ABSTRACT
The de novo aneurysms are the formation of new aneurysms in a location previously observed to be normal by a cerebral angiography or direct microsurgical exploration. In this report, we present a review of the theme and describe a case of a ruptured de novo basilar tip aneurysm in a patient previously treated with carotid occlusion for a giant intracavernous aneurysm and microsurgical clipping of contralateral posterior communicating artery aneurysm.
Subject(s)
Intracranial Aneurysm/therapy , Abducens Nerve Diseases/etiology , Aneurysm, Ruptured/complications , Aneurysm, Ruptured/therapy , Carotid Artery Diseases/complications , Carotid Artery Diseases/surgery , Cavernous Sinus , Cerebral Angiography , Craniotomy , Embolization, Therapeutic , Endovascular Procedures , Female , Headache/etiology , Humans , Incidence , Intracranial Aneurysm/complications , Intracranial Aneurysm/diagnostic imaging , Intracranial Aneurysm/epidemiology , Intracranial Aneurysm/surgery , Microsurgery , Middle Aged , Oculomotor Nerve Diseases/etiology , Postoperative Complications/therapy , Subarachnoid Hemorrhage/etiology , Unconsciousness/etiologyABSTRACT
AIM: The aim of this study was to evaluate the positive predictive value of two growth hormone stimulation tests (insulin-induced hypoglycemia and clonidine) for stature below percentile 10 in patients treated for acute lymphoblastic leukemia in childhood. METHODS: The study population was a cohort of 30 patients (aged 14.1+/-2.9 years; 20 male) treated for acute lymphoblastic leukemia during childhood and then examined after insulin-induced hypoglycemia (30 patients) and clonidine (16 patients) tests. The follow-up time was 7.7+/-2.8 years since treatment and 2.3+/-1.3 years after administration of the tests. RESULTS: In the last evaluation, 12 patients (40%) were below and 18 (60%) were above percentile 10. The insulin-induced hypoglycemia test response was: 9 patients (30%) had growth hormone peak <5 ng/mL and 19 (63.3%) <7 ng/mL. The clonidine test response was: 7 patients had growth hormone peak <5 ng/mL and 8 (50%) <7 ng/mL. For stature below of the percentile 10, the positive predictive values of insulin-induced hypoglycemia test (33%) and clonidine (28%) were low when growth hormone peak <5 ng/mL was considered; however, when growth hormone peak <7 ng/mL was considered, the positive predictive values were 83% and 50% for the insulin-induced hypoglycemia and clonidine tests, respectively. CONCLUSIONS: In patients treated for acute lymphoblastic leukemia in childhood, the positive predictive values for statural deficit of both tests were low, except for the insulin-induced hypoglycemia test when a growth hormone peak <7 ng/mL was considered.
