Mikko J. Pyysalo, T. Pessi, Joona Hallikainen, J. Frösen
The human body abounds in micro-organisms that maintain the vital balance of the internal ecosystem. Though it is well known that several benefit the human body while others are linked to disease, how the microbiota affects the pathology of intra-cranial aneurysms is an interesting arena that still requires exploration. Studies have suggested possible association between the excess of bacteria, such as those causing gingivitis, as well the deficit of bacteria, such as loss of gut flora due to antibiotics, to intracranial aneurysms and their subsequent behavior. The authors review existing literature on the subject and outline the scope for further research on the subject.
{"title":"The association of bacterial infection with intracranial aneurysm disease","authors":"Mikko J. Pyysalo, T. Pessi, Joona Hallikainen, J. Frösen","doi":"10.4103/jcvs.jcvs_20_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_20_20","url":null,"abstract":"The human body abounds in micro-organisms that maintain the vital balance of the internal ecosystem. Though it is well known that several benefit the human body while others are linked to disease, how the microbiota affects the pathology of intra-cranial aneurysms is an interesting arena that still requires exploration. Studies have suggested possible association between the excess of bacteria, such as those causing gingivitis, as well the deficit of bacteria, such as loss of gut flora due to antibiotics, to intracranial aneurysms and their subsequent behavior. The authors review existing literature on the subject and outline the scope for further research on the subject.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"238 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125414470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giant intracranial aneurysms, and aneurysms in the posterior circulation of the brain, are each rare entity when considered separately. It is more uncommon to find both coexisting. Aneurysms usually present when they rupture and haemorrhage, and for one to present with non-haemorrhagic symptoms, is rarer. The authors present an unusual case of a giant aneurysm of the anterior inferior cerebellar artery masquerading as a cerebellopontine angle tumour with cerebellar signs. The patient was treated with a retromastoid suboccipital craniectomy and microsurgical clipping and excision, with excellent results. A PubMed search of existing literature was carried out and reviewed and has been discussed.
{"title":"A giant anterior inferior cerebellar artery aneurysm in the guise of a cerebellopontine angle tumour: A case report and review of literature","authors":"Sumeet Narang, G. Manoharan, J. Dil, A. Raja","doi":"10.4103/jcvs.jcvs_3_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_3_20","url":null,"abstract":"Giant intracranial aneurysms, and aneurysms in the posterior circulation of the brain, are each rare entity when considered separately. It is more uncommon to find both coexisting. Aneurysms usually present when they rupture and haemorrhage, and for one to present with non-haemorrhagic symptoms, is rarer. The authors present an unusual case of a giant aneurysm of the anterior inferior cerebellar artery masquerading as a cerebellopontine angle tumour with cerebellar signs. The patient was treated with a retromastoid suboccipital craniectomy and microsurgical clipping and excision, with excellent results. A PubMed search of existing literature was carried out and reviewed and has been discussed.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116602592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gautam Dutta, D. Mahajan, Daljit Singh, A. Jagetia, Hukum Singh, A. Srivastava
Introduction: We present our experience of managing large and giant intracranial aneurysms by conventional endovascular techniques. We discuss the long-term clinical and angiographic outcome of coiling of these aneurysms. Materials and Methods: We assessed a prospectively maintained database of patients with large and giant intracranial aneurysms managed by the endovascular techniques from January 2010 to December 2014. In 412 patients with 468 aneurysms managed during this period, 58 patients with 60 aneurysms were identified as either large or giant. Each patient's records were reviewed with regard to size, location and morphology of the aneurysms, Hunt and Hess grade, occlusion and coiling/recoiling rates. Clinical outcome was assessed using the modified Rankin Scale (mRS) score with score of 0–2 and 3–6 taken as favourable and unfavourable outcome, respectively. Results: Overall complication rate was 13.8%, and no intraprocedural death was seen. Angiographic and clinical follow-up was available for 49 patients with 49 aneurysms at an average of 28.7 months. Recanalisation rate was 26.5% in this study and of them 38.5% required retreatment. Favourable mRS score (0–2) was seen in 82.6% of ruptured aneurysms and 92.3% in unruptured aneurysms. Conclusion: Coiling of large and giant aneurysms is a safe and viable option with a very good clinical outcome in the long run. However, long-term clinical and angiographic follow-up is necessary as angiographic results immediately after the procedure may be deceptive.
{"title":"Long-term follow-up of large and giant intracranial aneurysms managed by endovascular techniques: Experience from a tertiary care neurosurgery institute in India","authors":"Gautam Dutta, D. Mahajan, Daljit Singh, A. Jagetia, Hukum Singh, A. Srivastava","doi":"10.4103/jcvs.jcvs_18_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_18_20","url":null,"abstract":"Introduction: We present our experience of managing large and giant intracranial aneurysms by conventional endovascular techniques. We discuss the long-term clinical and angiographic outcome of coiling of these aneurysms. Materials and Methods: We assessed a prospectively maintained database of patients with large and giant intracranial aneurysms managed by the endovascular techniques from January 2010 to December 2014. In 412 patients with 468 aneurysms managed during this period, 58 patients with 60 aneurysms were identified as either large or giant. Each patient's records were reviewed with regard to size, location and morphology of the aneurysms, Hunt and Hess grade, occlusion and coiling/recoiling rates. Clinical outcome was assessed using the modified Rankin Scale (mRS) score with score of 0–2 and 3–6 taken as favourable and unfavourable outcome, respectively. Results: Overall complication rate was 13.8%, and no intraprocedural death was seen. Angiographic and clinical follow-up was available for 49 patients with 49 aneurysms at an average of 28.7 months. Recanalisation rate was 26.5% in this study and of them 38.5% required retreatment. Favourable mRS score (0–2) was seen in 82.6% of ruptured aneurysms and 92.3% in unruptured aneurysms. Conclusion: Coiling of large and giant aneurysms is a safe and viable option with a very good clinical outcome in the long run. However, long-term clinical and angiographic follow-up is necessary as angiographic results immediately after the procedure may be deceptive.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134359467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Sudhakar, A. Cheikh, Y. Yamada, Takao Teranishi, T. Kawase, Y. Kato
Background: Cerebral Arteriovenous Malformation represent a particularly challenging subset of lesions, given their overall low incidence and the high frequency with which some form of multimodality monitoring may be required for complete obliteration. Materials and Methods: We report retrospective analysis of 9 cases with unruptured cerebral arteriovenous malformation who got admitted in the Banbuntane Hotokokai Hospital, Fujita Health University, and Nagoya, Japan .from the year 2014 to 2017.surgical treatment was appropriate craniotomy and resection based on the location of the arteriovenous malformation with multimodality monitoring with Dual Image Video Angiography, Motor Evoked Potential, and FLOW 800. We studied the following factors: Sex, Age, Arteriovenous Malformation size, Location, occurrence of Intracranial Hemorrhage, Seizure type, Duration of Seizure history, Treatment modality, and Arteriovenous Malformation obliteration. We tested for statistical associations between these factors and seizure presentation and outcomes with Clinical follow-up. Outcome was compared with modified Rankin Scale Results: Out of 9 cases operated for intracranial arteriovenous malformation 5 patients were female and 4 were male. Age [ Mean 39.4 + 16.7] of the patients ranged from 20 to 66 , 5 patients were 25 - 40 and 2 were > 65 and < 25 each.6 patients were Spetzler - Martin Grade 2 ,1 patient was Spetzler - Martin Grade 4,Grade 3 and Grade 5. 3 patients were draining into superficial venous system and 2 patient were asymptomatic and incidentally diagnosed during screening procedure. There is no Mortality in this study.1 patient underwent Gamma Knife stereotactic radiosurgery. Conclusion: The increasing use of advance imaging techniques will increase the incidence of asymptomatic arteriovenous malformations. Non-ruptured arteriovenous malformation Spetzler Martin Grade 1 or Spetzler Martin Grade 2 have a good outcome for microsurgery [modified Rankin Scale and complete obliteration and there is better outcome with microsurgery.
背景:脑动静脉畸形是一种特别具有挑战性的病变子集，因为其总体发病率低，频率高，可能需要某种形式的多模式监测才能完全消除。材料与方法:回顾性分析2014年至2017年在日本名古屋的日本藤田卫生大学Banbuntane Hotokokai医院住院的9例未破裂的脑动静脉畸形。手术治疗是根据动静脉畸形的位置，在双像视频血管造影、运动诱发电位和FLOW 800多模态监测下进行适当的开颅和切除。我们研究了以下因素:性别，年龄，动静脉畸形大小，位置，颅内出血的发生，癫痫发作类型，癫痫发作史持续时间，治疗方式，动静脉畸形闭塞。我们通过临床随访检验了这些因素与癫痫发作表现和结果之间的统计学关联。结果:9例颅内动静脉畸形手术中，女性5例，男性4例。年龄[平均39.4 + 16.7]，20 ~ 66岁，25 ~ 40岁5例，> 65、< 25岁各2例。6例患者为Spetzler - Martin 2级，1例为Spetzler - Martin 4级、3级和5级。3例患者进入浅静脉系统引流，2例无症状，在筛查过程中偶然发现。在这项研究中没有死亡率。1例患者行伽玛刀立体定向放射手术。结论:先进影像学技术的应用将增加无症状动静脉畸形的发生率。非破裂型动静脉畸形(Spetzler Martin Grade 1或Spetzler Martin Grade 2)显微手术(改良Rankin评分法和完全闭塞法)预后良好，显微手术预后更好。
{"title":"Management strategies for cerebral arteriovenous malformation - An institutional experience","authors":"K. Sudhakar, A. Cheikh, Y. Yamada, Takao Teranishi, T. Kawase, Y. Kato","doi":"10.4103/jcvs.jcvs_6_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_6_20","url":null,"abstract":"Background: Cerebral Arteriovenous Malformation represent a particularly challenging subset of lesions, given their overall low incidence and the high frequency with which some form of multimodality monitoring may be required for complete obliteration. Materials and Methods: We report retrospective analysis of 9 cases with unruptured cerebral arteriovenous malformation who got admitted in the Banbuntane Hotokokai Hospital, Fujita Health University, and Nagoya, Japan .from the year 2014 to 2017.surgical treatment was appropriate craniotomy and resection based on the location of the arteriovenous malformation with multimodality monitoring with Dual Image Video Angiography, Motor Evoked Potential, and FLOW 800. We studied the following factors: Sex, Age, Arteriovenous Malformation size, Location, occurrence of Intracranial Hemorrhage, Seizure type, Duration of Seizure history, Treatment modality, and Arteriovenous Malformation obliteration. We tested for statistical associations between these factors and seizure presentation and outcomes with Clinical follow-up. Outcome was compared with modified Rankin Scale Results: Out of 9 cases operated for intracranial arteriovenous malformation 5 patients were female and 4 were male. Age [ Mean 39.4 + 16.7] of the patients ranged from 20 to 66 , 5 patients were 25 - 40 and 2 were > 65 and < 25 each.6 patients were Spetzler - Martin Grade 2 ,1 patient was Spetzler - Martin Grade 4,Grade 3 and Grade 5. 3 patients were draining into superficial venous system and 2 patient were asymptomatic and incidentally diagnosed during screening procedure. There is no Mortality in this study.1 patient underwent Gamma Knife stereotactic radiosurgery. Conclusion: The increasing use of advance imaging techniques will increase the incidence of asymptomatic arteriovenous malformations. Non-ruptured arteriovenous malformation Spetzler Martin Grade 1 or Spetzler Martin Grade 2 have a good outcome for microsurgery [modified Rankin Scale and complete obliteration and there is better outcome with microsurgery.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122959887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Neurosurgery has evolved with the times and as with all things with a rich history, there is much to be learnt from experience and much to be re-iterated in the present. Aims and objectives: To reinforce the key basic points in AVM surgery, for the benefit of all neurosurgeons operating on AVMs. Materials: Based on personal experience from over he author recollects integral points and principles of the surgical management of intra-cranial arterio-venous malformations (AVMs), highlighting the basic elements such as planning, exposure, equipment use, intra-operative identification, and safe approach, execution and hemostasis. Conclusion: The success of AVM surgery depends highly on methodical planning and precise execution.
{"title":"Musings about surgery for intra-cranial arterio-venous malformations","authors":"A. Raja","doi":"10.4103/jcvs.jcvs_15_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_15_20","url":null,"abstract":"Introduction: Neurosurgery has evolved with the times and as with all things with a rich history, there is much to be learnt from experience and much to be re-iterated in the present. Aims and objectives: To reinforce the key basic points in AVM surgery, for the benefit of all neurosurgeons operating on AVMs. Materials: Based on personal experience from over he author recollects integral points and principles of the surgical management of intra-cranial arterio-venous malformations (AVMs), highlighting the basic elements such as planning, exposure, equipment use, intra-operative identification, and safe approach, execution and hemostasis. Conclusion: The success of AVM surgery depends highly on methodical planning and precise execution.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124986108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Arteriovenous fistulae (AVF) are rare lesions. Patients typically present with slowly progressive myelopathy that is often mistaken for degenerative cervical or lumbar stenosis. Cranial presentations are even more innocuous ranging from seizures to tinnitus. The purpose of this study is to present a series of cases to aid in the assessment, diagnosis and treatment of this unusual pathology. Case Series: We present 11 cases of AVFs treated at our centre over an 4-year period. Seventy percent of patients were male. The mean age of presentation was 62.6 years. The most common lesion was a dural AVF emanating from the craniovertebral junction with single feeder. All patients underwent either microsurgical correction or endovascular embolization as the primary procedure. Eight patients showed improvement following treatment as graded by the Nurick system. Two patients failed to improve. None of the patients worsened. One patient had a cortical venous thrombosis after embolization that resolved well with anticoagulants. Conclusion: The successful treatment of AVF requires a detailed understanding of clinical presentation and imaging findings to allow for precise treatment. Owing to the rarity of the condition, clinicians must continue to share their experiences to advance our knowledge.
{"title":"Arteriovenous fistulae of the neuraxis: An institutional experience","authors":"S. Ganapathy, S. Gopal, P. Pandey","doi":"10.4103/jcvs.jcvs_4_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_4_20","url":null,"abstract":"Introduction: Arteriovenous fistulae (AVF) are rare lesions. Patients typically present with slowly progressive myelopathy that is often mistaken for degenerative cervical or lumbar stenosis. Cranial presentations are even more innocuous ranging from seizures to tinnitus. The purpose of this study is to present a series of cases to aid in the assessment, diagnosis and treatment of this unusual pathology. Case Series: We present 11 cases of AVFs treated at our centre over an 4-year period. Seventy percent of patients were male. The mean age of presentation was 62.6 years. The most common lesion was a dural AVF emanating from the craniovertebral junction with single feeder. All patients underwent either microsurgical correction or endovascular embolization as the primary procedure. Eight patients showed improvement following treatment as graded by the Nurick system. Two patients failed to improve. None of the patients worsened. One patient had a cortical venous thrombosis after embolization that resolved well with anticoagulants. Conclusion: The successful treatment of AVF requires a detailed understanding of clinical presentation and imaging findings to allow for precise treatment. Owing to the rarity of the condition, clinicians must continue to share their experiences to advance our knowledge.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127077945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Existing literature is devoid of data on true trifurcations of the internal carotid artery (ICA). The authors present a rare case of trifurcation of the ICA, discovered during the evaluation of a patient with subarachnoid haemorrhage, and discuss the surgical implications of the anomaly.
{"title":"A rare case of internal carotid artery trifurcation and an aneurysm associated with it","authors":"Harsh Agrawal, J. Varghese, M. Balamurugan","doi":"10.4103/jcvs.jcvs_21_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_21_20","url":null,"abstract":"Existing literature is devoid of data on true trifurcations of the internal carotid artery (ICA). The authors present a rare case of trifurcation of the ICA, discovered during the evaluation of a patient with subarachnoid haemorrhage, and discuss the surgical implications of the anomaly.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127287500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Since the outbreak of the coronavirus pandemic, much has changed in the protocol for management of healthcare setups and patients presenting with any illness including neurological and neurosurgical emergencies. Patients are themselves deterred from visiting a hospital in an emergency, and healthcare workers require stringent precautions and plans to prevent the spread of the virus to themselves and others, without compromising on the care that is to be provided. Aims and objectives: To outline the importance of identifying neurological emergencies requiring urgent intervention even in the time of a pandemic, and methods to effectively manage patients without compromising on safety and infection prevention measures. Materials: Guidelines reviewed from existing literature and retrospective analysis of management protocol and care delivered in a neurovascular unit during the COVID-19 pandemic.. Conclusion: Acute neurovascular care should not be compromised upon even during a pandemic, but neither should the safety of healthcare workers. Safety guidelines and protocols require strict adherence.
{"title":"Acute neurovascular care in the COVID era: Safety and resilience","authors":"S. Paramasivam, Harihara Sudan, D. Babu, N. Kumar","doi":"10.4103/jcvs.jcvs_5_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_5_20","url":null,"abstract":"Introduction: Since the outbreak of the coronavirus pandemic, much has changed in the protocol for management of healthcare setups and patients presenting with any illness including neurological and neurosurgical emergencies. Patients are themselves deterred from visiting a hospital in an emergency, and healthcare workers require stringent precautions and plans to prevent the spread of the virus to themselves and others, without compromising on the care that is to be provided. Aims and objectives: To outline the importance of identifying neurological emergencies requiring urgent intervention even in the time of a pandemic, and methods to effectively manage patients without compromising on safety and infection prevention measures. Materials: Guidelines reviewed from existing literature and retrospective analysis of management protocol and care delivered in a neurovascular unit during the COVID-19 pandemic.. Conclusion: Acute neurovascular care should not be compromised upon even during a pandemic, but neither should the safety of healthcare workers. Safety guidelines and protocols require strict adherence.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116228043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intracranial aneurysms are a subject of controversy. Anterior circulation aneurysms are usually considered surgical territory, yet endovascular prowess can affect good results with minimal morbidity and comparable long-term results. We present a complex anterior cerebral artery aneurysm that would require either a bypass or a complex vessel reconstructive procedure. Instead, we proceeded to perform a stent-assisted coiling trapping the coils inside the aneurysm through a covered stent, thereby ensuring vascular continuity and complete aneurysm control. A brief review of the literature is also added to put this report in perspective.
{"title":"Stent-assisted aneurysm coiling of a complex A1–A2 aneurysm: A technically demanding but useful procedure in complex intracranial aneurysms","authors":"S. Gopal, S. Ganapathy","doi":"10.4103/jcvs.jcvs_2_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_2_20","url":null,"abstract":"Intracranial aneurysms are a subject of controversy. Anterior circulation aneurysms are usually considered surgical territory, yet endovascular prowess can affect good results with minimal morbidity and comparable long-term results. We present a complex anterior cerebral artery aneurysm that would require either a bypass or a complex vessel reconstructive procedure. Instead, we proceeded to perform a stent-assisted coiling trapping the coils inside the aneurysm through a covered stent, thereby ensuring vascular continuity and complete aneurysm control. A brief review of the literature is also added to put this report in perspective.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128486190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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