Cerebral Ischemia Complicating Intracranial Aneurysm: A Warning Sign of Imminent Rupture?

Guillon, Benoı̂t; Daumas‐Duport, Benjamin; Delaroche, Odile; Warin-Fresse, K.; Sévin, M.; Herisson, Fanny; Auffray-Calvier, E.; Desal, Hubert

doi:10.3174/ajnr.a2645

Cited by 23 publications

(24 citation statements)

References 21 publications

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“…Of note, the prevalence of aneurysms was considerably higher in women than in men, corresponding to sex-related differences in the general population,11 indicating that known general risk factors have a recognizable impact on the prevalence rates observed in our patient sample. In addition, aneurysms may sometimes be causally related to the stroke 16. Although this seemed to hold in only one of our cases, this association would also contribute to a higher prevalence of aneurysms in patients with LVO stroke.…”

Section: Discussionmentioning

confidence: 65%

Aneurysms in the target vessels of stroke patients subjected to mechanical thrombectomy: prevalence and impact on treatment

Zibold

Kleine

Zimmer

et al. 2015

J NeuroIntervent Surg

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The prevalence of aneurysms is relatively high in patients with LVO stroke, particularly in older, female, hypertensive patients, presumably reflecting overlapping risk factors. MTE should not be withheld from patients with LVO stroke with aneurysms, but particularly cautious approaches may be warranted. Further research in larger samples is required to obtain precise data on the prevalence and associated complication rates in MTE procedures. This is necessary to estimate the true risk and to tailor endovascular strategies in these patients.

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Section: Discussionmentioning

confidence: 65%

Aneurysms in the target vessels of stroke patients subjected to mechanical thrombectomy: prevalence and impact on treatment

Zibold

Kleine

Zimmer

et al. 2015

J NeuroIntervent Surg

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“…The one possible mechanism causing the transient neurological deficit was subsequent distal embolisation or parent vessel occlusion due to local extension from an intrasaccular aneurysmal thrombosis 9. The factors associated with aneurysmal thrombosis are the size, and particularly, the ratio of the chamber volume to the orifice area, blood stagnation, slow flow and increased blood viscosity 9. The aneurysmal size of the present case was less than 10 mm and the neck was narrow, so this condition was considered to be unlikely.…”

Section: Discussionmentioning

confidence: 70%

“…There has been no report which described improvement of such deficit due to a ruptured cerebral aneurysm in the short time during transportation from the scene to a local hospital. The one possible mechanism causing the transient neurological deficit was subsequent distal embolisation or parent vessel occlusion due to local extension from an intrasaccular aneurysmal thrombosis 9. The factors associated with aneurysmal thrombosis are the size, and particularly, the ratio of the chamber volume to the orifice area, blood stagnation, slow flow and increased blood viscosity 9.…”

Section: Discussionmentioning

confidence: 99%

Transient hemiparesis due to a ruptured cerebral aneurysm in the prehospital setting

et al. 2013

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A 67-year-old woman developed a sudden onset headache and left hemiparesis. Emergency medical technicians found that she was conscious, but had left hemiparesis. On arrival, she had an isolated headache without any neurological deficits, however, suddenly became comatose during a head CT examination, which demonstrated a subarachnoid haemorrhage. The head CT angiography on the second day revealed a cerebral aneurysm at the right middle cerebral artery, which was clipped on the same day. The patient demonstrated left haemiplegia and total aphasia after the operation, however, the neurological deficit gradually subsided and discharged on foot in 4 months without any deficits. Some patients with a subarachnoid haemorrhage may demonstrate transient neurological deficits, like those occurring during an ischaemic stroke, so emergency medical technicians and physicians should pay attention to treat such patients gently to avoid the re-rupture of a cerebral aneurysm, especially if the patient has headache symptoms.

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“…18) However, in the present case, we selected a strategy to treat the aneurysm in the chronic stage, taking priority over recovery-phase rehabilitation for the following reasons: since the locus of the aneurysm was the cavernous sinus, the risk of subarachnoid hemorrhage is lower than that of aneurysms in other sites, and her mRS grade was 4, which requires aggressive rehabilitation in the acute stage.…”

Section: Discussionmentioning

confidence: 99%

A Case of Embolic Stroke due to a Thrombosed Cerebral Aneurysm that Underwent Mechanical Thrombectomy

Yasuda

Toma

Nakatsuka

et al. 2017

JNET

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Objective: We report a case of embolic stroke due to a thrombosed cerebral aneurysm that underwent mechanical thrombectomy.Case Presentation: A 39-year-old female was brought to our hospital by an ambulance with sudden left hemiparesis and dysarthria. Detailed examination revealed a partially thrombosed aneurysm of the right internal carotid artery and embolism of the right middle cerebral artery. Emergent mechanical thrombectomy was performed, and thrombolysis in cerebral infarction (TICI) 2b recanalization was achieved. There was no other potential source of cerebral embolism, and the thrombosed aneurysm was considered an etiology for the embolism. After the endovascular treatment, antiplatelet and anticoagulant therapies were conducted, leading to the disappearance of the intra-aneurysmal thrombus. Conclusion:Mechanical thrombectomy is effective for embolic stroke due to an unruptured thrombosed cerebral aneurysm if devices are carefully manipulated in an area adjacent to the aneurysm.

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Cerebral Ischemia Complicating Intracranial Aneurysm: A Warning Sign of Imminent Rupture?

Abstract: BACKGROUND AND PURPOSE:Patients harboring nongiant cerebral aneurysms may rarely present with an ischemic infarct distal to the aneurysm. The aim of this case series was to report clinical and radiologic characteristics of these patients, their management, and outcome.

Cited by 23 publications

References 21 publications

Aneurysms in the target vessels of stroke patients subjected to mechanical thrombectomy: prevalence and impact on treatment

Aneurysms in the target vessels of stroke patients subjected to mechanical thrombectomy: prevalence and impact on treatment

Transient hemiparesis due to a ruptured cerebral aneurysm in the prehospital setting

A Case of Embolic Stroke due to a Thrombosed Cerebral Aneurysm that Underwent Mechanical Thrombectomy

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