Abstract:
BACKGROUND:The treatment of giant fusiform middle cerebral artery (MCA) aneurysms remains daunting owing to their tendency to be associated with precarious end-vessel anatomy and the need for complex microsurgical techniques to appropriately address the aneurysm and the vasculature at risk. Extracranial-intracranial bypass revascularization remains a valuable tool for treating these complex lesions. In the present report, we have described a rare occurrence in which the creation of a double-barrel superficial temporal artery (STA-MCA) bypass facilitated spontaneous obliteration of the aneurysm. We have also highlighted our decision-making process, which was affected by operating in a low-to-middle income country with limited resources. CASE DESCRIPTION:A 32-year-old man had presented with recurrent ischemic events in the left MCA distribution and subsequent subarachnoid hemorrhage due to rupture of a giant complex fusiform MCA aneurysm. The patient underwent double-barrel STA-MCA bypass and was scheduled for second-stage clip reconstruction or partial trapping. Postoperative imaging studies revealed progressive thrombosis of the M1 segment, resulting in occlusion of the aneurysm without subsequent trapping or clipping. The patient recovered remarkably without further repeat hemorrhage or ischemic injury. We also reviewed the reported data. CONCLUSIONS:Double-barrel STA-MCA bypass is a potential salvage surgical technique to treat selected ruptured complex giant fusiform MCA aneurysms. In rare selected cases, the flow alteration induced by the bypass alone can potentially facilitate aneurysm thrombosis.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Huynh TD,Felbaum DR,Jean WC,Ngo HMdoi
10.1016/j.wneu.2020.01.047subject
Has Abstractpub_date
2020-04-01 00:00:00pages
161-168eissn
1878-8750issn
1878-8769pii
S1878-8750(20)30055-3journal_volume
136pub_type
abstract:BACKGROUND:Intracranial mycotic aneurysms are uncommon. They can occur due to extravascular extension or intravascular seeding of the vessel wall. They often result in subarachnoid hemorrhage with poor prognosis. We present a rare case of subarachnoid hemorrhage due to vertebral artery dissection with aproximal anterio...
journal_title:World neurosurgery
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更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:An aneurysm embedded in a pituitary adenoma is rare, and treatment for both the aneurysm and pituitary adenoma is complex and controversial. CASE DESCRIPTION:A 53-year-old woman presented with a visual field defect. Magnetic resonance imaging showed a pituitary adenoma and coexistence of an aneurysm located...
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abstract:BACKGROUND:Advances in acute and long-term poststroke care have resulted in improved survival and functional outcomes for patients who have suffered large vessel ischemic strokes. For years, tissue plasminogen activator was the mainstay of treatment for acute stroke. Its use was previously limited to patients without k...
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abstract:OBJECTIVE:To report a series of four patients with uterine sarcoma, including one with müllerian adenosarcoma (MA) and three with low-grade endometrial stromal sarcoma (LGESS), who developed intracranial meningiomas while receiving the progesterone agonist megestrol acetate. METHODS:The hospital records, imaging studi...
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doi:10.1016/j.wneu.2019.08.062
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更新日期:2017-11-01 00:00:00
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更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:The coexistence of a gangliocytoma and a pituitary adenoma is a rare event that has been reported in only case reports. The knowledge of its diagnosis and treatment is extremely limited. CASE DESCRIPTION:We present a rare case of intrasellar-suprasellar gangliocytoma and nonfunctioning pituitary adenoma. Th...
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doi:10.1016/j.wneu.2017.05.064
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doi:10.1016/j.wneu.2010.09.018
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Adenocarcinomas of müllerian origin are malignancies derived from tissues of the proximal third of the vagina, cervix, uterus, and fallopian tubes. These organs develop from the embryologic müllerian ducts. While reports of perineural spread of certain uterine and cervical carcinomas exist in the literature,...
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doi:10.1016/j.wneu.2020.06.121
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:We sought to analyze the clinical data and imaging features from a rare case presenting an intravertebral mobile nerve sheath tumor of the lumbar spine, review the relevant literature, discuss the imaging features and possible causes of the tumor, and propose preventive measures and solutions. CASE DESCRIPT...
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更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to develop and validate a nomogram to predict overall survival (OS) for adult patients with primary intramedullary spinal cord grade II/III ependymoma (PISCGE). We also elucidated the effectiveness of postoperative radiotherapy for this disease. METHODS:Clinical data of patient...
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doi:10.1016/j.wneu.2015.02.003
更新日期:2015-06-01 00:00:00
abstract::Traumatic atlantoaxial dislocation without associated odontoid fracture or neurologic deficit is rare. We present the case of a 39-year-old male pedestrian who was struck by a vehicle and sustained a traumatic grade 4 C1-2 retrolisthesis. Closed reduction was successful, and the patient underwent posterior occipitocer...
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doi:10.1016/j.wneu.2018.02.171
更新日期:2018-06-01 00:00:00
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doi:10.1016/j.wneu.2019.12.100
更新日期:2020-03-01 00:00:00
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更新日期:2015-09-01 00:00:00
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更新日期:2020-08-01 00:00:00
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更新日期:2020-11-13 00:00:00
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更新日期:2020-06-01 00:00:00