Journal of cerebrovascular and endovascular neurosurgery最新文献_第6页

Keyhole approach in anterior circulation aneurysm: Current indication, advantages, technical limitations, complications and their avoidance 锁眼入路治疗前循环动脉瘤的适应证、优势、技术限制、并发症及避免

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2022-03-10 DOI: 10.7461/jcen.2022.E2021.07.008

H. Prajapati, Ahmad Ansari, M. Jaiswal

{"title":"Keyhole approach in anterior circulation aneurysm: Current indication, advantages, technical limitations, complications and their avoidance","authors":"H. Prajapati, Ahmad Ansari, M. Jaiswal","doi":"10.7461/jcen.2022.E2021.07.008","DOIUrl":"https://doi.org/10.7461/jcen.2022.E2021.07.008","url":null,"abstract":"Keyhole surgery recently evolved as a minimal invasive surgical approach for treatment of anterior circulation aneurysm. This review was done to evaluate the keyhole approach for anterior circulation aneurysms, their indications, advantages, technical limitations, complications and their avoidance. The literature review was performed with the phrase “keyhole approach for anterior circulation aneurysm” as a search term in PubMed central, Medline, Google scholar and Embase data base to identify all the articles published till December 2020. Out of 113 articles searched, 22 were included in this review after screening for eligibility. On analyzing these articles, there was total 2058 aneurysm in 1871 patients. Out of 2058 aneurysm, 988 were ruptured and 547 unruptured. In 5 studies, which include 344 aneurysms in 344 cases, aneurysm ruptured or unruptured status was not specified. The most frequent aneurysm site was anterior communicating artery (n=573). The size of the aneurysm mentioned in most of the study was <15 mm. The rate of complete occlusion was ranged from 93.6-100%. The range of intra operative rupture (IOR) was 0-28.6%. The mean operative time was ranged from 70 min-5.34 hours as reported in 13 studies. Good outcome [Glasgow outcome scale (GOS): 4-5] were seen in 75-100% cases. The frontalis muscle weakness has been reported in 3 studies and ranged from 0-1.99%. Keyhole surgery can be a safe and effective treatment modality for treatment of a selected anterior circulation aneurysm. In the experienced hand it has certain advantages over standard pterional craniotomy.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":"24 1","pages":"101 - 112"},"PeriodicalIF":0.0,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47246995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical management of simultaneous supra- and infratentorial hemorrhages in a pediatric patient with multiple cavernomas 儿童多发性海绵状瘤同时幕上和幕下出血的外科治疗

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2022-02-28 DOI: 10.7461/jcen.2022.E2021.08.001

G. Tyagi, Abhay Sikaria, G. Birua, M. Beniwal, Dwarakanath Srinivas

{"title":"Surgical management of simultaneous supra- and infratentorial hemorrhages in a pediatric patient with multiple cavernomas","authors":"G. Tyagi, Abhay Sikaria, G. Birua, M. Beniwal, Dwarakanath Srinivas","doi":"10.7461/jcen.2022.E2021.08.001","DOIUrl":"https://doi.org/10.7461/jcen.2022.E2021.08.001","url":null,"abstract":"Multiple intracranial cavernomas are rare and occur mostly in familial cases. Clinical presentation with simultaneous rupture of two or more lesions has only been reported in four cases to date. A 15-year-old boy presented with simultaneous right frontal and superior vermian hematomas with hydrocephalus. The patient underwent a ventriculoperitoneal shunt, and his magnetic resonance imaging (MRI) revealed multiple cavernomas with bleed in the above-mentioned locations. The patient underwent a midline suboccipital craniotomy and excision of the cavernoma. The supratentorial lesions were left in situ in lieu of small size, no history of seizures, mass effect, or other neurological deficits. The patient recovered well from surgery with significant improvement in truncal ataxia. He remained asymptomatic for supratentorial lesions at follow-up. Cavernomas should be considered as differential diagnoses in cases of multiple intraparenchymal hemorrhages, especially in pediatric patients. The surgical management should be rationalized based on the lesion location, the eloquence of the surrounding parenchyma, mass effect, and the risks of re-rupture. Due to the rarity of multiple simultaneous hemorrhages, the management of multiple cavernomas remains controversial. The patient’s relatives can be screened with MRI to rule out the familial form of the disease. Strict clinical and radiological follow-up is a must in such patients.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":"24 1","pages":"263 - 266"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47456117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Type 1 Persistent Proatlantal Artery Originating from the External Carotid Artery Detected by Computed Tomographic Angiography 计算机断层扫描血管造影检测来源于颈外动脉的1型持续性寰前动脉

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2018-12-01 DOI: 10.7461/jcen.2018.20.4.231

Yunsuk Choi, Sang-Bong Chung, M. Kim

引用次数: 1

Coil Embolization of Ruptured Proximal Posterior Inferior Cerebellar Artery Aneurysm with Contralateral Retrograde Approach for LVIS Jr. Intraluminal Support Deployment 经对侧逆行入路螺旋栓塞治疗破裂的小脑后下动脉近端动脉瘤

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2018-12-01 DOI: 10.7461/jcen.2018.20.4.235

D. S. Kim, J. Sung, D. H. Lee, H. Yi

{"title":"Coil Embolization of Ruptured Proximal Posterior Inferior Cerebellar Artery Aneurysm with Contralateral Retrograde Approach for LVIS Jr. Intraluminal Support Deployment","authors":"D. S. Kim, J. Sung, D. H. Lee, H. Yi","doi":"10.7461/jcen.2018.20.4.235","DOIUrl":"https://doi.org/10.7461/jcen.2018.20.4.235","url":null,"abstract":"The safety and feasibility of simple coil embolization and stent deployment for the treatment of posterior inferior cerebellar artery (PICA) aneurysms, as well as their radiologic and clinical results, have not been adequately understood. Especially, if dissecting aneurysm of proximal PICA is associated with small caliber PICA and stenosis of ipsilateral vertebral artery orifice (VAO), endovascular coiling with saving of PICA is not always easy. This 64-year-old man presented with subarachnoid hemorrhage due to a ruptured dissecting aneurysm of left proximal PICA. The aneurysm was irregularly fusiform in nature with a shallow PICA orifice (1.4 mm) and narrow caliber (0.9–1.5 mm). Moreover, the ipsilateral VAO showed severe stenosis (1.8 mm). We performed bifemoral puncture and chose additional route from right vertebral artery to left vertebrobasilar junction for retrograde approach and deployment of LVIS Jr. intraluminal support at proximal PICA. And then, the antegrade approach and coiling of aneurysm was done. Despite of transient thrombus of PICA, the aneurysm was successfully secured with preservation of whole PICA course. For preservation of narrow PICA with ipsilateral VAO stenosis, the contralateral approach and deployment of LVIS Jr. intraluminal support may be considered.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":"20 1","pages":"235 - 240"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7461/jcen.2018.20.4.235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49158808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Delayed Monocular Blindness after Coil Embolization of Large Paraclinoid Aneurysm 大斜旁动脉瘤线圈栓塞后迟发性单眼失明

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2018-12-01 DOI: 10.7461/jcen.2018.20.4.241

Jaehong Han, Tae-Hun Kim, Jae-Sang Oh, Seok-Mann Yoon

{"title":"Delayed Monocular Blindness after Coil Embolization of Large Paraclinoid Aneurysm","authors":"Jaehong Han, Tae-Hun Kim, Jae-Sang Oh, Seok-Mann Yoon","doi":"10.7461/jcen.2018.20.4.241","DOIUrl":"https://doi.org/10.7461/jcen.2018.20.4.241","url":null,"abstract":"Treatment of paraclinoid aneurysms weather by surgery, or endovascular embolization has a risk of visual loss due to optic neuropathy, or diplopia due to cranial nerve palsies. Visual complications occur immediately after the clipping, whereas they can occur variable time after endovascular coiling. Recently, endovascular coiling for paraclinoid aneurysm is regarded as a safe and feasible treatment. But it still has risks of acute thromboembolic complication, or cranial nerve palsies. A 45-year-old woman was referred from local hospital to our hospital due to ruptured large ICA dorsal wall aneurysm. A total of 12 coils (195 cm) were used for obliteration of aneurysm. Postoperative diffusion weighted image showed no abnormal signal intensity lesion and magnetic resonance angiography demonstrated no sign of vasospasm, or vessel narrowing. But, she complained visual problem 23 days after coil embolization. Ophthalmologist confirmed the left optic disc atrophy on fundoscopy. Although steroid was started, but monocular blindness did not recover completely. The endovascular embolization of paraclinoid aneurysm, especially projecting superiorly with large irregular shape, has the risk of progressive visual loss because of the proximity to optic nerve.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":"20 1","pages":"241 - 247"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7461/jcen.2018.20.4.241","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43942116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spontaneous Aggressive Conversion of Venous Drainage Pattern in Dural Arteriovenous Fistula Treated with Onyx Embolization. 使用奥尼克斯栓塞术治疗硬脑膜动静脉瘘时静脉引流模式的自发积极转化

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2016-12-01 Epub Date: 2016-12-31 DOI: 10.7461/jcen.2016.18.4.396

Yeongu Chung, Seok Keun Choi, Sung Ho Lee, Eui Jong Kim

引用次数: 0