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

✓ 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.


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.


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.


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.


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.


2005 ◽  
Vol 103 (2) ◽  
pp. 275-283 ◽  
Author(s):  
Kazuomi Horiuchi ◽  
Kyouichi Suzuki ◽  
Tatsuya Sasaki ◽  
Masato Matsumoto ◽  
Jun Sakuma ◽  
...  

Object. The usefulness of motor evoked potential (MEP) monitoring to detect blood flow insufficiency (BFI) in the cortical branches of the middle cerebral artery (MCA) and lenticulostriate arteries (LSAs) during MCA aneurysm surgery was investigated based on the correlation between MEP and somatosensory evoked potential (SEP) monitoring. Methods. Fifty-three patients with MCA aneurysms underwent surgery accompanied by intraoperative MEP and SEP monitoring. There was no postoperative motor paresis in 43 patients in whom MEP and SEP results remained unchanged. In the other 10 patients, nine manifested transient MEP changes; in five of these, SEP changes did not occur. The transient MEP changes were thought to be attributable to BFI of the MCA cortical branches in two patients, the LSA in three, and either the MCA branches or the LSA in four patients. Of these nine patients, six did not present with postoperative motor paresis; transient motor paresis was recognized in the other three. In the 10th patient, MEP waves disappeared and did not recover. This patient's SEPs remained at 70% of the control level, and he developed severe hemiparesis. A postoperative computerized tomography scan revealed a new low-density area in the corona radiata and putamen. Conclusions. Blood flow insufficiency in both the LSA and MCA cortical branches that perfuse the corticospinal tract can be detected by intraoperative MEP monitoring. Somatosensory evoked potential monitoring is not reliable enough to detect BFI in the MCA branches and the LSAs.


1980 ◽  
Vol 53 (1) ◽  
pp. 88-91 ◽  
Author(s):  
Jesús Marín ◽  
Mercedes Salaices ◽  
Fernando Rivilla ◽  
Javier Burgos ◽  
Emilio J. Marco

✓ The effect of removal of the left superior cervical ganglion on the contractile response to norepinephrine (NE) and 5-hydroxytryptamine (5-HT, serotonin) was studied in isolated segments of the middle cerebral artery (MCA) and posterior communicating artery (PCoA) of the cat. Fifteen days after the excision, each dose of NE elicited a potentiated response in both the MCA and the PCoA, whichever side they originated. By contrast, 5-HT induced enhanced vasoconstriction at each dose only in the MCA and PCoA from the left side. When segments of MCA and PCoA from the right side were challenged against 5-HT, a significantly increased response was found only at the first three doses. On the other hand, the NE content of pools made of MCA, PCoA, and anterior cerebral artery from each side was reduced to the same level on both sides after ganglion removal. These results indicate that the excised superior cervical ganglion innervated the MCA and PCoA from both sides of the circle of Willis.


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.


1874 ◽  
Vol 20 (90) ◽  
pp. 256-259
Author(s):  
W. Julius Mickle

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.


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.


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