Treatment of a middle cerebral artery giant aneurysm using a covered stent

2006 ◽  
Vol 104 (6) ◽  
pp. 965-968 ◽  
Author(s):  
Guglielmo Pero ◽  
Federica Denegri ◽  
Luca Valvassori ◽  
Edoardo Boccardi ◽  
Giuseppe Scialfa
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Giant Aneurysm ◽  
Covered Stent ◽  
Left Middle Cerebral Artery ◽  
Transient Ischemic Attacks ◽  
Ischemic Lesion ◽  
Mca Aneurysm ◽  
Left Middle

✓ The authors report the case of a 60-year-old man harboring a wide-necked giant aneurysm of the M1 segment of the left middle cerebral artery (MCA); his symptoms included transient ischemic attacks characterized by right hemiparesis and aphasia. The aneurysm was treated by placing a covered stent across the orifice of the aneurysm. The 18-month follow-up examination showed a very good outcome, with perfect left MCA patency, no new ischemic lesion, and minor residual aphasia and right hemiparesis. This is the first report in the literature of an MCA aneurysm treated using a covered stent.

scholarly journals Clipping of bilateral MCA aneurysms and a coiled ACOM aneurysm through a modified lateral supraorbital craniotomy

2015 ◽  
Vol 38 (videosuppl1) ◽  
pp. Video19 ◽  
Author(s):  
Ziad A. Hage ◽  
Fady T. Charbel
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Aneurysm ◽  
Sylvian Fissure ◽  
Left Middle Cerebral Artery ◽  
Flow Measurements ◽  
Mca Aneurysm ◽  
The Right ◽  
Left Middle ◽  
Supraorbital Craniotomy

We showcase the microsurgical clipping of a left middle cerebral artery (MCA) aneurysm-(B) done through a modified right lateral supraorbital craniotomy, as well as clipping of a previously coiled anterior communicating (ACOM) artery aneurysm-(C) and a bilobed right MCA aneurysm-(A). Splitting of the right sylvian fissure is initially performed following which a subfrontal approach is used to expose and dissect the contralateral sylvian fissure. The left MCA aneurysm is identified and clipped. The ACOM aneurysm is then clipped following multiple clip repositioning based on flow measurements. The right MCA aneurysm is then identified and each lobe is clipped separately.The first picture showcased in this video is a side to side right and left ICA injection in AP projection. In this picture, (A) points to the bilobed right MCA aneurysm, (B) to the left middle cerebral artery (MCA) aneurysm, and (C) to the previously coiled anterior communicating (ACOM) artery aneurysm. The red dotted line shows that both MCA aneurysms lie within the same plane which makes it easier to clip both of them, through one small craniotomy.The video can be found here: http://youtu.be/4cQC7nHsL5I.

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.

scholarly journals Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts

2021 ◽  
pp. 174749302098455
Author(s):  
Nick A Weaver ◽  
Angelina K Kancheva ◽  
Jae-Sung Lim ◽  
J Matthijs Biesbroek ◽  
Irene MC Huenges Wajer ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Cognitive Deficits ◽  
Mini Mental State Examination ◽  
Left Middle Cerebral Artery ◽  
Post Stroke ◽  
Lesion Symptom Mapping ◽  
State Examination ◽  
Left Middle

Background Post-stroke cognitive impairment can occur after damage to various brain regions, and cognitive deficits depend on infarct location. The Mini-Mental State Examination (MMSE) is still widely used to assess post-stroke cognition, but it has been criticized for capturing only certain cognitive deficits. Along these lines, it might be hypothesized that cognitive deficits as measured with the MMSE primarily involve certain infarct locations. Aims This comprehensive lesion-symptom mapping study aimed to determine which acute infarct locations are associated with post-stroke cognitive impairment on the MMSE. Methods We examined associations between impairment on the MMSE (<5th percentile; normative data) and infarct location in 1198 patients (age 67 ± 12 years, 43% female) with acute ischemic stroke using voxel-based lesion-symptom mapping. As a frame of reference, infarct patterns associated with impairments in individual cognitive domains were determined, based on a more detailed neuropsychological assessment. Results Impairment on the MMSE was present in 420 patients (35%). Large voxel clusters in the left middle cerebral artery territory and thalamus were significantly (p < 0.01) associated with cognitive impairment on the MMSE, with highest odds ratios (>15) in the thalamus and superior temporal gyrus. In comparison, domain-specific impairments were related to various infarct patterns across both hemispheres including the left medial temporal lobe (verbal memory) and right parietal lobe (visuospatial functioning). Conclusions Our findings indicate that post-stroke cognitive impairment on the MMSE primarily relates to infarct locations in the left middle cerebral artery territory. The MMSE is apparently less sensitive to cognitive deficits that specifically relate to other locations.

Multiple middle cerebral artery aneurysms in an infant

1990 ◽  
Vol 72 (5) ◽  
pp. 806-809 ◽  
Author(s):  
Cornelia Cedzich ◽  
J. Schramm ◽  
G. Röckelein
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Systemic Disease ◽  
Intracerebral Hematoma ◽  
Left Middle Cerebral Artery ◽  
Content Type ◽  
Middle Cerebral Artery Aneurysms ◽  
Subarachnoid Blood ◽  
Left Middle ◽  
Control Angiography

✓ An 11-month-old boy was admitted for evaluation of drowsiness, vomiting, and convulsions. Computerized tomography showed subarachnoid blood in the left sylvian fissure and a small intracerebral hematoma in the temporal lobe. Angiography revealed several aneurysms of the left middle cerebral artery (MCA). During surgery, 13 aneurysms were found arising from one main branch of the left MCA, and this segment of the MCA was trapped. Somatosensory evoked potentials did not show any change during surgery. The diseased arterial segment was examined histologically and the pathogenetic aspects of the case are discussed. Control angiography 6 months later excluded systemic disease or other aneurysms. The rarity of such lesions in childhood and their successful surgical treatment are discussed briefly.

Delayed breaking of a Heifetz aneurysm clip

1977 ◽  
Vol 47 (3) ◽  
pp. 463-465 ◽  
Author(s):  
Antti Servo ◽  
Matti Puranen
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Left Middle Cerebral Artery ◽  
Carotid Angiography ◽  
Content Type ◽  
Aneurysm Clip ◽  
Correct Placement ◽  
Left Middle ◽  
Fine Print

✓ An aneurysm of the left middle cerebral artery was treated by clipping with a Heifetz clip. The correct placement was confirmed angiographically immediately after the operation. At carotid angiography 1 year later the clip was found to have broken, and the aneurysm had increased in size.

scholarly journals A Rare Case ofStreptococcus alactolyticusInfective Endocarditis Complicated by Septic Emboli and Mycotic Left Middle Cerebral Artery Aneurysm

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Patricia Almeida ◽  
Jaclyn Railsback ◽  
James Benjamin Gleason
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Aneurysm ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Left Middle Cerebral Artery ◽  
Middle Cerebral Artery Aneurysm ◽  
Microsurgical Clipping ◽  
Cerebral Artery Aneurysm ◽  
Left Middle

To date,S. alactolyticusendocarditis complicated by middle cerebral artery aneurysm has not been reported. We describe the case of a 65-year-old female with a history of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction presenting with confusion and a apical holosystolic murmur. Angiography of the brain identified new bilobed left middle cerebral artery aneurysm. Serial blood cultures grewS. alactolyticus, and aortic and mitral valve vegetation were discovered on transesophageal echocardiography. The patient was treated with antimicrobial therapy, mitral and aortic valve replacements, and microsurgical clipping of cerebral aneurysm. This case serves to highlight the pathogenicity of a sparsely described bacterium belonging to the heterogenousS. boviscomplex.

scholarly journals Adverse Outcome of Early Recurrent Ischemic Stroke Secondary to Atrial Fibrillation after Repeated Systemic Thrombolysis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Luciano A. Sposato ◽  
Valeria Salutto ◽  
Diego E. Beratti ◽  
Paula Monti ◽  
Patricia M. Riccio ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Neurological Outcome ◽  
Left Middle Cerebral Artery ◽  
Cerebrovascular Event ◽  
Middle Cerebral Artery Infarction ◽  
Systemic Thrombolysis ◽  
Left Middle

Background. Recurrent ischemic stroke is associated with adverse neurological outcome in patients with atrial fibrillation. There is very scarce information regarding the neurological outcome of atrial fibrillation patients undergoing repeated systemic thrombolysis after early recurrent ischemic stroke.Clinical Case and Discussion. We describe a case of a 76-year-old woman with known paroxysmal atrial fibrillation who was admitted because of an acute right middle cerebral artery ischemic stroke and who underwent repeated systemic thrombolysis within 110 hours. The patient underwent systemic thrombolysis after the first ischemic stroke with almost complete neurological recovery. On the fourth day after treatment, an acute left middle cerebral artery ischemic stroke was diagnosed and she was treated with full-dose intravenous recombinant tissue plasminogen activator. A hemorrhagic transformation of the left middle cerebral artery infarction was noted on follow-up cranial computed tomographic scans. The patient did not recover from the second cerebrovascular event and died 25 days after admission.Conclusion. To the best of our knowledge, this is the second case reporting the adverse neurological outcome of a patient with diagnosis of atrial fibrillation undergoing repeated systemic thrombolysis after early recurrent ischemic stroke. Our report represents a contribution to the scarce available evidence suggesting that repeated systemic thrombolysis for recurrent ischemic stroke should be avoided.

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