Traumatic dissecting posterior cerebral artery aneurysm. A case report and review of the literature.

Dissecting posterior cerebral artery (PCA) aneurysms are among rare cerebrovascular malformations accounting for 2% to 6% of all aneurysms. Herein we describe a case of pediatric dissecting aneurysm located in the PCA with documentation of aneurysm development. In addition, we discuss its treatment with a new therapeutic method involving glue injection.

Increasing exophthalmia after carotid-cavernous fistula closure with a detachable balloon: problems of incomplete treatment. A case report.

A 30-year-old woman with pulsating exophthalmia due to posttraumatic carotid-cavernous fistula underwent embolization with a detachable balloon. Because of balloon dislodgement, the drainage was derived to the superior ophthalmic vein and clinical worsening occurred. Complete ophthalmoplegia developed and visual acuity decreased. After a second embolization we inserted two balloons but the same findings were exaggerated. Finally coiling of the internal carotid artery was done and orbital decompression achieved. Ophthalmoplegia, proptosis, chemosis and nerve paralysis intraocular pressure improved.

Evaluation of angiographic findings in spontaneous aneurysmal subarachnoid hemorrhage patients.

This paper describes the angiographic findings of spontaneous aneurysmal subarachnoid hemorrhage (SAH) patients, including frequency, anatomic location and multiplicity of cerebral aneurysms. We retrospectively reviewed the records of 796 SAH patients at our university affiliated hospital. After confirming SAH by lumbar puncture or CT scan, all patients underwent digital subtraction angiography to find the definite anatomic location. The male to Female ratio in SAH patients was 9:10. The mean (SD) age of all patients with SAH was 47.9±14.7 years. The mean (SD) age of men with SAH was 46.6 ±15.6 years and women with SAH was 49.3±13.5 years (P=0.015). 357 (44.8%) patients had aneurysms. The mean (SD) age of aneurysmal patients was 49.8±14.3 years. The mean (SD) age of men with aneurysm was 47.8 ±15.9 years and women with aneurysm was 51.3±12.9 years (P= 0.03). The male to female ratio in aneurysms was 0.72:1. The most common aneurysm location was in the anterior communicating artery (N=166, 39%). The second most common anatomic location was the middle cerebral artery bifurcation (66 left, 60 right). The total number of patients with single aneurysms was 303 (84.9%) while 54 (15.1%) patients had multiple aneurysms. Among these patients, 49 had two aneurysms, three had three aneurysms and two had four aneurysms. In all, 418 aneurysms were detected. Of 357 patients with aneurysms 150 (42%) had vasospasm during angiography. In conclusion, the most common aneurysm location was the anterior communicating artery and the rate of multiplicity was also higher in our patients.