Thalamic syndrome caused by unruptured cerebral aneurysm

1995 ◽  
Vol 82 (2) ◽  
pp. 291-293 ◽  
Author(s):  
Marcus A. Stoodley ◽  
Jason D. Warren ◽  
Peter E. Oatey
Keyword(s):  
Cerebral Aneurysm ◽  
Unruptured Aneurysm ◽  
Sensory Disturbance ◽  
Content Type ◽  
Unruptured Cerebral Aneurysm ◽  
Fine Print

✓ A case is reported of a 63-year-old woman with thalamic syndrome as the presenting feature of an unruptured cerebral aneurysm. Unruptured aneurysm is a rare cause of thalamic syndrome; the possible mechanisms of production of the sensory disturbance are discussed.

Cerebral arterial aneurysm formation and rupture in 20,767 elderly patients: hypertension and other risk factors

1995 ◽  
Vol 83 (5) ◽  
pp. 812-819 ◽  
Author(s):  
Christopher L. Taylor ◽  
Zhong Yuan ◽  
Warren R. Selman ◽  
Robert A. Ratcheson ◽  
Alfred A. Rimm
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Cerebral Aneurysm ◽  
Primary Diagnosis ◽  
Content Type ◽  
Unruptured Aneurysms ◽  
Aneurysm Formation ◽  
Unruptured Cerebral Aneurysm ◽  
Significant Protective Effect ◽  
Fine Print

✓ Cerebral arterial aneurysms are common in the general population and their rupture is a catastrophic event. Considerable uncertainty remains concerning the conditions that predispose individuals to aneurysm formation or rupture. The role of systemic hypertension in aneurysm formation and rupture has been especially controversial. Demographic variables have rarely been addressed because of the small sample sizes in previous studies. The authors describe the demographics and prevalence of hypertension in 20,767 Medicare patients with an unruptured aneurysm and compare these to a random sample of the hospitalized Medicare population. The prevalence of hypertension in patients with unruptured aneurysms was 43.2% compared with 34.4% in the random sample. Patients who survived their initial hospitalization were separated into two groups: those with an unruptured cerebral aneurysm as the primary diagnosis and those with an unruptured cerebral aneurysm as a secondary diagnosis. Follow-up data for 18,119 patients were examined to determine the risk of subarachnoid hemorrhage (SAH) associated with age, gender, race, hypertension, insulin-dependent diabetes mellitus, and surgical treatment. For patients with an unruptured cerebral aneurysm as the primary diagnosis, hypertension was found to be a significant risk factor for future SAH (risk ratio: 1.46, 95% confidence interval (CI): 1.01–2.11), whereas surgical treatment (risk ratio: 0.29, 95% CI: 0.09–0.97) had a significant protective effect. Advancing age had a small but significant protective effect in both groups. Elderly patients identified with unruptured aneurysms are more likely to have coexisting hypertension than the general hospitalized population. In elderly patients hospitalized with an unruptured cerebral aneurysm as their primary diagnosis, hypertension is a risk factor for subsequent SAH, whereas surgical treatment is a protective factor against SAH.

False cerebral aneurysm associated with metastatic carcinoma of the brain

1974 ◽  
Vol 41 (3) ◽  
pp. 380-382 ◽  
Author(s):  
Abdon Reina ◽  
Robert B. Seal
Keyword(s):  
Cerebral Aneurysm ◽  
Clinical History ◽  
Metastatic Carcinoma ◽  
Malignant Cells ◽  
Carotid Angiography ◽  
Left Frontal Lobe ◽  
Content Type ◽  
Aneurysm Wall ◽  
The Brain ◽  
Fine Print

✓In a patient with metastatic carcinoma of the left frontal lobe, carotid angiography revealed a false cerebral aneurysm arising from the middle cerebral vessels. At craniotomy the aneurysm was found to be surrounded by tumor and cortex. Since the clinical history excluded trauma, it was inferred that the histologically-proven invasion of the aneurysm wall by malignant cells was responsible for the formation of a false cerebral aneurysm.

Basilar-middle meningeal artery anastomoses associated with a cerebral aneurysm

1981 ◽  
Vol 54 (5) ◽  
pp. 677-680 ◽  
Author(s):  
Marcia Katz ◽  
Hugh S. Wisoff ◽  
Robert D. Zimmerman
Keyword(s):  
Cerebral Aneurysm ◽  
Basilar Artery ◽  
Middle Meningeal Artery ◽  
Ruptured Aneurysm ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Autopsy Findings ◽  
Meningeal Artery ◽  
Fine Print

✓ Unique radiographic and autopsy findings are described in a patient with bilateral basilar artery-middle meningeal artery (BA-MMA) anastomoses associated with a ruptured aneurysm of the anterior communicating artery. The literature, anatomy, and embryology of BA-MMA anastomosis is reviewed.

Nonvisualization of a large cerebral aneurysm despite highresolution magnetic resonance angiography

1995 ◽  
Vol 82 (2) ◽  
pp. 294-295 ◽  
Author(s):  
Alan Turtz ◽  
David Allen ◽  
Robert Koenigsberg ◽  
H. Warren Goldman
Keyword(s):  
Magnetic Resonance ◽  
High Resolution ◽  
Magnetic Resonance Angiography ◽  
Cerebral Aneurysm ◽  
Mr Angiography ◽  
Cerebral Aneurysms ◽  
Arterial Aneurysm ◽  
Content Type ◽  
Fine Print

✓ The use of magnetic resonance (MR) angiography as a safe, accurate, and reliable substitute for invasive cerebral arteriography has been anticipated as refinements in this technique are introduced. We present the case of an unruptured, 11-mm pericallosal arterial aneurysm not visualized on high-resolution MR angiography. Although this case may be atypical, we caution against complete reliance on this test for exclusion of the presence of cerebral aneurysms.

Computerized tomography angiography in isolated third nerve palsies

1998 ◽  
Vol 88 (4) ◽  
pp. 679-684 ◽  
Author(s):  
Robert M. McFadzean ◽  
Evelyn M. Teasdale
Keyword(s):  
Cerebral Aneurysm ◽  
Ct Angiography ◽  
Computerized Tomography ◽  
Cerebral Angiography ◽  
Diagnostic Tool ◽  
Nerve Palsy ◽  
Content Type ◽  
Third Nerve Palsy ◽  
Third Nerve ◽  
Fine Print

Object. The goal of this study was to assess the value of computerized tomography (CT) angiography as a diagnostic tool in isolated oculomotor nerve palsies. Methods. One hundred consecutive patients who presented with an isolated third nerve palsy were examined by CT angiography. This procedure was followed by conventional cerebral angiography in most patients in whom a vascular abnormality was noted on the CT angiography. Thus, all patients whose symptoms were caused by a compressive aneurysm were identified. The remaining patients were observed clinically to exclude the possibility that a missed cerebral aneurysm caused the isolated third nerve palsy. Eighteen patients harbored a cerebral aneurysm responsible for causing the isolated third nerve palsy. Most of the remaining patients experienced some degree of spontaneous recovery. There was no clinical evidence to indicate that a case of compressive cerebral aneurysm causing the isolated third nerve palsy had been missed on CT angiography. Conclusions. Computerized tomography angiography is a reliable diagnostic tool for use in the assessment of patients with an isolated third nerve palsy; it can identify the minority of patients in whom conventional cerebral angiography may be required.

Bilateral median nerve compression at the level of Struthers' ligament

2000 ◽  
Vol 92 (4) ◽  
pp. 693-696 ◽  
Author(s):  
Atif Aydinlioglu ◽  
Bayram Cirak ◽  
Fuat Akpinar ◽  
Nihat Tosun ◽  
Ali Dogan
Keyword(s):  
Median Nerve ◽  
Motor Function ◽  
Surgical Decompression ◽  
Nerve Entrapment ◽  
Nerve Compression ◽  
Sensory Disturbance ◽  
Content Type ◽  
Median Nerve Compression ◽  
Function Loss ◽  
Fine Print

✓ Struthers' ligament syndrome is a rare cause of median nerve entrapment. Bilateral compression of the median nerve is even more rare. It presents with pain, sensory disturbance, and/or motor function loss at the median nerve's dermatomal area. The authors present the case of a 21-year-old woman with bilateral median nerve compression caused by Struthers' ligament. She underwent surgical decompression of the nerve on both sides. To the authors' knowledge, this case is the first reported bilateral compression of the median nerve caused by Struthers' ligament. The presentation and symptomatology of Struthers' ligament syndrome must be differentiated from median nerve compression arising from other causes.

Outcomes after cerebral aneurysm clip occlusion in the United States: the need for evidence-based hospital referral

2003 ◽  
Vol 99 (6) ◽  
pp. 947-952 ◽  
Author(s):  
John A. Cowan ◽  
Justin B. Dimick ◽  
Reid M. Wainess ◽  
Gilbert R. Upchurch ◽  
B. Gregory Thompson
Keyword(s):  
Cerebral Aneurysm ◽  
Cerebral Aneurysms ◽  
High Volume ◽  
Evidence Based ◽  
Content Type ◽  
Aneurysm Clip ◽  
Low Volume ◽  
Clip Occlusion ◽  
Very High ◽  
Fine Print

Object. In an age of multimodality and multidisciplinary treatment of cerebral aneurysms, patient outcomes have improved significantly. For a number of complex surgical procedures, hospitals with high case volumes yield superior outcomes. The effect of hospital volume on the mortality rate after emergency and elective cerebral aneurysm clip occlusion in a nationally representative sample of patients is unknown. Methods. Using clinical data derived from the Nationwide Inpatient Sample for the years from 1995 through 1999, 12,023 patients who underwent clip occlusion of a cerebral aneurysm (International Classification of Diseases, Ninth Revision, Clinical Modification code 3951) were included. Patient age, comorbid conditions, nature of admission, and diagnosis of subarachnoid hemorrhage were abstracted. Hospital case volume was grouped into quartiles. Unadjusted and case-mix adjusted analyses were performed. The mean patient age was 53.2 ± 13.5 years. The overall crude postoperative mortality rates for emergency and elective aneurysm clip occlusion were 12.2 and 6.6%, respectively. Very low volume hospitals demonstrated higher mortality rates than very high volume hospitals for both emergency (14.7 compared with 8.9%, p < 0.001) and elective (9.4 compared with 4.5%, p < 0.001) aneurysm surgery. Patient-specific predictors of death in the multivariate model were renal disease (odds ratio [OR] 3.32, p < 0.042); age (> 60 years, OR 2.36, p < 0.001; 51–60 years, OR 1.63, p < 0.001; 40–50 years, OR 1.25, p = 0.047); chronic obstructive pulmonary disease (present, OR 1.52, p < 0.001); and nature of admission (emergency, OR 1.18, p = 0.03). Provider-specific predictors of death included very low volume (OR 1.59, p < 0.001); low-volume (OR 1.37, p = 0.001); and high-volume (OR 1.45, p < 0.001) hospitals compared with very high volume hospitals. Conclusions. A significant volume—outcome effect exists for surgical treatment of cerebral aneurysms in the US. Factors influencing this effect should be investigated to guide future healthcare policy and evidence-based referral. Whenever possible, healthcare practitioners should refer patients to centers in which superior outcomes are consistently demonstrated.

Arteriovenous anomaly of the brain associated with cerebral aneurysm

1971 ◽  
Vol 34 (2) ◽  
pp. 225-228 ◽  
Author(s):  
Henry A. Shenkin ◽  
Felix Jenkins ◽  
Kwang Kim
Keyword(s):  
Blood Flow ◽  
Cerebral Aneurysm ◽  
Parent Vessel ◽  
Content Type ◽  
Large Aneurysm ◽  
The Brain ◽  
Fine Print ◽  
Feeding Vessel

✓ The removal of an arteriovenous anomaly of the brain resulted in a distinct reduction in the size of a large aneurysm located upon its principal feeding vessel. This confirms previous inferences that the development of aneurysms is related to the amount of blood flow in the parent vessel.

Unruptured aneurysm of the anterior spinal artery presenting as paraparesis

1976 ◽  
Vol 45 (3) ◽  
pp. 331-333 ◽  
Author(s):  
Peter J. Leech ◽  
Bryant A. R. Stokes ◽  
Trevor Apsimon ◽  
Clive Harper
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Unruptured Aneurysm ◽  
Neurological Recovery ◽  
Anterior Spinal Artery ◽  
Content Type ◽  
Fine Print

✓ A case is presented in which spinal cord compression was caused by an unruptured aneurysm of the anterior spinal artery. The nature of the mass was not disclosed until it was surgically exposed. Resection of the sac was followed by neurological recovery.

Role of estrogen deficiency in the formation and progression of cerebral aneurysms. Part I: experimental study of the effect of oophorectomy in rats

2005 ◽  
Vol 103 (6) ◽  
pp. 1046-1051 ◽  
Author(s):  
Mohammad A. Jamous ◽  
Shinji Nagahiro ◽  
Keiko T. Kitazato ◽  
Junichiro Satomi ◽  
Koichi Satoh
Keyword(s):  
Cerebral Aneurysm ◽  
Cerebral Aneurysms ◽  
Bilateral Oophorectomy ◽  
Gelatinase Activity ◽  
Content Type ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Fine Print

Object. Estrogen has been shown to play a central role in vascular biology. Although it may exert beneficial vascular effects, its role in the pathogenesis of cerebral aneurysms remains to be determined. To elucidate the role of hormones further, the authors examined the effects of bilateral oophorectomy on the formation and progression of cerebral aneurysms in rats. Methods. Forty-five female, 7-week-old Sprague—Dawley rats were divided into three equal groups. Group I consisted of intact rats (controls). To induce cerebral aneurysms, the animals in Groups II and III were subjected to ligation of the right common carotid and bilateral posterior renal arteries. One month later, the rats in Group II underwent bilateral oophorectomy. Three months after the experiment began all animals were killed and cerebral vascular corrosion casts were prepared and screened for cerebral aneurysms by using a scanning electron microscope. Plasma was used to determine the level of estradiol and the gelatinase activity. Hypertension developed in all rats except those in the control group. The estradiol level was significantly lower in Group II than in the other groups (p < 0.01). The incidence of cerebral aneurysm formation in Group II (60%) was three times higher than that in Group III (20%), and the mean size of aneurysms in Group II (76 ± 27 µm, mean ± standard deviation) was larger than that in Group III (28 ± 4.6 µm) (p < 0.05). No aneurysm developed in control animals (Group I), and there was no significant difference in plasma gelatinase activity among the three groups. Conclusions. The cerebral aneurysm model was highly reproducible in rats. Bilateral oophorectomy increased the susceptibility of rats to aneurysm formation, indicating that hormones play a role in the pathogenesis of cerebral aneurysms.

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