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.

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.

Cerebral blood flow patterns at major vessel bifurcations and aneurysms in rats

1991 ◽  
Vol 74 (2) ◽  
pp. 258-262 ◽  
Author(s):  
Hideyuki Nakatani ◽  
Nobuo Hashimoto ◽  
Yoo Kang ◽  
Naohiro Yamazoe ◽  
Haruhiko Kikuchi ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Experimental Treatment ◽  
Flow Patterns ◽  
Experimental Hypertension ◽  
Small Particles ◽  
Content Type ◽  
Constant Flow Rate ◽  
Aneurysm Wall ◽  
Major Vessel ◽  
Small Aneurysms

✓ Cerebral arterial bifurcations in rats were treated to induce cerebral aneurysms experimentally, and flow patterns of latex particles introduced under a constant flow rate were analyzed with a 16-mm cine-camera and videocassette recorder. Cerebral aneurysms were produced by ligating one common carotid artery, inducing experimental hypertension, and feeding the animals β-aminopropionitrile. After perfusion and fixation, samples of cerebral arterial bifurcations with shallow invaginations and with small aneurysms were obtained and used for analysis. Bifurcations in rats without experimental treatment were used as control specimens. Flow studies in the control bifurcations showed that the apical intimal pad, not the apex itself, acted as the flow divider. Small particles tended to accumulate at the region just distal to the apical intimal pad, where the initial aneurysmal changes are known to occur. This indicates stagnation of flow at that site. In the bifurcations with shallow invaginations and small aneurysms, a marked pressure gradient was present at the proximal end of the aneurysm orifice. A tendency for stagnation of small particles near the aneurysm wall was also observed. The wall shear stress was highest at the distal end of the aneurysmal orifice, which may be responsible for the development of these lesions.

scholarly journals Multiple cerebral metastases and metastatic aneurysms in patients with left atrial Myxoma: a case report

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Wan ◽  
Hai Du ◽  
Lei Zhang ◽  
Shuang Guo ◽  
Li Xu ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Metastases ◽  
Cardiac Myxoma ◽  
Cerebral Aneurysms ◽  
Surgical Excision ◽  
Atrial Myxoma ◽  
Surgical Removal ◽  
Left Atrial Myxoma ◽  
Complete Surgical Excision

Abstract Background Cardiac myxoma is the most common benign cardiac tumor. Brain metastases or multiple cerebral aneurysms are extremely rare, especially for the case of both complications. Brain metastases are usually found at the same time or few months after the diagnosis or surgical removal of cardiac myxoma Case presentation We describe a case of patient, operated for a cardiac myxoma, who presented multiple central nervous system metastases associated, cerebral aneurysms and subsequent intracerebral hemorrhage Conclusions The long-term follow-up of the patients with atrial myxoma even after complete surgical excision is recommended, especially for the patient with central nervous system manifestations before atrial myxoma excision

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.

Intracranial aneurysms in sickle-cell anemia: clinical features and pathogenesis

1991 ◽  
Vol 75 (3) ◽  
pp. 356-363 ◽  
Author(s):  
Nelson M. Oyesiku ◽  
Daniel L. Barrow ◽  
James R. Eckman ◽  
Suzie C. Tindall ◽  
Austin R. T. Colohan
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
World Literature ◽  
Intracranial Aneurysms ◽  
Arterial Wall ◽  
Muscle Layer ◽  
Unusual Complication ◽  
Internal Elastic Lamina ◽  
Content Type ◽  
Aneurysm Formation

✓ Intracranial aneurysms are an unusual complication of sickle-cell anemia; only 15 patients have been described in the world literature. An additional 15 patients with sickle-cell anemia and subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms are presented. There was a high incidence of multiple aneurysms (60%); some of which were in unusual locations. The clinical and pathological features of this series of patients have provided a paradigm for acquired aneurysm formation that may be applicable to other intracranial aneurysms. Thirteen patients underwent craniotomy and clip ligation; the perioperative management of these patients is discussed. Of these 13, eight had a good recovery, three were left with moderate disability, one patient died of surgical complications, and one died of complications related to sickle-cell anemia. Two of the 15 patients died of SAH. The authors propose that endothelial injury from the abnormal adherence of sickle erythrocytes to the endothelium is the initiating event in arterial wall injury. Subsequently, there is fragmentation of the internal elastic lamina and degeneration of the smooth-muscle layer. Hemodynamic stress at these loci of arterial wall damage results in aneurysm formation. This hypothesis also explains other cerebrovascular manifestations of sickle-cell anemia, namely vaso-occlusive disease and hemorrhage without aneurysm formation. Pathological material from this series and data from the literature are presented to support this hypothesis.

Flow changes caused by the sequential placement of stents across the neck of sidewall cerebral aneurysms

2005 ◽  
Vol 103 (5) ◽  
pp. 891-902 ◽  
Author(s):  
Gádor Cantón ◽  
David I. Levy ◽  
Juan C. Lasheras ◽  
Peter K. Nelson
Keyword(s):  
Shear Stress ◽  
Velocity Field ◽  
Cerebral Aneurysms ◽  
Parent Artery ◽  
Shear Stresses ◽  
Content Type ◽  
Aneurysm Neck ◽  
Aneurysm Wall ◽  
Aneurysm Model ◽  
Fine Print

Object. The goal of this study was to quantify the reduction in velocity, vorticity, and shear stresses resulting from the sequential placement of stents across the neck of sidewall cerebral aneurysms. Methods. A digital particle image velocimetry (DPIV) system was used to measure the pulsatile velocity field within a flexible silicone sidewall intracranial aneurysm model and at the aneurysm neck–parent artery interface in this model. The DPIV system is capable of providing an instantaneous, quantitative two-dimensional measurement of the velocity vector field of “blood” flow inside the aneurysm pouch and the parent vessel, and its changes at varying stages of the cardiac cycle. The corresponding vorticity and shear stress fields are then computed from the velocity field data. Three Neuroform stents (Boston Scientific/Target), each with a strut thickness between 60 and 65 µm, were subsequently placed across the neck of the aneurysm model and measurements were obtained after each stent had been placed. The authors measured a consistent decrease in the values of the maximal averaged velocity, vorticity, and shear stress after placing one, two, and three stents. Measurements of the circulation inside the sac demonstrated a systematic reduction in the strength of the vortex due to the stent placement. The decrease in the magnitude of the aforementioned quantities after the first stent was placed was remarkable. Placement of two or three stents led to a less significant reduction than placement of the first stent. Conclusions. The use of multiple flexible intravascular stents effectively reduces the strength of the vortex forming in an aneurysm sac and results in a decrease in the magnitude of stresses acting on the aneurysm wall.

scholarly journals Disruption of P2X4 purinoceptor and suppression of the inflammation associated with cerebral aneurysm formation

2019 ◽  
pp. 1-13 ◽  
Author(s):  
Miyuki Fukuda ◽  
Shunichi Fukuda ◽  
Joji Ando ◽  
Kimiko Yamamoto ◽  
Naohiro Yonemoto ◽  
...  
Keyword(s):  
Shear Stress ◽  
Cerebral Aneurysm ◽  
Arterial Wall ◽  
Quantitative Polymerase Chain Reaction ◽  
Cerebral Aneurysms ◽  
Artery Ligation ◽  
Hemodynamic Stress ◽  
Aneurysm Formation ◽  
Aneurysm Development ◽  
Cox 2

OBJECTIVEThere are no effective therapeutic drugs for cerebral aneurysms, partly because the pathogenesis remains unresolved. Chronic inflammation of the cerebral arterial wall plays an important role in aneurysm formation, but it is not clear what triggers the inflammation. The authors have observed that vascular endothelial P2X4 purinoceptor is involved in flow-sensitive mechanisms that regulate vascular remodeling. They have thus hypothesized that shear stress–associated hemodynamic stress on the endothelium causes the inflammatory process in the cerebral aneurysm development.METHODSTo test their hypothesis, the authors examined the role of P2X4 in cerebral aneurysm development by using P2X4−/− mice and rats that were treated with a P2X4 inhibitor, paroxetine, and subjected to aneurysm-inducing surgery. Cerebral aneurysms were induced by unilateral carotid artery ligation and renovascular hypertension.RESULTSThe frequency of aneurysm induction evaluated by light microscopy was significantly lower in the P2X4−/− mice (p = 0.0488) and in the paroxetine-treated male (p = 0.0253) and female (p = 0.0204) rats compared to control mice and rats, respectively. In addition, application of paroxetine from 2 weeks after surgery led to a significant reduction in aneurysm size in the rats euthanized 3 weeks after aneurysm-inducing surgery (p = 0.0145), indicating that paroxetine suppressed enlargement of formed aneurysms. The mRNA and protein expression levels of known inflammatory contributors to aneurysm formation (monocyte chemoattractant protein–1 [MCP-1], interleukin-1β [IL-1β], tumor necrosis factor–α [TNFα], inducible nitric oxide synthase [iNOS], and cyclooxygenase-2 [COX-2]) were all significantly elevated in the rats that underwent the aneurysm-inducing surgery compared to the nonsurgical group, and the values in the surgical group were all significantly decreased by paroxetine administration according to quantitative polymerase chain reaction techniques and Western blotting. Although immunolabeling densities for COX-2, iNOS, and MCP-1 were not readily observed in the nonsurgical mouse groups, such densities were clearly seen in the arterial wall of P2X4+/+ mice after aneurysm-inducing surgery. In contrast, in the P2X4−/− mice after the surgery, immunolabeling of COX-2 and iNOS was not observed in the arterial wall, whereas that of MCP-1 was readily observed in the adventitia, but not the intima.CONCLUSIONSThese data suggest that P2X4 is required for the inflammation that contributes to both cerebral aneurysm formation and growth. Enhanced shear stress–associated hemodynamic stress on the vascular endothelium may trigger cerebral aneurysm development. Paroxetine may have potential for the clinical treatment of cerebral aneurysms, given that this agent exhibits efficacy as a clinical antidepressant.

Oncotic aneurysm

1976 ◽  
Vol 45 (1) ◽  
pp. 98-100 ◽  
Author(s):  
Fredric A. Helmer
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Aneurysm ◽  
Tumor Cells ◽  
Vessel Wall ◽  
Metastatic Tumor ◽  
Content Type ◽  
Arterial Circulation ◽  
Aneurysm Formation ◽  
Oncotic Aneurysm ◽  
Fine Print

✓ The author describes a case of intracerebral and subarachnoid hemorrhage associated with an intracranial aneurysm caused by a metastatic tumor. The aneurysm formation is explained as being a result of tumor cells invading the vessel wall while still preserving the arterial circulation.

Gamma knife radiosurgery in the management of cavernous sinus meningiomas

2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 68-73 ◽  
Author(s):  
Pierre-Hugues Roche ◽  
Jean Régis ◽  
Henry Dufour ◽  
Henri-Dominique Fournier ◽  
Christine Delsanti ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Tumor Growth ◽  
Gamma Knife ◽  
Cavernous Sinus ◽  
Gamma Knife Radiosurgery ◽  
Surgical Removal ◽  
Content Type ◽  
Cavernous Sinus Meningioma ◽  
The Mean ◽  
Fine Print

Object. The authors sought to assess the functional tolerance and tumor control rate of cavernous sinus meningiomas treated by gamma knife radiosurgery (GKS). Methods. Between July 1992 and October 1998, 92 patients harboring benign cavernous sinus meningiomas underwent GKS. The present study is concerned with the first 80 consecutive patients (63 women and 17 men). Gamma knife radiosurgery was performed as an alternative to surgical removal in 50 cases and as an adjuvant to microsurgery in 30 cases. The mean patient age was 49 years (range 6–71 years). The mean tumor volume was 5.8 cm3 (range 0.9–18.6 cm3). On magnetic resonance (MR) imaging the tumor was confined in 66 cases and extensive in 14 cases. The mean prescription dose was 28 Gy (range 12–50 Gy), delivered with an average of eight isocenters (range two–18). The median peripheral isodose was 50% (range 30–70%). Patients were evaluated at 6 months, and at 1, 2, 3, 5, and 7 years after GKS. The median follow-up period was 30.5 months (range 12–79 months). Tumor stabilization after GKS was noted in 51 patients, tumor shrinkage in 25 patients, and enlargement in four patients requiring surgical removal in two cases. The 5-year actuarial progression-free survival was 92.8%. No new oculomotor deficit was observed. Among the 54 patients with oculomotor nerve deficits, 15 improved, eight recovered, and one worsened. Among the 13 patients with trigeminal neuralgia, one worsened (contemporary of tumor growing), five remained unchanged, four improved, and three recovered. In a patient with a remnant surrounding the optic nerve and preoperative low vision (3/10) the decision was to treat the lesion and deliberately sacrifice the residual visual acuity. Only one transient unexpected optic neuropathy has been observed. One case of delayed intracavernous carotid artery occlusion occurred 3 months after GKS, without permanent deficit. Another patient presented with partial complex seizures 18 months after GKS. All cases of tumor growth and neurological deficits observed after GKS occurred before the use of GammaPlan. Since the initiation of systematic use of stereotactic MR imaging and computer-assisted modern dose planning, no more side effects or cases of tumor growth have occurred. Conclusions. Gamma knife radiosurgery was found to be an effective low morbidity—related tool for the treatment of cavernous sinus meningioma. In a significant number of patients, oculomotor functional restoration was observed. The treatment appears to be an alternative to surgical removal of confined enclosed cavernous sinus meningioma and should be proposed as an adjuvant to surgery in case of extensive meningiomas.

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