Role of Neuroradiology in Evaluating Cerebral Aneurysms

Stafa, Altin; Leonardi, Marco

doi:10.1177/15910199080140s106

Cited by 19 publications

(11 citation statements)

References 47 publications

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“…Since the decision between surgical and endovascular interventions for ICAs depends on aneurysm location and morphology, preoperative analysis is imperative [10], [11], [12], [13], [14], [15]. An evaluation of the aneurysm size in all axes, shape, neck and dome width, its length, orientation, parent vessel width, and any possible branching vessels from the aneurysm or near the aneurysm neck are essential for surgical versus endovascular approach.…”

Section: Discussionmentioning

confidence: 99%

Four simultaneous anterior cerebral artery aneurysms (three initially unsuspected) with surgical treatment

Crandall

Challa

Tahir

2019

Radiology Case Reports

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Distal anterior cerebral artery aneurysms are rare, comprising approximately 6% of all intracranial aneurysms. These aneurysms tend to be smaller in size, broad-based, associated with additional aneurysms and at arterial branching sites, which can make both diagnosis and treatment difficult. Here we report a case of a 63-year-old female who presented with headache and perioral paresthesia determined to be Hunt & Hess scale grade 1. Computed tomography angiography discovered a medium-sized left A2 trunk saccular aneurysm. Intraoperatively 2 additional small blister type aneurysms not noted on initial computed tomography were discovered and treated via clipping and wrapping, respectively. Postoperatively a cerebral angiogram revealed an additional small right A2 trunk broad-based aneurysm. Preoperative evaluation of cerebral vasculature with a cerebral angiogram or high-resolution digital subtraction angiography is essential as multiple aneurysms are commonly associated with anterior cerebral artery aneurysms. The patient was successfully treated without any operative or postoperative complications and has remained symptom-free at 1 year follow up.

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Section: Discussionmentioning

confidence: 99%

Four simultaneous anterior cerebral artery aneurysms (three initially unsuspected) with surgical treatment

Crandall

Challa

Tahir

2019

Radiology Case Reports

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“…It can present as epistaxis immediately at the time of injury or in a delayed manner. If CT failed to show the site of injury leading to epistaxis, conventional angiography is indicated, which is the gold standard in evaluating these patients 4. If both CT angiography and digital subtraction angiography fails to show the site of injury and the patient continues to have epistaxis, repeat imaging in 3 weeks is advised; as 90% of patients with pseudoaneurysm will present in 3 weeks after injury, some of which have been reported to be fatal 5.…”

Section: Discussionmentioning

confidence: 99%

Traumatic intracranial internal carotid artery pseudoaneurysm presenting as epistaxis treated by endovascular coiling

Al-Jehani

Alwadaani

Almolani

2016

NSJ

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Traumatic intracranial pseudoaneurysm is a rare complication of blunt trauma. It is even more rare when it presents as epistaxis. Massive epistaxis of a ruptured intracranial internal carotid artery pseudoaneurysm is a major cause of mortality, which requires emergency intervention. We report a case of traumatic intracranial internal carotid artery pseudoaneurysm secondary to skull base fracture, which presented with delayed onset of epistaxis. This was successfully treated by primary endovascular coil embolization. We discuss endovascular treatment options and review the literature.

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“…These biometrics are macroscopic results of microscopic neurovascular changes, or biomarkers, mainly studied in basic science research, but important in clinical decisionmaking. [8][9][10][11] And so, we looked at what translational tools exist to fill this unmet need in the clinical research setting using virtual reality (VR). 12 Currently, some neurovascular biomarkers in flow diverted, coiled, and clipped aneurysms are suboptimally evaluated with standard imaging and diagnostic tools making their validated clinical significance unknown.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2020

JNSK

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Purpose: The purpose of this study was to measure sensitivity of virtual reality (VR) in detecting biomarkers of neurovascular remodeling suboptimally evaluated in digital subtraction angiography (DSA) of treated unruptured, intracranial aneurysms. Methods: The sensitivity of virtual reality and digital subtraction angiography in detection of neurovascular biomarkers in aneurysms treated with flow diversion, coiling, and clipping were evaluated. Validated grading scales were integrated into a standardized rating platform. The respective novel and conceptual measures of minimal imaging important difference (MIID) and number needed to image (NNI) were calculated for each biomarker. Results: In flow diversion, coiling, and clipping, minimal imaging important difference and number needed to image were associated with virtual reality in detection of abnormal biomarkers, with the exception of stasis phase associated with digital subtraction angiography. Number needed to image was associated with flow diversion stent stenosis (RR: 7.00, 95% CI 0.37 to 131.97; OR: 7.46, 95% CI 0.38 to 148.49). Minimal imaging important difference was greatest in residual aneurysm filling (25%±8.66, 95% CI) in flow diversion and Meyer score in coiling (42.5%±17.69, 95% CI) and clipping (22.2%±13.58, 95% CI). Regression models demonstrated minimal imaging important difference and number needed to image shared a significant correlation (R 2 0.99, 95% CI, p<0.001). Conclusion: Virtual reality adds value to digital subtraction angiography in evaluation of aneurysms treated with flow diversion, coiling, and clipping. Larger, prospective studies are warranted to increase statistical power and validate clinical significance.

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Role of Neuroradiology in Evaluating Cerebral Aneurysms

Cited by 19 publications

References 47 publications

Four simultaneous anterior cerebral artery aneurysms (three initially unsuspected) with surgical treatment

Four simultaneous anterior cerebral artery aneurysms (three initially unsuspected) with surgical treatment

Traumatic intracranial internal carotid artery pseudoaneurysm presenting as epistaxis treated by endovascular coiling

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