Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vertebral artery dissecting aneurysm (VADA) is a relatively rare cause of subarachnoid hemorrhage (SAH). Bilateral VADAs are even rarer, and there is no established treatment for this type of VADA. We report a case of bilateral VADAs with SAH. A 45-year-old man suddenly developed headache and consciousness disturbance and was referred to our hospital. CT scans demonstrated SAH mainly in the left cerebello-pontine cistern. Three dimensional computed tomographic angiography (3D-CTA) revealed fusiform dilatation of the bilateral vertebral arteries (VAs), suggesting dissecting aneurysms. The aneurysm on the left was larger in size than that on the right, and also had a bleb-like protrusion. Therefore, the left one was considered to be the cause of SAH. The patient was initially treated conservatively for one month to obtain spontaneous resolution of the aneurysms. On day 22, 3D-CTA revealed that the right VADA had decreased in size, however, the left VADA had slightly enlarged. On day 28, he underwent trapping of the ruptured left VADA. Postoperative course was uneventful. Occlusion of one VA may increase the hemodynamic pressure of the contralateral VA, inducing enlargement and subsequent rupture of the contralateral aneurysm. Therefore, both lesions of bilateral VADAs should be treated. However, if collateral blood flow through the posterior communicating artery is poor, occlusion of both VAs at the acute phase is considered to be intolerable. Therefore, waiting spontaneous resolution of the contralateral unnruptured dissecting aneurysm may be the treatment of choice for this type of lesion.
 ...
PMID:[Case of bilateral vertebral artery dissecting aneurysm presenting with subarachnoid hemorrhage]. 1936 30

A 58-year-old woman was admitted to our hospital with sudden onset of headache. CT and angiogram revealed subarachnoid hemorrhage due to a dissecting aneurysm at the left A1 segment. ACoA was not identified. We performed proximal clipping with A3-A3 bypass for preventing the recurrence of the hemorrhage and for reducing ischemia in the territory of the left ACA. After the operation, CT revealed the infarctions in the corpus callosum, the left medial frontal lobe and the genu of the internal capsule. But the postoperative angiogram demonstrated no aneurysm and the opacification of the recurrent artery of Heubner and the part of perforating branches. A3-A3 bypass was patent. The patient experienced a good recovery without recurrence of bleeding.
 ...
PMID:[A case of A3-A3 bypass and proximal clipping for a ruptured left A1 dissecting aneurysm]. 2022 71

A 30-year-old man was referred in our department for treatment of a midbasilar trunk aneurysm. His presenting symptoms included headache and dizziness. A CT scan at another hospital showed no significant findings whereas a digital subtraction angiogram disclosed a dissecting aneurysm in the midbasilar trunk, and there was severe stenosis in the basilar artery. After discussion, we planned to use stent-assisted-coil embolization technique. During the procedure, a LEO stent (Balt, Montmorency, France) was implanted into the basilar artery across the aneurysm neck, but fearing acute basilar artery occlusion because of stent collapse or thrombus we did not fill coils into the aneurysm. After the procedure, the completion angiography demonstrated considerably decreased flow into the aneurysm, with stasis persisting into the venous phase of angiography. The patient awoke from general anaesthesia after the procedure and had no additional neurological symptoms, he was discharged three days later and used clopidogrel and aspirin for antiplatelet therapy. Six months later when he was admitted for a recheck, a DSA showed the basilar artery was occluded completely and the aneurysm had disappeared even though the patient remained neurologically normal.
 ...
PMID:Delayed thrombosis of the basilar artery after stenting for a basilar trunk dissection aneurysm. A case report and review of the literature. 2037 83

A 61-year-old man presented with a ruptured vertebral artery dissecting aneurysm manifesting as severe headache, which was treated by internal trapping, and later resulted in recanalization of the affected vertebral artery without aneurysm recurrence. Computed tomography revealed subarachnoid hemorrhage caused by a dissecting right vertebral artery aneurysm located just distal to the origin of the posterior inferior cerebellar artery. The patient underwent uneventful internal trapping. However, recanalization of the affected vertebral artery with stenosis was found on the 22nd postoperative day, apparently caused by insufficient thrombosis related to the short trapping length. No aneurysm recurrence or ischemic events were detected, so the patient was observed carefully. After 4 months, right vertebral angiography revealed that the vertebral artery was normal with no stenosis or aneurysm. Restoration of the vertebral artery without complication probably occurred by complete thrombosis of the aneurysm followed by reconstruction of the injured arterial wall. We adopted a conservative approach in this case, but additional embolization and/or stenting should be considered if high risk of rebleeding is suggested by angiographic findings, although the management of recanalization remains controversial.
 ...
PMID:Internal trapping of a ruptured vertebral artery dissecting aneurysm followed by recanalization of the trapped vertebral artery without aneurysm recurrence: case report. 2103 Aug 4

A 60-year-old female presented with sudden onset of severe headache and back pain, followed by nausea. The initial head computed tomography (CT) scan revealed posterior fossa subarachnoid hemorrhage (SAH). Spinal T(2)-weighted magnetic resonance imaging demonstrated SAH, and a homogeneous and slightly low signal intensity mass at T11. Spinal angiography in the early arterial phase revealed a small pearl and string-like aneurysm of the proximal radiculomedullary artery on the left side at the T12 level. Forty days after the onset of SAH, CT angiography demonstrated complete occlusion of the dissecting aneurysm and the preserved anterior spinal artery. The present case of ruptured dissecting aneurysm of the radiculomedullary branch of the artery of Adamkiewicz with SAH underwent subsequent spontaneous occlusion, indicating that the wait-and-see strategy may be justified and will provide adequate treatment.
 ...
PMID:Dissection aneurysm of the radiculomedullary branch of the artery of Adamkiewicz with subarachnoid hemorrhage. 2194 30

A 65-year-old woman presented a rare dissecting aneurysm of the anterior temporal artery (ATA) manifesting as headache. Computed tomography and magnetic resonance imaging revealed a mixed-density mass in the horizontal segment of the middle cerebral artery. Emergent angiography demonstrated aneurysmal dilatation and a thrombosed mass in the sylvian fissure. Infectious aneurysm was excluded. She underwent emergent surgery to reduce the risk of repeated infarction and hemorrhage. The distal side of the ATA manifested occlusive changes suggestive of arterial dissection. The proximal side of the ATA was ligated and the lesion was excised. Histological examination confirmed that the aneurysmal dilatation was attributable to arterial dissection due to disruption of the internal elastic lamina. Distal dissecting aneurysms may occur in the absence of infectious disease. We recommend that ruptured distal dissecting aneurysms be treated surgically in the acute stage immediately after detection.
 ...
PMID:Dissecting aneurysm of the anterior temporal artery: case report. 2212 81

The authors report the rare case of a 58-year-old man with segmental arterial mediolysis (SAM) with associated intracranial and intraabdominal aneurysms, who suffered subarachnoid hemorrhage (SAH) due to rupture of an intracranial aneurysm. This disease primarily involves the intraabdominal arterial system, resulting in intraabdominal and retroperitoneal hemorrhage in most cases. The patient presented with severe headache and vomiting. The CT scans of the head revealed SAH. Cerebral angiography revealed 3 aneurysms: 1 in the right distal anterior cerebral artery (ACA), 1 in the distal portion of the A(1) segment of the right ACA, and 1 in the left vertebral artery. The patient had a history of multiple intraabdominal aneurysms involving the splenic, gastroepiploic, gastroduodenal, and bilateral renal arteries. He underwent a right frontotemporal craniotomy and fibrin coating of the dissecting aneurysm in the distal portion of the A(1) segment of the right ACA, which was the cause of the hemorrhage. Follow-up revealed no significant changes in the residual intracranial and intraabdominal aneurysms. An SAH due to SAM with associated multiple intraabdominal aneurysms is extremely rare. The authors describe their particular case and review the literature pertaining to SAM with associated intracranial and intraabdominal aneurysms.
 ...
PMID:Subarachnoid hemorrhage in a case of segmental arterial mediolysis with coexisting intracranial and intraabdominal aneurysms. 2238 2

A 79-year-old man with no history of trauma complained of a sudden onset of headache and backache. Computed tomography showed an isolated dissecting aneurysm 4 cm in diameter associated with contained rupture at the takeoff region of the brachiocephalic artery. Surgery was performed on an emergent basis. The proximal aortic arch was successfully replaced using antegrade selective cerebral perfusion. The patient was easily weaned from cardiopulmonary bypass and recovered uneventfully.
 ...
PMID:Isolated dissecting aneurysm of the brachiocephalic artery associated with contained rupture. 2245 Nov 45

We report an unusual case of lateral medullary infarction after successful embolization of the vertebral artery dissecting aneurysm (VADA). A 49-year-old man who had no noteworthy previous medical history was admitted to our hospital with a severe headache. Computed tomography (CT) revealed a subarachnoid hemorrhage, located in the basal cistern and posterior fossa. Cerebral angiography showed a VADA, that did not involve the origin of the posterior inferior cerebellar artery (PICA). We treated this aneurysm via endovascular trapping of the vertebral artery distal to the PICA. After operation, CT revealed post-hemorrhagic hydrocephalus, which we resolved with a permanent ventriculoperitoneal shunt procedure. Postoperatively, the patient experienced transient mild hoarsness and dysphagia. Magnetic resonance image (MRI) showed a small infarction in the right side of the medulla. The patient recovered well, though he still had some residual symptom of dysphagia at discharge. Such an event is uncommon but can be a major clinical concern. Further investigation to reveal risk factors and/or causative mechanisms for the medullary infarction after successful endovascular trapping of the VADA are sorely needed, to minimize such a complication.
 ...
PMID:A case of lateral medullary infarction after endovascular trapping of the vertebral artery dissecting aneurysm. 2263 14

A 35-year-old man presented with simultaneous occurrence of subarachnoid hemorrhage (SAH) and cerebral infarction (CI) caused by anterior cerebral artery (ACA) dissection. He complained of sudden onset of left frontal headache and his symptoms progressed to consciousness disturbance and right hemiparesis. Computed tomography and magnetic resonance imaging demonstrated SAH localized in the left interhemispheric fissure and CI in the territory of the left ACA. Right carotid angiography demonstrated a long double lumen sign at the left A2 to A4 segment of the left ACA, leading to a diagnosis of the combined type of CI and SAH caused by ACA dissection. Although many surgeons have previously tried to perform endovascular treatment, we selected only medication in this case, and his neurological findings gradually improved. Only 9 cases including the present case presented with simultaneous occurrence of SAH and CI caused by ACA dissection. Many of these patients showed stenosis with dilatation of ACA on carotid angiography. The prognoses of these patients were good. However, many SAH patients with dissecting aneurysm had poor prognoses. To improve the strategy for managing ACA dissection, we need to accumulate a greater number of such cases in the future. We also recommend that angiography should be performed in the patients with ACA dissection.
 ...
PMID:Anterior cerebral artery dissection presenting subarachnoid hemorrhage and cerebral infarction. 2268 60


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>