摘要
Owing to the rapid development of intervention techniques and devices, endovascular coil embolization of cerebral arteries has become standardized. It is particularly preferred when a patient presents with an unruptured intracranial aneurysm of the posterior communicating artery (PcomA). However, the risk of thrombogenic complications of the coil migration may also result in a large cerebral infarction. When coil migration occurs during embolization, a procedure for removal of the embolic coil should be performed immediately. We experienced a clinically rare case of migration of a framing coil to the distal middle cerebral artery aneurysm during endovascular embolization of an unruptured PcomA aneurysm. The migrated coil was barely retrieved using snare techniques.
Subject(s)
Humans , Aneurysm , Arteries , Cerebral Arteries , Cerebral Infarction , Embolization, Therapeutic , Intracranial Aneurysm , SNARE Proteins摘要
The pathogenesis of spontaneous cervicocephalic arterial dissection is still incompletely understood. The clinical presentation of the arterial dissection depends on the plane where the dissection occurred in the arterial wall. When the outer media or subadventitia is dissected, the intramural hematoma bulges outward to make dissecting aneurysm. When located in the subintima or inner media, the intramural hematoma produces narrowing or occlusion of the vessel lumen. Authors review etiopathogeness, clinical features, diagnosis and management of cerviococephalic arterial dissection.
Subject(s)
Aortic Dissection , Brain Ischemia , Diagnosis , Hematoma , Subarachnoid Hemorrhage , Vertebral Artery摘要
Patients who are devastated neurologically or medically after aneurysmal subarachnoid hemorrhage(SAH) are described as 'poor grade' patients. More recent studies have documented that the initial hemorrhage is by far the most important determinant of outcome after aneurysmal subarachnoid hemorrhage. This review mainly includes hemodynamics and suspected mechanisms of acute brain injury after aneurysmal SAH, particularly in special reference to increased intracranial pressure and cerebral ischemia during and after SAH.