Neoplastic cerebral aneurysm from metastatic gestational choriocarcinoma

1985 ◽  
Vol 63 (4) ◽  
pp. 644-647 ◽  
Author(s):  
Michael Pullar ◽  
Peter C. Blumbergs ◽  
Gael E. Phillips ◽  
Paul G. Carney
Keyword(s):  
Intracerebral Hemorrhage ◽  
Histopathological Examination ◽  
Cardiac Myxoma ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Undifferentiated Carcinoma ◽  
Intracerebral Hematoma ◽  
Content Type ◽  
Gestational Choriocarcinoma ◽  
Child Bearing

✓ This case of metastatic gestational choriocarcinoma presented as intracerebral hemorrhage from an atypical distal middle cerebral artery aneurysm. Operative evacuation of the intracerebral hematoma was undertaken and histopathological examination revealed choriocarcinoma invading the vessel wall. Neoplastic cerebral aneurysms are unusual, being reported in metastatic choriocarcinoma, cardiac myxoma, bronchogenic carcinoma, and undifferentiated carcinoma. Metastatic choriocarcinoma should be considered in the differential diagnosis of intracerebral hemorrhage in women of child-bearing age. Recent advances in treatment have resulted in a 75% cure rate for metastatic choriocarcinoma.

Surgery for angiographically occult cerebral aneurysms

1993 ◽  
Vol 79 (5) ◽  
pp. 674-679 ◽  
Author(s):  
Jafar J. Jafar ◽  
Howard L. Weiner
Keyword(s):  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Sylvian Fissure ◽  
Ct Scans ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Excellent Outcome ◽  
Interpeduncular Cistern ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Exploratory Surgery

✓ In 15% of patients with spontaneous subarachnoid hemorrhage (SAH), the source of bleeding cannot be determined despite repeated cerebral angiography. However, some patients diagnosed as having “SAH of unknown cause” actually harbor undetected aneurysms. The authors report six patients with SAH who, despite multiple negative cerebral angiograms, underwent exploratory surgery due to a high clinical and radiographic suspicion for the presence of an aneurysm. Brain computerized tomography (CT) scans revealed blood located mainly in the basal frontal interhemispheric fissure in four patients, in the sylvian fissure in one patient, and in the interpeduncular cistern in one patient. The patients were evaluated as Hunt and Hess Grades I to III, and had undergone at least two high-quality cerebral angiograms that did not reveal an aneurysm. Vasospasm was visualized in two patients. Three patients rebled while in the hospital. Exploratory surgery was performed at an average of 12 days post-SAH. Five aneurysms were discovered at surgery and were successfully clipped. All four patients with interhemispheric blood were found to have an anterior communicating artery (ACoA) aneurysm. The patient with blood in the sylvian fissure was found to have a middle cerebral artery aneurysm. These aneurysms were partially thrombosed. No aneurysm was detected in the patient with interpeduncular SAH, despite extensive basilar artery exploration. Five patients had an excellent outcome and one patient developed diabetes insipidus. These results show that exploratory aneurysm surgery is warranted, despite repeated negative cerebral angiograms, if the patient manifests the classical signs of SAH with CT scans localizing blood to a specific cerebral blood vessel (particularly the ACoA) and if a second SAH is documented at the same site.

CT infusion scanning for the detection of cerebral aneurysms

1989 ◽  
Vol 71 (2) ◽  
pp. 175-179 ◽  
Author(s):  
David W. Newell ◽  
Peter D. LeRoux ◽  
Ralph G. Dacey ◽  
Gary K. Stimac ◽  
H. Richard Winn
Keyword(s):  
Intracerebral Hemorrhage ◽  
Ct Scan ◽  
Computerized Tomography ◽  
Cerebral Aneurysms ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Content Type ◽  
Spontaneous Hemorrhage ◽  
Fine Print

✓ Computerized tomography (CT) infusion scanning can confirm the presence or absence of an aneurysm as a cause of spontaneous intracerebral hemorrhage. Eight patients who presented with spontaneous hemorrhage were examined using this technique. In five patients the CT scan showed an aneurysm which was later confirmed by angiography or surgery; angiography confirmed the absence of an aneurysm in the remaining three patients. This method is an easy effective way to detect whether an aneurysm is the cause of spontaneous intracerebral hemorrhage.

Histologically verified cerebral aneurysm formation secondary to embolism from cardiac myxoma

1995 ◽  
Vol 83 (1) ◽  
pp. 170-173 ◽  
Author(s):  
Kazuhide Furuya ◽  
Tomio Sasaki ◽  
Yuhei Yoshimoto ◽  
Yoshifumi Okada ◽  
Takamitsu Fujimaki ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Cardiac Tumor ◽  
Arterial Wall ◽  
Cardiac Myxoma ◽  
Cerebral Aneurysms ◽  
Surgical Removal ◽  
Arterial Aneurysm ◽  
Content Type ◽  
Aneurysm Formation ◽  
Aneurysm Wall

✓ Multiple aneurysm formation secondary to an embolism from the cardiac myxoma is a well-known phenomenon. The cerebral arterial aneurysm formation process involved remains to be elucidated, although occupation of the arterial wall by tumor cells has been proven histologically. The authors present the case of a patient in whom tumor cells in the aneurysm wall were demonstrated and penetration of viable myxoma cells into the wall was also observed 19 months after surgical removal of the cardiac tumor. Such findings have never before been verified histologically. In light of the histological findings, the authors discuss the therapeutic problems associated with cerebral aneurysms resulting from cardiac myxoma.

Results of early operations for ruptured aneurysms

1981 ◽  
Vol 54 (4) ◽  
pp. 473-479 ◽  
Author(s):  
Bengt Ljunggren ◽  
Lennart Brandt ◽  
Erik Kågström ◽  
Göran Sundbärg
Keyword(s):  
Anterior Part ◽  
Intracerebral Hematoma ◽  
Recurrent Bleeding ◽  
Consecutive Series ◽  
Good Recovery ◽  
Content Type ◽  
Urgent Surgery ◽  
Child Bearing ◽  
History Of ◽  
Fine Print

✓ In a consecutive series of 219 patients with a ruptured aneurysm of the anterior part of the circle of Willis, 119 patients (54%) made a good recovery and 67 (31%) died. Of 53 patients who did not have surgery, six (11%) made a good recovery and 37 (70%) died. Urgent surgery with evacuation of an associated significant intracerebral hematoma was performed in 30 patients; nine (30%) made a good recovery and 15 (50%) died. Delayed surgery was performed in 55 patients of whom 42 (76%) made a good recovery and two (4%) died. Early intracranial operation (within 48 to 60 hours after subarachnoid hemorrhage (SAH)) was performed in 81 patients who were in Grades I to III prior to surgery. Sixty patients (74%) made a good recovery, and eight died within a month. Five patients were severely disabled and died 2 to 8 months after SAH and surgery. In 17 patients, although the immediate postoperative course was uneventful, evidence of cerebral ischemia developed 4 to 13 days after the bleed and resulted in death in eight patients. A poor outcome was correlated with a history of elevated blood pressure before SAH. Seven patients, of whom six were women of child-bearing age, demonstrated pronounced vasospasm on postoperative angiography; nevertheless, they remained well and free from ischemic symptoms after surgery. Early operation combined with removal of subarachnoid clots and rinsing the basal cisterns does not eliminate the risk of delayed ischemic dysfunction. Such early surgery, however, improves overall outcome by preventing recurrent bleeding, and may also reduce the frequency of hydrocephalus.

Fusiform posterior cerebral artery aneurysm treated with excision and end-to-end anastomosis

1986 ◽  
Vol 64 (3) ◽  
pp. 501-504 ◽  
Author(s):  
Han Soo Chang ◽  
Takanori Fukushima ◽  
Shinichiro Miyazaki ◽  
Teruaki Tamagawa
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Fusiform Aneurysm ◽  
Pertinent Literature ◽  
Content Type ◽  
End To End ◽  
Cerebral Artery Aneurysm ◽  
Fine Print

✓ A case of a ruptured fusiform aneurysm of the posterior cerebral artery is reported. The aneurysm was excised and end-to-end anastomosis was carried out between the two ends of the posterior cerebral artery. There is no previous report of a posterior cerebral artery aneurysm treated with this technique. The pertinent literature is reviewed and the significance of this technique in the treatment of unclippable cerebral aneurysms is discussed.

Microsurgically produced bifurcation aneurysms in a rabbit model for endovascular coil embolization

1996 ◽  
Vol 85 (3) ◽  
pp. 488-495 ◽  
Author(s):  
Uwe Spetzger ◽  
Jürgen Reul ◽  
Joachim Weis ◽  
Helmut Bertalanffy ◽  
Armin Thron ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Histopathological Examination ◽  
Rabbit Model ◽  
Cerebral Aneurysms ◽  
Carotid Bifurcation ◽  
Content Type ◽  
Detachable Coils ◽  
Endovascular Coil Embolization ◽  
Basic Studies ◽  
Common Carotid Arteries

✓ The authors present a detailed account of the microsurgical production of bifurcation aneurysms in chinchilla rabbits for basic studies of endovascular coil embolization of aneurysms. End-to-side anastomoses of both common carotid arteries (CCAs) were performed, and a venous pouch was fitted into the newly created bifurcation. These experimental aneurysms closely mimic human cerebral aneurysms in size and hemodynamic features. Sixty-three animals underwent operation. Fifteen animals died in the course of the experiment and 15 were excluded because of a CCA occlusion within the carotid bifurcation. Electrical detachable platinum coils, also known as Guglielmi detachable coils (GDCs), and tungsten mechanical detachable coils (MDCs) were used for the endovascular occlusion of 26 bifurcation aneurysms (16 rabbits were treated with GDCs and 10 with MDCs). Initially, complete angiographic obliteration (95%–100% occlusion of the aneurysm) was achieved in nine rabbits and incomplete obliteration (< 95% occlusion) was seen in 17 animals. Final angiography 3 to 6 months later demonstrated complete occlusion in only four and partial occlusion in 22 aneurysms. At present, the histopathological examination of 17 embolized aneurysms has revealed incomplete obliteration of all aneurysms, even in those three cases that were thought to be completely embolized according to angiographic criteria. A general overestimation of the radiological degree of aneurysm obliteration was found.

Congenital astrocytoma presenting with intracerebral hematoma

1979 ◽  
Vol 51 (2) ◽  
pp. 237-239 ◽  
Author(s):  
Steven M. Rothman ◽  
James S. Nelson ◽  
Darryl C. DeVivo ◽  
William S. Coxe
Keyword(s):  
Intracerebral Hemorrhage ◽  
Vascular Malformation ◽  
Pathological Examination ◽  
Intracerebral Hematoma ◽  
Age Group ◽  
Bleeding Diathesis ◽  
Content Type ◽  
Congenital Tumor ◽  
Fibrillary Astrocytoma ◽  
Fine Print

✓ A massive left intracerebral hematoma was surgically evacuated from a 2-week-old infant. Pathological examination showed that the hemorrhage had developed within a fibrillary astrocytoma. Neonatal intracerebral hemorrhage should raise the question of congenital tumor because such a hemorrhage in this age group is rarely the result of trauma, bleeding diathesis, or vascular malformation.

Spontaneous thrombosis in agiant middle cerebral artery aneurysm

1972 ◽  
Vol 37 (3) ◽  
pp. 361-363 ◽  
Author(s):  
R. Michael Scott ◽  
H. Thomas Ballantine
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Left Middle Cerebral Artery ◽  
Content Type ◽  
Complete Thrombosis ◽  
Cerebral Artery Aneurysm

✓ Five-year follow-up angiography in a woman with an untreated giant aneurysm of the left middle cerebral artery revealed complete thrombosis of the aneurysm. Her case suggests that certain asymptomatic giant cerebral aneurysms may be treated without surgery.

Low incidence of delayed intracerebral hemorrhage secondary to ventriculoperitoneal shunt insertion

1999 ◽  
Vol 91 (1) ◽  
pp. 32-34 ◽  
Author(s):  
Martin H. Savitz ◽  
Lewis M. Bobroff
Keyword(s):  
Intracerebral Hemorrhage ◽  
Brain Parenchyma ◽  
Adult Patients ◽  
Vascular Lesions ◽  
Intracerebral Hematoma ◽  
Shunt Insertion ◽  
Content Type ◽  
Vp Shunt ◽  
The Brain ◽  
Fine Print

Object. Bleeding into the brain parenchyma or ventricles is an infrequently reported complication in adults who undergo insertion of a ventriculoperitoneal (VP) shunt. The purpose of this study was to establish the incidence of delayed intracerebral hemorrhage secondary to ventricular cannulation during shunting procedures.Methods. Over a 24-year period, in a series of 125 adult patients with hydrocephalus, postoperative computerized tomography scans were obtained in every case within 48 hours of shunt surgery performed by the same neurosurgeon. The rate of delayed intracerebral hematoma or intraventricular hemorrhage after VP shunt placement was documented by routine neuroradiological follow up to be 4%.Conclusions. In adult patients with no coagulopathy or occult vascular lesions, the rate of bleeding after VP shunt insertion may be low if the procedure is uncomplicated by multiple attempts at perforation, puncture of the choroid plexus, or improper placement of the tubing within the parenchyma of the brain.

Intracerebral hemorrhage caused by the rupture of a nontraumatic middle meningeal artery aneurysm

1999 ◽  
Vol 90 (5) ◽  
pp. 951-954 ◽  
Author(s):  
John A. Sandin ◽  
M. Shahriar Salamat ◽  
Mustafa Baskaya ◽  
Robert J. Dempsey
Keyword(s):  
Intracerebral Hemorrhage ◽  
Artery Aneurysm ◽  
Middle Meningeal Artery ◽  
Review Of The Literature ◽  
Intraparenchymal Hemorrhage ◽  
Content Type ◽  
Meningeal Artery ◽  
Fine Print

✓ The authors report on the case of a 46-year-old man who presented with an intraparenchymal hemorrhage after the rupture of a nontraumatic aneurysm arising from the middle meningeal artery (MMA). A review of the literature revealed no published cases of intraparenchymal hemorrhage resulting from the rupture of an MMA aneurysm.

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