scholarly journals Treatment Strategies for Infectious Intracranial Aneurysms: Report of Three Cases and Review of the Literature

2019 ◽  
Vol 59 (9) ◽  
pp. 344-350 ◽  
Author(s):  
Kazuhiro ANDO ◽  
Hitoshi HASEGAWA ◽  
Bumpei KIKUCHI ◽  
Shoji SAITO ◽  
Jotaro ON ◽  
...  
2020 ◽  
Vol 21 (14) ◽  
pp. 1072-1078
Author(s):  
Walter Milano ◽  
Paola Ambrosio ◽  
Francesca Carizzone ◽  
Walter Di Munzio ◽  
Valeria De Biasio ◽  
...  

: Childhood obesity has assumed epidemic proportions and is currently one of the most widespread public health problems. Many are the factors involved in the pathogenesis of excess weight with interactions between genetic, environmental and biological factors and therefore, also the therapeutic approach must be multidisciplinary and multidimensional. In this review of the literature, we report the contiguity of childhood obesity with eating disorders and the importance of involving the family context in order to induce stable lifestyle changes, both in relation to dietary and nutritional habits, but also in increasing physical activity. Finally, among the therapeutic options, although for selected cases, pharmacotherapy and bariatric surgery can be used as treatment strategies.


2015 ◽  
Vol 21 (6) ◽  
pp. 769-773 ◽  
Author(s):  
Xianli Lv ◽  
Zhongxue Wu

Objective The purpose of this study is to describe anatomic variations of the internal jugular vein (IJV), inferior petrosal sinus (IPS) and their confluence pattern and implications in IPS catheterization. The anatomic route of IPS after going out of the cranium and its confluence patterns with IJV and will supply knowledge about typing of IPS-IJV junction. Method A review of the literature was performed. Results There might be different routes for entering the intracranial segment of the IPS and multislice spiral computed tomography (MSCT) is effective in identifying the confluences of the IPS with the IJV and their courses. It is important to find the confluence of IPS with IJV for diagnosis and treatment of intracranial lesions via venous route. Meanwhile, IPS diameter at the confluence can significantly affect success of catheterization. Conclusion The classification and the theory of the development of the caudal end of the IPS may be useful in establishing treatment strategies that involve endovascular manipulation via the IPS.


2013 ◽  
Vol 6 (5) ◽  
pp. 353-356 ◽  
Author(s):  
Ramesh Grandhi ◽  
Nathan T Zwagerman ◽  
Guillermo Linares ◽  
Edward A Monaco ◽  
Tudor Jovin ◽  
...  

2017 ◽  
Vol 11 (10) ◽  
pp. 497-503
Author(s):  
Hajime Nakamura ◽  
Toshiyuki Fujinaka ◽  
Takeo Nishida ◽  
Tomohiko Ozaki ◽  
Katsunori Asai ◽  
...  

2018 ◽  
Vol 21 (5) ◽  
pp. 471-477 ◽  
Author(s):  
Jeewaka E. Mohotti ◽  
Nicole S. Carter ◽  
Victor Jia Wei Zhang ◽  
Leon T. Lai ◽  
Christopher Xenos ◽  
...  

Intracranial aneurysms in the neonate, presenting in the first 4 weeks of life, are exceedingly rare. They appear to have characteristics, including presentation and location, that vary from those found in adults. The authors present a case of a 28-day-old neonate with a ruptured distal middle cerebral artery (MCA) aneurysm. Initial noninvasive imaging with transfontanelle ultrasound and CT confirmed intraparenchymal and subarachnoid hemorrhage. Contrast-enhanced MRI revealed a 14-mm ruptured fusiform MCA aneurysm that was not identified on time-of-flight magnetic resonance angiography (MRA). Microsurgical treatment was performed with partial neurological recovery. A comprehensive review of the literature from 1949 to 2017 revealed a total of 40 aneurysms in 37 neonates, including the present case. The most common presenting symptom was seizure. Although subarachnoid hemorrhage was the most common form of hemorrhage, 40% had intraparenchymal hemorrhage. The median aneurysm size was 10 mm (range 2–30 mm) and the most common location was the MCA, with two-thirds of cases involving the distal intracranial vasculature. Over the last 10 years, there has been a trend of increasing noninvasive diagnosis of ruptured cerebral aneurysms in neonates, with CT angiography and contrast-enhanced MRI being the most useful diagnostic modalities. The use of contrast-enhanced MRI may improve sensitivity over time-of-flight MRA. Microsurgical treatment was the most common treatment modality overall, with increased use of endovascular treatment in the last decade. Most patients underwent microsurgical vessel ligation or endovascular parent vessel occlusion. There were high rates of neurological recovery after microsurgical or endovascular treatment, particularly for patients with distal aneurysms.


2021 ◽  
pp. 0271678X2110574
Author(s):  
Basil E Grüter ◽  
Fabio von Faber-Castell ◽  
Serge Marbacher

The development of new treatment strategies for intracranial aneurysms (IAs) has been and continues to be a major interest in neurovascular research. Initial treatment concepts were mainly based on a physical-mechanistic disease understanding for IA occlusion (lumen-oriented therapies). However, a growing body of literature indicates the important role of aneurysm wall biology (wall-oriented therapies) for complete IA obliteration. This systematic literature review identified studies that explored endovascular treatment strategies for aneurysm treatment in a preclinical setting. Of 5278 publications screened, 641 studies were included, categorized, and screened for eventual translation in a clinical trial. Lumen-oriented strategies included (1) enhanced intraluminal thrombus organization, (2) enhanced intraluminal packing, (3) bridging of the intraluminal space, and (4) other, alternative concepts. Wall-oriented strategies included (1) stimulation of proliferative response, (2) prevention of aneurysm wall cell injury, (3) inhibition of inflammation and oxidative stress, and (4) inhibition of extracellular matrix degradation. Overall, lumen-oriented strategies numerically still dominate over wall-oriented strategies. Among the plethora of suggested preclinical treatment strategies, only a small minority were translated into clinically applicable concepts (36 of 400 lumen-oriented and 6 of 241 wall-oriented). This systematic review provides a comprehensive overview that may provide a starting point for the development of new treatment strategies.


2020 ◽  
Vol 163 (2) ◽  
pp. 293-301
Author(s):  
Matthew Bartindale ◽  
Jeffrey Heiferman ◽  
Cara Joyce ◽  
Douglas Anderson ◽  
John Leonetti

Objective To evaluate facial nerve outcomes of various management strategies for facial schwannomas by assimilating individualized patient data from the literature to address controversies in management. Data Sources PubMed–National Center for Biotechnology Information and Scopus databases. Review Methods A systematic review of the literature was performed for studies regarding facial schwannomas. Studies were included if they presented patient-level data, type of intervention, pre- and postintervention House-Brackmann (HB) grades, and tumor location by facial nerve segment. Results Individualized data from 487 patients were collected from 31 studies. Eighty (16.4%) facial schwannomas were managed with observation, 25 (5.1%) with surgical decompression, 20 (4.1%) with stereotactic radiosurgery, 225 (46.2%) with total resection, and 137 (28.1%) with subtotal resection/stripping surgery. Stripping surgery/subtotal resection with good preoperative facial nerve function maintained HB grade 1 or 2 in 96% of cases. With a total resection of intradural tumors, preoperative HB grade did not significantly affect facial nerve outcome (n = 45, P = .46). However, a lower preoperative HB grade was associated with a better facial nerve outcome with intratemporal tumors (n = 56, P = .009). When stereotactic radiosurgery was performed, 40% of patients had improved, 35% were stable, and 25% had worsened facial function. Facial nerve decompression rarely affected short-term facial nerve status. Conclusion The data from this study help delineate which treatment strategies are best in which clinical scenarios. The findings can be used to develop a more definitive management algorithm for this complicated pathology.


2019 ◽  
Vol 80 ◽  
pp. 101892 ◽  
Author(s):  
Daniel H. Schanne ◽  
Jana Heitmann ◽  
Matthias Guckenberger ◽  
Nicolaus H.J. Andratschke

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