Dissecting aneurysm of the cerebral arteries

1980 ◽  
Vol 53 (5) ◽  
pp. 693-697 ◽  
Author(s):  
Harvey Grosman ◽  
Victor L. Fornasier ◽  
David Bonder ◽  
Kenneth E. Livingston ◽  
Marjorie E. Platts
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Early Recognition ◽  
Cerebral Arteries ◽  
Dissecting Aneurysm ◽  
Left Middle Cerebral Artery ◽  
Content Type ◽  
Left Middle ◽  
Angiographic Findings ◽  
Fine Print

✓ 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.

Cerebral dissecting aneurysm and intimal fibroelastic thickening of cerebral arteries

1982 ◽  
Vol 56 (4) ◽  
pp. 571-576 ◽  
Author(s):  
Tomohiko Mizutani ◽  
Herbert I. Goldberg ◽  
Justin Parr ◽  
Clive Harper ◽  
Carson J. Thompson
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Cerebral Arteries ◽  
Dissecting Aneurysm ◽  
The Other ◽  
Left Middle Cerebral Artery ◽  
Similar Distribution ◽  
Content Type ◽  
Left Middle ◽  
Fine Print

✓ 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.

Delayed breaking of a Heifetz aneurysm clip

1977 ◽  
Vol 47 (3) ◽  
pp. 463-465 ◽  
Author(s):  
Antti Servo ◽  
Matti Puranen
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Left Middle Cerebral Artery ◽  
Carotid Angiography ◽  
Content Type ◽  
Aneurysm Clip ◽  
Correct Placement ◽  
Left Middle ◽  
Fine Print

✓ 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.

Intracranial dissecting aneurysm

1971 ◽  
Vol 35 (4) ◽  
pp. 483-487 ◽  
Author(s):  
Osamu Sato ◽  
James F. Bascom ◽  
John Logothetis
Keyword(s):  
Middle Cerebral Artery ◽  
Age Distribution ◽  
Acute Onset ◽  
Dissecting Aneurysm ◽  
Left Middle Cerebral Artery ◽  
Content Type ◽  
Relative Rarity ◽  
Intracranial Dissecting Aneurysm ◽  
Left Middle ◽  
Fine Print

✓ 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.

Multiple middle cerebral artery aneurysms in an infant

1990 ◽  
Vol 72 (5) ◽  
pp. 806-809 ◽  
Author(s):  
Cornelia Cedzich ◽  
J. Schramm ◽  
G. Röckelein
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Systemic Disease ◽  
Intracerebral Hematoma ◽  
Left Middle Cerebral Artery ◽  
Content Type ◽  
Middle Cerebral Artery Aneurysms ◽  
Subarachnoid Blood ◽  
Left Middle ◽  
Control Angiography

✓ 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.

Catecholamine content of cerebral tissue after occlusion or manipulation of middle cerebral artery in cats

1975 ◽  
Vol 43 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Harold P. Cohen ◽  
Arthur G. Waltz ◽  
Ronald L. Jacobson
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Neurological Deficits ◽  
Left Middle Cerebral Artery ◽  
Cerebral Infarcts ◽  
Cerebral Tissue ◽  
Vasoactive Agents ◽  
Content Type ◽  
Catecholamine Content ◽  
Left Middle

✓ 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.

Intracranial pressure, blood pressure, and pulse rate after occlusion of a middle cerebral artery in cats

1975 ◽  
Vol 43 (4) ◽  
pp. 399-407 ◽  
Author(s):  
Toru Hayakawa ◽  
Arthur G. Waltz
Keyword(s):  
Blood Pressure ◽  
Middle Cerebral Artery ◽  
Pulse Rate ◽  
Cerebral Artery ◽  
Left Middle Cerebral Artery ◽  
Cerebral Infarcts ◽  
Content Type ◽  
Aortic Blood ◽  
Aortic Blood Pressure ◽  
Left Middle

✓ 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.

Case of Ataxic Aphasia, with Autopsy

1874 ◽  
Vol 20 (90) ◽  
pp. 256-259
Author(s):  
W. Julius Mickle
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Corpus Striatum ◽  
Cerebral Arteries ◽  
Left Middle Cerebral Artery ◽  
Left Middle

Ataxic Aphasia; no agraphia; incomplete dextral hemiplegia; dementia. Autopsy. Cerebral arteries greatly thickened; left middle cerebral artery degenerated; lesion of left corpus striatum; no gross lesion of frontal convolutions, or of insula on either side.

Acutely thrombosed aneurysm of the middle cerebral artery presenting as intracranial hemorrhage in a 3-year-old child

1984 ◽  
Vol 60 (6) ◽  
pp. 1303-1307 ◽  
Author(s):  
Brian T. Andrews ◽  
Michael S. B. Edwards ◽  
Peter Gannon
Keyword(s):  
Middle Cerebral Artery ◽  
Intracranial Hemorrhage ◽  
Cerebral Artery ◽  
Arterial Occlusion ◽  
Left Middle Cerebral Artery ◽  
Spontaneous Thrombosis ◽  
Ischemic Event ◽  
Content Type ◽  
Thrombosed Aneurysm ◽  
Left Middle

✓ 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.

Surgical manipulation of primate cerebral arteries in established vasospasm

1991 ◽  
Vol 75 (3) ◽  
pp. 425-432 ◽  
Author(s):  
J. Max Findlay ◽  
R. Loch Macdonald ◽  
Bryce K. A. Weir ◽  
Michael G. A. Grace
Keyword(s):  
Cerebral Ischemia ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Cerebral Arteries ◽  
Circle Of Willis ◽  
Content Type ◽  
Increased Risk ◽  
The Right ◽  
Surgical Manipulation ◽  
Fine Print

✓ It is generally believed that surgery in the face of angiographic vasospasm is dangerous due to an increased incidence of postoperative cerebral ischemia. One theory is that arterial narrowing is exacerbated by surgical manipulation of vasospastic vessels during aneurysm dissection and clipping. This theory was tested in a primate model of cerebral vasospasm and the results reported. Six monkeys underwent baseline cerebral angiography, followed by induction of subarachnoid hemorrhage (SAH) on both sides of the circle of Willis. An equal amount of fresh autologous blood clot was placed around each internal carotid, anterior cerebral, and middle cerebral artery. Six days later, angiography was repeated and the right craniectomy was reopened for clot evacuation and surgical manipulation of the right cerebral arteries, including placement of a temporary aneurysm clip on the right middle cerebral artery. The left cerebral arteries were not exposed or manipulated, and served as controls. Twenty-four hours later angiography was repeated, then the animals were killed. Equal and significant vasospasm (> 40% reduction in vessel caliber compared to baseline, p < 0.05) was seen in the middle cerebral arteries on both sides of the circle of Willis in all animals 6 and 7 days after SAH. There was no significant change in the severity of vasospasm on Day 7 compared with Day 6 in the right cerebral arteries. Increased risk of postoperative cerebral ischemia for surgery in the peak vasospasm period may be due to mechanisms other than increased arterial narrowing precipitated by surgical manipulation.

Intra-arterial urokinase for treatment of retrograde thrombosis following resection of an arteriovenous malformation

1992 ◽  
Vol 76 (6) ◽  
pp. 1004-1007 ◽  
Author(s):  
Eric P. Sipos ◽  
Jeffrey R. Kirsch ◽  
Haring J. W. Nauta ◽  
Gerard Debrun ◽  
John A. Ulatowski ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Middle Cerebral Artery ◽  
Arteriovenous Malformations ◽  
Preoperative Embolization ◽  
Left Middle Cerebral Artery ◽  
Successful Therapy ◽  
Content Type ◽  
Hemorrhagic Complications ◽  
Left Middle ◽  
Fine Print

✓ 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.

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