Posts Tagged ‘aneurysm’
Background and Importance: Olfactory tract dysfunction due to an unruptured intracranial aneurysm is rare. We present a case in which a patient with impaired olfaction related to bilateral internal carotid artery aneurysms experienced subjective and quantitative objective improvement of olfactory sensation after treatment of ophthalmic segment aneurysms with flow diversion.
Clinical Presentation: A 44-year-old woman presented with hyposmia and bilateral ophthalmic segment internal carotid artery aneurysms. The symptom of hyposmia, worsening over a period of several months, was suspected to be due to mass effect from bilateral unruptured ophthalmic segment aneurysms pressing on the olfactory tracts. Each aneurysm was treated with a Pipeline embolization device (PED). Follow-up angiography at five months showed occlusion of both aneurysms. The patient experienced subjective improvement in olfaction and complete objective resolution of her hyposmia as measured by the validated University of Pennsylvania Smell Identification Test (UPSIT).
Background: The anterior choroidal artery (AChA) supplies important areas of the nervous system, particularly the posterior limb of the internal capsule and optic radiation. Treatment of AChA aneurysms poses particular challenges due to the complex anatomy of the aneurysm associated with the relatively small diameter of AChAs, making preservation of the parent vessel during clip ligation or endosaccular coiling challenging.
Objective: To investigate the incidence and features of ischemia in treatment of AChA aneurysms.
Methods: A prospectively maintained database of patients who underwent treatment of aneurysms from 1985 to 2011 was queried to find patients with AChA aneurysms. Age, gender, Hunt Hess grade, treatment modality, and complications were analyzed using unpaired Student t test and Fisher’s exact test.
Background: Specific morphological factors contribute to the hemodynamics of the Anterior Communicating Artery (AComA). No study has examined the role of the A2 segment on AComA aneurysm presence and rupture.
Objective: To examine the possibility that the ratio between A1 and A2 segments (A1-2 Ratio) represents an independent risk factor for presence and rupture of AComAAs.
Methods: A retrospective review of an institutional aneurysm database was performed; patients with ruptured and unruptured AComAAs were identified. Two control groups were selected: Group A (posterior circulation aneurysms) and Group B (patients without intracranial aneurysms or other vascular malformations). Measurements of A1 and A2 diameters were obtained from DSA (64.1% of 3D rotational DSA), and the A1-A2 ratio calculated.
Background: The middle cerebral artery (MCA) is the most frequent location for unruptured intracranial aneurysms. Controversy remains as to which unruptured MCA aneurysms should be treated prophylactically.
Objective: To identify independent topographical and morphological variables that could predict increased rupture risk of MCA aneurysms.
Methods: A retrospective analysis of CT angiography (CTA) data of 1009 consecutive patients with 1309 MCA aneurysms, referred between 2000 and 2009 to Helsinki University Hospital, was carried out. Morphological and topographical parameters examined for MCA aneurysms comprised aneurysm wall regularity, size, neck width, aspect ratio (AR), bottleneck factor (BNF), height-width ratio, location along MCA, side, distance from internal carotid artery (ICA) bifurcation and dome projection in axial and coronal CTA views. Univariate and multivariate logistic regression analysis were performed to determine independent risk factors for rupture.
Background: Detection of procedural thromboembolism by diffusion-weighted MRI (MR-DWI+) can help identify and mitigate endovascular risk factors. Data remain scant on procedural MR-DWI+ following use of the Neuroform open-cell design stent in aneurysm embolization.
Objective: We sought to evaluate the incidence of MR-DWI+ in Neuroform simple and multi-stent construct stenting for intracranial aneurysms in a bid to delineate baseline risk and identify possible associated procedural factors.
Methods: 76 patients receiving 97 Neuroform stents in the treatment of intracranial aneurysm were identified from a prospective database and eligible for inclusion in the study. MR-DWI was obtained in all patients within 48 hours of the procedure and reviewed for the presence of MR-DWI+ with patient records reviewed for analysis of factors predisposing to these lesions.