Serpentine aneurysm of the posterior cerebral artery treated by internal maxillary artery bypass followed by parent artery occlusion: a case report and literature review

AbstractSerpentine aneurysms of the posterior cerebral artery (PCA) treated by the internal maxillary artery (IMA) bypass are rare. Here, the authors report the case of a 34-year-old male patient who presented with a half-year history of gradual severe headache and right-sided limb monoparesis and paresthesia lasting for 1  week. Preoperative angiograms showed a serpentine aneurysm in the left distal PCA, which was treated with internal maxillary artery-radial artery-posterior cerebral artery (IMA-RA-PCA) bypass followed by parent artery occlusion (PAO). The postoperative course was uneventful; radiological images re vealed that the aneurysm disappeared, and there was good graft patency and excellent perfusion of the distal PCA territories. To the authors’ knowledge, this is the first and only case of distal PCA serpentine aneurysm to be treated by IMA-RA-PCA bypass followed by proximal PAO. These findings sug gest that IMA bypass surgery is a good and feasible treatment option for serpentine aneurysms of the PCA that can preserve the parent artery. Moreover, the anatomic segments of the PCA and different treatment options available for PCA serpentine aneurysms are also discussed in this study.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research

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In this study, we aimed to elucidate the clinical features, neuroimaging characteristics and pathogenesis of IJVS, and explore their possible correlations, in attempt to provide useful clues for clinical diagnosis and treatment. Forty-three eligible patients with unilateral or bilateral IJVS confirmed by contrast-enhanced magnetic resonance venography of the brain and neck were enrolled in this study. Magnetic resonance imaging along with magnetic resonance angiography or computed tomography angiography was applied to identify the radiological pattern of parenchymal or arterial lesions. Cerebral perfusion and metabolism we...
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: Thromb Haemost Source Type: research
CONCLUSIONS: Cerebral AVMs with transdural blood supply represent a rare and heterogeneous subgroup. Lesions can be graded by quantifying the transdural blood supply of the nidus and by capturing hemodynamic characteristics. The broad spread of angiographic features and comparable clinical patterns of patients with or without transdural blood supply raises questions about the relevance of the transdural blood supply to the natural history risk of an AVM and the intention for treatment.
Source: American Journal of Neuroradiology - Category: Radiology Authors: Tags: INTERVENTIONAL Source Type: research
We present a 64-year-old man with a 6-month history of severe, non-exertional headaches occurring with increasing frequency. A resting ECG showed ST elevation in the inferior leads. His serum troponin I was not elevated. Coronary angiography showed severe stenosis of his right coronary artery, which was successfully stented by percutaneous coronary intervention. He remains headache free at 2-year follow-up. PMID: 30337475 [PubMed - as supplied by publisher]
Source: Practical Neurology - Category: Neurology Authors: Tags: Pract Neurol Source Type: research
Conclusion Slow decompression with closed-system drainage is recommended to avoid rapid dynamic intracranial changes during drainage of a subdural hematoma, including brain shift or restoration of normal perfusion,to prevent devastating complications.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
Publication date: Available online 5 May 2017 Source:European Journal of Radiology Author(s): Pedro Vilela Stroke mimics (SM) are non-vascular conditions that present with an acute neurological deficit simulating acute ischemic stroke and represent a significant percentage of all acute stroke hospital admissions. The most common clinical SM includes conversion/functional (psychiatric disorder); seizures and postictal paralysis; toxic-metabolic disturbances; brain tumours; infections, and migraine. Imaging is essential for SM recognition, being Diffusion weighted imaging (DWI), perfusion imaging and angiographic studies ve...
Source: European Journal of Radiology - Category: Radiology Source Type: research
Conclusions: Hypoperfusion on ASLMRP and increased oxygen extraction fraction on SWI results derived for a patient presenting with TCB were demonstrated. Thus, we hypothesize that endothelin-related vasoconstriction is a pathophysiologic mechanism for TCB. To the best of our knowledge, this report is the first to describe ASLMRP and SWI findings in TCB after angiography.
Source: The Neurologist - Category: Neurology Tags: Case Report/Case Series Source Type: research
Conclusions:This case identifies a novel, potentially pathogenic mutation of the ATP1A2 gene corresponding to a phenotype of a rare migraine variant and contributes to our evolving understanding of migraine molecular genetics and pathophysiology.Study Supported by:Disclosure: Dr. Stredny has nothing to disclose. Dr. Winden has nothing to disclose. Dr. Danehy has nothing to disclose. Dr. Robertson has nothing to disclose. Dr. Trenor has nothing to disclose. Dr. Rivkin has nothing to disclose. Dr. Lehman has nothing to disclose. Dr. Bernson-Leung has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Child Neurology I Source Type: research
Conclusions:The patient’s transient cerebrovascular and electrophysiologic abnormalities are consistent with those described in the literature for hemiplegic migraine. However, he did not meet International Headache Society criteria for hemiplegic migraine, such as headache with presentation or recurrent events. We hypothesize that transient vascular narrowing and resultant hypoperfusion, compounded by cerebral hypoxia from significant anemia, may explain the transient neurologic symptoms concurrent with anemia in TEC.Disclosure: Dr. Calahan has nothing to disclose. Dr. Lehman has nothing to disclose. Dr. Rivkin has ...
Source: Neurology - Category: Neurology Authors: Tags: Child Neurology II Source Type: research
Conclusions: Headache in the early phase of ischemic stroke tends to occur less often in patients with atherosclerosis than in patients without atherosclerosis in the large cerebral arteries. This finding lends support to the hypothesis that vessel wall elasticity is a necessary contributing factor in the occurrence of headache during acute ischemic stroke.
Source: Neurology - Category: Neurology Authors: Tags: All Headache, CT, All Clinical Neurology, All Cerebrovascular disease/Stroke, Infarction ARTICLE Source Type: research
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