scholarly journals Dissecting Aneurysms of Bilateral Anterior Cerebral Artery Complicated by Subarachnoid Hemorrhage after Cerebral Infarction: A Case Report

2008 ◽  
Vol 1 ◽  
pp. CCRep.S833
Author(s):  
Akihiro Kurosu ◽  
Shizuo Hatashita ◽  
Hideo Ueno
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Vascular Reconstruction ◽  
Dissecting Aneurysm ◽  
Vascular Anastomosis ◽  
Left Lower Extremity ◽  
The Right ◽  
Dissecting Aneurysms

Introduction Intracranial dissecting aneurysms have been increased due to recent advancements in diagnostic imaging. However there have been little article with subarachnoid hemorrhage and cerebral infarction occurring almost at the same time. We performed the surgical treatment and obtained good result. Case presentation A 47-year-old male presented to our hospital with chief complaints of sudden headache and mild paralysis of the left lower extremity. Brain imaging at admission revealed cerebral infarction in the right frontal lobe and subarachnoid hemorrhage in the frontal convexy and anterior interhemispheric fissure. The left and right internal carotid angiography showed a bulging cerebral aneurysm at the left A1–A2 junction and stenosis and arterial dissections in the peripheral of the bilateral anterior cerebral artery. Wrapping was performed for the dissecting aneurysm of the left anterior cerebral artery. For the right anterior cerebral artery, trapping was performed at the A2 segment without vascular anastomosis. The patient's postoperative course was uneventful. Conclusion A consensus has not been reached on the treatment for intracranial dissecting aneurysms. Proximal trapping without vascular reconstruction was performed for the right anterior cerebral artery without vascular anastomosis to prevent rebleeding. However no symptoms of neurological deficiency were observed. Proximal trapping of dissecting aneurysm seems to be a good option when patient's functional and life prognosis are taken into account in case that vascular reconstruction will be anticipated difficulty.

scholarly journals A Case of Anterior Cerebral Artery Dissecting Aneurysm Presenting Subarachnoid Hemorrhage and Cerebral Infarction at the Same Time

1993 ◽  
Vol 21 (6) ◽  
pp. 461-466 ◽  
Author(s):  
Kouji YASUKAWA ◽  
Yukihiro KAMIJO ◽  
Genki MOMOSE ◽  
Shigeru KOBAYASHI ◽  
Akira IKEDA
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Dissecting Aneurysm

scholarly journals Dissecting Aneurysm of the Anterior Cerebral Artery with Severe Subarachnoid Hemorrhage during Treatment for Cerebral Infarction

2003 ◽  
Vol 42 (5) ◽  
pp. 433-435 ◽  
Author(s):  
Shoko M. YAMADA ◽  
Makoto NAKANE ◽  
Makoto AOKI ◽  
Hitoshi NAKAYAMA
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Dissecting Aneurysm

Fusiform Aneurysm of the Anterior Communicating Artery Treated by Vascular Reconstruction

Neurosurgery ◽  
2010 ◽  
Vol 66 (5) ◽  
pp. E1025-E1026 ◽  
Author(s):  
Toshikazu Kimura ◽  
Kengo Nishimura ◽  
Syunsuke Fukaya ◽  
Akio Morita
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Vascular Reconstruction ◽  
Cerebral Revascularization ◽  
Anterior Communicating Artery ◽  
Fusiform Aneurysm ◽  
Digital Subtraction ◽  
Case Presentation ◽  
Ischemic Complications

Abstract OBJECTIVE Fusiform aneurysm of the anterior cerebral artery is rare and difficult to treat because of perforators. We encountered a patient with subarachnoid hemorrhage due to rupture of a fusiform aneurysm of the anterior communicating artery complex, and treated this patient with cerebral revascularization. CASE PRESENTATION A 39-year-old man presented with sudden severe headache resulting from subarachnoid hemorrhage. Digital subtraction angiography showed dilatation from the distal A1 segment to the proximal A2 segment of the left anterior cerebral artery. Despite intensive conservative treatment, repetitive angiography showed aneurysmal growth from this dilated portion. INTERVENTION Proximal clipping and clip-on wrapping on the A2 segment was successfully performed with a A3-A3 bypass. He was discharged without neurological deficit. CONCLUSION Cerebral revascularization technique is necessary to achieved appropriate obliteration without ischemic complications.

Sphenopalatine ganglion stimulation for vasospasm after experimental subarachnoid hemorrhage

2011 ◽  
Vol 114 (4) ◽  
pp. 1104-1109 ◽  
Author(s):  
Masataka Takahashi ◽  
Zhen-Du Zhang ◽  
R. Loch Macdonald
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Artery ◽  
Evans Blue ◽  
Internal Carotid ◽  
Anterior Cerebral Artery ◽  
Sphenopalatine Ganglion ◽  
Doppler Flowmetry ◽  
The Right

Object Sphenopalatine ganglion stimulation activates perivascular vasodilatory nerves in the ipsilateral anterior circle of Willis. This experiment tested whether stimulation of the ganglion could reverse vasospasm and improve cerebral perfusion after subarachnoid hemorrhage (SAH) in monkeys. Methods Thirteen cynomolgus monkeys underwent baseline angiography followed by creation of SAH by placement of autologous blood against the right intradural internal carotid artery, the middle cerebral artery (MCA), and the anterior cerebral artery. Seven days later, angiography was repeated, and the right sphenopalatine ganglion was exposed microsurgically. Angiography was repeated 15 minutes after exposure of the ganglion. The ganglion was stimulated electrically 3 times, and angiography was repeated during and 15 and 30 minutes after stimulation. Cerebral blood flow (CBF) was monitored using laser Doppler flowmetry, and intracranial pressure (ICP) was measured throughout. The protocol was repeated again. Evans blue was injected and the animals were killed. The brains were removed for analysis of water and Evans blue content and histology. Results Subarachnoid hemorrhage was associated with significant vasospasm of the ipsilateral major cerebral arteries (23% ± 10% to 39% ± 4%; p < 0.05, paired t-tests). Exposure of the ganglion and sham stimulation had no significant effects on arterial diameters, ICP, or CBF (4 monkeys, ANOVA and paired t-tests). Sphenopalatine ganglion stimulation dilated the ipsilateral extracranial and intracranial internal carotid artery, MCA, and anterior cerebral artery compared with the contralateral arteries (9 monkeys, 7% ± 9% to 15% ± 19%; p < 0.05, ANOVA). There was a significant increase in ipsilateral CBF. Stimulation had no effect on ICP or brain histology. Brain water content did not increase but Evans blue content was significantly elevated in the MCA territory of the stimulated hemisphere. Conclusions Sphenopalatine ganglion stimulation decreased vasospasm and increased CBF after SAH in monkeys. This was associated with opening of the blood-brain barrier.

scholarly journals Bilateral cerebral infarction associated with severe arteriosclerosis in the A1 segment: a case report

2019 ◽  
Vol 47 (3) ◽  
pp. 1373-1377
Author(s):  
Jing Lin ◽  
Wenbiao Xian ◽  
Rong Lai ◽  
Jiaoxing Li ◽  
Yufang Wang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Anterior Communicating Artery ◽  
Left Middle Cerebral Artery ◽  
Large Artery ◽  
Anterior Circulation ◽  
The Right ◽  
Left Middle

Large artery atherosclerosis and cardioembolism are the two major subtypes of ischemic stroke. We herein describe a 75-year-old man with acute complete cerebral infarction in the typical territories of the bilateral anterior cerebral artery (ACA) and left middle cerebral artery. Brain magnetic resonance angiography showed that the right A1 segment of the ACA was affected by severe arteriosclerosis and that the right ACA other than the A1 segment was compensated by the left ACA through the anterior communicating artery. Acute cardioembolism only occluded the left anterior circulation but simultaneously blocked the right ACA due to decompensation. We presume that the bilateral cerebral infarctions were caused by chronic atherosclerosis and acute cardioembolism.

Indocyanine Green Videoangiography for Surgery of a Ruptured Dissecting Aneurysm in the Precommunicating Anterior Cerebral Artery: A Technical Case Report

2017 ◽  
Vol 13 (4) ◽  
pp. E14-E18 ◽  
Author(s):  
Yasunori Nagai ◽  
Masanori Goto ◽  
Hiroki Toda ◽  
Namiko Nishida ◽  
Naoya Yoshimoto ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Connective Tissue Diseases ◽  
Vascular Wall ◽  
Dissecting Aneurysm ◽  
Indocyanine Green Videoangiography ◽  
Before And After ◽  
History Of ◽  
Dissecting Aneurysms

Abstract BACKGROUND AND IMPORTANCE: Indocyanine green videoangiography (ICG-VA) is an important intraoperative adjunct for saccular aneurysm surgery, but its efficacy in surgery for dissecting aneurysms has rarely been reported. The authors describe the usefulness of preclipping ICG-VA in a rare case of a ruptured dissecting aneurysm located at the precommunicating (A1) segment of the anterior cerebral artery. CLINICAL PRESENTATION: A 52-year-old woman, with no history of connective tissue diseases or vascular disorders, presented with sudden headache and convulsion. The CT scan showed that the patient had subarachnoid hemorrhage. Angiography showed a dissecting aneurysm in the left A1 segment of the anterior cerebral artery. Thus, the patient underwent trapping of the dissecting aneurysm. ICG-VA was used as an intraoperative adjunct before and after clipping. The preclipping ICG-VA showed the heterogeneously bright dissecting aneurysm and branching arteries even in the presence of hematoma. CONCLUSION: Preclipping ICG-VA may enhance the advantage of direct surgery for dissecting aneurysm by allowing visualization of the extent of the dissected vascular wall and the related branching arteries. ICG-VA can be an indispensable adjunct to minimize the compromise from the surgical treatment for intracranial dissecting aneurysms.

Posttraumatic Dissecting Aneurysm of the Anterior Cerebral Artery: Case Report

Neurosurgery ◽  
1988 ◽  
Vol 23 (2) ◽  
pp. 221-225 ◽  
Author(s):  
Masaharu Amagasa ◽  
So Sato ◽  
Kazunori Otabe
Keyword(s):  
Case Report ◽  
Head Injury ◽  
Corpus Callosum ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Mechanical Damage ◽  
Dissecting Aneurysm ◽  
Mechanical Injury ◽  
A Minor

ABSTRACT A case of cerebral infarction in the territory of the anterior cerebral artery after a minor head injury is reported. It is possible that direct or mechanical damage by the edge of the falx or stretching and shearing of the anterior cerebral artery after an acute shift of the corpus callosum caused the localized lesion of the left anterior cerebral artery. We think that this mechanical injury caused a dissecting aneurysm or a cerebral arterial dissection, which was diagnosed by sequential angiographic changes.

scholarly journals A Case of Dissecting Aneurysm of the Peripheral Anterior Cerebral Artery Causing Subarachnoid Hemorrhage

2009 ◽  
Vol 37 (4) ◽  
pp. 288-293 ◽  
Author(s):  
Masayasu KATO ◽  
Yoshitaka TANAKA ◽  
Tatsuya KURODA ◽  
Toshihiko NAKASHIMA ◽  
Tatsuaki HATTORI
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Dissecting Aneurysm
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