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Brain Aneurysm - Crossref

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Last Updated: 10 May 2022

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Sphenoparietal sinus transposition technique: optimization of the surgical corridor with preservation of prominent bridging veins between the brain and the cranial base during aneurysm clipping via the pterional approach

With the incision of the dura propria from the base of the temporal layer to just before the ICA's distal dural ring, the authors perform extradural anterior clinoidectomy with peeling of the temporal dura propria from the periosteal dura propria's inner cavernous membrane around the superior orbital fissure. Brain retraction for the expanding surgical space was limited in 8 patients in whom the bridging segments of the sylvian veins between the brain and the skull base prevented brain retraction for brain expansion. After the SPST procedure was applied, the mean surface area of the lateral retroced space and aneurysm was much increased from 18. 3 18. 8 and 2. 8 cm 2 before to 64. 2 20. 8 cm 2 and 20. 6 20. 6 cm 2 respectively.

Source link: https://doi.org/10.3171/2020.1.jns192823


Temporary occlusion of the middle cerebral artery in intracranial aneurysm surgery: time limitation and advantage of brain protection

During microsurgical dissection of middle cerebral artery aneurysms, the danger of focal infarction secondary to the reversible arrest of local arterial flow was assessed further to determine the correct route to temporary arterial occlusion. Overall infarction rate was 24. 4 percent, with 15. 8% in the IVBP group versus 45. 5% in the group that did not receive brain protection. Patients without infarction were 3. 9 2. 2 minutes, compared to 12. 2 4. 3 minutes for patients with focal infarction, according to the NBP group. Inffarction was seen in five of the five patients in the IVBP group's five patients with occlusion lasting ten minutes or longer than five in the IVBP group. Patients with multiple aneurysms were found to be at an elevated risk of experiencing focal infarction, whereas those treated with intermittent temporary clip application were at a reduced risk. Patients in whom focal iatrogenic ischemia is induced during MCA aneurysm clip ligation have a significant advantage over those receiving isoflurane, particularly if more than 10 minutes of occlusion time is required. Before specific recommendations can be made, intermittent temporary arterial occlusion and its use in patients with multiple aneurysms need to be investigated.

Source link: https://doi.org/10.3171/jns.1997.87.6.0817


Rapid development of an intranidal aneurysm with perifocal brain edema in an unruptured cerebral arteriovenous malformation

The authors explore the case of a 22-year-old man with unruptured arteriovenous malformation in which an intranidal aneurysm had developed in the course of 3 months and was complicated by perceptive brain edema. On magnetic resonance imaging, A left parietal AVM was mistakenly diagnosed on magnetic resonance imaging. Perceptive brain edema had been found on T2-weighted MR imaging three months ago. The perceptocal brain edema was confirmed by an MR image obtained 2 weeks aftersurgery. This is the first reported case of unruptured AVM in which an intranidal aneurysm with perceptive brain edema accelerated.

Source link: https://doi.org/10.3171/jns.2002.97.6.1436


Brain monoamine metabolites and tryptophan in ventricular CSF of patients with spasm after aneurysm surgery

After an operation for intracranial arterial aneurysm in 20 patients, the intraventricular pressure was monitored continuously. Patients with no clinical or angiographic signs of spasm, hydrocephalus, or elevated intracranial pressure were excluded from controls. HVA, tryptophan, and 5-HIAA in the tests were 264 40, 1116 85, and 88 8 ng/ml, respectively, and 182 89, and 78 93, respectively, in the patients with spasm. However, the poor results of HVA may have been caused by ischemic changes caused by the spasm. CSF tryptophan levels were statistically significant, with 5-HIAA levels higher than in controls in hydrocephalic patients, with insulin levels significantly higher than in controls. Neither changes nor intercorrelations of monoamine metabolites and tryptophan were found in patients with elevated ICP. The findings do not provide evidence pointing to prophylactic neuropharmacological therapy of postoperative arterial spasm.

Source link: https://doi.org/10.3171/jns.1978.48.1.0058

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions