Cerebral Aneurysms

Brisman, Jonathan L.; Song, JiHyeon; Newell, David W.

doi:10.1056/nejmra052760

Cited by 837 publications

(597 citation statements)

References 79 publications

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“…Reported morbidity rates for clipping of unruptured aneurysms range from 4%e11% (1). Morbidity is often due to inadvertent ischemic injury from brain retraction, compromise of small perforating arteries during dissection, temporary arterial occlusion, or permanent clips impinging on the parent vessel or perforating arteries (20,24).…”

Section: Introductionmentioning

confidence: 99%

The Incidence of Unacceptable Movement with Motor Evoked Potentials During Craniotomy for Aneurysm Clipping

et al. 2014

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Section: Introductionmentioning

confidence: 99%

The Incidence of Unacceptable Movement with Motor Evoked Potentials During Craniotomy for Aneurysm Clipping

et al. 2014

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“…About 50% of patients die within one month after the event, and of those who survive more than one third have major neurologic deficits (Brisman et al, 2006;Schievink, 1997). Aneurysms are a common pathology only in human arteries and in some primates A c c e p t e d m a n u s c r i p t (Canham et al, 2006), and intracranial aneurysms are more prevalent in females than in males (Mettinger, 1982).…”

Section: Introductionmentioning

confidence: 99%

A theoretical model for fibroblast-controlled growth of saccular cerebral aneurysms

Kroon

Holzapfel

2009

Journal of Theoretical Biology

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A new theoretical model for the growth of saccular cerebral aneurysms is proposed by extending the recent constitutive framework of Kroon and Holzapfel (J. Theor. Biol., 247:775-787, 2007). The continuous turnover of collagen is taken to be the driving mechanism in aneurysmal growth. The collagen production rate depends on the magnitude of the cyclic deformation of fibroblasts, caused by the pulsating blood pressure during the cardiac cycle. The volume density of fibroblasts in the aneurysmal tissue is taken to be constant throughout the growth process. The growth model is assessed by considering the inflation of an axisymmetric membranous piece of aneurysmal tissue, with material characteristics representative of a cerebral aneurysm. The diastolic and systolic states of the aneurysm are computed, together with its load-free state. It turns out that the value of collagen pre-stretch, that determines growth speed and stability of the aneurysm, is of pivotal importance. The model is able to predict aneurysms with typical berry-like shapes observed clinically, and the predicted wall stresses correlate well with the experimentally obtained ultimate stresses of this type of tissue. The model predicts that aneurysms should fail when reaching a size of about 1.2-3.6 mm, which is smaller than what has been clinically observed. With some refinements, the model may, however, be used to predict future growth of diagnosed aneurysms.

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“…[1] The Acommm aneurysm is the most common location of cerebral aneurysms and it accounts for about 36% of aneurysms. [2] Among patients admitted to hospital in good clinical status for the treatment of ruptured Acommm aneurysm, about 80% have achieved favourable outcome. [3] About 46% of survivors after SAH may have cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

Anterior communicating artery aneurysm clipping versus coiling: a comparative study of 50 cases

Kumar¹,

Jain²,

Sinha³

et al. 2017

Romanian Neurosurgery

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Abstract:Introduction: Aneurysmal Subarachnoid Hemorrhage (aSAH) remains a devastating and often fatal form of stroke. The aneurysm is targeted for obliteration to prevent re-bleeding and to manage the possible complications from the event. Endovascular coiling has emerged as a less invasive alternative to conventional surgical clipping to treat aneurysms. Patients and methods: This study was done in 50 cases of anterior communicating (Acommm) aneurysm presented in the department of neurosurgery, SMS medical college, Jaipur from November 2015 to August 2016 to evaluate the outcome of both modalities used in the treatment of ruptured Acommm aneurysm. 50 patients with Hunt and Hess (H&H) grade I, II or III were classified into two groups of microsurgical clipping and endovascular coiling. Results: Mortality rate was comparable in both groups that were 21. 21% in the clipping group and 23. 52% in the coiling group. Good Glasgow outcome score (GOS) were found in 60. 60% of clipping and 58. 58% of coiling group. All the complications found to be more in clipping group but that were not statistically significant except for hyponatremia which was significantly higher in clipping group(P=0. 007). Conclusion: There was no statistically significant difference in GOS at 6 month of follow up between the two groups. We recommend further interventional studies with larger sample sizes and longer follow up for better evaluation of the modalities.

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Cerebral Aneurysms

Cited by 837 publications

References 79 publications

The Incidence of Unacceptable Movement with Motor Evoked Potentials During Craniotomy for Aneurysm Clipping

The Incidence of Unacceptable Movement with Motor Evoked Potentials During Craniotomy for Aneurysm Clipping

A theoretical model for fibroblast-controlled growth of saccular cerebral aneurysms

Anterior communicating artery aneurysm clipping versus coiling: a comparative study of 50 cases

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