Traumatic middle meningeal arteriovenous fistula caused by three-point skull fixation

1984 ◽  
Vol 60 (4) ◽  
pp. 853-855 ◽  
Author(s):  
Tetsuji Inagawa ◽  
Tetsuji Takeda ◽  
Haruyoshi Taguchi ◽  
Kazuko Kamiya ◽  
Tohru Yamada

✓ Traumatic middle meningeal arteriovenous (AV) fistulas usually occur as rare complications of head injury. An unusual case of a middle meningeal AV fistula is presented which resulted from three-point fixation with a skull clamp to stabilize the head during surgery for an anterior communicating artery aneurysm.

1987 ◽  
Vol 67 (6) ◽  
pp. 940-943 ◽  
Author(s):  
Bruce Rosenblum ◽  
Stephanie Rifkinson-Mann ◽  
Michael Sacher ◽  
Rosemaria Gennuso ◽  
Allen Rothman

✓ A case of atraumatic arteriovenous (AV) fistula of the extracranial vertebral artery associated with an atraumatic aneurysm of the contralateral extracranial vertebral artery is reported. The fistulous lesion was excised after distal and proximal ligation of the vessel. Subsequently, the contralateral aneurysm underwent spontaneous dissolution. Seven cases of extracranial vertebral AV fistulae associated with ipsilateral vertebral artery aneurysms (four traumatic and three as part of vascular dysplastic syndromes) have been reported previously.


2000 ◽  
Vol 92 (2) ◽  
pp. 355-358 ◽  
Author(s):  
A. Shahram Makoui ◽  
Donald A. Smith ◽  
Avery J. Evans ◽  
David W. Cahill

✓ Guglielmi detachable coil (GDC) therapy was initially intended as a treatment for select patients harboring aneurysms deemed to be at high risk for clip ligation. As experience with the technique has grown, many centers are now offering GDC therapy as a primary treatment to patients who are also good surgical candidates. The authors report a case in which a ruptured anterior communicating artery aneurysm recurred within 2 weeks of a technically satisfactory GDC procedure. The patient subsequently underwent successful surgery for clip ligation of the lesion. This is the earliest reported recurrence of an aneurysm after angiographically confirmed successful GDC therapy and underscores the need for performing early control angiography in patients undergoing this procedure.


1983 ◽  
Vol 58 (2) ◽  
pp. 291-294 ◽  
Author(s):  
G. Rees Cosgrove ◽  
Jean-Guy Villemure ◽  
Denis Melançon

✓ A case is presented of false intracranial aneurysm of traumatic origin which developed following direct surgical attack on a congenital anterior communicating artery aneurysm. The secondary aneurysm was discovered on the 25th postoperative day and was clipped at a subsequent procedure. The possible pathophysiology is discussed with respect to other direct vessel injuries.


1979 ◽  
Vol 51 (5) ◽  
pp. 697-699 ◽  
Author(s):  
Dwight Parkinson ◽  
Venkatesha Reddy ◽  
R. T. Ross

✓ A rare case of anastomosis between the vertebral artery and the internal carotid artery in the neck of a patient with an anterior communicating artery aneurysm is reported.


1999 ◽  
Vol 91 (5) ◽  
pp. 871-874 ◽  
Author(s):  
Masahiro Ogino ◽  
Masashi Nakatsukasa ◽  
Toru Nakagawa ◽  
Ikuro Murase

✓ This 70-year-old woman suffered a subarachnoid hemorrhage (SAH) from a ruptured anterior communicating artery aneurysm encased in a meningioma in the tuberculum sellae. Although preoperative magnetic resonance imaging disclosed that the aneurysmal complex was completely enclosed in the tumor, angiographic studies did not reveal arterial narrowing. The embedded aneurysm caused diffuse SAH rather than intratumoral hemorrhage. These factors indicated very little adhesion between the tumor and the encased arteries. Surgery was performed on the 20th day post-SAH. Intraoperative findings revealed that the tumor did not adhere to the enclosed vasculature except at the point of rupture of the aneurysm. The authors were able to clip the aneurysm safely after piecemeal removal of the tumor, which was finally extirpated without fear of aneurysm rupture. Careful stepwise procedures were essential to treat the aneurysm and the tumor simultaneously.


2000 ◽  
Vol 92 (6) ◽  
pp. 991-994 ◽  
Author(s):  
Huma Sethi ◽  
Anne Moore ◽  
James Dervin ◽  
Andrew Clifton ◽  
J. Emma MacSweeney

Object. In this retrospective study conducted at Atkinson Morley's Hospital and Middlesbrough General Hospital, the authors analyzed 100 matched patients who had suffered subarachnoid hemorrhage (SAH) to determine whether the technical procedure by which aneurysms are treated affects the development of chronic hydrocephalus.Methods. Four hundred seventy-five patients presented with SAH between 1995 and 1998. Exclusion criteria included posterior circulation aneurysms, multiple aneurysms, electively clipped or embolized aneurysms, angiographically undetected SAH, patients who died within 1 month of neurosurgical intervention, and patients with the same aneurysm location but a different Fisher grade.The authors matched 50 patients who underwent embolization of their aneurysms with another 50 who had similar Fisher grades and aneurysm types and underwent clipping of their aneurysms. The maximum incidence of ruptured aneurysms occurred in patients who were between 41 and 60 years of age, with women preponderant in both study groups. In each group, 27 patients had anterior communicating artery aneurysm, 13 had posterior communicating artery aneurysm, seven had middle cerebral artery aneurysm, and three had internal carotid artery aneurysm. The lesions in three patients in each group were Fisher Grade I, in 23 patients they were Fisher Grade II, in 14 they were Fisher Grade III, and 10 patients had Fisher Grade IV SAH. Nine patients among those with clipped aneurysms and eight of the patients who underwent embolization had hydrocephalus for which they needed intervention. These interventions included lumbar puncture, ventricular drainage, and ventriculoperitoneal (VP) shunt placement; three patients in each group needed VP shunt placement.Conclusions. The technical procedure used to treat aneurysms, whether clipping or embolization, does not significantly affect the development of chronic hydrocephalus. However, a larger sample of patients is needed for accurate comparisons and stronger conclusions.


2000 ◽  
Vol 63 (3-4) ◽  
pp. 265-278 ◽  
Author(s):  
Franca Stablum ◽  
Carlo Umiltà ◽  
Carla Mogentale ◽  
Michela Carlan ◽  
Chiara Guerrini

1996 ◽  
Vol 84 (4) ◽  
pp. 690-695 ◽  
Author(s):  
Brent L. Clyde ◽  
Andrew D. Firlik ◽  
Anthony M. Kaufmann ◽  
MichaelP. Spearman ◽  
Howard Yonas

✓ Reports of intraarterial papaverine infusion as treatment for cerebral vasospasm are few and documented complications are uncommon. The authors report the case of a patient with paradoxical aggravation of cerebral arterial narrowing during selective intraarterial papaverine infusion intended to treat vasospasm following aneurysmal subarachnoid hemorrhage (SAH). A 48-year-old man presented to the authors' service with symptomatic vasospasm 10 days after experiencing an SAH. The ruptured anterior communicating artery aneurysm was surgically obliterated the following day, and thereafter maximum hypervolemic and hypertensive therapies were used. However, the patient remained lethargic, and a stable xenon—computerized tomography (CT) cerebral blood flow (CBF) study revealed CBF to be 15 cc/100 g/minute in the left anterior cerebral artery (ACA) and 25 cc/100 g/minute in the right ACA territories. Cerebral arteriography demonstrated diffuse severe left ACA and mild left middle cerebral artery (MCA) vasospasm. In response intraarterial papaverine was infused into the internal carotid artery just proximal to the ophthalmic artery. During the infusion the patient became aphasic and exhibited right hemiplegia. Arteriography performed immediately after the intraarterial papaverine infusion revealed diffuse exacerbation of vasospasm in the distal ACA and MCA territories. A repeat xenon—CT CBF study showed that CBF in the left ACA and the MCA had drastically decreased (2 cc/100 g/minute and 10 cc/100 g/minute, respectively). Despite aggressive management, infarction ultimately developed. This is the first clinical case to illustrate a paradoxical effect of intraarterial papaverine treatment for vasospasm following aneurysmal SAH. The possible mechanisms of this paradoxical response and potential therapeutic reactions are reviewed.


1987 ◽  
Vol 67 (5) ◽  
pp. 765-767 ◽  
Author(s):  
Patrick T. Tracy

✓ The case is presented of a 34-year-old man with subarachnoid hemorrhage from rupture of an anterior communicating artery aneurysm. The magnetic resonance imaging and angiographic findings are reported. Angiography showed the aneurysm plus an unusual anastomosis between the intracavernous portions of both internal carotid arteries. The anastomosis crossed posterior to the base of the dorsum sellae and was associated with absence of the right internal carotid artery and the A1 segment of the right anterior cerebral artery. This is the 11th case of such an unusual intercarotid anastomosis reported in the literature.


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