scholarly journals Anatomy Variation of Ruptured Anterior Communicating Artery (AcoA) Aneurysm : Serial Cases

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Muhammad Ari Irsyad ◽  
Iskandar Nasution ◽  
Muhammad Ihsan Zulkarnain Tala
Keyword(s):  
Clinical Manifestations ◽  
Case Series ◽  
Anterior Communicating Artery ◽  
Anatomic Variations ◽  
Base Region ◽  
Surgical Clipping ◽  
Intracranial Arteries ◽  
The Right ◽  
Vascular Neurosurgery ◽  
Selection Of

Introduction : Intracranial aneurysms (IA) is an acquired disease characterized by dilatation of intracranial arteries, and is usually found at the location of arterial branches in the cranii base region. The selection of management and anatomic variations is quite interesting to be discussed in the case of aneurysms. Cases Report : Four cases of AcoA aneurysm were reported with variations in clinical manifestations, A1 segment anatomy, fundal projections and management considerations (Coiling vs. Clipping). This case series illustrates the compatibility with previous case studies that have existed. Discussion : The author concludes that the actions taken in cases I, II and III are in the form of coiling due to age, dome and neck ratio and access to perform such difficult surgical procedures. In case IV , it was considered to be performed surgical clipping action due to the presence of intracerebal hemoraghic, and the approach can be done from a non dominant hemisphere, proximal control only through the right carotid and the location of the posterior dome which was favorable for surgical clipping Conclusion : Aneurysms from the ACA-anterior communicating artery (ACoA) complex are some of the most complex lesions in the field of vascular neurosurgery. This location is where most rupture aneurysms occured with high mortalities due to complications of vasospasm and SAH. The choice of management in aneurysm cases which involved many factors such as age and anatomic variations.  

Case-series analysis of intracranial saccular aneurysms treatment

2015 ◽  
Vol 22 (3) ◽  
pp. 142-149
Author(s):  
Gytis Šustickas ◽  
Dainius Rinkevičius ◽  
Jurgita Ušinskienė ◽  
Simona Rūta Letautienė ◽  
Audrius Širvinskas
Keyword(s):  
Intracranial Aneurysms ◽  
Internal Carotid ◽  
Case Series ◽  
Treatment Method ◽  
Anterior Communicating Artery ◽  
Surgical Clipping ◽  
Unruptured Aneurysms ◽  
Aneurysm Embolization ◽  
Radical Method ◽  
Selection Of

Nowadays, selection of the best treatment method for intracranial aneurysms is one of the most discussed topics. We report our operative and coiling experience of 128 cases  –  series with 106 ruptured and 22 unruptured aneurysms. The aim of the research was to identify the factors influencing the optimal radical method for treatment of intracranial aneurysms and to compare the neurosurgical and neuroradiological activity of our hospital with that of other regions of the world. Of 128 aneurysms the clipped group was 94 patients (mean age ± SD: 52.21 ± 13.34 years, 73.4%) while 34 patients underwent aneurysm embolization (mean age ± SD: 61.59 ± 13.34 years, 36.6%). Most of the aneurysms were located at the anterior communicating artery (n = 36, 28.13%), the middle cerebral artery (n = 34, 26.56%) and the internal carotid artery (n  =  20, 15.63%). Comorbidity, neurology status at admission, clinical outcomes, operative complications, aneurysm localization, size and condition were analysed. According to our experience, surgical clipping of aneurysms is more efficient and safe for patients with no or mild comorbidity, with less severe neurological symptoms, ruptured aneurysms, and anterior cerebral circulation aneurysms.

Absent right superior caval vein in situs solitus

2015 ◽  
Vol 26 (2) ◽  
pp. 334-339 ◽  
Author(s):  
Rebekka Lytzen ◽  
Karin Sundberg ◽  
Niels Vejlstrup
Keyword(s):  
Incidental Finding ◽  
Clinical Manifestations ◽  
Case Series ◽  
Retrospective Case ◽  
Caval Vein ◽  
Cardinal Vein ◽  
Benign Condition ◽  
Superior Caval Vein ◽  
Case Series Study ◽  
The Right

AbstractIntroductionIn up to 0.07% of the general population, the right anterior cardinal vein obliterates and the left remains open, creating an absent right superior caval vein and a persistent left superior caval vein. Absent right superior caval vein is associated with additional congenital heart disease in about half the patients. We wished to study the consequences of absent right superior caval vein as an incidental finding on prenatal ultrasonic malformation screening.Material and methodsThis is a retrospective case series study of all foetuses diagnosed with absent right superior caval vein at the national referral hospital, Rigshospitalet, Denmark, from 2009 to 2012.ResultsIn total, five cases of absent right superior caval vein were reviewed. No significant associated cardiac, extra-cardiac, or genetic anomalies were found. Postnatal echocardiographies confirmed the diagnosis and there were no postnatal complications. All children were found to have healthy hearts at follow-up.ConclusionsIn all cases, the findings proved to be a benign condition with no clinical manifestations or complications. Although isolated absent right superior caval vein does not seem to affect the outcome, associated anomalies may be serious. Absent right superior caval vein should, therefore, prompt a search for additional malformations. Furthermore, the diagnosis of an isolated absent right superior caval vein is important, because knowledge of the anomaly can prevent future problems when invasive procedures are necessary.

scholarly journals Anatomic Variations of the Right Portal Vein: Prevalence, Imaging Features, and Implications for Successful Transjugular Intrahepatic Portosystemic Shunt Creation

2017 ◽  
Vol 7 ◽  
pp. 14 ◽  
Author(s):  
Senthil S Gunasekaran ◽  
Ron C Gaba
Keyword(s):  
Portal Vein ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Case Series ◽  
Portosystemic Shunt ◽  
Imaging Features ◽  
Anatomic Variations ◽  
Pictorial Essay ◽  
Intrahepatic Portosystemic Shunt ◽  
Anatomic Variants ◽  
The Right

Given the widespread use of transjugular intrahepatic portosystemic shunt (TIPS) creation for the treatment of portal hypertensive complications, a working knowledge of portal venous anatomy is critical for interventional radiologists. The right portal vein – which is most commonly accessed during TIPS – is subject to various anatomic variants that may potentially impact procedure success. This pictorial essay characterizes the anatomic patterns of the right portal vein branching in terms of type and frequency based on case series review. The work also explains the potential procedural implications of the right portal vein anatomic variations as they pertain to TIPS technical success.

Walter E. Dandy's contributions to vascular neurosurgery

2010 ◽  
Vol 112 (6) ◽  
pp. 1182-1191 ◽  
Author(s):  
Ryan M. Kretzer ◽  
Alexander L. Coon ◽  
Rafael J. Tamargo
Keyword(s):  
Intracranial Aneurysm ◽  
Case Series ◽  
Vein Of Galen Malformation ◽  
Surgical Clipping ◽  
Cavernous Malformations ◽  
X Ray ◽  
Operative Case ◽  
Developmental Venous Anomalies ◽  
Vascular Neurosurgery

Although Walter E. Dandy (1886–1946) is appropriately credited with the first surgical clipping of an intracranial aneurysm in 1937—a procedure that established the modern field of vascular neurosurgery—his numerous other contributions to this specialty are not as well known. Dandy can be credited with the first detailed description of the vein of Galen malformation, the first description of x-ray visualization of an intracranial aneurysm, the first characterization of basilar artery dolichoectasia, and the publication of the first comprehensive operative case series of arteriovenous malformations, cavernous malformations, and developmental venous anomalies. In addition, Dandy performed the first surgical trapping of a cavernous internal carotid artery (ICA) aneurysm by clipping the supraclinoid ICA and ligating the cervical ICA, and he also executed the first intracranial surgical clipping of the ICA to treat a carotid-cavernous fistula. In this article the authors describe Dandy's contributions to the field of vascular neurosurgery.

scholarly journals High resolution MRI in treatment decision of anterior communicating artery aneurysm accompanied by visual symptoms: Endovascular treatment or surgical clipping? A report of two cases and literature review

2016 ◽  
Vol 22 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Peng Liu ◽  
Xianli Lv ◽  
Youxiang Li ◽  
Ming Lv
Keyword(s):  
High Resolution ◽  
Endovascular Treatment ◽  
Visual Loss ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Surgical Clipping ◽  
Visual Symptoms ◽  
First Case ◽  
High Resolution Mri ◽  
The Right

Anterior communicating artery (AComA) aneurysm accompanied by visual symptoms is rarely reported. The first case is an asymptomatic 65-year-old woman who presented with an AComA aneurysm, and the pre-procedure high-resolution magnetic resonance imaging (MRI) revealed an AComA aneurysm compressed the left optic nerve and the chiasma with a size of 8.3 × 9.2 mm. She suffered a sudden onset of left eye visual loss and the temporal hemianopia of the right eye after endovascular embolization. She had a light sensation of the left eye and minor enlargement of the visual field in the right eye at the six-month follow-up. The second case is a symptomatic 55-year-old woman suffering a visual loss in the left eye and inferior nasal quadrantanopsia in her right eye. Pre-operative high-resolution MRI found an AComA aneurysm compressing the left part of the chiasma with a size of 7.1 × 8.3 mm. Her visual symptoms improved after surgical clipping. High-resolution MRI could depict the anatomic relationship between the AComA aneurysm and the surrounding optic pathways. Endovascular treatment of an AComA aneurysm may result in visual deterioration due to the mass effect or ischemia after the procedure. Surgical clipping of the AComA aneurysm could relieve the compression symptoms.

scholarly journals Interhemispheric Transcallosal Transforaminal Approach and Microscopic Third Ventriculostomy for Intraventricular Craniopharyngioma Associated with Asymmetric Hydrocephalus: Case Report and Literature Review

Folia Medica ◽  
2019 ◽  
Vol 61 (1) ◽  
pp. 143-147
Author(s):  
Ivo Kehayov ◽  
Vladimir Nakov ◽  
Borislav Kitov ◽  
Hristo Zhelyazkov ◽  
Toma Spiriev
Keyword(s):  
Literature Review ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Visual Field Loss ◽  
Anterior Communicating Artery ◽  
Third Ventriculostomy ◽  
Transforaminal Approach ◽  
The Right ◽  
Total Tumor Removal ◽  
Selection Of

Abstract We report on a case of a solid adamantinomatous variant of craniopharyngioma located entirely within the third ventricle causing asymmetric obstructive hydrocephalus in a 43-year-old male patient. The patient complaints included intermittent severe headache and progressive bilateral visual field loss. Initially, the lesion was accessed via the bifrontal interhemispheric translamina terminalis approach but total removal was not possible due to short anterior communicating artery which limited the exposure. In the second stage, we used the right interhemispheric transcallosal transforaminal approach and achieved total tumor removal followed by microscopic third ventriculostomy. The present article discusses the selection of appropriate surgical approach based on concise literature review that provides favorable surgical management of these rare lesions.

scholarly journals Interleukin-17 and lupus: enough to be a target? For which patients?

Lupus ◽  
2019 ◽  
Vol 29 (1) ◽  
pp. 6-14 ◽  
Author(s):  
M Robert ◽  
P Miossec
Keyword(s):  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Interleukin 17 ◽  
Disease Heterogeneity ◽  
Autoantibody Production ◽  
Complex Deposition ◽  
The Many ◽  
The Right ◽  
Circulating Levels ◽  
Selection Of

The involvement of the interleukin (IL)-17 axis in many inflammatory and autoimmune diseases is now well established, and this has led to the development of successful targeted therapies. Its role in systemic lupus erythematosus (SLE) is less described, since SLE is characterized by the impairment of many other immune actors. However, results from animal models and patients strongly suggest that IL-17 and its producing cells are involved in SLE pathogenesis. Circulating levels of IL-17 are increased in lupus, and tissue staining shows the presence of IL-17-producing cells in organ lesions. Through different mechanisms, the IL-17 axis promotes autoantibody production, immune complex deposition, complement activation and then tissue damage. There are also many interactions with other immune and non-immune actors, which account for the broad spectrum of clinical manifestations and disease heterogeneity. SLE treatment faces challenges with many disappointing trials and persistent unmet needs. The identification of subsets of SLE patients with an IL-17-driven disease now constitutes the key priority before starting trials. More preclinical studies are needed to improve the selection of the right patients able to respond and tolerate the many inhibitors that are already available.

Use of photodynamic therapy for photodamage skin (review of literature)

2019 ◽  
Vol 1 (7) ◽  
pp. 19-23
Author(s):  
S. I. Surkichin ◽  
N. V. Gryazeva ◽  
L. S. Kholupova ◽  
N. V. Bochkova
Keyword(s):  
Photodynamic Therapy ◽  
Comparative Evaluation ◽  
Clinical Manifestations ◽  
Light Sources ◽  
Review Of Literature ◽  
Photosensitizing Agents ◽  
Selection Of

The article provides an overview of the use of photodynamic therapy for photodamage of the skin. The causes, pathogenesis and clinical manifestations of skin photodamage are considered. The definition, principle of action of photodynamic therapy, including the sources of light used, the classification of photosensitizers and their main characteristics are given. Analyzed studies that show the effectiveness and comparative evaluation in the selection of various light sources and photosensitizing agents for photodynamic therapy in patients with clinical manifestations of photodamage.

СОВРЕМЕННЫЕ ПОДХОДЫ К ДИАГНОСТИКЕ И ЛЕЧЕНИЮ АНГИООТЕКОВ В ПЕДИАТРИИ

2019 ◽  
Author(s):  
A.R. Denisova ◽  
A.N. Pampura
Keyword(s):  
Clinical Manifestations ◽  
Personalized Therapy ◽  
Diagnostics And Therapy ◽  
Selection Of

Ангиоотеки довольно часто встречаются в детском возрасте. Эффективность ведения детей с ангиоотеками определяется пониманием патогенеза заболевания и подбором персонифицированной терапии. В статье представлены сведения о классификации, клинических проявлениях, диагностике и терапии как брадикинин-, так и гистаминергических ангиоотеков.Angioedema often occurs in childhood. The effectiveness of the management of children with angioedema is determined by understanding the pathogenesis of the disease and the selection of personalized therapy. This article provides information on the classification, clinical manifestations, diagnostics and therapy of both bradykinin and histaminergic angioedema.

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