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Neurosurgery: Cerebrovascular diseases
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
Paolo Gritti, Luigi Andrea Lanterna, Francesco Ferri, Carlo Brembilla, Ferdinando Luca Lorini
Hemorrhagic stroke is the third most frequent cause of stroke after AIS and TIA (2). Hypertensive hemorrhages (11%–15.5%) compared with hemorrhage due to ruptured aneurysms and vascular malformations (4.5%–7%) have a higher overall incidence in the context of the major CVD (2). Primary hypertensive ICH is the mundane “spontaneous” brain hemorrhage (9). It is predominantly due to chronic hypertension and degenerative changes in cerebral arteries. In recent decades, with increased awareness of the need to control BP, the percentage of hemorrhages caused by factors other than hypertension has greatly increased. In order of frequency, ICH is classified according to its anatomical site or presumed etiology. The most common sites of ICH are supratentorial (85%–95%), including deep (50%–75%) and lobar (25%–40%). The most common causes are hypertension (30%–60%), cerebral amyloid angiopathy (10%–30%), anticoagulation (1%–20%), and vascular structural lesions (3%–8%), while undetermined causes account for about 5%–20% of cases (27).
Neuroscience
Published in Bhaskar Punukollu, Michael Phelan, Anish Unadkat, MRCPsych Part 1 In a Box, 2019
Bhaskar Punukollu, Michael Phelan, Anish Unadkat
Pass on each side into the temporal lobe to enter the subarachnoid space. These arteries then join the circle of Willis where each bifurcates to form two main branches: the anterior and the middle cerebral arteries.
The circulatory system
Published in Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella, Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella
Aneurysm of the cerebral arteries often present with symptoms that are characteristic of increased intracranial pressure. Stroke can result if the abnormal blood vessel ruptures and bleeding occurs into the brain tissue.
Delineation atlas of the Circle of Willis and the large intracranial arteries for evaluation of doses to neurovascular structures in pediatric brain tumor patients treated with radiation therapy
Published in Acta Oncologica, 2021
L. Toussaint, S. Peters, R. Mikkelsen, S. Karabegovic, C. Bäumer, L. P. Muren, L. Tram-Henriksen, M. Høyer, Y. Lassen-Ramshad, B. Timmermann
Long-term survivors of pediatric brain tumors treated with radiation therapy are at an increased risk of developing cerebrovascular disease compared to the general population [1–4]. Damage to the major cerebral arteries of the brain, in part forming the Circle of Willis (CW), may lead to stenosis or occlusion of these large vessels. In the literature, stenosis and occlusive changes in patients treated with radiotherapy during childhood have been reported mostly in the proximal segment of the middle cerebral artery, the terminal part of the internal carotid artery as well as the anterior circulation of the CW [5–7]. Clinically, the patients may present with potentially life-threatening transient ischemic attacks, intracranial hemorrhages or ischemic strokes for which they remain at increased risk throughout their lifespan compared to their peers [1–4], affecting their quality of life.
Anti-embolic and anti-oxidative effects of a novel (E)-4-amino-N′-(1-(7-hydroxy-2-oxo-2H-chromen-3-yl) ethylidene) benzohydrazide against isoproterenol and vitamin-K induced ischemic stroke
Published in Archives of Physiology and Biochemistry, 2021
Kais Mnafgui, Emna Khdhiri, Lakhdar Ghazouani, Marwa Ncir, Zouhaier Zaafouri, Noureddine Allouche, Abdelfattah Elfeki, Houcine Ammar, Souhir Abid, Raouf Hajji
Stroke is the third leading cause of death in developing countries, the second leading cause of dementia and the leading cause of motor disability (Radu et al.2017). It constitutes a major problem of public health, which underlines the importance of the disease prevention, diagnosis and urgent treatment (Ovbiagele and Nguyen-Huynh 2011). Stroke is a sudden neurological deficit of presumed vascular origin that involves a lesion or dysfunction of the cerebral parenchyma and an underlying vascular lesion. The parenchymal lesion may be hemorrhagic or ischemic in nature. In fact, more than 85% of human strokes are ischemic (Amarenco et al.2013). Hence, cerebral ischemic infarction can be functional. It causes disruption of neuron metabolism without destroying it as in transient ischemic attacks (Johnston et al.2003). Ischemic strokes are commonly caused by atherothrombotic and thromboembolic proceedings in large and small cerebral arteries (Nieswandt et al.2011, Warden et al.2012). The thromboembolic occlusive process contributing to stroke could have two origins such as cardiac thrombus formation (associated with atrial fibrillation, acute phase myocardial infarction, valvular abnormality, interventricular septal aneurysm) and mural thrombus from an ulcerated atheromatous plaque located at the level of the intracranial and extracranial cervical cephalic vessels (Radu et al.2017).
Type 2 persistent primitive proatlantal intersegmental artery, a rare variant of persistent carotid-vertebrobasilar anastomoses
Published in Baylor University Medical Center Proceedings, 2019
Gagandeep Choudhary, Narendra Adhikari, Jad Chokr, Nishant Gupta
There was a three-vessel aortic arch. The right vertebral artery (VA) was hypoplastic arising from the subclavian artery and ended as a posterior inferior cerebellar artery. The left VA was absent. Both common carotid arteries, carotid bulbs, ICAs, and external carotid arteries were patent. An anomalous artery equal to the caliber of the ICA was seen arising from the proximal left external carotid artery at the origin of the lingual artery at the C2 vertebral level (Figure 1). The anomalous vessel coursed cranially and entered the foramen magnum coursing between the C1 arch and the occiput, without passing through the transverse foramina of the cervical vertebrae. Intracranially, it had a tortuous course and continued as a basilar artery, which terminated in posterior cerebral arteries. The right-sided posterior communicating artery was present but small in caliber, and the left posterior communicating artery was not seen. Both intracranial ICAs and proximal middle cerebral arteries, the anterior cerebral arteries, and the anterior communicating artery were present and unremarkable. The patient did not have any symptoms attributable to this vascular variant. He was discharged in stable condition with a short course of pain medication.