Artery/arterial aneurysm

Methamphetamines indirectly cause side effects to many other areas of the body through their actions on the CNS. Concerning the heart, methamphetamine use can cause an increased and/or irregular heart rate heart pains that a user may believe is a heart attack (and may actually be a heart attack) skipped heart beats, or palpitations high or low blood pressure and the bursting of blood vessels in the heart called an arterial aneurysm. 

Atherothromboembolism ntracranial small vessel disease Leukoaraiosis Dissection (Table 6.4) Fibromuscular dysplasia Congenital arterial anomalies Moyamoya syndrome Embolism from arterial aneurysms Inflammatory vascular diseases Irradiation... 

Embolism from intra- and extracranial arterial aneurysms... 

Embolism from thrombus within the cavity of an aneurysm is rare and is difficult to prove in cases where there maybe other potential sources of embolization. Intracranial aneurysms more commonly present with rupture and subarachnoid hemorrhage, whereas internal carotid artery aneurysms tend to cause pressure symptoms including a pulsatile and sometimes painful mass in the neck or pharynx, ipsilateral Horner s syndrome or compression of the lower cranial nerves. Extracranial vertebral artery aneurysms may cause pain in the neck and arm, a mass, spinal cord compression and upper limb ischemia (Catala et al. 1993). 

Fig. 12.1. Digitally subtracted arterial angiograms showing a large distal internal carotid artery aneurysm (a) and a severe stenosis of the proximal internal carotid artery (b).

A ruptured middle cerebral artery aneurysm originating from the site of anastomosis 20 years after extracranial-intracranial bypass for moyamoya disease case report. Surgical Neurology 64 261-265... 

Approximately 85% of spontaneous SAHs are caused by ruptured aneurysm 10% are perimesencephalic and the remainder are caused by rare disorders (van Gijn and Rinkel 2001). The pattern of bleeding on CT is a clue to the underlying cause. Blood in the interhemispheric fissure suggests an anterior communicating artery aneurysm and in the sylvian fissure suggests internal carotid artery or middle cerebral artery aneurysm (Fig. 30.1). 

Fig. 30.1. These CT brain scans from a patient with a burst right middle cerebral artery aneurysm (arrow) show widespread subarachnoid blood, and rupture into the right cerebral hemisphere and the ventricular system.

Anosmia is a sequela in almost 30% of patients, particularly after surgery and anterior communicating artery aneurysms. 

Unruptured aneurysms not associated with SAH should normally be clipped or coiled if they are symptomatic, for instance if there is a third nerve palsy caused by a posterior communicating artery aneurysm (Fig. 30.2) (Raps et al. 1993). The optimal management of incidental unruptured asymptomatic aneurysms is unclear because the risk of rupture is... 

Percutaneous splenoportography has lost its importance. Should a direct procedure be indicated, laparoscopic splenoportography is a possible alternative. Recently, a new technique has been described. (134) The percutaneous splenic puncture is performed using a thin needle under screen control, with the needle directed at the splenic hilus. The pressure of the splenic pulp can be measured directly in order to estimate the portal vein pressure. Contrast medium is injected manually or by a special device. From this depot in the red pulp, the splenic vein, the portal vein and the intrahepatic branches of the portal vein are contrasted within a few seconds, (s. fig. 8.12) Complications resulting from percutaneous splenoportography include afterbleeding from the spleen, bilateral rupture of the spleen, arterial aneurysms and a.v. shunts — these complications are serious in nature, but rare. Contraindications for the procedure should be carefully observed, (s. tab. 8.6)... 

Liou, T.-C., Ling, C.-C., Pang, K.-K. Liver abscess concomitant with hemobilia due to rupture of hepatic artery aneurysm a case report. Hepato-Gastroenterol. 1996 43 241-244... 

Countryman, D., Norwood, S., Raster, D., Torma, M., Andrassy, R. Hepatic artery aneurysm report of an unusual case and review of the literature. Amer. Surg. 1983 49 51—54... 

G. Hepatic artery aneurysm, an unusual cause of obstructive jaundice MR cholangiography findings. Abdom. Imag. 2003 28 835-837... 

Zachary, K., Geier, S., Pellecchia, C, Irwin, G. Jaundice secondary to hepatic artery aneurysm radiological appearance and clinical features. Amer. J. Gastroenterol. 1986 81 295 - 298... 

Pajewski M, Modai D, Wisgarten J, Freund E, Manor A, Starinski R. Iatrogenic arterial aneurysm associated with ergotamine therapy. Lancet 1981 2(8252) 934-5. 

A coronary artery aneurysm occurred in a 49-year-old man 1 month after successful percutaneous transluminal coronary recanalization with streptokinase (12). 

Chen MF, Liau CS, Lee YT. Coronary arterial aneurysm after percutaneous transluminal coronary recanalization with streptokinase. Int J Cardiol 1990 28(1) 117-19. 

ADPKD families haye a strong family history of intracranial artery aneurysm rupture. Hypertension is an early and frequent manifestation and gross hematuria is a common presenting symptom. 

J. Ge, F. Liu, P. Kearney, G. Gorge, M. Haude, D. Baumgart, M. Ashry and R. Erbel, Intravascular ultrasound approach to the diagnosis of coronary artery aneurysm, Am Heart J130, 765-771 (1995). 

Konishi N, Baba K, Abe J, Maruko T, Waki K, Takeda N, Tanaka M A case of Kawasaki disease with coronary artery aneurysms documenting Yersinia pseudotuberculosis infection. Acta Paediatr 1996 86 661-664. 

The above findings confirm that exposure to PSCI RCAs by airborne dispersion or by contamination in solution produce abrupt and marked increases in SBP and DBP, with resolution within about 0.5 h of the start of exposure. The magnitude and duration of the changes can be tolerated without significant medical hazards in healthy individuals. However, as with other stressful situations, some susceptible individuals may be at increased risk from the induced transient hypertensive episode this will include those with essential hypertension, established myocardial infarction and coronary artery disease, cardiac arrhythmias and arterial aneurysms (Ballantyne, 1977a, 1987 Ballantyne and Salem, 2004). 

M.J. Bratby, E.D. Lehmann, J. Bottomley, et al. Endovascular embolization of visceral artery aneurysms with ethylene-vinyl alcohol (Onyx) a case series. Cardiovascular and Interventional Radiology. 2006 29 1125-1128. 

Lohani, B. (2004) Fusiform middle cerebral artery aneurysm. Journal of Neuroscience, 1,... 

Kasirajan K, Greenberg RK, Clair D, Ouriel K (2001) Endovascular management of visceral artery aneurysm. J Endovasc Ther 8 150-155... 

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