Cerebral aneurysms

Adult polycystic kidney disease (APKD) is one of the most common autosomal dominant diseases, affecting about 1/1,000 whites. The key feature of this disease is the progressive accumulation of renal cysts, which ultimately culminate in kidney failure. APKD is responsible for approximately 10% of end-stage renal disease in North America. Patients may also have hypertension, cerebral aneurysms, liver cysts, and cardiac valvular defects. 

Akedo, Y., Oshima, M., Oishi, M., and Saga, T.,"Visualization of flow structure in cerebral aneurysm model", The 8th Asian Symposium on Visualization, Chiangmai, Thailand, ID46 (2005). 

Steinberg G. K., Bell-Stephens T., Shuer L. M., et al. (2003) Comparison of endovascular cooling to surface-cooling during unruptured cerebral aneurysm repair. Stroke 34, 246. 

Lopez J. R., Chang S. D., and Steinberg G. K. (1999) The utility of electrophysi-ological monitoring during microsurgery of cerebral aneurysms. J. Neurol. Neurosur. Ps. 66,189-196. 

Vascular conditions have been associated with ,-anti trypsin deficiency, including panniculitis (an ulcerative, necrotizing skin condition) and cerebral aneurysm, among others. 

Ruby RJ, Burton JR (1977). Acute reversible hemiparesis and hyponatremia. Lancet i 1212 Sabolek M, Bachus-Banaschak K, Bachus R et al. (2005). Multiple cerebral aneurysms as delayed complication of left cardiac myxoma a case report and review. Acta Neurology Scandinavica 111 345-350 Sacco RL, Kargman DE, Gu Q et al. (1995). Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction. The Northern Manhattan Stroke Study. Stroke 26 14-20 Salgado AV (1991). Central nervous system complications of infective endocarditis. 

The main clinical indications for imaging the cerebral circulation are TIA (e.g. to identify arterial stenosis), acute ischemic stroke (e.g. to identify vessel occlusion), intracerebral hemorrhage (e.g. to identify an underlying vascular malformation) and possible arterial dissection, flbromuscular dysplasia or other arteriopathies, cerebral aneurysm, intracranial venous thrombosis or cerebral vasculitis. 

Chappell ET, Moure FC, Good MC (2003). Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms a meta-analysis. Neurosurgery 52 624-631... 

Ruijs AC, Dirven CM, Algra A et al. (2005). The risk of rebleeding after external lumbar drainage in patients with untreated ruptured cerebral aneurysms. Acta Neurochirurgie 147 1157-1161... 

Slaba SG, El-Hajj LF, Abboud GA, Gebara VA. Selective angiography of cerebral aneurysm using gadodiamide in polycystic kidney disease with renal insufficiency. AJR Am J Roentgenol 2000 175(5) 1467-8. 

Gill JS, Zezulka AV, Horrocks PM. Rupture of a cerebral aneurysm associated with nifedipine treatment. Postgrad Med J 1986 62(733) 1029-30. 

Suxamethonium-induced fasciculation or increased muscle tone can be dangerous in patients with fractures or dislocations (especially vertebral, when the drug is relatively contraindicated), in patients with open-eye injuries or after the eyeball is opened surgically, when an increase in abdominal pressure must be avoided (pheochromocytoma, aortic aneurysm, full stomach, ileus), and in patients in whom a rise in arterial pressure may be catastrophic (cerebral aneurysm, raised intracranial pressure). Prolonged paralysis, occasionally lasting hours, is a risk if the patient is, or has been, taking certain drugs. 

Iwatsuki N, Kuroda N, Amaha K, Iwatsuki K. Succinylcholine-induced hyperkalemia in patients with ruptured cerebral aneurysms. Anesthesiology 1980 53(l) 64-7. 

Therapeutically, cellulose acetate has been used to treat cerebral aneurysms, and also for spinal perimedullary arteriovenous fistulas. 

Atrial myxoma is a rare atrial tumor that causes multiple emboli of either thrombus or myxomatous tissue. When myxomatous material is embolized from the left atrium into the brain arteries, they may cause the formation of multiple distal cerebral aneurysms with risk of hemorrhage [46]. Papillary fibroelastomas are rare benign cardiac tumors usually involving a heart valve. They are small vascular growths with marked papillary projections. They usually grow on the aortic or mitral valves. The tumor consists of fibrous tissue surrounded by an elastic membrane, which in turn is covered by endothelium. One of the most conunon clinical presentations is of transient ischemic attack or stroke [47,48]. 

Yavuz K, Geyik S, Pamuk AG et al. Immediate and midterm follow-up results of using an electrodetachable, fuUy retrievable SOLO stent system in the endovascular coU occlusion of widenecked cerebral aneurysms. J Neurosutg. 2(X)7 107 49-55... 

Farming, N. F., Berentei, Z., Brerman, P. R. Thornton, J. (2007) HydroCoil as an adjuvant to bare platinum coil treatment of 100 cerebral aneurysms. Neuroradiology, 49, 139-148. 

Molyneux, A. J., Cekirge, S., Saatci, I. Gal, G. (2004) Cerebral aneurysm multicenter European Onyx (CAMEO) trial results of a prospective observational study in 20 European centers. American Journal of Neuroradiology, 25, 39-51. 

For neurovascular use, the development of the Gugliemi detachable coil (GDC) without fibers was essential for treatment of intracerebral aneurysm [10]. This coil and subsequent variations remains the standard for occlusion of narrow neck aneurysms. Variations of the GDC coil continue to be developed for management of cerebral aneurysm and other narrow neck aneurysms throughout the body [11]. The downside to the widespread use of GDC type coils for occluding arteries and veins are their expense and lack of thrombogenicity [12]. 

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