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Aneurysms
Published in Charles Theisler, Adjuvant Medical Care, 2023
An aneurysm is an abnormal bulge or ballooning in a weakened area of an arterial wall. Smoking and high blood pressure are the two major risk factors for the development of an aneurysm. A family history of aneurysms and being over 40 years of age are also factors. Aneurysms can occur anywhere in the body but are more frequent in the brain, aorta, legs (behind the knee), and spleen. Most aneurysms remain asymptomatic unless they grow unusually large or rupture.
Stroke
Published in Henry J. Woodford, Essential Geriatrics, 2022
When SAH is clinically suspected it is recommended that urgent CT scanning is obtained. When performed within 12 hours, this will detect around 95% of SAH. If the CT is negative, a lumbar puncture (LP) should be performed.6 A period of at least 12 hours should have passed since the symptom onset to the time of the LP and the direct measurement of bilirubin concentration, or spectrophotometry should be used to maximise the chance of detecting xanthochromia (the result of breakdown of blood cells in the cerebrospinal fluid [CSF] to form yellow bilirubin, which cannot be caused by a traumatic tap). CT or MR angiography can be used to identify any aneurysm.
Stroke
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Approximately 35% of subarachnoid hemorrhage patients die after an initial aneurysmal hemorrhage. About 15% more will die within several weeks due to another rupture. After 6 months have passed, second ruptures occur in about 3% of cases annually. The prognosis is generally the worst when an aneurysm is the cause. Prognosis is better if the cause was an arteriovenous malformation. The best prognosis is when angiography finds no lesion because the source of bleeding is small and has already sealed. Even with the best treatments, most survivors of subarachnoid hemorrhage have neurologic damage.
Hugh-Stovin syndrome: the ‘incomplete Behcet’s disease’. A case study of a young adult with recurrent pulmonary embolism and pulmonary arterial aneurysms
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Chinedu Ukemenam, Sivaram Prabhuji Muppaneni, Debapriya De, Alexandre Lacasse
Given shared similarities, medical management of HSS resembles BD [6]. Aggressive treatment of the PAAs is necessary because of its significant morbidity and mortality [6,12]. Potential treatment options for pulmonary aneurysms are: immediate surgical intervention, embolization, or observation with management of underlying disease [3,12]. Surgical lobectomy or pneumonectomy are options for massive hemoptysis secondary to large pulmonary aneurysms, expanding aneurysms or lesions confined to one segment or one lung [13]. Primary surgical repair of proximal main pulmonary artery aneurysms may be feasible [6]. Transcatheter PAA embolization is a less invasive option [3,13]. In our case, the role of surgery is limited given extensive bilateral PAAs, which confers high operative morbidity and mortality as well as recurrence in 25% of cases [3].
Comparison of Two Endovascular Interventions with Low-Profile Visualized Intraluminal Support or Pipeline Embolization Device in Middle Cerebral Arterial Aneurysms Patients
Published in Journal of Investigative Surgery, 2021
Zhonghua Lv, Yong Zhu, Wei Wang, Qiangjun Wu, Wen Li, Qiang Li, Liang Xu
This retrospective study included a total of 144 MCA patients who visited our hospital from January 2013 to December 2017. All patients were initially diagnosed with MCA aneurysm, and this was confirmed by computed tomography (CT), digital subtraction angiography (DSA), or CT angiography (CTA). Patients with MCA aneurysm recurrence were excluded. A fundus-to-neck ratio of <2 or neck diameter of >4 mm was defined as wide-necked. There were a total of 162 aneurysms. Among these, 131 cases had single aneurysms and 13 cases had multiple aneurysms (eight cases had two aneurysms and five cases had three aneurysms). Among all patients, 137 patients had unruptured aneurysms, while 25 patients had ruptured aneurysms. The Hunt-Hess grade of patients with ruptured aneurysms were evaluated before surgery. The other characteristics of these patients are all listed in Table 1. All patients provided a signed informed consent. Furthermore, the experiments were in full compliance with the Guide for the Care and Use of patients, and have gained the agreement of the Ethic Committee of The Second Hospital Affiliated to Zhejiang University.
Evaluating the effect of transplanting umbilical cord matrix stem cells on ischemic tolerance in an animal model of stroke
Published in Neurological Research, 2021
Mahmoud Ramdan, Mohammad Reza Bigdeli, Sepideh Khaksar, Abbas Aliaghaei
For example, there are serious risks for patients with aneurysm even during surgeryincludingsubarachnoid hemorrhage or reduced blood supply to the brain (cerebral ischemia) [2]. Accordingly, using some strategies to prevent or reduce surgical complications such as cerebral ischemia can be effective in this patients.One of the most important interventions that can be done is the induction of ischemic tolerance [3].Cell therapy is one of the most recent methods and has been reported to lessen the injuries of cerebral ischemia. It has been proved that this therapy saves cells in the penumbra region and decreases the effects of damage in the brain tissue [4]. Since 1988, the results of researches on the transplantation of stem cells for treating cerebral ischemia have confirmed the potential of stem cellsinreducing brain damages [4]. The most notable properties of stem cells after they are transplanted into the central nervous system are that they can remain alive in the transplanted tissue, can release neuroprotective factors, and can replace damaged neuronal cells [5].