG, Brazil

2004 ◽  
Vol 62 (2a) ◽  
pp. 245-249 ◽  
Author(s):  
Leodante Batista da Costa Jr ◽  
Josaphat Vilela de Morais ◽  
Agustinho de Andrade ◽  
Marcelo Duarte Vilela ◽  
Renato P. Campolina Pontes ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Intracranial Aneurysms ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
The United States ◽  
Anterior Circulation ◽  
Common Location ◽  
Belo Horizonte ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Anterior Circulation Aneurysms

Spontaneous subarachnoid hemorrhage accounts for 5 to 10 % of all strokes, with a worldwide incidence of 10.5 / 100000 person/year, varying in individual reports from 1.1 to 96 /100000 person/year. Angiographic and autopsy studies suggest that between 0.5% and 5% of the population have intracranial aneurysms. Approximately 30000 people suffer aneurysmal subarachnoid hemorrhage in the United States each year, and 60% die or are left permanently disabled. We report our experience in the surgical treatment of intracranial aneurysms in a six year period, in Belo Horizonte, Minas Gerais, Brazil. We reviewed the hospital files, surgical and out-patient notes of all patients operated on for the treatment of intracranial aneurysms from January 1997 to January 2003. Four hundred and seventy-seven patients were submitted to 525 craniotomies for treatment of 630 intracranial aneurysms. The majority of patients were female (72.1%) in the fourth or fifth decade of life. Anterior circulation aneurysms were more common (94.4%). The most common location for the aneurysm was the middle cerebral artery bifurcation. The patients were followed by a period from 1 month to 5 years. The outcome was measured by the Glasgow Outcome Scale (GOS). At discharge, 62.1% of the patients were classified as GOS 5, 13.9% as GOS 4, 8.7% as GOS 3, 1.7% as GOS 2 and 14.8% as GOS 1.

scholarly journals Outcome of patients of Subarachnoid Hemorrhage due to ruptured anterior communicating artery aneurysm after surgical clipping

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Anjum Habib Vohra ◽  
Mubasher Ahmed
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Subarachnoid Haemorrhage ◽  
Prospective Study ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Surgical Clipping ◽  
Radiological Investigation ◽  
Female Ratio ◽  
Male To Female ◽  
Grade Iii

This prospective study was done to determine the outcome of subarachnoid haemorrhage (SAH) due to ruptured anterior communicating artery ( a Corn) aneurysm in 8 consecutive patients after craniotomy and clipping of the aneurysm. The study was conducted at Mayo Hospital, Lahore from September 1999 to January 2002. All patients presented with history and examination suggestive of SAH had CT scan brain as first radiological investigation. Patients of SAH were graded clinically according to Hung and Hess scale. After confirmation of diagnosis of SAH, four vessels cerebral angiography was done to localize site of aneurysm in patiens of Hunt and Hess grade I, II and III or after they improved to at least grade III. Craniotomy and clipping of aneursm was done only in patients with Hunt & Hess grade I, II and III. Maximum patients presented during 6th decade i.e., 38%. Male to female ratio was 6:2. Hunt & Hess grade I, II and III was observed in 5,2 and 1 patients respectively. Outcome was assessed according to G lasgow Outcome Scale (GOS). Good outcome was present in 75% patients and moderate disability in 25%.

RECURRENT SUBARACHNOID HEMORRHAGE CAUSED BY A DE NOVO BASILAR TIP ANEURYSM DEVELOPING WITHIN 8 WEEKS AFTER CLIPPING OF A RUPTURED ANTERIOR COMMUNICATING ARTERY ANEURYSM

Neurosurgery ◽  
2008 ◽  
Vol 62 (1) ◽  
pp. E259-E260 ◽  
Author(s):  
Karl-Michael Schebesch ◽  
Christian Doenitz ◽  
Roland Zoephel ◽  
Thomas Finkenzeller ◽  
Alexander T. Brawanski
Keyword(s):  
Subarachnoid Hemorrhage ◽  
De Novo ◽  
Case Reports ◽  
Rapid Development ◽  
Transcranial Doppler Sonography ◽  
Artery Aneurysm ◽  
Posterior Circulation ◽  
Anterior Communicating Artery ◽  
Anterior Circulation ◽  
De Novo Aneurysm

Abstract OBJECTIVE Well-documented case reports of the rapid formation and rupture of de novo aneurysms of the posterior circulation are rare. CLINICAL PRESENTATION We report a patient with subarachnoid hemorrhage caused by an aneurysm of the anterior communicating artery that was clipped consecutively. Forty-four days after the initial subarachnoid hemorrhage, the patient experienced a second subarachnoid hemorrhage after the rupture of a newly grown aneurysm of the basilar tip. Between the two hemorrhages, transcranial Doppler sonography and neuroimaging revealed a fulminant generalized vasospasm. INTERVENTION To our knowledge, this is the first report of the rapid development and rupture of a de novo aneurysm of the posterior circulation after the rupture of an initial aneurysm of the anterior circulation. CONCLUSION We review the pertinent literature and discuss possible reasons for the development and rupture of this second aneurysm.

Single-Stage Clipping of Seven Intracranial Aneurysms in the Anterior Circulation via Unilateral Pterional Approach: A Case Report and Literature Review

2020 ◽  
Vol 81 (03) ◽  
pp. 271-278
Author(s):  
Kan Xu ◽  
Kun Hou ◽  
Baofeng Xu ◽  
Yunbao Guo ◽  
Jinlu Yu
Keyword(s):  
Intracranial Aneurysms ◽  
Ophthalmic Artery ◽  
Artery Aneurysm ◽  
Postoperative Recovery ◽  
Anterior Communicating Artery ◽  
Pterional Approach ◽  
Anterior Circulation ◽  
First Case ◽  
Sporadic Cases ◽  
Middle Cerebral Artery Aneurysms

AbstractThe occurrence of multiple intracranial aneurysms (MIAs) is not rare, with a reported incidence of 15 to 35%. However, patients harboring seven or more intracranial aneurysms are so uncommon that only sporadic cases have ever been reported. We present a rare case with seven intracranial aneurysms (two anterior communicating artery aneurysms, two right middle cerebral artery aneurysms, two left ophthalmic artery aneurysms, and one right ophthalmic artery aneurysm) in the anterior circulation that were simultaneously clipped via the extended right pterional approach. The surgery was uneventful. The patient experienced a rapid postoperative recovery with no neurologic deficits. To our knowledge, this is the first case of seven bilateral intracranial aneurysms that were surgically clipped via unilateral craniotomy. This case showed that in properly selected patients with anterior circulation MIAs, even as many as seven, one-stage clipping can be achieved. Successful clipping of the contralateral ophthalmic aneurysms was the key step in the operation.

Computed Tomography Angiography (CTA) Evaluation of Spontaneous Subarachnoid Hemorrhage

2020 ◽  
Vol 6 (2) ◽  
pp. 78-81
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Chowdhury ◽  
Mohammad Sadekur Rahman Sarkar ◽  
KM Ahasan Ahmed ◽  
Md Nazmul Kabir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Computed Tomography Angiography ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multiple Aneurysm ◽  
Traumatic Subarachnoid Hemorrhage ◽  
One Year ◽  
Spontaneous Subarachnoid Hemorrhage

Background: In evaluation of non-traumatic subarachnoid hemorrhage CT angiography (CTA) has 97-98% sensitivity and near 100% specificity. Objective: This study was conducted to evaluate the CTA findings of CT positive non traumatic subarachnoid hemorrhage. Methodology: This is an observational cross sectional study performed in Neurology department of National Institute of Neurosciences and Hospital, Dhaka over one year period (January 2019 to December 2019). Total 87 CT positive subarachnoid hemorrhage cases were purposively included in this study. All CT positive patients underwent CTA of Cerebral vessels for further evaluation. The angiography were evaluated by competent neuro-radiologists blinded about the study. Result: Among 87 patients, 40.2% were male and 59.8% were female. The average age was 53.33±11.1 years. Among the studied patient the source of bleeding was found 78.16% aneurysmal and 21.84% non-aneurysmal. 85.30% patients had single aneurysm and 14.70% had multiple aneurysm. The highest number of patient had Acom aneurysm (41.17%) followed by MCA (22.05%), ICA (13.23%), ACA (7.35%) and vertebral artery (1.14%) in order of frequency. Among the multiple aneurysm group most of the patients had combination of Acom, MCA and ICA aneurysm. Conclusion: From this study, we can conclude that CTA can be used as the primary diagnostic tool in evaluation of spontaneous SAH. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 78-81

Coil embolisation of an internal iliac artery aneurysm after surgical repair of an infrarenal aortic aneurysm

VASA ◽  
2007 ◽  
Vol 36 (2) ◽  
pp. 138-142 ◽  
Author(s):  
Sixt ◽  
Rastan ◽  
Schwarzwälder ◽  
Schwarz ◽  
Frank ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Artery Aneurysm ◽  
High Morbidity ◽  
Coil Embolisation ◽  
Iliac Artery Aneurysm ◽  
Cross Sectional ◽  
Infrarenal Aortic Aneurysm ◽  
Internal Iliac

We report a case of an 86-year-old asymptomatic patient, who underwent a repair of the infrarenal abdominal aortic aneurysm 13 years ago. He presented with a left internal iliac artery (IIA) aneurysm with a short neck of 3 mm, and a partially thrombosed lumen with a cross sectional diameter of 5.6 cm and a length of 8.9 cm. With respect to the high morbidity and mortality and awareness of the recommendation to treat aneurysms larger than 3 cm in diameter, we discussed the optimal treatment options. As endoprosthesis implantation was not feasible we performed a selective coil embolisation of the distal branches of the left internal artery, which successively lead to a complete thrombosis of the aneurysm. Although coiling additive to other procedures is applied frequently, only few cases of internal iliac aneurysm were treated with coil embolisation alone. During a first outpatient visit 2 months following the procedure the aneurysm was still completely thrombosed.

Surgery for angiographically occult cerebral aneurysms

1993 ◽  
Vol 79 (5) ◽  
pp. 674-679 ◽  
Author(s):  
Jafar J. Jafar ◽  
Howard L. Weiner
Keyword(s):  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Sylvian Fissure ◽  
Ct Scans ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Excellent Outcome ◽  
Interpeduncular Cistern ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Exploratory Surgery

✓ In 15% of patients with spontaneous subarachnoid hemorrhage (SAH), the source of bleeding cannot be determined despite repeated cerebral angiography. However, some patients diagnosed as having “SAH of unknown cause” actually harbor undetected aneurysms. The authors report six patients with SAH who, despite multiple negative cerebral angiograms, underwent exploratory surgery due to a high clinical and radiographic suspicion for the presence of an aneurysm. Brain computerized tomography (CT) scans revealed blood located mainly in the basal frontal interhemispheric fissure in four patients, in the sylvian fissure in one patient, and in the interpeduncular cistern in one patient. The patients were evaluated as Hunt and Hess Grades I to III, and had undergone at least two high-quality cerebral angiograms that did not reveal an aneurysm. Vasospasm was visualized in two patients. Three patients rebled while in the hospital. Exploratory surgery was performed at an average of 12 days post-SAH. Five aneurysms were discovered at surgery and were successfully clipped. All four patients with interhemispheric blood were found to have an anterior communicating artery (ACoA) aneurysm. The patient with blood in the sylvian fissure was found to have a middle cerebral artery aneurysm. These aneurysms were partially thrombosed. No aneurysm was detected in the patient with interpeduncular SAH, despite extensive basilar artery exploration. Five patients had an excellent outcome and one patient developed diabetes insipidus. These results show that exploratory aneurysm surgery is warranted, despite repeated negative cerebral angiograms, if the patient manifests the classical signs of SAH with CT scans localizing blood to a specific cerebral blood vessel (particularly the ACoA) and if a second SAH is documented at the same site.

Intraoperative transaneurysmal coil-assisted clip occlusion of a complex anterior communicating artery aneurysm

2007 ◽  
Vol 107 (1) ◽  
pp. 202-205 ◽  
Author(s):  
Niklaus Krayenbühl ◽  
Ali F. Krisht
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysm ◽  
Complete Obliteration ◽  
Clip Occlusion ◽  
First Time

✓The combination of surgical and endovascular treatment for complex intracranial aneurysms has previously been used in a staged fashion. To perfect the clipping process of a complex anterior communicating artery aneurysm and to avoid a second staged procedure, the authors used a method of direct intraoperative transaneurysmal coil-assisted clip occlusion of the aneurysm. To the authors' knowledge this is the first time direct intraoperative transaneurysmal coil-assisted clip occlusion has been reported. It should be kept in mind as one of the options to help in complete obliteration of complex intracranial aneurysms.

scholarly journals Vasa Vasorum Formation is Associated With Rupture of Intracranial Aneurysms

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Haruka Miyata ◽  
Hirokazu Koseki ◽  
Kampei Shimizu ◽  
Yu Abekura ◽  
Mieko Oka ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Aneurysms ◽  
Histopathological Examination ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Vasa Vasorum ◽  
Systemic Hypertension ◽  
External Carotid ◽  
Anterior Communicating Artery ◽  
Sprague Dawley ◽  
The Right

Abstract INTRODUCTION Subarachnoid hemorrhage has a poor outcome despite a modern advancement in medical care. The development of a novel therapeutic strategy to prevent rupture of intracranial aneurysms (IAs) or a novel diagnostic marker to predict rupture-prone lesions is thus mandatory. Therefore, in the present study, we established a rat model in which IAs spontaneously rupture and examined this model to clarify histopathological features associated with rupture of lesions. METHODS In detail, female Sprague-Dawley rats were subjected to the bilateral ovariectomy, the ligation of the left common carotid, the right external carotid, and the right pterygopalatine arteries, the induced systemic hypertension, and the administration of a lysyl oxidase inhibitor. RESULTS Aneurysmal subarachnoid hemorrhage occurred one-thirds of manipulated animals and locations of ruptured IAs were exclusively at a posterior or an anterior communicating artery. Histopathological examination using ruptured IAs, rupture-prone ones induced at a posterior or an anterior communicating artery, ones induced at an anterior cerebral artery-olfactory artery bifurcation that never rupture revealed the formation of vasa vasorum as an event associated with rupture of IAs. CONCLUSION We thus proposed the contribution of a structural change in an adventitia, vasa vasorum formation, to rupture of IAs. Findings from this study provide important insights about the pathogenesis of IAs.

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