Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0220723 (PCA)
 4,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three hundred sixty-four patients who suffered a subarachnoid hemorrhage from an aneurysm at either the anterior (ACA) or posterior (PCA) communicating artery location and who were not surgically treated have been followed for up to 21 years in order to study the late morbidity and mortality. For patients surviving six months: (1) little improvement in morbidity was noted during the many years of subsequent follow-up; (2) in general, ACA patients fared better than PCA patients; (3) the neurological state on original admission was strongly correlated with the degree of morbidity; (4) other factors measured at time of original hemorrhage which adversely affected morbidity included the level of blood pressure or the presence of clot or spasm; (5) if deaths from late hemorrhage are excluded, cardiovascular causes account for the majority of subsequent deaths; and (6) the risk of dying from all causes is increased when compared to a population matched by age and sex.
 ...
PMID:The long-term prognosis in untreated cerebral aneurysms: II. Late morbidity and mortality. 73 25

A case of fibromuscular dysplasia (FMD) with intra- and extracranial multiple aneurysms is reported. A 42-year-old woman was admitted to Kagawa Central Hospital with severe headache and stiffness of the neck. CT scan showed subarachnoid hemorrhage predominantly in the left side of the basal cisterns and hydrocephalus. Angiography at admission revealed marked stenosis and dilatation of the extracranial major arteries and multiple aneurysms in the lt. PCA, lt. ICA, bil. VA, and the lt. renal artery. String-of-beads appearance was also seen in the branches of the lt. external carotid artery. During the operation, the PCA aneurysm which has been diagnosed as the ruptured one, was found to arise from the posterior communicating artery itself. It was thus a so-called true posterior communicating aneurysm. The aneurysm was trapped by clipping the artery on both the ICA and the PCA sides. The giant aneurysm of the lt. ICA was successfully treated by lt. STA-MCA anastomosis and ligation of the lt. ICA. Postoperative angiography demonstrated no visualization of the aneurysm and total occlusion at the origin of the lt. VA that had been patent preoperatively. On histological examination, intimal and medial hyperplasia was seen in the aneurysmal wall and occipital artery biopsied at operation. There has been no report of FMD associated with multiple and very rare posterior communicating aneurysms. Wide involvement of vascular change and advance of arterial occlusion noted by serial angiography indicates that FMD is a disease in which pathology would be progressive in some cases.
 ...
PMID:[A case of fibromuscular dysplasia associated with intra- and extracranial multiple aneurysms]. 159 38

Measurements of flow velocity in the basal cerebral arteries can be obtained non-invasively through the intact skull using 2 MHz pulsed Doppler ultrasound. We investigated 47 patients with subarachnoid hemorrhage and compared flow velocity with angiography. Flow velocity in the middle and posterior cerebral arteries (MCA and PCA) was inversely related to the lumen diameter. Further clues to diagnose MCA spasm were obtained from the ratio of MCA flow velocity divided by the velocity in the distal extracranial internal carotid artery. In the individual patient, the two anterior cerebral arteries should be considered together, since this communicating system often has unique possibilities for collateral flow. Recordings from large MCA aneurysms were obtained before angiography in 4 patients.
 ...
PMID:A non-invasive Doppler ultrasound method for the evaluation of patients with subarachnoid hemorrhage. 298 Jun 23

Measurements of flow velocity in defined segments of the basal cerebral arteries can be obtained through the intact adult skull using 2 MHz pulsed Doppler ultrasound. We compared flow velocity in these vessels with findings from 56 cerebral angiographies obtained in 51 patients at from day 1 to day 21 after subarachnoid haemorrhage (SAH). The diameter of the proximal segment of the middle cerebral, anterior cerebral, and posterior cerebral arteries (MCA, ACA, and PCA, respectively) were measured from anteroposterior films produced in one angiographic laboratory. In patients investigated on day 1-2, the median MCA diameter was 2.8 mm with range 2.3-3.4 mm. The median flow velocity was 56 cm/s, range 36-88 cm/s (within normal limits). There was a clear inverse relationship between the MCA diameter and MCA flow velocity. Eleven of the 13 MCA's having diameter 1.5 mm or less showed flow velocity in excess of 140 cm/s. This seems a useful limit to diagnose pronounced MCA spasm (50% diameter reduction) with this method. Further clues to the severity of MCA spasm were obtained from the ratio calculated dividing the MCA flow velocity by the flow velocity in the ipsilateral, extracranial internal carotid artery (ICA), since spasm probably does not involve the neck vessels. This ratio was from 1.1 to 2.3, median 1.7 at day 1-2, but rose to over 10 in patients with the most severe MCA lumen narrowing. The PCA flow velocity was inversely related to the PCA diameter. Assessment of ACA spasm requires considering findings from both hemispheres combined, since the two proximal ACA's usually anastomose through the anterior communicating artery.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Cerebral vasospasm after subarachnoid haemorrhage investigated by means of transcranial Doppler ultrasound. 305 38

Three hundred and sixty-four patients who suffered a subarachnoid haemorrhage from an aneurysm at either the anterior (ACA) or posterior (PCA) communicating artery location and who were not surgically treated have been followed for up to 21 years in order to study the late morbidity and mortality. For the 213 patients surviving to six months or longer: (1) little improvement in morbidity was noted during the many years of subsequent follow-up; (2) in general, ACA patients fared better than PCA patients; (3) the neurological state on original admission was strongly correlated with the degree of morbidity; (4) other factors measured at the time of original haemorrhage which adversely affected morbidity included the level of blood pressure or the presence of clot or spasm; (5) rebleeding occurs on the average of 3.5% per year during the first decade; (6) the mortality associated with a late rebleed is 67%; (7) if deaths from late haemorrhage are excluded, cardiovascular causes account for the majority of subsequent deaths, and (8) the risk of dying from all causes is increased when compared to a population matched by age and sex.
 ...
PMID:The late morbidity and mortality in ruptured single anterior circulation aneurysms treated by non-surgical therapy. 710 30

In this report the authors describe a noninvasive transcranial method of determining the flow velocities in the basal cerebral arteries. Placement of the probe of a range-gated ultrasound Doppler instrument in the temporal area just above the zygomatic arch allowed the velocities in the middle cerebral artery (MCA) to be determined from the Doppler signals. The flow velocities in the proximal anterior (ACA) and posterior (PCA) cerebral arteries were also recorded at steady state and during test compression of the common carotid arteries. An investigation of 50 healthy subjects by this transcranial Doppler method revealed that the velocity in the MCA, ACA, and PCA was 62 +/- 12, 51 +/0 12, and 44 +/- 11 cm/sec, respectively. This method is of particular value for the detection of vasospasm following subarachnoid hemorrhage and for evaluating the cerebral circulation in occlusive disease of the carotid and vertebral arteries.
 ...
PMID:Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. 714 59

This is a report of unruptured aneurysms with occlusion of the basilar artery. A 61-year-old female was admitted to our hospital because of dysarthria and numbness of her left face. Angiography revealed occlusion of the basilar artery and severe arteriosclerosis of the bilateral cerebral carotid arteries. Pcom was not visualized on bilateral carotid angiogram. These neurological signs were considered to be derived from vertebrobasilar insufficiency by occlusion of the basilar artery. Right STA-SCA anatomosis was performed to prevent brain stem infarction. Postoperative angiography showed a good filling of both PCA and SCA by collateral circulation via a right STA and an unruptured basilar top aneurysm. Seven months after the bypass surgery, angiography disclosed that the basilar top aneurysm was visualized clearly, and its size was unchanged. The fact that there was no thrombus formation in the aneurysm was considered to be due to ticlopidine, and the hemodynamic changes after the bypass surgery were suspected to have increased the intraaneurysmal pressure. Therefore we performed neck clipping of the basilar top aneurysm by using a right pterional approach. Two years after the second operation, the patient complained of severe headache and vomiting. CT scan showed subarachnoid hemorrhage, and angiography demonstrated a newly developed aneurysm which might have ruptured on left internal carotid anterior choroidal artery bifurcation. Emergency neck clipping of the second aneurysm was performed, and the patient showed a good postoperative course. The newly developed second aneurysm might have been caused by severe arteriosclerosis and hypertension in addition to hemodynamic stress.
 ...
PMID:[A case of growing up aneurysms with occlusion of basilar artery]. 766 40

Nontraumatic arterial dissection of the anterior cerebral artery (NAD-ACA) is a relatively rare disease entity, although case reports have recently been increased. We treated 6 patients suffering from NAD-ACA from January 1996 to December 2003, and the neuroradiological findings together with the clinical courses were reviewed. There were 3 males and 3 females with a mean age of 57.7-year-old, ranging from 41 to 65. Five patients had a past history of hypertension and one diabetes mellitus. At the onset, all patients presented with clinical manifestations of cerebral ischemia. Among them, all exhibited contralateral hemiparesis with greater weakness of the lower extremity, and two patients exhibited headache. Initial angiography revealed the pearl and string sign in four patients and string sign, tapered occlusion in each one. Follow-up angiographies revealed sequential changes in all patients; four improved and two progressed. Main anatomic site of the lesion was as follows; five in the A2 and one in the A1 portion, in addition, one patient was complicated by saccular aneurysm, one by PCA dissection, and two had with saccular aneurysm contralateral ACA & MCA and VA dissection each other. Four patients were treated conservatively by intravenous administration of argatroban, one by intravenous administration of Dextrane and one by anti-platelet agent in the acute stage. All patients were treated by anti-platelet agents in the chronic stage. Good recovery was achieved in five patients, but one who suffered from severe subarachnoid hemorrhage in the chronic stage died. Our experience suggests that hypertension and/or the succeeding abnormal structural changes in the arterial wall may contribute to the occurrence of this disease. NAD-ACA showing clinical manifestations of cerebral ischemia could result in a relatively good prognosis; however, attention should be paid to patients treated conservatively with a very closed follow-up angiography to prevent a possibility of severe hemorrhage.
 ...
PMID:[Nontraumatic arterial dissection of the anterior cerebral artery: six cases report]. 1602 47

A 59-year-old female was found to be drawn in a swimming pool and transferred to our hospital. The patient was comatose on admission (Hunt & Kosnk: Grade IV). Computed tomography (CT) showed diffuse subarachnoid hemorrhage (SAH) with thick hematoma in the left ambient cistern. Conventional cerebral angiography and 3D-digital subtraction angiography revealed aneurysms (ANs) of the left posterior cerebral artery (P2), and bifurcation of the left internal carotid and posterior communicating arteries (IC-PC). Successful neck clipping was performed the same day through the temporal horn via the insula for ruptured P2 AN, and the non-ruptured IC-PC AN was also obliterated using a pterional approach. Postoperative course was uneventful except for initial disturbance of consciousness and aphasia. The patient was discharged with no neurological deficit 1 month after surgery. This approach may be preferable in cases involving high positioned PCA AN in the ambient cistern, particularly in the acute phase of severe SAH, as the brain is protected from the detrimental effects of strong temporal retraction and a wider working space is provided.
 ...
PMID:[Case of clipping of a ruptured aneurysm of the posterior cerebral artery (P2) via the transchoroidal-fissure approach]. 1661 25

We present the case of a traumatic posterior cerebral artery pseudoaneurysm of a 29-year-old man due to a penetrating stab wound to the brain. The patient was brought to the emergency room in coma. The neurological examination revealed a Glasgow Coma Scale Score of 8 and left hemiplegy. The initial CT scan showed right temporal lobe haemorrhage with penetration in the lateral ventricle and subarachnoid haemorrhage. The cerebral angiography performed after three weeks, revealed a high PCA pseudoaneurysm. After surgery, a pseudoaneurysm was demonstrated in the histological study.
 ...
PMID:[Posttraumatic pseudoaneurysm of the posterior cerebral artery]. 1732


1 2 Next >>