scholarly journals The mechanical thrombectomy during coil embolisation of the ruptured intracranial aneurysm

2020 ◽  
Vol 11 (1) ◽  
pp. 41-43
Author(s):  
Deniz Bulja ◽  
Odej Ali Abud ◽  
Merim Jusufbegović ◽  
Sandra Vegar - Zubović

Experience in managing thromboembolic complications of distal blood vessels during coil embolization in the case of subarachnoid hemorrhage (SAH) is still limited. This is the presentation of the case of a 23-year-old man with a ruptured small aneurysm who experienced thromboembolic occlusion during coil embolization. Mechanical thrombectomy resulted in complete recanalization of the occluded branches without ischemic complications. This case should be used for the use of mechanical thrombectomies as an effective rescue strategy and treatment of distal arteries occlusions of the brain.

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Leng ◽  
Dan Fan ◽  
Zhong Ren ◽  
Qiaoying Li

Abstract Background This study was performed to identify genes and lncRNAs involved in the pathogenesis of subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysm (RIA). Methods Microarray GSE36791 was downloaded from Gene Expression Omnibus (GEO) database followed by the identification of significantly different expressed RNAs (DERs, including lncRNA and mRNA) between patients with SAH and healthy individuals. Then, the functional analyses of DEmRNAs were conducted and weighted gene co-expression network analysis (WGCNA) was also performed to extract the modules associated with SAH. Following, the lncRNA-mRNA co-expression network was constructed and the gene set enrichment analysis (GSEA) was performed to screen key RNA biomarkers involved in the pathogenesis of SAH from RIA. We also verified the results in a bigger dataset GSE7337. Results Totally, 561 DERs, including 25 DElncRNAs and 536 DEmRNAs, were identified. Functional analysis revealed that the DEmRNAs were mainly associated with immune response-associated GO-BP terms and KEGG pathways. Moreover, there were 6 modules significantly positive-correlated with SAH. The lncRNA-mRNA co-expression network contained 2 lncRNAs (LINC00265 and LINC00937) and 169 mRNAs. The GSEA analysis showed that these two lncRNAs were associated with three pathways (cytokine-cytokine receptor interaction, neurotrophin signaling pathway, and apoptosis). Additionally, IRAK3 and NFKBIA involved in the neurotrophin signaling pathway and apoptosis while IL1R2, IL18RAP and IL18R1 was associated with cytokine-cytokine receptor interaction pathway. The expression levels of these genes have the same trend in GSE36791 and GSE7337. Conclusion LINC00265 and LINC00937 may be implicated with the pathogenesis of SAH from RIA. They were involved in three important regulatory pathways. 5 mRNAs played important roles in the three pathways.


2018 ◽  
Vol 4 (02) ◽  
pp. 065-070
Author(s):  
Abhinav Amarnath Mohan ◽  
Pankaj Banode ◽  
Sachin Dhomne

Abstract Background Ruptured intracranial aneurysm and nontraumatic subarachnoid hemorrhage (SAH) are synonyms and indicators of a high-risk medical emergency. They can be treated either with endovascular approach with interventional radiological (IR) coil embolization or by neuro-surgical (NS) approach by clipping with each having their own merits and demerits and time-tested applications either requiring perioperative expectant management to prevent or curb complications of SAH or post-procedure aiming to achieve better patient outcomes. We conducted this retrospective study to analyze and gain experience from our past cases managed at tertiary care super specialty center and serve as baseline study to implement further studies and have insight for future trends in rural hospital setup in management of critical cases aimed to improve and upscale clinical outcomes in these patients. Materials and Methods Study comprised patients belonging to either of two groups, depending on the management they underwent. Analysis was done by using descriptive and inferential statistics. Results The overall study population consisted of 29.83% males and 70.18% females in this study. The overall mean age was found to be 47.33 years (standard deviation [SD] 15.68 years). In IR group, the pre- and post-procedure modified Fisher's scale (MFS) values were 53 and 50, respectively, in 31 cases, whereas the same in NS group were 43 and 53, respectively, in 23 cases. The difference change in MFS for pre- to post-procedure in IR group was small (3) and showed decreasing trend (from 53 to 50 as well as in individual Fisher grade) whereas that in NS group was big (10) and showed increasing trends (from 43 to 53 as well as in the individual Fisher grade). Conclusion Endovascular coil embolization is the surgery of choice for management of intracranial aneurysm and is minimally invasive procedure with favorable comparative outcomes on MFS than NS clipping group in our study. We recommend undertaking further prospective comparative study, incorporating our study principles and observations with inclusion of prospective clinical scale—modified Rankin's scale (MRS).


Neurosurgery ◽  
1982 ◽  
Vol 11 (3) ◽  
pp. 367-371 ◽  
Author(s):  
Yoshifumi Hirata ◽  
Yasuhiko Matsukado ◽  
Akinobu Fukumura

Abstract Contrast-enhanced computed tomographic scans of 30 patients with acute subarachnoid hemorrhage due to ruptured intracranial aneurysm were analyzed in relation to subarachnoid enhancement and clinical features. In 15 cases, subarachnoid enhancement was noted either early or late during the clinical progress of subarachnoid hemorrhage. In the positive group, hydrocephalus and cerebral infarction due to vasospasm frequently accompanied enhancement during the early stage of subarachnoid hemorrhage. The diffuse type of subarachnoid enhancement was most valuable for predicting cerebral infarction due to vasospasm. The authors review the literature on the pathogenesis of subarachnoid enhancement.


2009 ◽  
Vol 73 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Paolo Gaetani ◽  
Riccardo Rodriguez Baena ◽  
Vittorio Silvani ◽  
Federico Rainoldi ◽  
Pietro Paoletti

2019 ◽  
pp. 189-192
Author(s):  
Bruno Bertoli Esmanhotto ◽  
Elcio Juliato Piovesan ◽  
Marcos Christiano Lange

Thunderclap headache (TCH) is a head pain that begins suddenly and is severe at onset. TCH might be the first sign of subarachnoid hemorrhage. This study was conducted to evaluate the presence of thunderclap headache (TCH) in patients with ruptured intracranial aneurysm (RIA) and endovascular treatment (EVT). We evaluated the pattern of headache in 60 patients who suffered a RIA and EVT at time of admission and prospectively evaluated the characteristics of previous headache within one year before the rupture. Thirty-one patients (51,7 %) had TCH related to the rupture. Aneurysm size does not affect the occurrence of thunderclap headache (p=0,08). The vascular aneurysm territory is not related to presence of TCH (p=0,527). The prevalence of TCH in this cohort was similar to previous studies. All patients with acute thunderclap headache should be evaluated for subarachnoid hemorrhage.


2008 ◽  
Vol 2 (2) ◽  
pp. 145-148
Author(s):  
Takashi MITSUHASHI ◽  
Hidenori OISHI ◽  
Tatsuya NOMOTO ◽  
Kensaku YOSHIDA ◽  
Yasuyuki UEKI ◽  
...  

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