Delayed breaking of a Heifetz aneurysm clip

1977 ◽  
Vol 47 (3) ◽  
pp. 463-465 ◽  
Author(s):  
Antti Servo ◽  
Matti Puranen

✓ An aneurysm of the left middle cerebral artery was treated by clipping with a Heifetz clip. The correct placement was confirmed angiographically immediately after the operation. At carotid angiography 1 year later the clip was found to have broken, and the aneurysm had increased in size.

1982 ◽  
Vol 56 (4) ◽  
pp. 571-576 ◽  
Author(s):  
Tomohiko Mizutani ◽  
Herbert I. Goldberg ◽  
Justin Parr ◽  
Clive Harper ◽  
Carson J. Thompson

✓ A 19-year-old white man developed aphasia and right hemiplegia after several falls while waterskiing. Cerebral angiography displayed a ripple appearance and a “string of beads” sign along the left middle cerebral artery, with occlusion or stenosis of most of its branches. The patient died after 6 days, of transtentorial herniation due to massive left cerebral infarction. At necropsy, the infarct was found to be due to a subintimal dissecting aneurysm of the left middle cerebral artery. Multifocal areas of intimal fibroelastic thickening (IFT) were found not only at the site of dissection, but also in the other cerebral arteries, most prominent at the bifurcations of the vessels. A systematic study of cerebral arteries performed in six control cases revealed that IFT was present in a similar distribution to that seen in the patient described. However, the degree of IFT in this patient was greater than in the controls. Some individuals with excessive IFT may be more susceptible to cerebral dissecting aneurysm under a variety of stresses, especially trauma.


1980 ◽  
Vol 53 (5) ◽  
pp. 693-697 ◽  
Author(s):  
Harvey Grosman ◽  
Victor L. Fornasier ◽  
David Bonder ◽  
Kenneth E. Livingston ◽  
Marjorie E. Platts

✓ A spontaneous dissecting aneurysm of the left middle cerebral artery with extension into its major branches is reported in a 23-year-old man. The characteristic pathological and angiographic findings are demonstrated, including the rarely documented progression of this lesion. The etiological factors, the early recognition by the neuroradiologist, and the possibility of immediate treatment are briefly discussed in this report.


1990 ◽  
Vol 72 (5) ◽  
pp. 806-809 ◽  
Author(s):  
Cornelia Cedzich ◽  
J. Schramm ◽  
G. Röckelein

✓ An 11-month-old boy was admitted for evaluation of drowsiness, vomiting, and convulsions. Computerized tomography showed subarachnoid blood in the left sylvian fissure and a small intracerebral hematoma in the temporal lobe. Angiography revealed several aneurysms of the left middle cerebral artery (MCA). During surgery, 13 aneurysms were found arising from one main branch of the left MCA, and this segment of the MCA was trapped. Somatosensory evoked potentials did not show any change during surgery. The diseased arterial segment was examined histologically and the pathogenetic aspects of the case are discussed. Control angiography 6 months later excluded systemic disease or other aneurysms. The rarity of such lesions in childhood and their successful surgical treatment are discussed briefly.


1972 ◽  
Vol 37 (2) ◽  
pp. 226-228 ◽  
Author(s):  
Jusuke Ito ◽  
Komei Ueki ◽  
Hisayuki Ishikawa

✓ Carotid angiography of a patient with suspected subdural hematoma showed extravasation of the contrast medium from an ascending branch of the middle cerebral artery. The leak was verified at operation. There was no visual evidence of an aneurysm, angioma, subarachnoid or subpial hemorrhage.


1975 ◽  
Vol 43 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Harold P. Cohen ◽  
Arthur G. Waltz ◽  
Ronald L. Jacobson

✓ The authors determined by fluorimetry the norepinephrine-epinephrine content (NE-E) of cerebral tissue from 38 cats, to ascertain whether constriction of hypersensitive arterial vessels by vasoactive agents in ischemic cerebral tissue could cause extension of cerebral infarcts and worsening of neurological deficits. Twenty-three cats had the left middle cerebral artery (MCA) occluded transorbitally, and 10 cats had sham operations. Five cats had only the surgical procedures necessary for obtaining tissue; mean NE-E content was 0.30 µg/gm (SD = 0.041). For the other 33 cats, including those with sham operations, values were variable, ranging from 0.07 to 0.60 µg/gm. Low values usually were obtained for ischemic hemispheres 24 hours and 7 days after MCA occlusion, but at other times values could be high or low on either side. Many factors unrelated to tissue damage, including arterial manipulation, influence the catecholamine content of cerebral tissue.


1971 ◽  
Vol 35 (4) ◽  
pp. 483-487 ◽  
Author(s):  
Osamu Sato ◽  
James F. Bascom ◽  
John Logothetis

✓ The case of a 6-year-old boy who died 4 days after the acute onset of a left middle cerebral artery aneurysmal dissection is described. A review of the 30 reported cases with similar lesions reveals their relative rarity. The age distribution, sex incidence, intracranial vessels affected, and postulated causes of the dissection are discussed.


1975 ◽  
Vol 43 (4) ◽  
pp. 399-407 ◽  
Author(s):  
Toru Hayakawa ◽  
Arthur G. Waltz

✓ The left middle cerebral artery was occluded in 12 tranquilized but unanesthetized cats with use of a device implanted transorbitally 5 to 7 days earlier. Bilateral epidural pressures, mean aortic blood pressure, and pulse rate were measured at intervals for up to 48 hours after occlusion. The relationships of these measurements to each other and to the extent and severity of cerebral infarcts is described.


1984 ◽  
Vol 60 (6) ◽  
pp. 1303-1307 ◽  
Author(s):  
Brian T. Andrews ◽  
Michael S. B. Edwards ◽  
Peter Gannon

✓ Spontaneous thrombosis of aneurysms occurs rarely in children, and, to our knowledge, there are no reports of aneurysms presenting as an embolic event in a child. We describe the case of a 3-year-old boy whose symptoms initially suggested an ischemic event to the dominant hemisphere. Initial computerized tomography scans indicated an intracranial hemorrhage. Subsequent radiographic study revealed evidence of emboli and, at exploration, a large acutely thrombosed aneurysm of the left middle cerebral artery associated with arterial occlusion was found. Entrapment of the aneurysm and thrombectomy provided excellent operative results.


1992 ◽  
Vol 76 (6) ◽  
pp. 1004-1007 ◽  
Author(s):  
Eric P. Sipos ◽  
Jeffrey R. Kirsch ◽  
Haring J. W. Nauta ◽  
Gerard Debrun ◽  
John A. Ulatowski ◽  
...  

✓ Retrograde thrombosis of feeding arteries is a potentially catastrophic complication occasionally reported following resection of arteriovenous malformations (AVM's). No successful therapy for this condition, which causes postoperative stroke, has previously been reported. A case of retrograde thrombosis of the left middle cerebral artery immediately following resection of a parietal AVM is reported in a patient with a retained intra-arterial catheter from preoperative embolization. The administration of urokinase within 4 hours of surgery resulted in dramatic clinical and angiographic improvement without hemorrhagic complications. While urokinase is considered highly experimental in this setting, this case demonstrates that thrombolytic agents should be viewed as therapeutic options worthy of further investigation.


2021 ◽  
pp. 174749302098455
Author(s):  
Nick A Weaver ◽  
Angelina K Kancheva ◽  
Jae-Sung Lim ◽  
J Matthijs Biesbroek ◽  
Irene MC Huenges Wajer ◽  
...  

Background Post-stroke cognitive impairment can occur after damage to various brain regions, and cognitive deficits depend on infarct location. The Mini-Mental State Examination (MMSE) is still widely used to assess post-stroke cognition, but it has been criticized for capturing only certain cognitive deficits. Along these lines, it might be hypothesized that cognitive deficits as measured with the MMSE primarily involve certain infarct locations. Aims This comprehensive lesion-symptom mapping study aimed to determine which acute infarct locations are associated with post-stroke cognitive impairment on the MMSE. Methods We examined associations between impairment on the MMSE (<5th percentile; normative data) and infarct location in 1198 patients (age 67 ± 12 years, 43% female) with acute ischemic stroke using voxel-based lesion-symptom mapping. As a frame of reference, infarct patterns associated with impairments in individual cognitive domains were determined, based on a more detailed neuropsychological assessment. Results Impairment on the MMSE was present in 420 patients (35%). Large voxel clusters in the left middle cerebral artery territory and thalamus were significantly (p < 0.01) associated with cognitive impairment on the MMSE, with highest odds ratios (>15) in the thalamus and superior temporal gyrus. In comparison, domain-specific impairments were related to various infarct patterns across both hemispheres including the left medial temporal lobe (verbal memory) and right parietal lobe (visuospatial functioning). Conclusions Our findings indicate that post-stroke cognitive impairment on the MMSE primarily relates to infarct locations in the left middle cerebral artery territory. The MMSE is apparently less sensitive to cognitive deficits that specifically relate to other locations.


Sign in / Sign up

Export Citation Format

Share Document