Multiple intracranial aneurysms in sickle cell anemia

1985 ◽  
Vol 62 (3) ◽  
pp. 430-434 ◽  
Author(s):  
M. Chris Overby ◽  
Allen S. Rothman
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Intracranial Aneurysms ◽  
Neurological Complications ◽  
Review Of The Literature ◽  
Hemoglobin S ◽  
Content Type ◽  
Multiple Intracranial Aneurysms ◽  
Fine Print

✓ Neurological complications of sickle cell anemia occur in 18% to 29% of patients with homozygous hemoglobin S disease. A review of the literature yielded reports of two cases, both treated conservatively, of multiple intracranial aneurysms occurring in patients with sickle cell anemia. The authors report two cases of subarachnoid hemorrhage secondary to multiple intracranial aneurysms in patients with sickle cell anemia. One of the two patients underwent three craniotomies for ablation of six intracranial aneurysms. The techniques used in the treatment of these patients are presented.

Treatment of multiple intracranial aneurysms

1971 ◽  
Vol 35 (6) ◽  
pp. 728-730 ◽  
Author(s):  
Lester A. Mount ◽  
Ronald Brisman
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Neurological Deficit ◽  
Intracranial Aneurysms ◽  
Content Type ◽  
Multiple Intracranial Aneurysms ◽  
Risk Patients ◽  
Good Risk ◽  
Fine Print

✓ The authors report a series of 70 patients with 161 multiple intracranial aneurysms. There was no mortality in 23 patients in whom all aneurysms were treated intracranially. Unoperated aneurysms later caused morbidity or mortality in eight of 33 patients. The authors believe that patients who have had a subarachnoid hemorrhage should have four-vessel arteriography to identify all aneurysms, and that all surgically accessible aneurysms should be treated, preferably intracranially in good-risk patients who have no disabling neurological deficit.

Surgical experiences with giant intracranial aneurysms

1984 ◽  
Vol 61 (6) ◽  
pp. 1009-1028 ◽  
Author(s):  
Lindsay Symon ◽  
Janos Vajda
Keyword(s):  
Blood Pressure ◽  
Subarachnoid Hemorrhage ◽  
Mortality Rate ◽  
Intracranial Aneurysms ◽  
Visual Loss ◽  
Considerable Improvement ◽  
Brain Circulation ◽  
Content Type ◽  
Space Occupying Lesion ◽  
Fine Print

✓ A series of 35 patients with 36 giant aneurysms is presented. Thirteen patients presented following subarachnoid hemorrhage (SAH) and 22 with evidence of a space-occupying lesion without recent SAH. The preferred technique of temporary trapping of the aneurysm, evacuation of the contained thrombus, and occlusion of the neck by a suitable clip is described. The danger of attempted ligation in atheromatous vessels is stressed. Intraoperatively, blood pressure was adjusted to keep the general brain circulation within autoregulatory limits. Direct occlusion of the aneurysm was possible in over 80% of the cases. The mortality rate was 8% in 36 operations. Six percent of patients had a poor result. Considerable improvement in visual loss was evident in six of seven patients in whom this was a presenting feature, and in four of seven with disturbed eye movements.

Spinal cord compression by extramedullary hemopoietic tissue in sickle cell anemia

1975 ◽  
Vol 43 (4) ◽  
pp. 483-485 ◽  
Author(s):  
Abdel A. Ammoumi ◽  
Joanna H. Sher ◽  
Daniel Schmelka
Keyword(s):  
Spinal Cord ◽  
Sickle Cell ◽  
Spinal Cord Compression ◽  
Sickle Cell Anemia ◽  
Cord Compression ◽  
Content Type ◽  
Hemopoietic Tissue ◽  
Fine Print ◽  
Mass Recovery

✓ The authors report a patient with sickle cell anemia who suffered from paraplegia of 18 months duration due to spinal cord compression by a hemopoietic mass. Recovery following removal of the mass was complete.

Multiple intracranial aneurysms associated with moyamoya disease

1981 ◽  
Vol 54 (5) ◽  
pp. 673-676 ◽  
Author(s):  
Yoshihide Nagamine ◽  
Shinichiro Takahashi ◽  
Makoto Sonobe
Keyword(s):  
Moyamoya Disease ◽  
Intracranial Aneurysms ◽  
Operative Indication ◽  
Content Type ◽  
Multiple Intracranial Aneurysms ◽  
Vertebrobasilar System ◽  
Initial Symptoms ◽  
Fine Print

✓ A case of multiple intracranial aneurysms associated with unilateral moyamoya vessels is reported. The authors have reviewed the age, sex, initial symptoms, site of aneurysm, and operative indication in similar cases reported in the literature. It was found that aneurysms associated with moyamoya disease were frequently located in the vertebrobasilar system.

Intracranial Aneurysms in Children with Sickle-Cell Anemia

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4756-4756
Author(s):  
Manoelle Kossorotoff ◽  
Valentine Brousse ◽  
David Grevent ◽  
Michel Zerah ◽  
Olivier Naggara ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Brain Mri ◽  
Posterior Circulation ◽  
Moyamoya Syndrome ◽  
Stenotic Lesion ◽  
Concurrent Development

Abstract Abstract 4756 Background: Intracranial aneurysms in sickle-cell anemia (SCA) have been reported in about 50 adult patients, mostly presenting with subarachnoid hemorrhage (SAH). Aneurysms in those patients tend to be multiple (50%), to involve the posterior circulation more frequently than in the general population (33% vs 14%) and to be diagnosed at a younger age. In pediatric SCA patients, SAH has scarcely been reported, without evident link with stenotic cerebral vasculopathy. An associated intracranial aneurysm has only been demonstrated once in a teenager. Case reports: We report the cases of 2 children with sickle-cell anemia (HbSS) with intracranial aneurysms. The first patient was a 5-year old girl with abnormal transcranial Doppler (TCD) screening for cerebral vasculopathy: left middle cerebral artery time-averaged mean velocity (MCA TAMV) 208cm/sec, right MCA TAMV 196cm/sec. She had normal neurological assessment. On her brain MRA, no stenotic lesion was found within the Circle of Willis and the Internal Carotid arteries. A 6mm distal left posterior cerebral artery unruptured saccular aneurysm was observed. The brain MRI revealed a left thalamic lacunar infarction likely due to asymptomatic embolic infarction from the aneurysm. Longitudinal MR imaging showed spontaneous but incomplete thrombotic aneurysm occlusion. The second patient, an 11 year-old boy with slight cognitive delay and normal annual TCD procedures, presented with a non-traumatic SAH. Brain MRI showed several small silent cerebral infarctions in the white matter watershed territories. Brain MRA revealed multiple aneurysms without any stenotic lesion. A ruptured aneurysm was located on the basilar artery termination. Four unruptured aneurysms were found: 3 on the posterior cerebral arteries (1 right, 2 left) and 1 on the ophthalmic artery ostium. Endovascular coil embolization resulted in angiographic occlusion of the 2 accessible aneurysms. Clinical outcome was excellent. Discussion: Hemorrhagic strokes are more frequent than ischemic strokes in young adult SCA patients. Two main mechanisms are described: intracerebral or intraventricular hemorrhage due to major occlusive vasculopathy (moyamoya syndrome) or subarachnoid hemorrhage due to aneurysm rupture or leak. Our pediatric patients have no evidence for moyamoya syndrome. Their intracranial aneurysms bear similar characteristics with adult SCA patients': possibility of multiple aneurysms and posterior circulation involvement. They are observed at a very young age and are associated with mild cerebral vasculopathy: abnormal TCD without MRA stenosis in one case, silent cerebral infarcts without MRA stenosis in the other case. These findings plead for a possible concurrent development of vascular lesions leading either to ischemic or hemorrhagic stroke. This hypothesis is supported by similar histopathological findings in both aneurysms and cerebrovascular occlusive lesions in SCA: intimal hyperplasia, smooth-muscle layer hyalinization and elastic lamina fragmentation. This challenges the supposedly sequential pathophysiology of strokes in SCA, based on the high prevalence of infarctive strokes in children and hemorrhagic strokes in young adults. Conclusion: This report of pediatric intracranial aneurysms, associated with mild cerebral vasculopathy in both patients, supports the hypothesis of a common pathophysiological mechanism and the possible concurrent development of stenotic lesions and dilatations. This is also the first report of successful coil embolization in a pediatric SCA patient. Disclosures: No relevant conflicts of interest to declare.

Bacterial intracranial aneurysms

1980 ◽  
Vol 53 (5) ◽  
pp. 633-641 ◽  
Author(s):  
John G. Frazee ◽  
Leslie D. Cahan ◽  
James Winter
Keyword(s):  
Cerebral Angiography ◽  
Intracranial Aneurysms ◽  
Elective Surgery ◽  
Bacterial Endocarditis ◽  
Severe Headache ◽  
High Dose ◽  
Review Of The Literature ◽  
Content Type ◽  
Neurological Signs ◽  
Fine Print

✓ The treatment of 13 patients with bacterial intracranial aneurysms is reported. The incidence of bacterial intracranial aneurysms was 4% of all patients admitted with intracranial aneurysms and 3% of all patients admitted with bacterial endocarditis. Each patient had neurological signs or symptoms suggestive of intracranial disease prior to the diagnosis of an aneurysm. Alpha Streptococcus was the most common infecting organism. All patients were treated with specific, high-dose antibiotics, and five patients underwent surgery as well. There were no surgical deaths. Six of eight nonsurgically treated patients died. A review of the literature confirms a high mortality for patients treated with only antibiotics, and a low mortality for elective surgery. The authors conclude that 1) patients with bacterial endocarditis, who develop sudden severe headache, focal neurological signs or symptoms, or seizures, should undergo serial cerebral angiography every 7 to 10 days throughout their hospitalization; 2) if an aneurysm is identified it should be excised whenever possible; and 3) patients with proximal or multiple aneurysms should be considered for surgery.

Recurrent subarachnoid hemorrhage complicating cerebral arterial ectasia

1981 ◽  
Vol 55 (1) ◽  
pp. 139-142 ◽  
Author(s):  
Steven J. Goldstein ◽  
Phillip A. Tibbs
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cranial Nerve ◽  
Review Of The Literature ◽  
Radiographic Findings ◽  
Content Type ◽  
Clinical Complications ◽  
Cranial Nerve Palsies ◽  
Arterial Ectasia ◽  
Fine Print

✓ A case of subarachnoid hemorrhage (SAH) complicating cerebral arterial ectasia is reported. While ischemia and cranial nerve palsies are commonly associated with this condition, review of the literature reveals that SAH is exceedingly rare. The pathogenesis, radiographic findings, and clinical complications of cerebral arterial ectasia are discussed.

Abnormal origin of bilateral ophthalmic arteries

1991 ◽  
Vol 74 (2) ◽  
pp. 287-289 ◽  
Author(s):  
Jun-ichiro Hamada ◽  
Isao Kitamura ◽  
Masahito Kurino ◽  
Nobuyuki Sueyoshi ◽  
Shozaburo Uemura ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Intracranial Aneurysms ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
Content Type ◽  
Multiple Intracranial Aneurysms ◽  
Operative Findings ◽  
Ophthalmic Arteries ◽  
Fine Print

✓ The case of a 64-year-old woman with multiple intracranial aneurysms and abnormal ophthalmic arteries arising from the bifurcation of the internal carotid artery is described. It is believed that this type of anomaly of the ophthalmic artery has not previously been reported. The neuroradiological and operative findings of this case are presented.

Familial occurrence of multiple intracranial aneurysms

1972 ◽  
Vol 37 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Kazuhisa Nagae ◽  
Ikuo Goto ◽  
Kazuo Ueda ◽  
Yasuyuki Morotomi
Keyword(s):  
Histological Examination ◽  
Intracranial Aneurysms ◽  
Causative Factor ◽  
Internal Elastic Lamina ◽  
Content Type ◽  
Multiple Intracranial Aneurysms ◽  
The Brain ◽  
Elastic Lamina ◽  
Fine Print ◽  
Saccular Aneurysms

✓ A 48-year-old man and his 66-year-old mother had multiple intracranial saccular aneurysms visualized by angiography or verified at autopsy. Histological examination of the arteries at the base of the brain in the case autopsied showed a caterpillar tread-like appearance (“Raupenketten Elastica”) of the internal elastic lamina, which may indicate thinning of the elastic lamina and deserve consideration as a causative factor in the development of intracranial saccular aneurysms.

Multiple intracranial aneurysms due to Coccidioides immitis infection

1987 ◽  
Vol 66 (3) ◽  
pp. 453-456 ◽  
Author(s):  
Mark N. Hadley ◽  
Neil A. Martin ◽  
Robert F. Spetzler ◽  
Peter C. Johnson
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Young Woman ◽  
Intracranial Aneurysms ◽  
Mycotic Aneurysm ◽  
Coccidioides Immitis ◽  
Content Type ◽  
Multiple Intracranial Aneurysms ◽  
Fine Print

✓ True mycotic (fungal) aneurysms are distinctly uncommon. The case of a young woman with multiple intracranial aneurysms of Coccidioides immitis origin is presented. Coccidioides immitis organisms are not uncommon central nervous system pathogens and usually cause basilar meningitis and hydrocephalus. There are no previous reports of a coccidioidal mycotic aneurysm. The management of intracranial coccidioidomycosis and fungal aneurysms is reviewed.

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