Repair of Two Unruptured Intracranial Aneurysms in the Presence of Coarctation of the Aorta-Anesthetic Implications and Management

Orsi, Paolo; Rosa, Gian Marco; G, Liberatori; Pp, Lunardi; Ferrante, L

doi:10.1097/00008506-199301000-00008

Cited by 9 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The diagnosis of AC preceded in five cases (11.6%) the diagnosis of IA. 16,[19][20][21][22] The location of aneurysms was similar to that described for ruptured aneurysms in the Cooperative Study on the Timing of Aneurysm Surgery, 10 with the ACA being the most commonly affected vessel (40.8%). Multiple aneurysms occurred in six patients (13.9%).…”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

Intracranial aneurysms associated with unsuspected aortic coarctation

Mercado¹,

López²,

Cantú³

et al. 2002

Journal of Neurosurgery

View full text Add to dashboard Cite

Intracranial aneurysms (IAs) are found more often in patients with aortic coarctation (AC) than in the general population and aneurysm rupture occurs much earlier in the lives of these patients when there is coexistent AC. The diagnosis of AC is frequently made only after a serious cerebrovascular complication has developed. The aim of this paper is to call attention to AC in patients presenting with aneurysmal subarachnoid hemorrhage. The literature is reviewed, the key clinical features are highlighted, and the proposed pathogenesis of this association is discussed. The authors present clinical information and imaging data obtained in three young patients with ruptured IAs that were associated with initially unnoticed AC. Abnormal results of cardiovascular examinations led the authors to consider an underlying AC, which was later confirmed by aortography. These aneurysms were successfully treated prior to correction of the ACs. The diagnosis of AC should be considered in adolescent and young adult patients presenting with IAs.

show abstract

Section: Discussionmentioning

confidence: 93%

“…1,2,[4][5][6][7][8]11,14,16,17,[19][20][21][22][23] Table 1 shows the clinical and demographic features of the cases reported, including our three. There were 30 male and 13 female patients.…”

Section: Discussionmentioning

confidence: 99%

Intracranial aneurysms associated with unsuspected aortic coarctation

Mercado¹,

López²,

Cantú³

et al. 2002

Journal of Neurosurgery

View full text Add to dashboard Cite

show abstract

“…Two lines of thought suggest that there is either a common inherited predisposition for the two lesions 19 22 , or that both entities result from inadequately controlled hypertension 23,24 .…”

Section: Discussionmentioning

confidence: 99%

Subarachnoid Aneurysmal Hemorrhage Associated with Coarctation of the Aorta: Case Report and Review of the Literature

et al. 2017

View full text Add to dashboard Cite

Intracranial aneurysms (IAs) that undergo rupture causing subarachnoid hemorrhage (SAH), are common in young patients with coarctation of the aorta (CoA), but rarer in middle-aged and elderly patients. The pathogenesis of IAs associated with CoA remains unclear. We report the case of a 50-yearold woman who presented with SAH. On evaluation, six IAs were distributed among the anterior communicating artery (ACoA) (ruptured), distal segments of both anterior cerebral arteries (ACA), the left internal carotid artery (ICA), the bifurcation of the left middle cerebral artery (MCA)/MCA early branch, and the inferior trunk of the left MCA. CoA was also diagnosed. The ruptured ACoA IA, and two other unruptured IAs, were successfully clipped during emergency surgery. Postoperative intensive care was instituted to avoid cerebral vasospasm and renal or spinal cord ischemia. During the same hospitalization, the remaining three IAs were clipped at a second surgery. She was discharged with slight cognitive impairment eighty days after admission. Subsequently, she underwent elective treatment for the CoA. According to the literature, IAs associated with CoA have a higher tendency to involve the ACoA than IAs without CoA. Moreover, adult CoA patients tend to have multiple IAs, considered to be due to hypertension associated with CoA, as well as genetic predisposition. In CoA patients, ruptured IAs should be treated as early as possible before correction of the CoA. Close postoperative observation with management of cerebral vasospasm, renal or spinal cord ischemia, and respiratory compromise in the perioperative period is vital. (J Nippon Med Sch 2017; 84: 186 192)

show abstract

“…In patients with intracranial aneurysms, the incidence is estimated to range from 0.19 to 1.9% [1][2][3]. With an 4.8% incidence of aneurysm rupture as a cause of death, spontaneous SAH is far more common when compared to the general population [4].…”

Section: Introductionmentioning

confidence: 99%

“…Narrowing of the lumen of the aorta usually occurs distal to the origin of the left subcalvian artery leading to a high arterial pressure state in the arteries prior to that [5]. The main pathophysiologic mechanism leading to intracranial aneurysms in AC is arterial hypertension [2]; however, a developmental disorder of the neuronal chest has also been postulated [6]. In patients with AC autoregulatory mechanisms facilitate adequate perfusion to organs before and after the stenosis.…”

Section: Introductionmentioning

confidence: 99%