Science.gov

Sample records for secondary aneurysmal bone

  1. Aneurysmal Bone Cyst: An Uncommon Secondary Event in Calcaneal Chondroblastoma.

    PubMed

    Barman, Sandip; Diwaker, Preeti; Bansal, Divya; Wadhwa, Neelam; Singh, Gurvinder

    2016-06-01

    Chondroblastoma is an uncommon benign bone tumour, involvement of epiphysis of long bones is typical. Chondroblastoma of the calcaneum is uncommon and its association with secondary aneurysmal bone cyst is even rarer. Only two cases of calcaneal chondroblastoma associated with secondary aneurysmal bone cyst have been reported till date. A 22-year-old male presented to the department of orthopaedics with complains of pain and swelling in the left heel since the last 10 months. On clinico-radiological grounds differentials considered were giant cell tumour of bone and aneurysmal bone cyst. In view of the histopathological findings of bone curettage and results of special stain and immunohistochemical marker, final diagnosis of chondroblastoma with secondary aneurysmal bone cyst, left calcaneum was rendered. Although rare, chondroblastoma should always be considered in osteolytic lesions of calcaneum. The identification of secondary aneurysmal bone cyst component is important as it has higher chances of recurrence than usual chondroblastoma. PMID:27504302

  2. Aneurysmal Bone Cyst: An Uncommon Secondary Event in Calcaneal Chondroblastoma

    PubMed Central

    Barman, Sandip; Bansal, Divya; Wadhwa, Neelam; Singh, Gurvinder

    2016-01-01

    Chondroblastoma is an uncommon benign bone tumour, involvement of epiphysis of long bones is typical. Chondroblastoma of the calcaneum is uncommon and its association with secondary aneurysmal bone cyst is even rarer. Only two cases of calcaneal chondroblastoma associated with secondary aneurysmal bone cyst have been reported till date. A 22-year-old male presented to the department of orthopaedics with complains of pain and swelling in the left heel since the last 10 months. On clinico-radiological grounds differentials considered were giant cell tumour of bone and aneurysmal bone cyst. In view of the histopathological findings of bone curettage and results of special stain and immunohistochemical marker, final diagnosis of chondroblastoma with secondary aneurysmal bone cyst, left calcaneum was rendered. Although rare, chondroblastoma should always be considered in osteolytic lesions of calcaneum. The identification of secondary aneurysmal bone cyst component is important as it has higher chances of recurrence than usual chondroblastoma. PMID:27504302

  3. Secondary Aneurysmal Bone Cyst Following Chondroblastoma of the Patella

    PubMed Central

    Tomoyuki, Kato; Susa, Michiro; Nakayama, Robert; Watanabe, Itsuo; Horiuchi, Keisuke; Toyama, Yoshiaki; Morioka, Hideo

    2013-01-01

    Aneurysmal bone cyst (ABC) is a rare benign cystic lesion of the bone that composes 1-2% of the entire bone tumors. Some are idiopathic, and some occur secondary to other tumors such as giant cell tumor and chondroblastoma. In this article, we report the clinical, radiographic, and histological findings of a secondary ABC following chondroblastoma of the patella with a review of the literature. PMID:24179655

  4. Secondary aneurysmal bone cyst following chondroblastoma of the patella.

    PubMed

    Tomoyuki, Kato; Susa, Michiro; Nakayama, Robert; Watanabe, Itsuo; Horiuchi, Keisuke; Toyama, Yoshiaki; Morioka, Hideo

    2013-01-01

    Aneurysmal bone cyst (ABC) is a rare benign cystic lesion of the bone that composes 1-2% of the entire bone tumors. Some are idiopathic, and some occur secondary to other tumors such as giant cell tumor and chondroblastoma. In this article, we report the clinical, radiographic, and histological findings of a secondary ABC following chondroblastoma of the patella with a review of the literature. PMID:24179655

  5. Parosteal aneurysmal bone cyst☆

    PubMed Central

    Meohas, Walter; de Sá Lopes, Ana Cristina; da Silveira Möller, João Victor; Barbosa, Luma Duarte; Oliveira, Marcelo Bragança dos Reis

    2015-01-01

    The incidence of aneurysmal bone cysts is 0.14 cases per 100,000 individuals. Parosteal aneurysmal bone cysts are the least prevalent subtype and represent 7% of all aneurysmal bone cysts. We present the case of a 38-year-old male patient with pain and bulging in his right arm for eight months. He had previously been diagnosed as presenting giant-cell tumor, but his slides were reviewed and his condition was then diagnosed as parosteal aneurysmal bone cyst. The patient was treated with corticosteroid and calcitonin infiltration into the lesion and evolved with clinical and radiological improvement within the first five weeks after the operation. PMID:26535209

  6. Aneurysmal bone cyst secondary to a giant cell tumor of the patella: A case report

    PubMed Central

    YU, XIAOLONG; GUO, RUNSHENG; FAN, CONGLIANG; LIU, HUCHENG; ZHANG, BIN; NIE, TAO; TU, YI; DAI, MIN

    2016-01-01

    The patella is an unusual location for primary and metastatic bone tumors to develop. The most frequently encountered primary osteolytic lesions at the patella include giant cell tumors of the bone (GCT), chondroblastoma and aneurysmal bone cysts (ABC). However, the presentation of an ABC originating secondary to a GCT at the patella is rare. The present study describes such a case in a 46-year-old female. The differential diagnosis of the condition was extensive. The patient underwent curettage and the addition of bone cement to fill the defect. Pathological analysis of the resected tissue demonstrated that the lesion was consistent with an ABC forming secondary to a GCT. A 3-month follow-up was completed subsequent to the surgery, with a computed tomography scan demonstrating no evidence of recurrence. However, frequent and continuous observations of the patient following diagnosis are planned in order to evaluate the long-term efficacy of the surgical treatment. To the best of our knowledge, the present study describes the third reported case in the literature of this rare, double synchronous, benign tumor located at the patella. PMID:26893764

  7. Giant cell tumor of the patella with a secondary aneurysmal bone cyst: A case report

    PubMed Central

    SONG, MINGZHI; DAI, WEI; SUN, RAN; LIANG, HONGFENG; LIU, BINGWU; WU, YUXUAN; MA, KAI; LU, MING

    2016-01-01

    The substance of the patella is an uncommon location for tumor occurrence and development. The present study reports a case of giant cell tumor (GCT) of the patella, combined with an aneurysmal bone cyst (ABC). To the best of our knowledge, this is the second report of GCT with ABC published in English. GCT is the most common type of benign tumor. Secondary ABC is frequently associated with GCT, but this symbiotic tumor rarely occurs in the patella. A 27-year-old male patient was examined at the outpatient clinic, and clinicopathological characteristics of the tumor were observed. X-ray and computed tomography (CT) scans revealed a lytic lesion located in the center of the right patella. Curettage, followed by autogenic and allograft bone grafting, was performed. Histopathologically, the lesion was diagnosed as a GCT with secondary ABC. No recurrence or metastasis was identified during the 1-year follow-up period. The present study reports a case of GCT with secondary ABC, and discusses the rare location and histopathological type of this tumor, in order to improve diagnosis and treatment of patellar tumors in general. PMID:27313738

  8. Pelvic aneurysmal bone cyst

    PubMed Central

    Sharifah, MIA; Nor Hazla, MH; Suraya, A; Tan, SP

    2011-01-01

    This paper describes an extremely rare case of a huge aneurysmal bone cyst (ABC) in the pelvis, occurring in the patient’s 5th decade of life. The patient presented with a history of painless huge pelvic mass for 10 years. Plain radiograph and computed tomography showed huge expansile lytic lesion arising from the right iliac bone. A biopsy was performed and histology confirmed diagnosis of aneurysmal bone cyst. Unfortunately, the patient succumbed to profuse bleeding from the tumour. PMID:22279501

  9. Bone cysts: unicameral and aneurysmal bone cyst.

    PubMed

    Mascard, E; Gomez-Brouchet, A; Lambot, K

    2015-02-01

    Simple and aneurysmal bone cysts are benign lytic bone lesions, usually encountered in children and adolescents. Simple bone cyst is a cystic, fluid-filled lesion, which may be unicameral (UBC) or partially separated. UBC can involve all bones, but usually the long bone metaphysis and otherwise primarily the proximal humerus and proximal femur. The classic aneurysmal bone cyst (ABC) is an expansive and hemorrhagic tumor, usually showing characteristic translocation. About 30% of ABCs are secondary, without translocation; they occur in reaction to another, usually benign, bone lesion. ABCs are metaphyseal, excentric, bulging, fluid-filled and multicameral, and may develop in all bones of the skeleton. On MRI, the fluid level is evocative. It is mandatory to distinguish ABC from UBC, as prognosis and treatment are different. UBCs resolve spontaneously between adolescence and adulthood; the main concern is the risk of pathologic fracture. Treatment in non-threatening forms consists in intracystic injection of methylprednisolone. When there is a risk of fracture, especially of the femoral neck, surgery with curettage, filling with bone substitute or graft and osteosynthesis may be required. ABCs are potentially more aggressive, with a risk of bone destruction. Diagnosis must systematically be confirmed by biopsy, identifying soft-tissue parts, as telangiectatic sarcoma can mimic ABC. Intra-lesional sclerotherapy with alcohol is an effective treatment. In spinal ABC and in aggressive lesions with a risk of fracture, surgical treatment should be preferred, possibly after preoperative embolization. The risk of malignant transformation is very low, except in case of radiation therapy. PMID:25579825

  10. Aneurysmal bone cyst.

    PubMed

    Rapp, Timothy B; Ward, James P; Alaia, Michael J

    2012-04-01

    Aneurysmal bone cysts are rare skeletal tumors that most commonly occur in the first two decades of life. They primarily develop about the knee but may arise in any portion of the axial or appendicular skeleton. Pathogenesis of these tumors remains controversial and may be vascular, traumatic, or genetic. Radiographic features include a dilated, radiolucent lesion typically located within the metaphyseal portion of the bone, with fluid-fluid levels visible on MRI. Histologic features include blood-filled lakes interposed between fibrous stromata. Differential diagnosis includes conditions such as telangiectatic osteosarcoma and giant cell tumor. The mainstay of treatment is curettage and bone graft, with or without adjuvant treatment. Other management options include cryotherapy, sclerotherapy, radionuclide ablation, and en bloc resection. The recurrence rate is low after appropriate treatment; however, more than one procedure may be required to completely eradicate the lesion. PMID:22474093

  11. Aneurysmal bone cyst of medial end of clavicle in a child, a rare case report.

    PubMed

    Yashavntha, Kumar C; Nalini, K B; Menon, Jagdish; Patro, D K

    2014-06-01

    Aneurysmal bone cyst is a locally aggressive benign tumor accounting for 3 % of all benign bone tumors. It most commonly arises from ends of long bones and relatively rare in flat bones. Clavicle is a very rare site for bone tumors with secondaries more common than primaries. Very few cases of aneurysmal bone cyst have been reported in literature. We hereby report interesting and a rare case of aneurysmal bone cyst of medial end of clavicle in a eight year old lady which was treated with extended curettage and calcium sulfate bone grafting. PMID:25114473

  12. Aneurysmal bone cyst involving the metacarpal bone in a child.

    PubMed

    Song, Kwang Soon; Lee, Si Wook; Bae, Ki Cheor; Sohn, Eun Seok

    2015-03-01

    Aneurysmal bone cysts associated with tubular bones of the hand occur rarely and require particular diagnostic and therapeutic management techniques. While optimal treatment has not been established, accepted treatments range from aggressive radical treatment, including en bloc resection and excision diaphysectomy with strut bone grafting, to relatively simple techniques, such as thorough curettage followed by bone graft. Aggressive treatment approaches may be optimal for the cases with articular surface involvement, full-bone invasion of the phalanx or metacarpal, or more than 1 recurrence. We report a monocentric case of aneurysmal bone cysts involving metacarpal bone in a child who achieved favorable outcome with curettage and morselized cancellous bone grafts. PMID:25750953

  13. Pediatric aneurysmal bone cyst of the distal tibia.

    PubMed

    Goss, L R; Walter, J H

    1997-03-01

    A rare, large pediatric aneurysmal bone cyst with pathologic fracture of the distal tibia of a 4-year-old female was presented. Classic radiographic and magnetic resonance imaging findings have been discussed. In a comprehensive review of the literature, aneurysmal bone cysts are an infrequently reported neoplasm of the foot and ankle bones. Lesions are characteristically seen in patients younger than 20 years of age, but rarely younger than 5 years. The benign cyst has a 2:1 female-to male predilection. In long bones, the lesion is typically metaphyseal in nature. Although the pathogenesis is still unknown, there exists the possibility of two types of aneurysmal bone cysts: a primary type without preexisting lesion and a secondary form associated with some other lesion. The diagnosis of aneurysmal bone cyst can be strongly suspected by correlating the radiographic and magnetic resonance imaging findings. For definitive diagnosis, accurate histologic evaluation is imperative to rule out any confusion or possibility with a malignant tumor. PMID:9086721

  14. Ultrasound of Primary Aneurysmal Bone Cyst

    PubMed Central

    Glazebrook, Katrina N.; Keeney, Gary L.; Rock, Michael G.

    2014-01-01

    Aneurysmal bone cysts (ABC) are rare, benign, expansile lesions of bone often found in the metaphyses of long bones in pediatric and young adult population. Multiple fluid levels are typically seen on imaging with magnetic resonance imaging (MRI) or computed tomography (CT). We describe a case of a primary ABC in the fibula of a 34-year-old man diagnosed on ultrasound with a mobile fluid level demonstrated sonographically. PMID:24587935

  15. Bone cement treatment for aneurysmal bone cyst in a dog.

    PubMed

    Sarierler, Murat; Cullu, Emre; Yurekli, Yakup; Birincioglu, Serap

    2004-09-01

    An eighteen month old female Doberman pinscher dog was referred to teaching hospital of Adnan Menderes University, Faculty of Veterinary Medicine with the complaint of right forelimb lameness for a month. On the basis of clinical, radiographical, scintigraphical, computed tomographical and histopathological findings, aneurysmal bone cyst was diagnosed. Surgical curettage and bone cement treatment were applied. The patient recovered after 12 months. This case proves that aneurysmal bone cyst, without osteolysis and/or damages to the surrounding tissues, may result in a good prognosis if curettage and treatment with bone cement are done. PMID:15472481

  16. Multiple aneurysmal bone cysts in a foal.

    PubMed Central

    Thomas, H L; Livesey, M A; Caswell, J L

    1997-01-01

    Multiple aneurysmal bone cysts (ABCs) are previously unreported in horses. An ABC was diagnosed in the left 3rd metacarpal of a Thoroughbred foal, which partially resolved following surgical curettage. A 2nd ABC developed in the left tibia, 7 wk postoperatively, and the foal was euthanized. Images Figure 1. Figure 2. PMID:9285139

  17. Solid variant of aneurysmal bone cist on the distal extremity of the radius in a child.

    PubMed

    Ferreira, Adriano Jander; de Almeida Leitão, Sebastião; Rocha, Murilo Antônio; Nascimento, Valdênia das Graças; Lima, Giovanni Bessa Pereira; de Meneses, Antonio Carlos Oliveira

    2016-01-01

    The solid variant of aneurismal bone cysts (ABC) is considered rare. It occurs with greater frequency in pediatric patients and in the tibia, femur, pelvis and humerus. We present a case of a metaphyseal lytic lesion on the distal extremity of the radius in a child whose radiograph was requested after low-energy trauma. The hypothesis of a pathological bone fracture secondary to an aneurysmal bone cyst was suggested. After biopsy, the child underwent intralesional excision without bone grafting and the histopathological findings were compatible with the solid variant of aneurysmal bone cyst. PMID:27274493

  18. Primary aneurysmal bone cyst of coronoid process

    PubMed Central

    Goyal, Amit; Tyagi, Isha; Syal, Rajan; Agrawal, Tanu; Jain, Manoj

    2006-01-01

    Background Aneurysmal bone cysts are relatively uncommon in the facial skeleton. These usually affect the mandible but origin from the coronoid process is even rarer. To the best of our knowledge, this is the first reported case of a coronoid process aneurysmal bone cyst presenting as temporal fossa swelling. Case presentation A 17 year old boy presented with a progressively increasing swelling in the left temporal region developed over the previous 8 months. An expansile lytic cystic lesion originating from the coronoid process of the left mandible and extending into the infratemporal and temporal fossa regions was found on CT scan. It was removed by a superior approach to the infratemporal fossa. Conclusion Aneurysmal bone cyst of the coronoid process can attain enormous dimensions until the temporal region is also involved. A superior approach to the infratemporal fossa is a reasonable approach for such cases, providing wide exposure and access to all parts of the lesion and ensuring better control and complete excision. PMID:16533409

  19. Aneurysmal bone cyst of the ethmoid sinus: A case report

    PubMed Central

    Sinha, Nitin Raj; Szmigielski, Wojciech; Khanna, Maneesh

    2010-01-01

    Summary Background: Aneurysmal bone cyst is an expansile bone lesion, non-neoplastic in nature, occurring most commonly in long bones. It is uncommon in facial bones and exceptionally rare in ethmoid bone. Ten cases of aneurysmal bone cysts of ethmoid bone have been reported so far. Case Report: A young adolescent presented with decreased vision and pain in the right eye. MRI revealed an expansile lesion having conspicuous fluid levels with a multiloculated appearance in the right ethmoid bone extending to the right orbit. CT was done to characterize better bone details. Both biopsy of the lesion and histopathology of resected specimen confirmed aneurysmal bone cyst. Conclusions: A characteristic appearance on MRI and CT examinations helped to confidently diagnose a relatively common lesion in an exceedingly rare location. PMID:22802795

  20. Metastatic potential of an aneurysmal bone cyst.

    PubMed

    van de Luijtgaarden, Addy C M; Veth, Rene P H; Slootweg, Piet J; Wijers-Koster, Pauline M; Schultze Kool, Leo J; Bovee, Judith V M G; van der Graaf, Winette T A

    2009-11-01

    Aneurysmal bone cysts (ABCs) are benign bone tumors consisting of blood-filled cavities lined by connective tissue septa. Recently, the hypothesis that ABCs are lesions reactive to local hemodynamics has been challenged after the discovery of specific recurrent chromosomal abnormalities. Multiple cases of malignant transformation of ABC into (osteo)sarcoma have been described, as well as a number of cases of telangiectatic osteosarcoma which had been misdiagnosed as ABC. We herewith document a case of a pelvic ABC metastatic to the lung, liver, and kidneys. Diagnosis was confirmed by the presence of a break in the USP6 gene, which is pathognomonic for ABC, in a pulmonary metastasis of our patient. Sarcomatous transformation as an explanation for this behavior was ruled out by demonstrating diploid DNA content in both the pulmonary lesion and the primary tumor. PMID:19838726

  1. Multiple soft tissue aneurysmal cysts: An occurrence after resection of primary aneurysmal bone cyst of fibula

    PubMed Central

    Karkuzhali, P; Bhattacharyya, Mahuya; Sumitha, P

    2007-01-01

    We report a case of multiple extraosseous aneurysmal cysts occurring in the muscle and subcutaneous plane of postero-lateral aspects of the upper right leg. They appeared about 15 months after resection of aneurysmal bone cyst of the upper end of the fibula. They varied in size from 2 cm to 5 cm. Radiologically they were well-defined lesions with central septate areas surrounded by a rim of calcification. Histologically they showed central cystic spaces separated by septa consisting of fibroblasts, osteoclast type of giant cells and reactive woven bone. Thus they showed histological similarity with aneurysmal bone cysts, but did not show any connection with the bone. Only very few examples of aneurysmal cysts of soft tissue had been described in the past one decade and they were reported in various locations including rare sites such as arterial wall and larynx. Recent cytogenetic analyses have shown abnormalities involving 17p11-13 and/or 16q22 in both osseous and extraosseous aneurysmal cysts indicating its probable neoplastic nature. Our case had unique features like multiplicity and occurrence after resection of primary aneurysmal bone cyst of the underlying bone. PMID:21139755

  2. Case reports: malignant transformation of aneurysmal bone cysts.

    PubMed

    Brindley, George W; Greene, John F; Frankel, Lawrence S

    2005-09-01

    An aneurysmal bone cyst is an uncommon benign primary bone tumor. Careful intralesional curettage through a wide cortical window in addition to cauterization with or without adjuvant therapy (phenol or hydrogen peroxide) and bone grafting or cementation is the preferred surgical treatment. Adjuvant or primary radiation of an aneurysmal bone cyst rarely is used because of its association with malignant transformation of the lesion. Several cases of late malignant transformation of primary aneurysmal bone cysts without adjuvant radiation have been reported. We provide additional documentation of two primary aneurysmal bone cysts treated surgically with careful intralesional curettage through a wide cortical window and allograft bone grafting without adjuvant radiation. At 5.5 years and 12 years after treatment, a telangiectatic osteosarcoma and a fibroblastic osteosarcoma, respectively, were identified in the site of the original lesions. Not only should aneurysmal bone cysts be evaluated carefully through histologic examination at presentation, patients also should be counseled regarding possible recurrence and the need for routine followups, especially if symptoms change. PMID:16131903

  3. Aneurysmal bone cyst of the larynx presenting with hypoglottic obstruction.

    PubMed

    Della Libera, D; Redlich, G; Bittesini, L; Falconieri, G

    2001-05-01

    We report a new case of aneurysmal bone cyst of the larynx occurring in a 22-year-old man. The lesion manifested with progressive breathing discomfort and appeared as a polypoid pedunculated mass attached to the subglottic mucosa. Microscopically, it featured numerous mononuclear and multinucleated giant cells surrounding cavernous spaces filled with blood. Foci of proliferating spindle cells and mature osteoid tissue could be recognized. There was no apparent relationship with the cricoid perichondrium. Clinical follow-up was negative for local recurrence. Based on this report and a review of the literature, we conclude that aneurysmal bone cyst of the larynx is phenotypically comparable to its bone homologue; however, its microscopic recognition may be difficult, especially on small biopsy fragments. Since it can be confused with several lesions, including telangiectatic osteosarcoma, awareness of this rare appearance of aneurysmal bone cyst is important to avoid unnecessary radical surgery. PMID:11300943

  4. Aneurysmal Bone Cyst of the Calcaneus

    PubMed Central

    Kaplanoğlu, Veysel; Ciliz, Deniz Sözmen; Kaplanoğlu, Hatice; Elverici, Eda

    2014-01-01

    Aneurysmal bone cysts (ABCs) are benign, non-neoplastic, expansile, vascular, locally destructive lesions. The lesion may arise de novo (65%) or secondarily (35%) in pre-existing benign or malignant lesions (giant cell tumor, osteoblastoma, chondroblastoma, angioma, and others). The calcaneus is a rare localization for ABC, comprising only 1.6% of the cases. In this paper, we present a case of a female patient with a 3-month history of heel pain that got worse and was accompanied by swelling and difficulty in walking. The magnetic resonance images of the postero-lateral calcaneus showed a contrast-enhanced cystic lesion located in the medullary cavity; exophytic portion of the tumor extended into the soft tissue causing distinctive cortical thinning. Heterogeneous hyperintense septae formations and blood level components were also detected. After correlation with pathology results, the lesion was diagnosed as an ABC. Since an ABC of the calcaneus is a rarely seen phenomenon, we present the radiologic findings in this case and a review of the literature. PMID:25396076

  5. Challenges in imaging and histopathological assessment of a giant cell tumour with secondary aneurysmal cyst in the patella

    PubMed Central

    Low, Soo Fin; Hanafiah, Mohammad; Nurismah, Md Isa; Suraya, Aziz

    2013-01-01

    The patella is an uncommon site for all primary and metastatic bone tumours and primary intra-osseous tumours of the patella are very rare. A majority of the patella tumours are benign. We report a patient with a sudden onset swelling and pain of the right knee following a staircase fall. The plain radiograph showed an expansile multiseptated patella lesion and it was further assessed with an MRI. The radiological findings and the initial histopathological features from a limited sample were suggestive of a primary aneurysmal bone cyst. However, the final histopathological diagnosis from a more adequate specimen was a giant cell tumour with a secondary aneurysmal bone cyst. PMID:24057334

  6. Aneurysmal bone cyst of maxillary alveolus: A rare case report

    PubMed Central

    Debnath, Subhas Chandra; Adhyapok, Apurba Kumar; Hazarika, Kriti; Malik, Kapil; Vatsyayan, Ashutosh

    2016-01-01

    Aneurysmal bone cyst (ABC) is a nonneoplastic rare pathologic entity of the jaws. Its locally aggressive nature and high recurrence rate after curettage make surgical resection a better treatment option. Here, we present a case of ABC of maxillary alveolus and its management by alveolectomy followed by white head varnish pack application in the surgical defect. PMID:27041915

  7. Aneurysmal bone cyst of the sphenoid with orbital involvement.

    PubMed Central

    Hunter, J. V.; Yokoyama, C.; Moseley, I. F.; Wright, J. E.

    1990-01-01

    We present a case of aneurysmal bone cyst involving the roof of the orbit and sphenoid bone, with plain film, computed tomography, and magnetic resonance imaging findings. The natural history and treatment depend on the presence of associated abnormalities such as fibrous dysplasia or a giant cell tumour. In this case the lesion was solitary and was successfully removed, so that possible complications from radiotherapy were avoided. Images PMID:2202437

  8. Primary Epiphyseal Aneurysmal Bone Cyst Of Distal Ulna

    PubMed Central

    Kapila, Rajesh; Sharma, Rakesh; Sohal, Yadwinder Singh; Singh, Dhalwinder; Singh, Sukhpal

    2015-01-01

    Introduction: Aneurysmal Bone Cyst (ABC) is a benign expansile cystic blood filled reactive lesion of the bone, most common in the first 2 decades of life. Though it can involve any bone in the body but tibia, humerus, femur and posterior elements of spine are most commonly affected. They most commonly involve metaphysis or metaphysio-diaphyseal part of the bone. Primary involvement of epiphysis is rarely reported. Here we present a case of 6 year old male child with an epiphyseal ABC of distal ulna. Its diagnosis, surgical management, clinical outcome with review of literature is discussed. PMID:27299110

  9. Cardiovocal Syndrome Secondary to an Aortic Aneurysm

    PubMed Central

    Wang, Hsing-Won; Chen, Mei-Chien; Chao, Pin-Zhir; Lee, Fei-Peng

    2016-01-01

    We reported that a 68-year-old man presented to the ENT outpatient department complaining of hoarseness for more than 10 months. Clinical exam identified left vocal palsy in the paramedian position and atrophic vocal folds were noted. Chest radiography revealed a large bulging contour overlying aorta and left hilar shadow. Aortic aneurysm was proved by CT scanning. Contrast-enhanced chest computed tomography for further evaluation showed a broad-based aortic aneurysm at proximal descending aorta, projecting anterolaterally. Cardiovocal syndrome was proved. The syndrome is a rare clinical presentation. While a patient with unilateral vocal palsy is encountered, one might keep in mind the possibility of cardiovocal syndrome especially in an adult who had a cardiovascular disease. PMID:27088024

  10. Cardiovocal Syndrome Secondary to an Aortic Aneurysm.

    PubMed

    Wang, Hsing-Won; Chen, Mei-Chien; Chao, Pin-Zhir; Lee, Fei-Peng

    2016-01-01

    We reported that a 68-year-old man presented to the ENT outpatient department complaining of hoarseness for more than 10 months. Clinical exam identified left vocal palsy in the paramedian position and atrophic vocal folds were noted. Chest radiography revealed a large bulging contour overlying aorta and left hilar shadow. Aortic aneurysm was proved by CT scanning. Contrast-enhanced chest computed tomography for further evaluation showed a broad-based aortic aneurysm at proximal descending aorta, projecting anterolaterally. Cardiovocal syndrome was proved. The syndrome is a rare clinical presentation. While a patient with unilateral vocal palsy is encountered, one might keep in mind the possibility of cardiovocal syndrome especially in an adult who had a cardiovascular disease. PMID:27088024

  11. Giant aneurysmal bone cyst of the mandible with unusual presentation.

    PubMed

    Capote-Moreno, Ana; Acero, Julio; García-Recuero, Ignacio; Ruiz, Julián; Serrano, Rosario; de Paz, Víctor

    2009-03-01

    Aneurysmal bone cysts are rare benign lesions of bone tissue, infrequent in craneofacial skeleton with regard to other structures like long bones or the spine. They are composed of sinusoidal and vascular spaces blood-filled and surrounded by fibrous tissue septa. We present a case of a 29-year-old Caucasian male with a big swelling in the left mandible associated to pain and rapid growth. He referred previous extraction of the left inferior third molar. On the X-ray study, an expansive multilocular and high vascularized bony lesion within the mandibular angle was observed. It produced expansion and destruction of lingual and buccal cortex. An incisional biopsy was performed showing a fibrous tissue with blood-filled spaces lesion suggestive of an aneurysmal bone cyst. After selective embolization of the tumour, surgical resection was done with curettage and immediate reconstruction of the defect with an anterior iliac crest graft. Aneurysmal bone cysts are non-neoplastic but locally aggressive tumours with occasional rapid growth that may be differentiated from other multilocular process like ameloblastoma, ossifying fibroma, epithelial cyst, giant cell granuloma and sarcomas. Treatment of choice consists on conservative surgical excision of the mass with curettage or enucleation. When resection creates a big defect, primary surgical reconstruction is recommended. PMID:19242394

  12. Surgical Treatment of Aneurysmal Bone Cysts of the Spine

    PubMed Central

    Mesfin, Addisu; McCarthy, Edward F.; Kebaish, Khaled M.

    2012-01-01

    Objective Our goal was to document the presentation, location, diagnostic modalities, preoperative embolization status, treatment, histology, complications, and recurrence rates for aneurysmal bone cysts of the mobile spine. Methods We reviewed our institution's database to identify patients diagnosed with aneurysmal bone cysts of the mobile spine (excluding the sacrum) from 1995 through 2006. Of those 17 patients, three were treated elsewhere and 14 underwent surgical treatment at our institution. Of those 14 patients, the nine (mean age at presentation, 17.2 years; range, 5‥32 years) with at least 2 years of follow-up (average, 49.6 months; range, 24‥88 months) formed our study group. For those nine patients, we tabulated the presentation, location, diagnostic modalities, preoperative embolization status, treatment, histology, complications, and recurrence rates. Results Pain was the presenting symptom in all nine patients. The lesion most commonly occurred in the cervical spine (five); two occurred in the lumbar spine, and two occurred in the thoracic spine. Patients underwent resection and combined anterior and posterior spinal arthrodesis (six) or resection and posterior spinal arthrodesis (three). There were four complications: one iliac crest donor site infection, one incidental durotomy, and two neurologic defcits. We noted two recurrences (both within 3 months). Conclusions Aneurysmal bone cysts of the spine can be successfully treated with surgical resection and instrumentation. PMID:23576920

  13. Aneurysm

    MedlinePlus

    ... is thought to play a role in abdominal aortic aneurysms. Atherosclerotic disease (cholesterol buildup in arteries) may also ... your risk of an aneurysm. Images Cerebral aneurysm Aortic aneurysm Intracerebellar hemorrhage - CT scan References Hauser SC. Vascular ...

  14. Aneurysmal Bone Cyst: An Analysis of 38 Cases and Report of Four Unusual Surface Ones

    PubMed Central

    Shooshtarizadeh, Tina; Movahedinia, Sajjadeh; Mostafavi, Hassan; Jamshidi, Khodamorad; Sami, Sam Hajialiloo

    2016-01-01

    Aneurysmal bone cyst (ABC) is a benign expansile bone tumor, most commonly involving the medulla of long bones. ABC rarely arises within the cortex or in the subperiosteal region, radiographically mimicking other conditions, in particular surface osteosarcomathat is low-grade in nature and may go secondary ABC changes, and telangiectatic osteosarcoma. Both of these are sometimes mistaken microscopically for primary ABC. We review the characteristics of ABC cases in our center and report four unusualsurface ABCs arising in the subperiosteal or cortical region of long bones, identified among 38 histologically proven ABCs during a four-year period in our center. The surface ABCs occurred at an older agewith a predilection for diaphysis of femur, tibia, and humerus. PMID:27200397

  15. Spinal aneurysmal bone cyst presenting as acute paraparesis during pregnancy.

    PubMed

    Li, Luyuan; Tan, Lee A; Wewel, Joshua T; Kasliwal, Manish K; O'Toole, John E

    2016-06-01

    Aneurysmal bone cysts (ABC) are benign but locally aggressive osseous lesions characterized by blood-filled cystic cavities that account for 1-2% of all bone tumors. While pain remains the most common presenting symptom of spinal ABC, extensive anterior column involvement can result in vertebral fractures, spinal instability, and neurological deficits from compression of neural elements. An exceedingly rare case of thoracic ABC presenting as acute paraparesis in a 21-year-old pregnant woman, that was successfully treated with urgent surgical decompression and stabilization, is reported, with discussion of management strategies and review of the pertinent literature. PMID:26846358

  16. Primary Aneurysmal Bone Cyst in the Iliac Bone: A Case Report

    PubMed Central

    Kim, Chae Geun

    2014-01-01

    Symptomatic aneurysmal bone cysts with expansible lesions in the pelvis are rare in children. The management of an aggressive vascular lesion in a female child is challenging. The standard treatment for aneurysmal bone cysts is accompanied by a high risk of local recurrence. A 12-year-old female presented with a history of pelvic pain for 5 months. Plain radiographs and magnetic resonance imaging showed a very large expansile lytic lesion arising from the right iliac bone. Intralesional curettage, electric cauterization, chemical sclerotherapy and allogeneic bone graft were performed through the window of the iliac crest. At a follow-up consultation 3.5 years post-surgery, the child had painless full-range movement in the hip joint with no recurrence. Although many treatment options are described, our patient was treated successfully using curettage and allogeneic bone graft without recurrence.

  17. Intradiploic frontal bone aneurysmal bone cyst in a child: a case report

    PubMed Central

    Sanghvi, D A; Iyer, V R; Chagla, A S; Shenoy, A

    2010-01-01

    This report presents the imaging appearances of an uncommon case of intradiploic frontal bone aneurysmal bone cyst (ABC) in a 10-year-old girl. ABCs are rare in the calvarium. The radiological and aetiopathological differences between the more commonly occurring ABCs of the long bones and vertebrae, and their rarer counterparts in the calvarium and facial bones, have been discussed. Unique also to this case is the reconstruction performed using the outer table of the bone flap after excising the tumour. PMID:20395468

  18. Aneurysmal Bone Cyst Of Pubic Ramus: A Rare Entity

    PubMed Central

    Rao, Ashith; Samant, Prakash D; Varshneya, Ankit

    2013-01-01

    Introduction: Aneurysmal bone cyst is an expansile, lytic, multiloculated, fluid filled cavities which usually occurs in the metaphysis of the long bones. ABC of the pubic ramus is a rare entity.. Case Report: We present a case of a 21 year old male who presented with a swelling of the right inguinal region which was gradually progressive. Radiologically, there was a lytic expansile lesion of the superior pubic ramus. A contrast computed tomography revealed multiloculated cystic cavities and histopathology confirmed the diagnosis of ABC. Surgical excision of the complete tumor by anterior approach was done. Till date (2 years since surgery) patient has no recurrence. Conclusion: ABC of pubic ramus is a rare entity and other differentials should always be kept in mind with confirmation of diagnosis by histopathology. Treatment with surgical curettage and bone grafting the defect is curative in selective cases but in this case due to size and location excision is the choice of treatment. PMID:27298931

  19. Current Strategies for the Treatment of Aneurysmal Bone Cysts.

    PubMed

    Tsagozis, Panagiotis; Brosjö, Otte

    2015-12-28

    Aneurysmal bone cysts are benign bone tumors that usually present in childhood and early adulthood. They usually manifest as expansile osteolytic lesions with a varying potential to be locally aggressive. Since their first description in 1942, a variety of treatment methods has been proposed. Traditionally, these tumors were treated with open surgery. Either intralesional surgical procedures or en bloc excisions have been described. Furthermore, a variety of chemical or physical adjuvants has been utilized in order to reduce the risk for local recurrence after excision. Currently, there is a shift to more minimally invasive procedures in order to avoid the complications of open surgical excision. Good results have been reported during percutaneous surgery, or the use of embolization. Recently, sclerotherapy has emerged as a promising treatment, showing effective consolidation of the lesions and functional results that appear to be superior to the ones of open surgery. Lastly, non-invasive treatment, such as pharmaceutical intervention with denosumab or bisphosphonates has been reported to be effective in the management of the disease. Radiotherapy has also been shown to confer good local control, either alone or in conjunction to other treatment modalities, but is associated with serious adverse effects. Here, we review the current literature on the methods of treatment of aneurysmal bone cysts. The indication for each type of treatment along reported outcome of the intervention, as well as potential complications are systematically presented. Our review aims to increase awareness of the different treatment modalities and facilitate decision-making regarding each individual patient. PMID:26793296

  20. [Aneurysmal bone cyst of the spine. Case report].

    PubMed

    Rosales-Olivares, Luis Miguel; Baena-Ocampo, Leticia del Carmen; Miramontes-Martínez, Victor Paul; Alpízar-Aguirre, Armando; Reyes-Sánchez, Alejandro

    2006-01-01

    The aneurysmal bone cyst (ABC) is a fast-growing tumor of undefined neoplastic nature. It is occasionally an aggressive benign lesion whose treatment of choice is a complete resection, even though the risk of profuse transoperative bleeding exists. We present a female patient with thoracic spine deformity, with progressive paresthesias and muscle weakness of lower extremities that evolved to paralysis of both lower extremities and sphincter incontinence. Based on radiographic films, lytic lesions were identified at T7 to T9 vertebrae as well as medullary space invasion. In electrophysiologic tests, a complete somatosensorial pathway block was reported. Prior to resection of the neoplastic lesion and thoracolumbar stabilization, an incisional biopsy was performed. There was no postoperative medullary functional improvement. Morphological findings corresponded to an aneurysmal bone cyst at T8. This lesion is mainly located in the long bones and less frequently of the spine, where instability and medullary compression may occur. It is possible to confuse this neoplasia with other lesions. Hence, definite diagnosis with biopsy is necessary for determining an adequate therapeutic plan to eradicate recurrence risk or associated neurologic sequelae, as well as to gain proper stability at the involved vertebral segments. PMID:17224110

  1. Current Strategies for the Treatment of Aneurysmal Bone Cysts

    PubMed Central

    Brosjö, Otte

    2015-01-01

    Aneurysmal bone cysts are benign bone tumors that usually present in childhood and early adulthood. They usually manifest as expansile osteolytic lesions with a varying potential to be locally aggressive. Since their first description in 1942, a variety of treatment methods has been proposed. Traditionally, these tumors were treated with open surgery. Either intralesional surgical procedures or en bloc excisions have been described. Furthermore, a variety of chemical or physical adjuvants has been utilized in order to reduce the risk for local recurrence after excision. Currently, there is a shift to more minimally invasive procedures in order to avoid the complications of open surgical excision. Good results have been reported during percutaneous surgery, or the use of embolization. Recently, sclerotherapy has emerged as a promising treatment, showing effective consolidation of the lesions and functional results that appear to be superior to the ones of open surgery. Lastly, non-invasive treatment, such as pharmaceutical intervention with denosumab or bisphosphonates has been reported to be effective in the management of the disease. Radiotherapy has also been shown to confer good local control, either alone or in conjunction to other treatment modalities, but is associated with serious adverse effects. Here, we review the current literature on the methods of treatment of aneurysmal bone cysts. The indication for each type of treatment along reported outcome of the intervention, as well as potential complications are systematically presented. Our review aims to increase awareness of the different treatment modalities and facilitate decision-making regarding each individual patient. PMID:26793296

  2. Lower Limb Reconstruction with Tibia Allograft after Resection of Giant Aneurysmal Bone Cyst

    PubMed Central

    2016-01-01

    Aneurysmal bone cysts (ABCs) are benign, expansible, nonneoplastic lesions of the bone, characterized by channels of blood and spaces separated by fibrous septa, which occur in young patients and, occasionally, with aggressive behavior. Giant ABC is an uncommon pathological lesion and can be challenging because of the destructive effect of the cyst on the bones and the pressure on the nearby structures, especially on weight-bearing bones. In this scenario, en bloc resection is the mainstay treatment and often demands complex reconstructions. This paper reports a difficult case of an unusual giant aneurysmal bone cyst, which required extensive resection and a knee fusion like reconstruction with tibia allograft. PMID:27413565

  3. Aneurysms

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Aneurysms Basic Facts & Information Fill a balloon too full ... of what can happen when you have an aneurysm. Medically, when an artery “balloons,” or widens, it ...

  4. Aneurysmal bone cyst of the lunate: Case report and literature review.

    PubMed

    Sá Rodrigues, André; Dopico, Carlos; Matos, Rui; Pinto, Rui; Vidinha, Vitor

    2016-12-01

    The aneurysmal bone cyst (ABC) is a benign osteolytic bone neoplasm. Although most ABC is asymptomatic, in some cases they produce a mass effect, impinging against soft tissues or interfering with joint function. The authors present a rare case report of a lunate ABC successfully treated by curettage and bone grafting, and review the literature of this pathology. PMID:27453641

  5. Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

    PubMed

    Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

    2015-06-01

    Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture. PMID:26280957

  6. Bone marrow-derived endothelial progenitor cells are involved in aneurysm repair in rabbits.

    PubMed

    Fang, Xinggen; Zhao, Rui; Wang, Kuizhong; Li, Zifu; Yang, Penfei; Huang, Qinghai; Xu, Yi; Hong, Bo; Liu, Jianmin

    2012-09-01

    Endothelial progenitor cells (EPC) are believed to be involved in aneurysmal repair and remodeling. The aim of this study was to test this hypothesis and, if true, explore how EPC contribute to aneurysm repair in a rabbit model of elastase-induced carotid aneurysm. Rabbits were divided randomly into an in situ carotid EPC transfusion group (ISCT group, n=5), and an intravenous EPC transfusion group (IVT group, n=5). Autologous EPC were double-labeled with Hoechst 33342 and 5,6-carboxyfluorescein diacetate succinimidyl ester before injection into the animals in either the carotid artery (ISCT group) or marginal ear veins (IVT group). Three weeks later, labeled cells in the aneurysms were observed with respect to location, adhesion, and growth to detect signs of aneurysm repair. Labeled EPC were detected within the neointima in all five aneurysms in the ISCT group and in three of the five aneurysms in the IVT group, but there was no endothelial growth in the aneurysmal neointima in either group. These results show that bone marrow-derived EPC are involved in the process of aneurysm repair in this rabbit model. PMID:22789632

  7. Aneurysmal bone cysts of the spine: treatment options and considerations.

    PubMed

    Boriani, Stefano; Lo, Sheng-fu L; Puvanesarajah, Varun; Fisher, Charles G; Varga, Peter P; Rhines, Laurence D; Germscheid, Niccole M; Luzzati, Alessandro; Chou, Dean; Reynolds, Jeremy J; Williams, Richard P; Zadnik, Patti; Groves, Mari; Sciubba, Daniel M; Bettegowda, Chetan; Gokaslan, Ziya L

    2014-10-01

    Aneurysmal bone cysts (ABCs) are benign bone lesions with annual incidences ranging from 1.4 to 3.2 cases per million people. Approximately, 10-30% of ABCs are found in the spine. Such lesions are traditionally treated with curettage or other intralesional techniques. Because ABCs can be locally aggressive, intralesional resection can be incomplete and result in recurrence. This has led to increased use of novel techniques, including selective arterial embolization (SAE). This study aims to: (1) compare outcomes based on extent of surgical resection, and (2) compare the efficacy of SAE versus surgical resection. Clinical data pertaining to 71 cases of spinal ABCs were ambispectively collected from nine institutions in Europe, North America, and Australia. Twenty-two spinal ABCs were treated with surgery, 32 received preoperative embolization and surgery, and 17 were treated with SAE. Most tumors were classified as Enneking stage 2 (n = 29, 41%) and stage 3 (n = 29, 41%). Local recurrence and survival were investigated and a significant difference was not observed between treatment groups. However, all three local recurrences occurred following surgical resection. Surgical resection was further categorized based on Enneking appropriateness. Recurrences only occurred following intralesional Enneking inappropriate (EI) resections (P = 0.10), a classification that characterized 47% of all surgical resections. Furthermore, 56% of intralesional resections were EI, compared to only 10% of en bloc resections (P = 0.01). Although SAE treatment did not result in any local recurrences, 35% involved more than five embolization procedures. Spinal ABCs can be effectively treated with intralesional resection, en bloc resection, or SAE. Preoperative embolization should be considered before intralesional resection to limit intraoperative bleeding. Treatment plans must be guided by lesion characteristics and clinical presentation. PMID:25059450

  8. Temporal aneurysmal bone cyst: cost-effective method to achieve gross total resection.

    PubMed

    Sodhi, Harsimrat Bir Singh; Salunke, Pravin; Agrawal, Parimal; Gupta, Kirti

    2016-08-01

    Aneurysmal bone cyst (ABC) is a vascular benign bony expansile lesion. The treatment is gross total resection. Surgery for a skull base aneurysmal bone cyst poses a significant challenge because of its vascularity and the adjacent neurovascular structures. We present the case of a young male with a temporal aneurysmal bone cyst who underwent gross total resection of the lesion. The external carotid artery (ECA) was temporarily clamped to cut off the vascular supply. There was no intraoperative event, and the patient made a good postoperative clinical recovery. This technique was used as an alternative to subselective endovascular embolization of the ECA branches. This case represents a simple yet cost-effective surgical technique to control bleeding for a highly vascular lesion such as ABCs, especially in resource-deficient countries. PMID:27334736

  9. Malignant transformation of aneurysmal bone cyst, with an analysis of the literature.

    PubMed

    Kyriakos, M; Hardy, D

    1991-10-15

    An 11-year-old girl had a lytic, benign-appearing, expansive lesion of the distal tibia radiologically interpreted as an aneurysmal bone cyst (ABC). Tissue from two extensive curettage procedures was also histologically diagnosed as ABC. Approximately 50 months after the onset of symptoms, and 28 months after her last curettage, a highly pleomorphic osteosarcoma developed. The patient had not received prior radiation therapy. The cases in the literature of possible malignant transformation of ABC are reviewed. The authors separate their case from telangiectatic osteosarcoma, and from "aneurysmal bone cyst-like osteosarcoma." PMID:1913522

  10. Aneurysmal bone cyst of the orbit: a case report and review of literature.

    PubMed

    Menon, J; Brosnahan, D M; Jellinek, D A

    1999-12-01

    Aneurysmal bone cyst is a benign fibroosseous lesion which rarely occurs in the orbit. We report on a 7-year-old girl with aneurysmal bone cyst of the orbit who presented with painless proptosis and diplopia. Optic nerve compression resulted in field loss and delayed visual evoked potentials. Radiological and histological features are discussed. The lesion was excised via a frontal craniotomy and the orbital roof reconstructed with a prefabricated titanium plate. Post-operatively a rapid resolution of the proptosis and diplopia followed. Previous reported cases of this rare entity in the orbit are also reviewed. PMID:10707141

  11. Secondary alveolar bone grafting: our experience with olecranon bone graft.

    PubMed

    Nadal, Emmanuela; Sabás, Mariana; Dogliotti, Pedro; Espósito, Raquel

    2010-03-01

    Management of alveolar cleft has dramatically changed during the last century: secondary alveolar bone grafting is now an integral part of cleft palate and craniofacial center's protocols. The objectives of alveolar repair and bone grafting are as follows: providing a continuous and stable maxillary dental arch, closure of oronasal fistulae, adequate bone for tooth eruption or orthodontic movement, and nasal base support, improving facial aesthetic. Although cancellous iliac bone is the donor site selected more frequently, bone grafts harvested from different sites have been advocated to decrease donor site morbidity.The aim of this study was to propose and evaluate the use of olecranon as a donor site in 24 patients with secondary alveolar cleft. The graft is taken as a single piece to fit the alveolar cleft defect, and it includes periosteum and corticocancellous bone to improve early vascularization and greater volume maintenance. PMID:20186086

  12. Aneurysmal bone cyst primary - about eight pediatric cases: radiological aspects and review of the literature

    PubMed Central

    Boubbou, Meryem; Atarraf, Karima; Chater, Lamiae; Afifi, Abderrahmane; Tizniti, Siham

    2013-01-01

    The aneurysmal bone cyst is a pseudotumoral lesion that can take several aspects. This is a rare lesion representing 1% of bone tumors. It appears usually during the first 30 years of life. The pathogenesis is that of a process of “dysplasia/hyperplasia”, favored by a circulatory deficiency and hemorrhage within the lesion and the phenomena of osteoclasis. The objective of this work is to illustrate with analysis, the specific forms and atypical aneurysmal bone cyst which often pose a diagnostic challenge requiring radiological investigation with histological confirmation. We report eight pediatric cases of aneurysmal cysts collected over a period of 3 years, 3 boys and 5 girls. All patients had standard radiographs. MRI was performed in three patients. The diagnosis was confirmed histologically. The atypia has been in the seat: fibula (1 case), metaphyseal (2 cases), diaphyseal (4 cases) and metatarsal (1 case). Aneurysmal bone cyst is a rare benign tumor with predilection to the metaphysis of long bones. Atypical forms even fewer are dominated by the atypical seat. PMID:24244797

  13. [Spinal cord compression caused by spinal aneurysmal bone cyst (author's transl)].

    PubMed

    Steimlé, R; Pageaut, G; Jacquet, G; Gehin, P; Sexe, C B

    1975-01-01

    Spinal aneurysmal bone cyst is sufficiently rare for the authors to report this case with rapid evolution and development of paraplegia. Total removal was achieved, and clinical recovery remained complete six months after operation. The pathogenic, clinical, radiological, histological and therapeutic aspects are briefly reviewed and discussed. PMID:1225017

  14. Skull Base Aneurysmal Bone Cyst Presented with Foramen Jugular Syndrome and Multi-Osseous Involvement

    PubMed Central

    Aghaghazvini, Leila; Sedighi, Nahid; Karami, Parisa; Yeganeh, Omid

    2012-01-01

    Aneurysmal bone cyst (ABC) is an expansile bone lesion that usually involves the long bones. Skull base involvement is rare. Hereby, we describe a 17-year-old man with hoarseness, facial asymmetry, left sided sensorineural hearing loss and left jugular foramen syndrome. CT scan and MRI showed a skull base mass that was confirmed as ABC in histopathology. The case was unusual and interesting due to the clinical presentation of jugular foramen syndrome and radiological findings such as severe enhancement and multiosseous involvement. PMID:23329983

  15. Soft tissue aneurysmal bone cyst: a rare case in a middle aged patient

    PubMed Central

    Baker, Kevin S; Gould, Elaine S; Patel, Hiten B; Hwang, Sonya J

    2015-01-01

    Soft tissue aneurysmal bone cyst is a rare entity, with about 20 cases reported in literature, only 3 of which are in patients over 40 years of age. We present a case of a 41 year old Latin American female who presented for evaluation of atraumatic chest pain with radiation to the left shoulder. Her initial workup was negative, including radiographic imaging of the chest and left shoulder. 4 months later, she presented to her orthopedic surgeon with a palpable mass and mild left shoulder pain. Radiographs acquired at that time demonstrated a 7.0 × 5.5 × 6.7 cm mass with rim calcification in the region of the upper triceps muscle. Subsequent CT imaging showed central areas of hypodensity and thin septations, a few of which were calcified. MR evaluation showed hemorrhagic cystic spaces with multiple fluid-fluid levels and enhancing septations. Surgical biopsy was performed and pathology was preliminarily interpreted as cystic myositis ossificans, however on final review the diagnosis of soft tissue aneurysmal bone cyst was made. The lesion was then surgically excised and no evidence of recurrence was seen on a 3 year post-op radiograph. Following description of our case, we conduct a literature review of the imaging characteristics, diagnosis, and treatment of soft tissue aneurysmal bone cyst. PMID:25926918

  16. Giant aneurysmal bone cyst of the mandible: A case report and review of literature

    PubMed Central

    Bharadwaj, Gaurav; Singh, Neeraj; Gupta, Amit; Sajjan, Anand K.

    2013-01-01

    Aneurysmal bone cysts are rare benign lesions of bone tissue. They are composed of vascular spaces blood-filled and surrounded by fibrous tissue septa. They are considered as pseudo cysts because of lack of epithelial lining. Here, we describe a giant case of ABC in 12-year-old female child having a massive swelling over the right side of the mandible treated with segmental resection and reconstruction with a reconstruction plate. Case is also discussed with the review of literature. PMID:24163565

  17. Aneurysmal bone cyst of medial cuneiform and a novel surgical technique for mid-foot reconstruction

    PubMed Central

    Sampath Kumar, Venkatesan; Jalan, Divesh; Khan, Shah Alam; Mridha, Asit Ranjan

    2014-01-01

    Aneurysmal bone cyst of the foot is extremely rare and the involvement of medial cuneiform has never been reported in the literature. In this report, we describe a 15-year-old boy who presented with a 6-month history of pain and swelling in his left foot. Radiograph demonstrated a lytic lesion in the medial cuneiform extending on to the middle cuneiform, the navicular bone and the base of the first metatarsal. En bloc resection of the lesion was performed using a dorsal longitudinal incision along the first ray. Tricortical iliac crest graft was harvested and shaped to fill the defect. Two drill holes were made and the tibialis anterior tendon was attached to the graft. Prepared, morcellised allograft was placed along the junction of autograft and host bone. At 1-year follow-up, the patient was pain free, the medial arch of the foot was maintained and the graft had united with the host bone. PMID:24563041

  18. Automatic bone-free rendering of cerebral aneurysms via 3D CTA

    NASA Astrophysics Data System (ADS)

    Saha, Punam K.; Abrahams, John M.; Udupa, Jayaram K.

    2001-07-01

    3D computed tomographic angiography (3D-CTA) has been described as an alternative to digital subtraction angiography (DSA) in the clinical evaluation of cerebrovascular diseases. A bone-free rendition of 3D-CTA facilitates a quick and accurate clinical evaluation of the disease. We propose a new bone removal process that is accomplished in three sequential steps - (1) primary delineation and removal of bones, (2) removing the effect of partial voluming around bone surfaces, and (3) removal of thin bones around nose, mouth and eyes. The bone removed image of vasculature and aneurysms is rendered via maximum intensity projection (MIP). The method has been tested on 10 patients' 3D-CTA images acquired on a general Electric Hi-Speed Spiral CT Scanner. The algorithm successfully subtracted bone showing the cerebral vasculature in all 10 patients' data. The method allows for a unique analysis of 3D-CTA data for near automatic removal of bones. This greatly reduces the need for manual removal of bones that is currently utilized and greatly facilitates the visualization of the anatomy of vascular lesions.

  19. Endovascular Treatment of a Superior Mesenteric Artery Aneurysm Secondary to Behcet's Disease with Onyx (Ethylene Vinyl Alcohol Copolymer)

    SciTech Connect

    Gueven, Koray Rozanes, Izzet; Kayabali, Murat; Minareci, Ozenc

    2009-01-15

    Behcet's disease is a complex multisystemic chronic inflammatory disease that is characterized by oral and genital aphtous ulcers and vasculitis. Aneurysms of major arteries are the most important cause of mortality in Behcet's disease. Four patients with superior mesenteric artery (SMA) aneurysms related to Behcet's disease have been reported in the literature. We report here the first successful endovascular treatment of a giant, wide-necked SMA aneurysm secondary to Behcet's disease. We performed a balloon-assisted embolization technique using ethylene vinyl alcohol copolymer (Onyx, ev3, Irvine, CA, USA). There were no signs of recurrence during 2-year follow-up.

  20. Aneurysmal Bone Cyst Presenting as a Pathologic Fracture in a 12-Year-Old Football Player

    PubMed Central

    Welk, Aaron B.; Norman W., Kettner

    2014-01-01

    Objective The purpose of this report is to describe a case of an aneurysmal bone cyst presenting as a pathologic fracture in a young athlete. Case report A 12-year-old patient presented to a chiropractic teaching clinic with a 1-week history of posterior neck pain and stiffness following a helmet-to-helmet collision in football practice. Cervical spine radiographs were taken. Lateral view radiograph demonstrated a pathologic fracture through a lytic, expansive lesion in the posterior arch of C7 with mild subluxation of the C7/T1 apophyseal joints and angulation of the C7/T1 disk space. Based upon these findings, additional diagnostic imaging was ordered. Findings on advanced imaging studies included the following: On computed tomography, the C7 lesion showed medullary destruction, cortical thinning and expansion, and a horizontally oriented fracture through the spinous and lamina. Magnetic resonance imaging studies for sagittal T2 and contrast-enhanced T1-weighted magnetic resonance images revealed fluid/fluid levels in the C7 spinous and peripheral enhancement with contrast. Outcome The patient was referred to a local hospital for treatment. The lesion was treated with resection of the posterior arch, and an aneurysmal bone cyst was confirmed histologically. The patient developed a kyphotic deformity at the site of resection and cervical instability. A subsequent fusion was performed. Conclusion Aneurysmal bone cysts are rare lesions. In this case, the initial traumatic history masked the underlying pathology. Although rare, pathologic fracture should be considered in cases of vertebral fracture in young patients. PMID:24711787

  1. Aneurysmal bone cyst and telangiectatic osteosarcoma. A histopathological and morphometric study.

    PubMed

    Ruiter, D J; Cornelisse, C J; van Rijssel, T G; van der Velde, E A

    1977-04-29

    In a series of 105 cases of aneurysmal bone cyst, 18 showed an unusually high level of mitotic activity and/or increased nuclear pleomorphism which complicated the differential diagnosis with respect to telangiectatic osteosarcoma. An attempt was made to use semi-automatized morphometric and histophotometric techniques to establish objective morphological differences between these unusual cases of aneurysmal bone cyst and 16 cases of telangiectatic osteosarcoma. Three cases (two of aneurysmal bone cyst and one of telangiectatic osteosarcoma) proved unsuitable for analysis. In 24 of the remaining 31 cases (77%) a computerized discriminant analysis permitted correct discreimination with a high degree of certainty on the basis of quantitative nuclear characteristics determined in paraffin sections. In the other 7 cases the diagnosis was less certain (3), doubtful (2) or erroneous (2). The relevant nuclear characteristics were (in ascending sequence of discrimination): the largest nuclear surface area, the mitotic index, and the percentage of nuclear sections exceeding an arbitrarily chosen limit of 60 micron2. The criterion of nuclear size for discrimination between these benign and malignant lesions could be applied for two reasons: firstly, because a group of extremely large nuclei occur in malignant cases, and secondly, because the average nuclear size is larger in malignant than in benign lesions. The extremely large nuclei occur as only a small percentage of the total nuclear population. The other variables investigated, i.e., cellularity and nuclear contour ratio, did not contribute greatly to the differentiation. In 11 cases, the average nuclear Feulgen extinction was estimated as an additional variable. PMID:140511

  2. Aggressive aneurysmal bone cyst of the maxilla confused with telangiectatic osteosarcoma.

    PubMed

    Lee, Hyun-Min; Cho, Kyu-Sup; Choi, Kyung-Un; Roh, Hwan-Jung

    2012-06-01

    Aneurysmal bone cyst (ABC) is a benign, expansile lesion typically affecting the long bones and vertebrae of patients younger than 20 years. Approximately 2% of ABCs occur in the head and neck region, most commonly affecting the mandible. Although the most common co-existing lesion associated with ABCs is the giant cell tumor, ABCs can be radiologically confused with telangiectatic osteosarcoma in cases of aggressive behavior and rapid growth. Here, we report a case of an aggressive ABC of the maxilla confused with telangiectatic osteosarcoma in a patient who underwent several operations for an osteoblastoma that was diagnosed histopathologically. This case highlights the need for a differential diagnosis both radiologically and histopathologically, because ABCs can easily be interpreted as a giant cell tumor or an osteoblastoma, and, on occasion, can be mistaken for osteogenic malignancies. PMID:21862268

  3. Diagnosis of an aneurysmal bone cyst of the cricoid cartilage: A case report

    PubMed Central

    CHENG, YUSHENG; XU, HONGMING; KVIT, ANTON A.; YU, ZIWEI

    2015-01-01

    An aneurysmal bone cyst (ABC) is a type of reactive reparative bone neoplasm that rarely occurs in the head and neck. To date, only a small number of cases have been previously reported. The present study reports the case of a 58-year-old male who presented with a tumor in the laryngeal cricoid cartilage, a rare position for a tumor, who subsequently underwent treatment by surgical resection. Based on the observations of the present study and a literature review, it was concluded that an ABC of the larynx can be identified based on a combination of radiology and postoperative histopathology examinations. However, following a tracheotomy and excision, the difficulty of performing tracheal cannula removal is inevitable. The present study described in detail a rare disease, ABC, occurring in the larynx. More cases are required for follow-up studies. PMID:26622349

  4. Treatment of a spinal aneurysmal bone cyst using combined image-guided cryoablation and cementoplasty.

    PubMed

    Tsoumakidou, Georgia; Too, Chow Wei; Garnon, Julien; Steib, Jean-Paul; Gangi, Afshin

    2015-02-01

    The authors describe the case of a 6.6-cm symptomatic spinal aneurysmal bone cyst (ABC) in a 17-year-old athlete treated percutaneously. Surgical treatment was not considered as the first option owing to its invasiveness and associated morbidity. CT-guided cryoablation of the expansile part of the ABC was performed for tumour shrinkage and nerve decompression. Thermal insulation, temperature monitoring and functional control/electrostimulation of the neural structures at risk were applied. Finally, the bony defect was cemented. No complications occurred during the procedure. Complete resolution of the ABC on imaging and clinical improvement were achieved. Percutaneous cryoablation should be considered as an alternative treatment option, especially when tumour size reduction is desired. PMID:25091121

  5. Soft tissue aneurysmal bone cyst in a 10-year-old girl

    PubMed Central

    HAO, YONGQIANG; WANG, LEI; YAN, MENGNING; JIN, FANGCHUN; GE, SHENGFANG; DAI, KERONG

    2011-01-01

    We report the case of a 10-year-old girl with a soft tissue aneurysmal bone cyst (STABC) located in the posterior aspect of the left shoulder. Conventional radiography revealed an oblong mass with a calcified rim. On the computed tomography scan, the lesion appeared to have a non-uniform intralesional density with an incomplete rim. Magnetic resonance imaging revealed a multi-cavity lesion with fluid-fluid levels. Following pathological examination, the lesion was diagnosed as a STABC. This may be only the twentieth reported case in the English literature of this extremely rare benign tumor occurring in soft tissue. Eight months after surgery the patient was assessed at our outpatient clinic and found to have excellent mobility of her left shoulder and no sign of recurrence. PMID:22740948

  6. Unusual mandibular condylar pathology: Aneurysmal bone cyst, a case report and review on reconstruction

    PubMed Central

    Kar, Indu Bhusan; Mishra, Niranjan; Ukey, Rahul B.; Chopda, Prashant D.

    2015-01-01

    Aneurysmal bone cysts (ABCs) involving condyle are unusual clinical presentation affecting younger group of society with only 12 cases reported till today in English literature. In this case of ABC condyle following resection, reconstruction of temporomandibular joint was done by alloplastic condylar prosthesis as a primary choice. Monthly basis follow-up was done for 1-year with a successful result. Reviewing the reconstructive options used in ABC condyle cases we found that the condylar head add-on system has shown a satisfactory result in comparison to costochondral graft with no donor site morbidity. We recommend condylar head add-on system should be preferred as a primary reconstructive option, reserving the autograft for recurrence cases. PMID:26668469

  7. First report of an aneurysmal bone cyst presenting as subungual mass.

    PubMed

    Müller, Cornelia Sigrid Lissi; Kim, Yoo-Jin; Koch, Katrin; Schneider, Günther; Pföhler, Claudia; Kohn, Dieter; Vogt, Thomas; Baumhoer, Daniel

    2016-08-01

    Painful subungual tumor masses in the toes usually emerge as glomus tumors or subungual exostoses. We present a patient with an aneurysmal bone cyst located subungually in whom the diagnosis was delayed due to inadequate diagnostic procedures, which led to marked destruction of the distal phalanx of the great toe of the right foot. After biopsy, the distal phalanx could not be preserved due to critical soft tissue involvement and the size of the process. Thus, we describe this rare entity to encourage clinicians to establish the diagnosis by biopsy of a tissue swelling of unclear origin and duration that does not resolve after a short time. Imaging examinations are useful in demonstrating periosteal involvement and extension of the lesion and can be helpful in the diagnostic algorithm. An interdisciplinary approach is a top priority to ensure optimal treatment. PMID:27106295

  8. New Bone Formation after Ligation of the External Carotid Artery and Resection of a Large Aneurysmal Bone Cyst of the Mandible with Reconstruction: A Case Report

    PubMed Central

    Perumal, Colin; Mohamed, Ashraf; Singh, Avin

    2011-01-01

    The aneurysmal bone cyst (ABC) is a benign cystic and expanding osteolytic lesion consisting of bone-filled spaces of variable size, separated by connective tissue containing trabeculae of bone or osteoid tissue and osteoclast giant cells. Radiographic findings may vary from unicystic or moth-eaten radiolucencies to extensive multilocular lesions with bilateral expansion and destruction of mandibular cortices. Treatment modalities include curettage (with reported recurrences) and resection with immediate reconstruction. The main arterial and feeder vessels may be embolized to prevent profuse intraoperative blood loss and achieve a bloodless surgical field. Failed embolization may necessitate ligation of the external carotid artery of the affected side. PMID:23450035

  9. Five-year evolution of a telangiectatic osteosarcoma initially managed as an aneurysmal bone cyst.

    PubMed

    Saito, Tsuyoshi; Oda, Yoshinao; Kawaguchi, Ken-Ichi; Tanaka, Kazuhiro; Matsuda, Shuichi; Sakamoto, Akio; Iwamoto, Yukihide; Tsuneyoshi, Masazumi

    2005-05-01

    We present the clinical, radiographic, and pathologic features of a telangiectatic osteosarcoma (TOS) of the right femoral neck in a 20-year-old man which was initially diagnosed and managed as an aneurysmal bone cyst (ABC). The lesion recurred twice. At the second recurrence TOS was diagnosed. The first local recurrence was recognized 4 years 8 months after the first operation. The clinical diagnosis for the recurrent lesion was recurrent ABC, and curettage and bone graft with internal fixation were performed. The second local recurrence was observed 8 months after the second surgery. The right lesser trochanter appeared destroyed on the radiograph, and a large medial soft tissue mass was demonstrated by computed tomography. The patient underwent wide resection of the tumor with prosthetic replacement of the right proximal femur. The histologic section for this lesion showed a blood-filled cystic lesion, and its wall contained sarcomatous cells with atypical mitoses and tumor osteoid. The histologic diagnosis for the second recurrent lesion was high-grade TOS. The retrospective review of the histologic section for the primary lesion showed similar features to ABC except for a few bizarre cells without mitosis in the tissue of cystic wall. The patient demonstrates no evidence of disease 13 months after the last surgery without adjuvant therapy (he declined chemotherapy). PMID:15570421

  10. Conversion of Aneurysmal Bone Cyst into Fibrous Dysplasia: A Rare Pediatric Case Report.

    PubMed

    Arango-Fernández, Hernán; Pineda, Saulo; Elneser, Nadim; Gómez-Delgado, Andrés

    2016-07-01

    Aneurysmal bone cyst (ABC) is an uncommon, non-neoplastic, expansive and erosive bone lesion. Considered as a pseudocyst due the lack of epithelial lining, the presence of giant cells and similarity to other lesions can make preoperative diagnosis difficult; biopsy findings must be co-related to complete clinical and radiological assessment. ABC's controversial etiopathogenesis and variable clinicopathological presentations have been widely described, but to date, there are just a few reports in literature describing the development of fibrous dysplasia (FD) from an ABC, and even less cases occurring in the jaws. We describe the case of an ABC in an 8 year-old male patient, affecting the body of the mandible, which showed accelerated growth associated to thinning of the buccal, lingual and lower cortical plates. The treatment consisted of repetitive surgical resection, curettage of the lesion and mandibular reinforcement with osteosynthesis reconstruction plates. A 16-month follow-up showed self-limitation of the overgrowth. The final histopathological and radiological analysis confirmed the FD diagnosis. PMID:27408470

  11. Fibrohistiocytoma combined with an aneurysmal bone cyst at T7 in a 63-year-old woman

    PubMed Central

    LI, QI; FU, YISHAN; DONG, YANG; ZENG, BINGFANG; ZHANG, CHANGQING

    2013-01-01

    We present a case of spinal tumor, with fibrohistiocytoma combined with aneurysmal bone cyst (ABC) at the pedicle and transverse process of T7 in a 63-year-old female. ABC is a rare skeletal tumor and spinal ABC is extremely rare. Fibrohistiocytoma is a type of primary benign bone tumor. ABC is also a rare bone tumor that most often occurs in the pelvis. The combined lesion of two primary bone benign tumors is relatively rare in clinic. In addition, fibrohistiocytoma and ABC are widely confused with other giant cell containing tumors of the bone. X-rays, magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) scans were performed and assessed. Finally, the diagnosis was confirmed by pathological tests. The patient underwent surgery and had an extremely good recovery. The correct diagnosis of a spine tumor is important when determining the surgical procedure. PMID:24223633

  12. TEVAR for Flash Pulmonary Edema Secondary to Thoracic Aortic Aneurysm to Pulmonary Artery Fistula.

    PubMed

    Bornak, Arash; Baqai, Atif; Li, Xiaoyi; Rey, Jorge; Tashiro, Jun; Velazquez, Omaida C

    2016-01-01

    Enlarging aneurysms in the thoracic aorta frequently remain asymptomatic. Fistulization of thoracic aortic aneurysms (TAA) to adjacent structures or the presence of a patent ductus arteriosus and TAA may lead to irreversible cardiopulmonary sequelae. This article reports on a large aneurysm of the thoracic aorta with communication to the pulmonary artery causing pulmonary edema and cardiorespiratory failure. The communication was ultimately closed after thoracic endovascular aortic aneurysm repair allowing rapid symptom resolution. Early diagnosis and closure of such communication in the presence of TAA are critical for prevention of permanent cardiopulmonary damage. PMID:26522587

  13. Locally aggressive aneurysmal bone cyst of C4 vertebra treated by total en bloc excision and anterior plus posterior cervical instrumentation

    PubMed Central

    Parmar, Himanshu N.; Agrawal, Vinod A.; Shah, Munjal S.; Nanda, Saurav N.

    2015-01-01

    We are presenting a case of cervical (C4) aneurysmal bone cyst in a 13-year-old girl, came to the outpatient department with neck pain and stiffness since 6 months and normal neurology. We did an en bloc excision of locally aggressive tumor through anterior plus posterior approach and stabilization by lateral mass screw fixation and anterior cervical instrumentation. Involvement of several adjacent cervical vertebrae by an aneurysmal bone cyst is rare, and conventional treatment with curettage and bone grafting is most likely to carry a high rate of recurrence and spinal instability. We recommend complete excision of the tumor and instrumentation in a single stage to avoid instability. PMID:26288549

  14. Cytogenetic and molecular cytogenetic findings in 43 aneurysmal bone cysts: aberrations of 17p mapped to 17p13.2 by fluorescence in situ hybridization.

    PubMed

    Althof, Pamela A; Ohmori, Kazuo; Zhou, Ming; Bailey, Jacqueline M; Bridge, R Stuart; Nelson, Marilu; Neff, James R; Bridge, Julia A

    2004-05-01

    Aneurysmal bone cyst is a benign, cystic lesion of bone composed of blood-filled spaces separated by fibrous septa. Relatively few cases of aneurysmal bone cyst have been cytogenetically characterized, yet abnormalities of the short arm of chromosome 17 appear to be recurrent. In this study, conventional cytogenetic analysis of 43 aneurysmal bone cyst specimens from 38 patients over a 12-year period revealed clonal chromosomal abnormalities in 12 specimens. Karyotypic anomalies of 17p, including a complex translocation and inversion, were identified in eight of these 12 specimens. In an effort to further define the aberrant 17p breakpoint, fluorescence in situ hybridization (FISH) analyses were performed using a series of probe combinations spanning a 5.1 Mb region between the TP53 (17p13.1) and Miller-Dieker lissencephaly syndrome (17p13.3) gene loci. These studies revealed the critical breakpoint locus at 17p13.2, flanked proximally by an RP11-46I8, RP11-333E1, and RP11-457I18 bacterial artificial chromosome (BAC) probe cocktail and distally by an RP11-198F11 and RP11-115H24 BAC and RP5-1050D4 P1 artificial chromosome (PAC) probe cocktail. Overall, abnormalities of the 17p13.2 locus were identified by metaphase and/or interphase cell FISH analysis in 22 of 35 (63%) aneurysmal bone cyst specimens examined including 26 karyotypically normal specimens. These cytogenetic and molecular cytogenetic findings expand our knowledge of chromosomal alterations in aneurysmal bone cyst, further localize the critically involved 17p breakpoint, and provide an alternative approach (ie FISH) for detecting 17p abnormalities in nondividing cells of aneurysmal bone cysts. The latter could potentially be utilized as an adjunct in diagnostically challenging cases. PMID:15044915

  15. Stroke Secondary to Aseptic Meningitis After Endovascular Treatment of a Giant Aneurysm with Parent Artery Occlusion

    SciTech Connect

    Doenmez, Halil Mavili, Ertugrul Ikizceli, Tuerkan; Durak, Ahmet Candan; Kurtsoy, Ali

    2009-07-15

    Aseptic meningitis related to hydrogel-coated coils is a known complication, but it is extremely rare after platinum bare coil aseptic meningitis. Here we report the development of aseptic meningitis causing brain stem and cerebellar infarct in a patient with a giant aneurysm treated with bare platinum coils. We conclude that aneurysm size is an important factor affecting the occurrence of aseptic meningitis associated with stroke.

  16. Results of cement augmentation and curettage in aneurysmal bone cyst of spine

    PubMed Central

    Basu, Saumyajit; Patel, Dharmesh R; Dhakal, Gaurav; Sarangi, T

    2016-01-01

    Aneurysmal bone cyst (ABC) is a vascular tumor of the spine. Management of spinal ABC still remains controversial because of its location, vascular nature and incidence of recurrence. In this manuscript, we hereby describe two cases of ABC spine treated by curettage, vertebral cement augmentation for control of bleeding and internal stabilization with two years followup. To the best of our knowledge, this is the first case report in the literature describing the role of cement augmentation in spinal ABC in controlling vascular bleeding in curettage of ABC of spine. Case 1: A 22 year old male patient presented with chronic back pain. On radiological investigation, there were multiple, osteolytic septite lesions at L3 vertebral body without neural compression or instability. Percutaneous transpedicular biopsy of L3 from involved pedicle was done. This was followed by cement augmentation through the uninvolved pedicle. Next, transpedicular complete curettage was done through involved pedicle. Case 2: A 15-year-old female presented with nonradiating back pain and progressive myelopathy. On radiological investigation, there was an osteolytic lesion at D9. At surgery, decompression, pedicle screw-rod fixation and posterolateral fusion from D7 to D11 was done. At D9 level, through normal pedicle cement augmentation was added to provide anterior column support and to control the expected bleeding following curettage. Transpedicular complete curettage was done through the involved pedicle with controlled bleeding at the surgical field. Cement augmentation was providing controlled bleeding at surgical field during curettage, internal stabilization and control of pain. On 2 years followup, pain was relieved and there was a stable spinal segment with well filled cement without any sign of recurrence in computed tomography scan. In selected cases of spinal ABC with single vertebral, single pedicle involvement; cement augmentation of vertebra through normal pedicle has an

  17. Results of cement augmentation and curettage in aneurysmal bone cyst of spine.

    PubMed

    Basu, Saumyajit; Patel, Dharmesh R; Dhakal, Gaurav; Sarangi, T

    2016-01-01

    Aneurysmal bone cyst (ABC) is a vascular tumor of the spine. Management of spinal ABC still remains controversial because of its location, vascular nature and incidence of recurrence. In this manuscript, we hereby describe two cases of ABC spine treated by curettage, vertebral cement augmentation for control of bleeding and internal stabilization with two years followup. To the best of our knowledge, this is the first case report in the literature describing the role of cement augmentation in spinal ABC in controlling vascular bleeding in curettage of ABC of spine. Case 1: A 22 year old male patient presented with chronic back pain. On radiological investigation, there were multiple, osteolytic septite lesions at L3 vertebral body without neural compression or instability. Percutaneous transpedicular biopsy of L3 from involved pedicle was done. This was followed by cement augmentation through the uninvolved pedicle. Next, transpedicular complete curettage was done through involved pedicle. Case 2: A 15-year-old female presented with nonradiating back pain and progressive myelopathy. On radiological investigation, there was an osteolytic lesion at D9. At surgery, decompression, pedicle screw-rod fixation and posterolateral fusion from D7 to D11 was done. At D9 level, through normal pedicle cement augmentation was added to provide anterior column support and to control the expected bleeding following curettage. Transpedicular complete curettage was done through the involved pedicle with controlled bleeding at the surgical field. Cement augmentation was providing controlled bleeding at surgical field during curettage, internal stabilization and control of pain. On 2 years followup, pain was relieved and there was a stable spinal segment with well filled cement without any sign of recurrence in computed tomography scan. In selected cases of spinal ABC with single vertebral, single pedicle involvement; cement augmentation of vertebra through normal pedicle has an

  18. Enhanced bone healing using collagen-hydroxyapatite scaffold implantation in the treatment of a large multiloculated mandibular aneurysmal bone cyst in a thoroughbred filly.

    PubMed

    David, Florent; Levingstone, Tanya J; Schneeweiss, Wilfried; de Swarte, Marie; Jahns, Hanne; Gleeson, John P; O'Brien, Fergal J

    2015-10-01

    An unmet need remains for a bone graft substitute material that is biocompatible, biodegradable and capable of promoting osteogenesis safely in vivo. The aim of this study was to investigate the use of a novel collagen-hydroxyapatite (CHA) bone graft substitute in the clinical treatment of a mandibular bone cyst in a young horse and to assess its potential to enhance repair of the affected bone. A 2 year-old thoroughbred filly, presenting with a multilobulated aneurysmal bone cyst, was treated using the CHA scaffold. Post-operative clinical follow-up was carried out at 2 weeks and 3, 6 and 14 months. Cortical thickening in the affected area was observed from computed tomography (CT) examination as early as 3 months post-surgery. At 14 months, reduced enlargement of the operated mandible was observed, with no fluid-filled area. The expansile cavity was occupied by moderately dense mineralized tissue and fat and the compact bone was remodelled, with a clearer definition between cortex and medulla observed. This report demonstrates the promotion of enhanced bone repair following application of the CHA scaffold material in this craniomaxillofacial indication, and thus the potential of this material for translation to human applications. PMID:25712436

  19. Secondary Alveolar Bone Grafting (CLEFTSiS) 2007-2010.

    PubMed

    Paterson, Michael; Rae, Jennifer; Paterson, Paul; Gilgrass, Toby; Devlin, Mark; McIntyre, Grant

    2016-03-01

    Objective To determine whether alveolar bone graft outcomes for unilateral and bilateral cleft lip and palate patients have continued to improve since the reorganization of cleft services in Scotland in 2000. Design Retrospective analysis of postoperative anterior occlusal radiographs. Patients and Participants Eighty-one of 106 patients who were eligible for alveolar bone grafting between 2007 and 2010 had suitable postoperative radiographs available. Interventions Twenty-seven percent of the patients (n = 22) had presurgical orthodontic intervention. All patients underwent alveolar bone grafting with bone harvested from the iliac crest. Main Outcome Measures The Kindelan bone-fill index was used to evaluate success. Weighted kappa statistics were used to assess intra- and interobserver reproducibility. A comparison was made with results from 2000 to 2004 to assess any improvement. Chi-square tests (or Fisher exact test) were used to determine whether outcomes differed depending on the laterality of the cleft, use of presurgical expansion, or age at bone grafting. Results Interobserver scoring agreement was good (weighted kappa = .383). Intraobserver reproducibility was greater (weighted kappas of .835 and .620). Success was achieved in 99% of bone grafts, compared with 76% in the period from 2000 to 2004 (P < .001). There was no statistically significant relationship between the laterality of the cleft (P = 1.000), use of presurgical expansion (P = 1.000), or age at time of bone grafting and outcome (P = .259). Conclusion Scottish secondary alveolar bone graft outcomes improved during 2007 to 2010 in comparison to the 2000 to 2004 results. PMID:26914161

  20. A method for semi-automatic segmentation and evaluation of intracranial aneurysms in bone-subtraction computed tomography angiography (BSCTA) images

    NASA Astrophysics Data System (ADS)

    Krämer, Susanne; Ditt, Hendrik; Biermann, Christina; Lell, Michael; Keller, Jörg

    2009-02-01

    The rupture of an intracranial aneurysm has dramatic consequences for the patient. Hence early detection of unruptured aneurysms is of paramount importance. Bone-subtraction computed tomography angiography (BSCTA) has proven to be a powerful tool for detection of aneurysms in particular those located close to the skull base. Most aneurysms though are chance findings in BSCTA scans performed for other reasons. Therefore it is highly desirable to have techniques operating on standard BSCTA scans available which assist radiologists and surgeons in evaluation of intracranial aneurysms. In this paper we present a semi-automatic method for segmentation and assessment of intracranial aneurysms. The only user-interaction required is placement of a marker into the vascular malformation. Termination ensues automatically as soon as the segmentation reaches the vessels which feed the aneurysm. The algorithm is derived from an adaptive region-growing which employs a growth gradient as criterion for termination. Based on this segmentation values of high clinical and prognostic significance, such as volume, minimum and maximum diameter as well as surface of the aneurysm, are calculated automatically. the segmentation itself as well as the calculated diameters are visualised. Further segmentation of the adjoining vessels provides the means for visualisation of the topographical situation of vascular structures associated to the aneurysm. A stereolithographic mesh (STL) can be derived from the surface of the segmented volume. STL together with parameters like the resiliency of vascular wall tissue provide for an accurate wall model of the aneurysm and its associated vascular structures. Consequently the haemodynamic situation in the aneurysm itself and close to it can be assessed by flow modelling. Significant values of haemodynamics such as pressure onto the vascular wall, wall shear stress or pathlines of the blood flow can be computed. Additionally a dynamic flow model can be

  1. Percutaneous Treatment of an Infected Aneurysmal Sac Secondary to Aortoesophageal Fistula with a History of Stent-Graft Treatment for Thoracic Aortic Aneurysm

    SciTech Connect

    Numan, Furuzan Gulsen, Fatih; Cantasdemir, Murat; Solak, Serdar; Arbatli, Harun

    2012-06-15

    A 68-year-old man who was subjected to stent-grafting of a descending thoracic aortic aneurysm (TAA) 4 months previously was admitted to our hospital with constitutional symptoms, including high fever, sweating, nausea, vomiting, weight loss, and backache. An infected aneurysmal sac was suspected based on computed tomography (CT) findings, and an aortoesophageal fistula (AEF) was identified during esophagoscopy. CT-guided aspiration was performed using a 20-G Chiba needle, confirming the presence of infection. For treatment of the infected aneurysmal sac, CT-guided percutaneous catheter drainage in a prone position was performed under general anesthesia with left endobronchial intubation. Drainage catheter insertion was successfully performed using the Seldinger technique, which is not a standard treatment of an infected aneurysmal sac. Improvement in the patient's clinical condition was observed at follow-ups, and CT showed total regression of the collection in the aneurysmal sac.

  2. Secondary aorto-esophageal fistula after thoracic aortic aneurysm endovascular repair treated by covered esophageal stenting

    PubMed Central

    Tao, Mary; Shlomovitz, Eran; Darling, Gail; Roche-Nagle, Graham

    2016-01-01

    Thoracic endovascular aortic repair for thoracic aortic aneurysms is an accepted alternative to open surgery, especially in patients with significant comorbidities. The procedure itself has a low risk of complications and fistulas to surrounding organs are rarely reported. An 86-year-old patient was admitted to our hospital with gastro intestinal (GI) bleeding and a suspected aortoesophageal fistula. Eight months prior, the patient had undergone a stent graft repair of a mycotic thoracic aneurysm. Computerized tomography angiography and upper GI endoscopy confirmed an aortoesophageal fistula, which was treated by esophageal stenting. With early recognition, esophageal stenting may have a role in the initial emergency control of bleeding from and palliation of aortoesophageal fistula. PMID:27574612

  3. Secondary aorto-esophageal fistula after thoracic aortic aneurysm endovascular repair treated by covered esophageal stenting.

    PubMed

    Tao, Mary; Shlomovitz, Eran; Darling, Gail; Roche-Nagle, Graham

    2016-08-16

    Thoracic endovascular aortic repair for thoracic aortic aneurysms is an accepted alternative to open surgery, especially in patients with significant comorbidities. The procedure itself has a low risk of complications and fistulas to surrounding organs are rarely reported. An 86-year-old patient was admitted to our hospital with gastro intestinal (GI) bleeding and a suspected aortoesophageal fistula. Eight months prior, the patient had undergone a stent graft repair of a mycotic thoracic aneurysm. Computerized tomography angiography and upper GI endoscopy confirmed an aortoesophageal fistula, which was treated by esophageal stenting. With early recognition, esophageal stenting may have a role in the initial emergency control of bleeding from and palliation of aortoesophageal fistula. PMID:27574612

  4. Levodopa-Responsive Hemiparkinsonism Secondary to Cystic Expansion from a Coiled Cerebral Aneurysm

    PubMed Central

    Norris, Scott A.; Derdeyn, Colin P.; Perlmutter, Joel S.

    2015-01-01

    An 80-year-old woman with longstanding hemifacial spasm had a 1 cm × 1.5 cm internal carotid artery terminus aneurysm treated with endovascularly delivered bare metal coils. Follow-up imaging revealed an expansile perianeurysmal cyst that coincided with development of contralateral dopa-responsive hemiparkinsonism. This is the first report of perianeurysmal cyst expansion causing levodopa-responsive hemiparkinsonism. PMID:24707971

  5. Soft-tissue aneurysmal bone cyst with translocation t(17;17)(p13;q21) corresponding to COL1A1 and USP6 loci.

    PubMed

    Jacquot, Cyril; Szymanska, Jadwiga; Nemana, Lakshmi J; Steinbach, Lynne S; Horvai, Andrew E

    2015-11-01

    We present the case of a 46-year-old woman with no significant past medical history who developed left mid-thigh pain and fullness. Imaging demonstrated a mineralized soft-tissue mass, which increased in size during a year of monitoring, but retained a circumscribed appearance. The mass was located in the medial soft tissues of the thigh, separate from the bone on imaging studies, and this finding was confirmed during excision. The mass showed gross and microscopic features of an aneurysmal bone cyst. This diagnosis was supported by cytogenetic analysis revealing a t(17;17)(p13;q21) translocation corresponding to the USP6 and COL1A1 loci. Soft-tissue aneurysmal bone cyst is a rare entity, with fewer than 25 reports in the literature. Limited cytogenetic information about these tumors is available. To our knowledge, the USP6 and COL1A1 rearrangement has only previously been described in a pediatric soft-tissue aneurysmal bone cyst. We also discuss the differential diagnosis of ossifying soft-tissue lesions. PMID:26142538

  6. Solid variant of aneurysmal bone cyst presenting as a giant cervical mass: A clinical, radiological, histopathological dilemma

    PubMed Central

    Savardekar, Amey R.; Patra, Deviprasad; Chatterjee, Debajyoti; Ahuja, Chirag K.; Salunke, Pravin

    2015-01-01

    Background: Typical aneurysmal bone cysts (ABCs) are osteolytic, multicystic lesions with parietal sclerosis and blood-filled cysts. In rare instances, the cystic components may be completely absent. Such solid variants in ABC (s-ABC) exhibit a solid architecture; making the clinical, radiological, and histological differentiation from other solid bone tumors like osteosarcoma (especially giant cell rich osteosarcoma) and giant cell tumor, a difficult task. Case Report: We report the case of a 45–year-old male presenting with a giant solid cervical spine lesion. Histopathology revealed solid variant of ABC, even though the radiological and fine needle aspiration cytology studies pointed toward a giant cell tumor. Conclusion: We aim to discuss the clinical, radiological, and histological findings of solid ABC (a rare benign entity) vis-à-vis the common neoplastic entities of osteosarcoma and giant cell tumor. The histopathological nuisances in making the diagnosis of s-ABC are put forth, along with its impact on management of such giant bony spinal lesions. PMID:26005581

  7. Giant Subclavian Artery Aneurysm.

    PubMed

    Counts, Sarah; Zeeshan, Ahmad; Elefteriades, John

    2016-06-01

    We report the case of a 37-year-old construction executive presenting with chest pain, shortness of breath, and dizziness on exertion secondary to a giant left subclavian artery aneurysm and aortic valvular disease. PMID:27231430

  8. Cerebral Aneurysms

    MedlinePlus

    ... Enhancing Diversity Find People About NINDS NINDS Cerebral Aneurysms Information Page Synonym(s): Aneurysm, Brain Aneurysm Condensed from ... Español Additional resources from MedlinePlus What is Cerebral Aneurysms? A cerebral aneurysm is a weak or thin ...

  9. Aortic Aneurysm

    MedlinePlus

    ... chest and abdomen. There are two types of aortic aneurysm: Thoracic aortic aneurysms - these occur in the part of the aorta running through the chest Abdominal aortic aneurysms - these occur in the part of the aorta ...

  10. Aneurysm Repair

    MedlinePlus

    ... to other parts of the body (the aorta). Aortic aneurysms can occur in the area below the stomach ( ... or in the chest (thoracic aneurysms). An abdominal aortic aneurysm (AAA) is usually located below the kidneys. In ...

  11. Aortic Aneurysm

    MedlinePlus

    ... chest and abdomen. There are two types of aortic aneurysm: Thoracic aortic aneurysms (TAA) - these occur in the part of the aorta running through the chest Abdominal aortic aneurysms (AAA) - these occur in the part of the ...

  12. Giant Aneurysmal Bone Cyst of the Anterior Cranial Fossa and Paranasal Sinuses Presenting in Pregnancy: Case Report and Literature Review

    PubMed Central

    Hnenny, Luke; Roundy, Neil; Zherebitskiy, Victor; Grafe, Marjorie; Mansoor, Atiya; Dogan, Aclan

    2015-01-01

    Background and Purpose Aneurysmal bone cysts (ABCs) rarely involve the cranium and have seldom been reported in pregnancy. Clinical Presentation We describe a case of a 28-year-old woman who presented at 37 weeks of gestation with 3 months of gradually worsening vision, 10 months of proptosis, and restricted ocular motility on the left. Brain imaging revealed a multicystic enhancing mass measuring 5.9 × 5.3 × 3.7 cm, centered on the cribriform plate on the left, extending into the anterior cranial fossa superiorly as well as the left nasal cavity, maxillary, sphenoid, and frontal sinuses. Her clinical course is described in detail; 3-month postoperative imaging demonstrated no residual mass. Conclusion A literature review revealed five previous cases of ABCs associated with pregnancy. We report a rare case of a giant ABC of fibrous dysplasia involving the paranasal sinuses and anterior cranial fossa. We postulate on the possible influence of pregnancy on the clinical course. PMID:26623230

  13. Secondary Alveolar Bone Grafting and Iliac Cancellous Bone Harvesting for Patients With Alveolar Cleft.

    PubMed

    Pan, Weiyi; Wu, Chenzhou; Yang, Zheng; Duan, Zexi; Su, Zhifei; Wang, Peiqi; Zheng, Qian; Li, Chunjie

    2016-06-01

    To assess the efficacy of present interventions optimizing the result of secondary alveolar bone grafting (SABG) and the interventions alleviating the donor site morbidity after iliac cancellous bone harvesting. Researches were identified by searching the electronic database of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Chinese BioMedical Literature Database, and the China National Knowledge Infrastructure. In addition, relevant journals and references of the included studies were searched manually. The Oxford 2011 Levels of Evidence were applied to assess the methodological quality of selected studies, and the best evidence synthesis system was applied afterward to measure the strength of evidence. As a result, 42 studies were considered eligible and included, among which 4 were of high quality while 38 were of low quality. Thirty lines of evidences were acquired after the synthesis, among which 13 were rated as moderate while 17 were rated as insufficient. As for the interventions optimizing the result of SABG, moderate evidence confirmed the efficacy of preoperative orthodontic treatment, the superiority of performing SABG before the eruption of canine, and the accuracy of cone beam computed tomography in preoperative estimation of the cleft volume. As for the interventions alleviating the morbidity of iliac cancellous bone harvesting, moderate evidence confirmed the treatment benefit of the interventions below: minimally invasive technique, including trephine and Shepard osteotomy; preemptive analgesia, including continuous bupivacaine infusion or transversus abdominis plane block. As for the rest interventions, only insufficient evidence was found. PMID:27244214

  14. A comparison of cyst wall curettage and en bloc excision in the treatment of aneurysmal bone cysts

    PubMed Central

    2013-01-01

    Background The recurrence rate after aneurysmal bone cyst (ABC) treatment is quite high despite its benign nature. In ABC therapy, curettage is the treatment of choice; en bloc excision results in a lower recurrence rate, but more extensive reconstructive surgery is needed with associated morbidity. The aim of the present study was to compare the outcomes of the two treatment options. Methods A retrospective analysis was performed on 26 patients treated for ABCs: 16 by curettage and 10 by en bloc excision. Each lesion was classified according to Enneking and patients were followed up for a mean time of 9.2 years. On follow-up, radiological examination and functional assessment (range of motion, muscle strength) were performed. Recurrence was defined as the presence of an osteolytic lesion, especially one with a tendency to grow. Results On follow-up, the following symptoms were more prevalent in the en bloc excision group compared to the curettage group: pain (en bloc 20% versus curettage 6.25%), limb length differences (en bloc 20% versus curettage 12.5%), reduced range of motion (en bloc 20% versus curettage 6.25%) and muscle strength impairment (en bloc 50% versus curettage 31.2%); however, the differences were not statistically significant (P >0.05). In the curettage group, two cases of postoperative complications and two cases of recurrence were seen, while in the en bloc excision group one case of complications was noted. Conclusions Curettage is a standard procedure in ABC management. En bloc excision is another option, albeit more technically demanding, that may be considered in recurrent lesions with extensive bone destruction or for cysts in an expendable location. PMID:23701661

  15. Aneurysmal bone cyst does not hinder the success of kidney transplantation. A case report.

    PubMed

    Giordano, Mario; Caloro, Giorgia; Gaeta, Alberto; Vergori, Antonio; Santangelo, Luisa; Giordano, Paolo; Ruggieri, Pietro

    2015-03-01

    Uremic osteodystrophy is an expected complication in subjects with chronic renal insufficiency. It develops gradually and progressively already during the conservative treatment and then during the dialysis treatment. It can present a wide histopathological spectrum including typical alterations (from osteitis fibrosa to osteomalacia and/or mixed lesions) or, more rarely, isolated bone lesions indicative of a brown tumor of the bone. These conditions must be clearly identified in the pretransplant phase, especially if a bone lesion indicative of a pathological condition possibly evolving into a neoplasm is detected fortuitously. We report the case of a 19-yr-old boy with renal insufficiency and candidate for a pre-emptive renal transplantation from a living donor, in whom the diagnosis of ABC of the pubic symphysis - asymptomatic and fortuitously detected while performing instrumental investigations - was suspected through the imaging studies (CT scan, MRI) and was confirmed by the histological examination. This made it possible to perform the renal transplant. The immunosuppressive treatment, which was subsequently administered, was based on steroids, calcineurin inhibitors (tacrolimus), and mycophenolate and did not determine any modification in the radiological aspect of the bone lesion, even after more than one yr from the transplant. PMID:25514989

  16. Aneurysmal bone cyst on the left zygomatic arch concomitant with bilateral inferior turbinate gasification in an adult female: A case report

    PubMed Central

    XIN, JINGWEI; ZHENG, JUN; YUAN, CHUNLI; KONG, HONG

    2016-01-01

    The simultaneous occurrence of an aneurysmal bone cyst (ABC) on a zygomatic arch with bilateral inferior turbinate gasification is extremely rare, and no previous studies are available. Here we report the case of a 34-year-old Chinese Han female who presented with hyperplasia of the left maxillary bone for one and a half years. The patient was observed to have an ABC on the left zygomatic arch concomitant with bilateral inferior turbinate gasification, as indicated by X-ray computed tomography, contrast-enhanced computed tomography and three-dimensional maxillofacial reconstruction. The patient underwent surgical resection of the cyst, and no postoperative symptoms were observed during the 4 years of follow-up. The etiology of this case is considered to be associated with a gene abnormality. PMID:26893709

  17. Infectious or Noninfectious? Ruptured, Thrombosed Inflammatory Aortic Aneurysm with Spondylolysis

    SciTech Connect

    Stefanczyk, Ludomir; Elgalal, Marcin; Papiewski, Andrzej; Szubert, Wojciech; Szopinski, Piotr

    2013-06-15

    Osteolysis of vertebrae due to inflammatory aortic aneurysm is rarely observed. However, it is estimated that up to 10 % of infectious aneurysms coexist with bone tissue destruction, most commonly the vertebrae. Inflammatory aneurysms with no identified infection factor, along with infiltration of adjacent muscle and in particular extensive destruction of bone tissue have rarely been described in the literature. A case of inflammatory aneurysm with posterior wall rupture and inflammatory infiltration of the iliopsoas muscle and spine, together with extensive vertebral body destruction, is presented. The aneurysm was successfully treated with endovascular aneurysm repair EVAR.

  18. Brain Aneurysm

    MedlinePlus

    A brain aneurysm is an abnormal bulge or "ballooning" in the wall of an artery in the brain. They are sometimes called berry aneurysms because they ... often the size of a small berry. Most brain aneurysms produce no symptoms until they become large, ...

  19. Aspergillus mycotic aneurysm--case report.

    PubMed

    Komatsu, Y; Narushima, K; Kobayashi, E; Tomono, Y; Nose, T

    1991-06-01

    A 61-year-old female developed subarachnoid hemorrhage after trans-sphenoidal surgery for Rathke's cleft cyst. Neuroradiological examination revealed a large aneurysm at the C1 portion of the right internal carotid artery. Autopsy revealed marked proliferation of aspergillus hyphae in the wall of the aneurysm. A review of previously reported cases of fungal aneurysm proposes two developmental processes. Aneurysms secondary to fungal meningitis tend to be large in size and located in the major cerebral artery trunk, but aneurysms following fungal sepsis tend to be small and in peripheral branches. The former aneurysms are probably caused by fungus invasion into the intracranium, usually from the paranasal sinus, and the latter may be due to fungal emboli like bacterial emboli in bacterial endocarditis. Ruptured fungal aneurysms are difficult to treat, so fungal meningitis or sepsis must be eradicated before an aneurysm develops. PMID:1724300

  20. Donor Site Evaluation: Anterior Iliac Crest Following Secondary Alveolar Bone Grafting

    PubMed Central

    Vura, Nandagopal; Reddy K., Rajiv; R., Sudhir; G., Rajasekhar; Kaluvala, Varun Raja

    2013-01-01

    Introduction: The use of autogenous bone graft for Secondary alveolar bone grafting is well established in the treatment of cleft lip and palate patients. Aims and Objectives: To evaluate post-operative morbidity of anterior iliac crest graft after secondary alveolar bone grafting in cleft patients. Material and Methods: Forty patients during the period from July 2008 to March 2013, who underwent secondary alveolar bone grafting by harvesting graft from anterior iliac crest in Mamata Dental Hospital, Khammam, Andhra Pradesh, India are included in the present study. Unilateral and bilateral cleft patients who had undergone secondary alveolar bone grafting (SABG) with anterior iliac crest as their donor site have been selected and post- operative complications from the surgery were evaluated with the help of a questionnaire which included pain, gait disturbances, numbness and scar problems (infection, irritation). Results: Patients who were operated gave maximum score for pain as 8 on visual analogue scale. No pain was observed in any of the cases after 8 days, gait disturbances were seen in all patients (limping) for 2-6 days, there was no post-operative numbness with all the patients returning to their routine in 6- 15 days and 90% of the patients gave a satisfied response towards scar. Conclusion: From the results in our study the morbidity after harvesting bone from iliac crest was found to be moderate to low, which had minimal complications and were well tolerated and greater acceptance from the patient. PMID:24392424

  1. Mother’s fibula in son’s forearm: use of maternal bone grafting for aneurysmal bone cyst not amenable to curettage – a case report with review of literature

    PubMed Central

    Ansari, Mohammed Tahir; Gautam, Deepak; Kotwal, Prakash P.

    2016-01-01

    It has always been a challenge to reconstruct large bone gaps. The aim of this case report is to highlight the success of homologous maternal bone grafting in a large cystic lesion. A six and half years old boy presented to us with an aneurysmal bone cyst (ABC) of the right radius, not amenable to curettage. We excised the lesion in toto, which created an 11 cm bone loss. Considering the age of the patient, we reconstructed the bone gap with maternal fibular graft. Accordingly, 12 cm of fibular graft was harvested and fashioned to fit into the bone gap. It was fixed with an intramedullary K-wire. No cancellous graft was used in the procedure. The limb was kept in the above elbow cast till incorporation of the fibula was noted on the radiographs. Six months following surgery the skiagram showed that the fibula was incorporated. Mobilization of the elbow and wrist was started along with strengthening of the forearm muscles. K-wire was removed at nine months. At the latest follow up of 24 months, the fibula is fully incorporated, the child regained full range of motion and strength of elbow. We discuss the techniques adopted in this particular case along with the review of literature. PMID:27163107

  2. Prospective Analysis of Secondary Alveolar Bone Grafting in Cleft Lip and Palate Patients

    PubMed Central

    Reddy, M Gokul Chandra; Babu, V Ramesh; Rao, V Eswar; Chaitanya, J Jaya; Allareddy, S; Reddy, C Charan Kumar

    2015-01-01

    Background: To assess the success of the uptake of bone graft in cleft alveolus of the cleft lip and palate patients, quantitatively through computed tomography (CT) scan 6 months postoperative. To assess the successful eruption of permanent lateral incisor or canine in the bone grafted area. Materials and Methods: The children age group of 9-21 years with unilateral cleft lip and palate came to the hospital, needing secondary alveolar bone grafting. A detailed history and clinical examination of the patient was taken. A 3D CT scan was taken and the volume of the cleft was measured pre-operatively. After ambulatory period, 3D CT scan of the alveolar cleft region was taken and volume of the bone grafted was measured and patient was discharged from the hospital. After 6 months, patient was recalled and again 3D CT scan was taken and the volume of remaining bone was measured. Results: The mean volume of the defect pre-operatively is 0.80 cm3 with a standard deviation of 0.36 cm3 with minimum volume of the defect 0.44 cm3 and maximum volume of the defect 1.60 cm3. The mean volume of the bone post-operative immediately after grafting is 1.01 cm3 with a standard deviation of 0.52 cm3 with minimum of bone volume is 0.48 cm3 and maximum of 2.06 cm3. The mean volume of the bone after 6 months after bone grafting is 0.54 cm3 with a standard deviation of 0.33 cm3, minimum bone volume of 0.22 cm3 and maximum bone volume of 1.42 cm3. Conclusion: The CT scan is a valuable radiographic imaging modality to assess and follow the clinical outcome of secondary alveolar bone grafting. PMID:25954076

  3. Idiopathic subvalvular aortic aneurysm masquerading as acute coronary syndrome.

    PubMed

    Natarajan, Balaji; Ramanathan, Sundar; Subramaniam, Natarajan; Janardhanan, Rajesh

    2016-01-01

    Subvalvular aneurysms are the least common type of left ventricular (LV) aneurysms and can be fatal. Subaortic LV aneurysms are much rarer than submitral LV aneurysms and mostly reported in infancy. They can be congenital or acquired secondary to infections, cardiac surgery or trauma. Here, we report a unique presentation of a large, idiopathic subaortic aneurysm in an adult masquerading as an acute coronary syndrome. Diagnosis was made with the help of a CT aortography. Aneurysm was surgically resected with good results. This case highlights the clinical presentation and management of subaortic aneurysms, an important differential for congenital aortic malformations. PMID:27591034

  4. Kidney stones and crushed bones secondary to hyperparathyroidism

    PubMed Central

    Sreejith, G. Nair; Pranab, K. Prabhakaran

    2016-01-01

    Here we report a 65-year-old woman with multiple brown tumors and renal stones secondary to primary hyperparathyroidism. This case highlights the need for early recognition of parathyroid hyperactivity. PMID:26722166

  5. Secondary neuroendocrine tumor after allogeneic bone marrow transplantation.

    PubMed

    Tamura, Shinichi; Ishida, Hiroyuki; Naito, Takeshi; Kondo, Osamu; Inoue, Masami; Kawa, Keisei; Kawabata, Kenji; Hojo, Hiroshi; Ouchi, Kazutaka; Imamura, Toshihiko

    2015-12-01

    Here we report a case of aggressive neuroendocrine tumor (NET), which is an extremely rare secondary solid tumor that occurs after allogeneic hematopoietic cell transplantation (allo-HSCT). A patient with chronic active Epstein-Barr virus infection received allo-HSCT from an HLA-DR two allele-mismatched unrelated donor. Four years later, he developed NET with multiple metastases. He received thoraco-abdominal irradiation as a conditioning regimen, and developed repeated episodes of intestinal graft-versus-host disease, for which he received long-term immunosuppressive therapy. Although these factors may be potential contributing factors to the development of secondary NET, the exact pathogenesis remains unclear. PMID:26711919

  6. Transcatheter Coil Embolization of Splenic Artery Aneurysm

    SciTech Connect

    Yamamoto, Satoshi Hirota, Shozo; Maeda, Hiroaki; Achiwa, Sachiko Arai, Keisuke; Kobayashi, Kaoru; Nakao, Norio

    2008-05-15

    The purpose of this study was to evaluate clinical results and technical problems of transcatheter coil embolization for splenic artery aneurysm. Subjects were 16 patients (8 men, 8 women; age range, 40-80 years) who underwent transcatheter embolization for splenic artery aneurysm (14 true aneurysms, 2 false aneurysms) at one of our hospitals during the period January 1997 through July 2005. Two aneurysms (12.5%) were diagnosed at the time of rupture. Multiple splenic aneurysms were found in seven patients. Aneurysms were classified by site as proximal (or strictly ostial) (n = 3), middle (n = 3), or hilar (n = 10). The indication for transcatheter arterial embolization was a false or true aneurysm 20 mm in diameter. Embolic materials were fibered coils and interlocking detachable coils. Embolization was performed by the isolation technique, the packing technique, or both. Technically, all aneurysms were devascularized without severe complications. Embolized aneurysms were 6-40 mm in diameter (mean, 25 mm). Overall, the primary technical success rate was 88% (14 of 16 patients). In the remaining 2 patients (12.5%), partial recanalization occurred, and re-embolization was performed. The secondary technical success rate was 100%. Seven (44%) of the 16 study patients suffered partial splenic infarction. Intrasplenic branching originating from the aneurysm was observed in five patients. We conclude that transcatheter coil embolization should be the initial treatment of choice for splenic artery aneurysm.

  7. The effect of LLLT on bone metabolism in children with severe cerebral palsy (a secondary publication)

    PubMed Central

    2014-01-01

    Background and aims: It is said that the average frequency of bone fracture in hospitalized children with severe cerebral palsy (unable to remain seated) is 1% (0.2 to 2.0%). Cerebral palsy patients' bones are known to be vulnerable to fracture, and refractory bone atrophy may be observed. However, the effect of low level laser therapy (LLLT) on bone density or bone metabolism has not been fully investigated. In recent years, tests for bone density or bone metabolism markers have become available. Material and methods: In this study, we evaluated changes in bone density and bone metabolism markers in 4 children with severe cerebral palsy who underwent LLLT for an average of 22 days. Results: B-ALP, a marker of ossification, increased 1 month after the start of irradiation in 3 of the 4 subjects and returned to a level close to the pre-irradiation level 2 months after the start of irradiation. In the remaining subjects in whom B-ALP failed to increase, B-ALP had been low before irradiation. Urinary N-terminal telopeptide (NTx) levels, a marker of bone resorption, decreased in 3 of the 4 subjects after the start of irradiation and remained low even 10 months later. Serum NTx levels tended to decrease in 3 of the 4 subjects. The levels of serum NTx/Crea, Deoxy-Pyridinoline (DPd) and DPd/Crea (DPd/Crea) also decreased in 3 of the 4 subjects. Transient decreases in intact parathyroid hormone (PTH) levels were observed in all 4 cases. Changes were particularly apparent in 2 cases: one with high NTx levels, which showed enhanced bone resorption, and one with high PTH levels, probably due to a vitamin D (VitD) deficiency. Although the metacarpal bone density measured by DIP was found to be lower than in normal children, there were no changes due to LLLT. Conclusion: These results suggest that LLLT has a positive influence on bone metabolism in that it temporarily increases bone formation and suppresses bone resorption while also tending to improve secondary

  8. Complete Heart Block with Diastolic Heart Failure and Pulmonary Edema Secondary to Enlarging Previously Diagnosed Thrombosed Aneurysm of Sinus of Valsalva in a Patient with History of Autosomal Dominant Polycystic Kidney Disease

    PubMed Central

    Eltawansy, Sherif Ali; Thomas, Maria Joana; Daniels, Jeffrey

    2015-01-01

    Autosomal dominant polycystic kidney disease (ADPKD) is associated with vascular aneurysms that can affect any part of the vascular tree, like ascending aorta or coronary arteries. Sinus of Valsalva is known as an anatomical dilation at the root of aorta above the aortic valve and very few cases show aneurysm at that site in patients with ADPKD. Sinus of Valsalva aneurysm (SVA) can present with rupture and acute heart failure and infective endocarditis or could be asymptomatic accidentally discovered during cardiac catheterization. We report a case of a 76-year-old male with a unique constellation of cardiovascular anomalies associated with ADPKD. Patient was previously diagnosed with aneurysms affecting ascending aorta, sinus of Valsalva, and coronary arteries. Several years later, he came with complete heart block which was discovered later to be secondary to enlargement of his previously diagnosed thrombosed SVA. His case was complicated with acute heart failure and pulmonary edema. Conclusion. Patients with ADPKD can present with extrarenal manifestations. In our case, aneurysm at sinus of Valsalva was progressively enlarging and presented with complete heart block. PMID:25861484

  9. Orientation and size-dependent mechanical modulation within individual secondary osteons in cortical bone tissue

    PubMed Central

    Carnelli, Davide; Vena, Pasquale; Dao, Ming; Ortiz, Christine; Contro, Roberto

    2013-01-01

    Anisotropy is one of the most peculiar aspects of cortical bone mechanics; however, its anisotropic mechanical behaviour should be treated only with strict relationship to the length scale of investigation. In this study, we focus on quantifying the orientation and size dependence of the spatial mechanical modulation in individual secondary osteons of bovine cortical bone using nanoindentation. Tests were performed on the same osteonal structure in the axial (along the long bone axis) and transverse (normal to the long bone axis) directions along arrays going radially out from the Haversian canal at four different maximum depths on three secondary osteons. Results clearly show a periodic pattern of stiffness with spatial distance across the osteon. The effect of length scale on lamellar bone anisotropy and the critical length at which homogenization of the mechanical properties occurs were determined. Further, a laminate-composite-based analytical model was applied to the stiffness trends obtained at the highest spatial resolution to evaluate the elastic constants for a sub-layer of mineralized collagen fibrils within an osteonal lamella on the basis of the spatial arrangement of the fibrils. The hierarchical arrangement of lamellar bone is found to be a major determinant for modulation of mechanical properties and anisotropic mechanical behaviour of the tissue. PMID:23389895

  10. Bone mineral density evaluation among patients with neuromuscular scoliosis secondary to cerebral palsy☆

    PubMed Central

    Rezende, Rodrigo; Cardoso, Igor Machado; Leonel, Rayana Bomfim; Perim, Larissa Grobério Lopes; Oliveira, Tarcísio Guimarães Silva; Jacob Júnior, Charbel; Júnior, José Lucas Batista; Lourenço, Rafael Burgomeister

    2014-01-01

    Objective To evaluate bone mineral density among patients with neuromuscular scoliosis secondary to quadriplegic cerebral palsy. Methods This was a descriptive prospective study in which both bone densitometric and anthropometric data were evaluated. The inclusion criteria used were that the patients should present quadriplegic cerebral palsy, be confined to a wheelchair, be between 10 and 20 years of age and present neuromuscular scoliosis. Results We evaluated 31 patients (20 females) with a mean age of 14.2 years. Their mean biceps circumference, calf circumference and body mass index were 19.4 cm, 18.6 cm and 16.9 kg/m2, respectively. The mean standard deviation from bone densitometry was −3.2 (z-score), which characterizes osteoporosis. Conclusion There is high incidence of osteoporosis in patients with neuromuscular scoliosis secondary to quadriplegic cerebral palsy. PMID:26229882

  11. Bone tumor

    MedlinePlus

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  12. Brain aneurysm repair

    MedlinePlus

    ... aneurysm repair; Dissecting aneurysm repair; Endovascular aneurysm repair - brain; Subarachnoid hemorrhage - aneurysm ... Your scalp, skull, and the coverings of the brain are opened. A metal clip is placed at ...

  13. Aortic Aneurysm Statistics

    MedlinePlus

    ... Blood Pressure Salt Cholesterol Million Hearts® WISEWOMAN Aortic Aneurysm Fact Sheet Recommend on Facebook Tweet Share Compartir ... cause of most deaths from aortic aneurysms. Aortic Aneurysm in the United States Aortic aneurysms were the ...

  14. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  15. What Is an Aneurysm?

    MedlinePlus

    ... from the NHLBI on Twitter. What Is an Aneurysm? An aneurysm (AN-u-rism) is a balloon-like bulge ... the weakened or injured walls can cause an aneurysm. An aneurysm can grow large and rupture (burst) ...

  16. Thoracic aortic aneurysm

    MedlinePlus

    Aortic aneurysm - thoracic; Syphilitic aneurysm; Aneurysm - thoracic aortic ... The most common cause of a thoracic aortic aneurysm is hardening of the ... with high cholesterol, long-term high blood pressure, or who ...

  17. The experimental study on aneurysm with PIV system

    NASA Astrophysics Data System (ADS)

    Yueshe, Wang; Xiaoqi, Ma; Di, Li

    2013-07-01

    Cerebral aneurysm, a local enlargement of an artery caused by weakness in the wall of a cerebral artery, has the high death rate and disability rate, and is a threat to public health. The forming mechanism of aneurysm is complex, which motivated many researchers to conduct studies in this field. The results indicated that increasing heart frequency can aggravate the oscillation of wall shear stress, and push The growth points of aneurysm along the aneurysm wall, thereby significantly affecting bthe growth and rupture mechanism of aneurysm. In addition, it is found that the curvature of the vessel is the key to induce the secondary vortex in the aneurysm; the secondary vortex increases the magnitude of WSS near the dome of aneurysm, which can cause the rupture of aneurysm dome. there is a linear relationship between the velocity of blood flow and the square root of hear frequency.

  18. Abdominal Aortic Aneurysms: Treatments

    MedlinePlus

    ... information Membership Directory (SIR login) Interventional Radiology Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

  19. Aneurysms: thoracic aortic aneurysms.

    PubMed

    Chun, Kevin C; Lee, Eugene S

    2015-04-01

    Thoracic aortic aneurysms (TAAs) have many possible etiologies, including congenital heart defects (eg, bicuspid aortic valves, coarctation of the aorta), inherited connective tissue disorders (eg, Marfan, Ehlers-Danlos, Loeys-Dietz syndromes), and degenerative conditions (eg, medial necrosis, atherosclerosis of the aortic wall). Symptoms of rupture include a severe tearing pain in the chest, back, or neck, sometimes associated with cardiovascular collapse. Before rupture, TAAs may exert pressure on other thoracic structures, leading to a variety of symptoms. However, most TAAs are asymptomatic and are found incidentally during imaging for other conditions. Diagnosis is confirmed with computed tomography scan or echocardiography. Asymptomatic TAAs should be monitored with imaging at specified intervals and patients referred for repair if the TAAs are enlarging rapidly (greater than 0.5 cm in diameter over 6 months for heritable etiologies; greater than 0.5 cm over 1 year for degenerative etiologies) or reach a critical aortic diameter threshold for elective surgery (5.5 cm for TAAs due to degenerative etiologies, 5.0 cm when associated with inherited syndromes). Open surgery is used most often to treat asymptomatic TAAs in the ascending aorta and aortic arch. Asymptomatic TAAs in the descending aorta often are treated medically with aggressive blood pressure control, though recent data suggest that endovascular procedures may result in better long-term survival rates. PMID:25860136

  20. Delayed postpartum haemorrhage secondary to a ruptured uterine artery pseudo-aneurysm, successfully treated by transarterial embolisation

    PubMed Central

    Moatti, Zoe; Nisner, Tamar; Saini, Ashish; Karoshi, Mahantesh

    2011-01-01

    A 29-year-old woman (gravida 1, para 1) had an uneventful first pregnancy and a delivery by emergency caesarean section at term. The caesarean section was complicated by a massive obstetric haemorrhage of 5000 ml. After closure, an immediate re-laparotomy was indicated due to heavy vaginal bleeding. The site of bleeding was identified as an extension of the uterine incision, and was sutured. She was stabilised by transfusion of blood and blood products in the intensive therapy unit, and discharged 5 days later. The patient was re-admitted 6 weeks later with brisk, painless vaginal bleeding, passing large clots from a well-contracted uterus. Her haemoglobin decreased from 11.8 to 7.8 g/dl overnight. In view of her history, an urgent CT angiogram was performed, which revealed the presence of a pseudo-aneurysm arising from the left uterine artery. This was successfully occluded by transarterial embolisation, obviating the need for further surgical exploration. PMID:22674937

  1. Delayed postpartum haemorrhage secondary to a ruptured uterine artery pseudo-aneurysm, successfully treated by transarterial embolisation.

    PubMed

    Moatti, Zoe; Nisner, Tamar; Saini, Ashish; Karoshi, Mahantesh

    2011-01-01

    A 29-year-old woman (gravida 1, para 1) had an uneventful first pregnancy and a delivery by emergency caesarean section at term. The caesarean section was complicated by a massive obstetric haemorrhage of 5000 ml. After closure, an immediate re-laparotomy was indicated due to heavy vaginal bleeding. The site of bleeding was identified as an extension of the uterine incision, and was sutured. She was stabilised by transfusion of blood and blood products in the intensive therapy unit, and discharged 5 days later. The patient was re-admitted 6 weeks later with brisk, painless vaginal bleeding, passing large clots from a well-contracted uterus. Her haemoglobin decreased from 11.8 to 7.8 g/dl overnight. In view of her history, an urgent CT angiogram was performed, which revealed the presence of a pseudo-aneurysm arising from the left uterine artery. This was successfully occluded by transarterial embolisation, obviating the need for further surgical exploration. PMID:22674937

  2. Secondary malignant giant-cell tumor of bone. Clinicopathological assessment of nineteen patients

    SciTech Connect

    Rock, M.G.; Sim, F.H.; Unni, K.K.; Witrak, G.A.; Frassica, F.J.; Schray, M.F.; Beabout, J.W.; Dahlin, D.C.

    1986-09-01

    Twenty-six patients who had a malignant giant-cell tumor of bone--a sarcoma either juxtaposed to a zone of typical benign giant-cell tumor or occurring at the site of a previously documented benign giant-cell tumor--have been seen at the Mayo Clinic. Of the twenty-six tumors, nineteen were secondary to a previous attempt at local control of a benign giant-cell tumor. All but one of these nineteen patients with a secondary tumor had received therapeutic irradiation four to thirty-nine years earlier. The nature and duration of the symptoms and the sites of predilection of the malignant giant-cell tumors were the same as for benign giant-cell tumor. Fibrosarcoma occurred three times as frequently as osteosarcoma. The best results of treatment of the secondary sarcoma were obtained with early ablation.

  3. Intracranial aneurysm and sildenafil

    PubMed Central

    Edriss, Hawa; Nugent, Kenneth

    2016-01-01

    Sildenafil is one of the most commonly used drugs for the treatment of erectile dysfunction. To date, we found five reported cases of intracerebral bleeding and two reported cases of subarachnoid hemorrhage related to sildenafil use. We report a 49-year-old hypertensive and diabetic patient who presented with acute pulmonary edema and loss of consciousness following ingestion of 100 mg of sildenafil prior to sexual intercourse. He was not previously aware of the presence of an aneurysm and had no family history of it. Computed tomography of his head revealed a subarachnoid hemorrhage due to rupture of a saccular aneurysm with subsequent repeat hemorrhage within a few hours of presentation. A sudden increase in blood pressure led to pulmonary edema. Studies have shown that sildenafil acts on phosphodiesterase-1, -2 and -5 receptors and leads to a secondary increase in intracerebral circulation and vasodilatory effects, leading to sympathetic overactivity which increases the risk for intracranial bleeding. PMID:27034561

  4. Time evolution and hemodynamics of cerebral aneurysms

    NASA Astrophysics Data System (ADS)

    Sforza, Daniel M.; Putman, Christopher; Tateshima, Satoshi; Viñuela, Fernando; Cebral, Juan

    2011-03-01

    Cerebral aneurysm rupture is a leading cause of hemorrhagic strokes. Because they are being more frequently diagnosed before rupture and the prognosis of subarachnoid hemorrhage is poor, clinicians are often required to judge which aneurysms are prone to progression and rupture. Unfortunately, the processes of aneurysm initiation, growth and rupture are not well understood. Multiple factors associated to these processes have been identified. Our goal is to investigate two of them, arterial hemodynamics (using computational fluid dynamics) and the peri-aneurysmal environment, by studying a group of growing cerebral aneurysms that are followed longitudinally in time. Six patients with unruptured untreated brain aneurysms which exhibited growth during the observation period were selected for the study. Vascular models of each aneurysm at each observation time were constructed from the corresponding computed tomography angiography (CTA) images. Subsequently, models were aligned, and geometrical differences quantified. Blood flow was modeled with the 3D unsteady incompressible Navier-Stokes equation for a Newtonian fluid, and wall shear stress distribution and flow patterns were calculated and visualized. Analysis of the simulations and changes in geometry revealed asymmetric growth patterns and suggests that areas subject to vigorous flows, i.e. relative high wall shear stress and concentrated streamlines patterns; correspond to regions of aneurysm growth. Furthermore, in some cases the geometrical evolution of aneurysms is clearly affected by contacts with bone structures and calcifications in the wall, and as a consequence the hemodynamics is greatly modified. Thus, in these cases the peri-aneurysmal environment must be considered when analyzing aneurysm evolution.

  5. Cerebral Aneurysms Fact Sheet

    MedlinePlus

    ... Awards Enhancing Diversity Find People About NINDS Cerebral Aneurysms Fact Sheet See a list of all NINDS ... I get more information? What is a cerebral aneurysm? A cerebral aneurysm (also known as an intracranial ...

  6. Aortic aneurysm repair - endovascular

    MedlinePlus

    ... Endovascular aneurysm repair - aorta; AAA repair - endovascular; Repair - aortic aneurysm - endovascular ... leaking or bleeding. You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. ...

  7. Aortic aneurysm repair - endovascular

    MedlinePlus

    EVAR; Endovascular aneurysm repair - aorta; AAA repair - endovascular; Repair - aortic aneurysm - endovascular ... leaking or bleeding. You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. ...

  8. Popliteal aneurysms.

    PubMed

    Farina, C; Cavallaro, A; Schultz, R D; Feldhaus, R J; di Marzo, L

    1989-07-01

    A 15 year experience with 50 popliteal aneurysms in 36 patients is reviewed. Forty-seven popliteal aneurysms were atherosclerotic while three were related to entrapment of the popliteal artery. Fourteen asymptomatic popliteal aneurysms were observed preoperatively during a mean period of 26 months. Ischemic complications developed in five of these. At admission, 16 limbs were asymptomatic (group 1) while the other 34 limbs presented with ischemic symptoms (group 2). No operation was performed upon three limbs, and another two were surgically explored and amputated. No operative deaths resulted from 45 vascular reconstructions. Results from follow-up study of one to 176 months (a mean of 57 months) revealed a late patency rate of 62 per cent. The late patency rate of autologous saphenous vein (ASV) was 100 per cent; polytetrafluoroethylene (PTFE) and Dacron (polyester fiber) grafts had a patency rate of 74 and 34 per cent, respectively (ASV versus PTFE, p = N.S.; ASV versus Dacron, p less than 0.002). The rate of late salvage of limbs was 88 per cent. The bypass grafts of group 1 and those performed upon limbs with good runoff fared significantly better than others (p less than 0.05 and p less than 0.001). The risk of natural complications of popliteal aneurysms and the good results from surgical treatment suggested that a revascularization procedure in the asymptomatic stage is always recommended. The use of PTFE grafts for repair of popliteal aneurysms is justified when the ASV is not available. The use of Dacron grafts is no longer indicated. PMID:2740973

  9. Ultrastructural Analyses of Alveolar Bone in a Patient With Osteomyelitis Secondary to Osteopetrosis: A Review of the Literature.

    PubMed

    Mikami, Toshinari; Miake, Yasuo; Bologna-Molina, Ronell; Takeda, Yasunori

    2016-08-01

    Osteopetrosis is a generic term for generalized sclerotic conditions caused by rare genetic disorders. Decreased osteoclastic activities disturb bone remodeling, resulting in greater mineral density and greater compressive strength; therefore, bone fracture is a major physical symptom of osteopetrosis. Osteomyelitis of the maxilla or mandible is a common and well-documented complication of osteopetrosis. Local infection, such as odontogenic infection, is more likely to lead to osteomyelitis, and treatment strategies can be challenging. However, detailed ultrastructural analyses of bone from patients with osteopetrosis and odontogenic infection are limited. This report describes a case of osteomyelitis of the maxilla and mandible secondary to osteopetrosis in an adult patient and presents ultrastructural data of alveolar bone tissue analyzed by contact microradiography, electron probe microanalysis, and x-ray diffraction. Cases of osteomyelitis of the jaw secondary to osteopetrosis also are reviewed. PMID:27000409

  10. Expression of mutant bone morphogenetic protein receptor II worsens pulmonary hypertension secondary to pulmonary fibrosis

    PubMed Central

    Robinson, Linda J.; Moore, Christy S.; Blackwell, Thomas R.; Gladson, Santhi; Penner, Niki L.; Burman, Ankita; McClellan, Lucas J.; Polosukhin, Vasiliy V.; Tanjore, Harikrishna; McConaha, Melinda E.; Gleaves, Linda A.; Talati, Megha A.; Hemnes, Anna R.; Fessel, Joshua P.; Lawson, William E.; Blackwell, Timothy S.; West, James D.

    2015-01-01

    Abstract Pulmonary fibrosis is often complicated by pulmonary hypertension (PH), and previous studies have shown a potential link between bone morphogenetic protein receptor II (BMPR2) and PH secondary to pulmonary fibrosis. We exposed transgenic mice expressing mutant BMPR2 and control mice to repetitive intraperitoneal injections of bleomycin for 4 weeks. The duration of transgene activation was too short for mutant BMPR2 mice to develop spontaneous PH. Mutant BMPR2 mice had increased right ventricular systolic pressure compared to control mice, without differences in pulmonary fibrosis. We found increased hypoxia-inducible factor (HIF)1-α stabilization in lungs of mutant-BMPR2-expressing mice compared to controls following bleomycin treatment. In addition, expression of the hypoxia response element protein connective tissue growth factor was increased in transgenic mice as well as in a human pulmonary microvascular endothelial cell line expressing mutant BMPR2. In mouse pulmonary vascular endothelial cells, mutant BMPR2 expression resulted in increased HIF1-α and reactive oxygen species production following exposure to hypoxia, both of which were attenuated with the antioxidant TEMPOL. These data suggest that expression of mutant BMPR2 worsens secondary PH through increased HIF activity in vascular endothelium. This pathway could be therapeutically targeted in patients with PH secondary to pulmonary fibrosis. PMID:26697175

  11. Fibrous Dysplasia of the Temporal Bone with External Auditory Canal Stenosis and Secondary Cholesteatoma.

    PubMed

    Liu, Yu Hsi; Chang, Kuo Ping

    2016-04-01

    Fibrous dysplasia is a slowly progressive benign fibro-osseous disease, rarely occurring in temporal bones. In these cases, most bony lesions developed from the bony part of the external auditory canals, causing otalgia, hearing impairment, otorrhea, and ear hygiene blockade and probably leading to secondary cholesteatoma. We presented the medical history of a 24-year-old woman with temporal monostotic fibrous dysplasia with secondary cholesteatoma. The initial presentation was unilateral conductive hearing loss. A hard external canal tumor contributing to canal stenosis and a near-absent tympanic membrane were found. Canaloplasty and type I tympanoplasty were performed, but the symptoms recurred after 5 years. She received canal wall down tympanomastoidectomy with ossciculoplasty at the second time, and secondary cholesteatoma in the middle ear was diagnosed. Fifteen years later, left otorrhea recurred again and transcanal endoscopic surgery was performed for middle ear clearance. Currently, revision surgeries provide a stable auditory condition, but her monostotic temporal fibrous dysplasia is still in place. PMID:27340999

  12. Endovascular stent-graft repair of spontaneous aorto-caval fistula secondary to a ruptured abdominal aortic aneurysm: An emergency management of hostile anatomy

    PubMed Central

    Liu, Mingyuan; Wang, Haofu

    2016-01-01

    Objectives: Although endovascular aneurysm repair of aorto-caval fistula offers a safe and efficient approach compared to traditional open repair, endovascular techniques for the treatment of aorto-caval fistula with ruptured abdominal aortic aneurysms in emergency circumstance are not well established. This study aims to evaluate the effect of endovascular repair of aorto-caval fistula of a patient with ruptured abdominal aortic aneurysm and hostile anatomy. Methods: we report a case of an aorto-caval fistula endovascular repaired in a 78-year-old male using a hybrid stent-graft technique. Results: The patient had an uneventful recovery and CTA follow up showed no sign of ACF or any endoleak. Conclusion: This case highlights ACF might be managed by composite endograft implantation with careful and solid sealing of anchoring zones on the two sides. PMID:27489717

  13. The Asymmetric Vascular Stent: Efficacy in a rabbit aneurysm model

    PubMed Central

    Ionita, Ciprian N; Paciorek, Ann M; Dohatcu, Andreea; Hoffmann, Kenneth R; Bednarek, Daniel R; Kolega, John; Levy, Elad I; Hopkins, L. Nelson; Rudin, Stephen; Mocco, J.

    2009-01-01

    Background and Purpose Development of hemodynamic modifying devices to treat intracranial aneurysms (IAs) is an active area of research. The asymmetric vascular stent (AVS), a stent containing a low porosity patch, is such device. We evaluate AVS efficacy in an in vivo IA model. Methods We created twenty-four elastase rabbit model aneurysms: thirteen treated with the AVS, five treated with standard coronary stents, and six untreated controls. Four weeks following treatment, aneurysms underwent follow-up angiography, cone-beam micro-CT, histologic evaluation, and selective electron microscopy scanning. Results Four rabbits died early in the study: three during AVS treatment and one control (secondary to intra-procedural vessel injury and an unrelated tumor, respectively). AVS-treated aneurysms exhibited very weak or no aneurysm flow immediately after treatment and no flow in all aneurysms at follow-up. Stent-treated aneurysms showed flow both after treatment (5/5) and at follow-up (3/5). All control aneurysms remained patent during the study. Micro-CT scans showed: 9/9 of scanned AVS aneurysms were occluded, (6/9) AVSs were ideally placed and (3/9) the low porosity region partially covered the aneurysm neck; stent-treated aneurysms were 1/5 occluded, 2/5 patent, and 2/5 partially-patent. Histology results demonstrated: for AVS-treated aneurysms, advanced thrombus organization in the (9/9); for stent-treated aneurysms (1/4) no thrombus, (2/4) partially-thrombosed and (1/4) fully-thrombosed; for control aneurysms (4/4) no thrombus. Conclusion The use of AVSs shows promise as a viable new therapeutic in intracranial aneurysm treatment. These data encourage further investigation and provide substantial support to the AVS concept. PMID:19131663

  14. Strategies for the chemical analysis of highly porous bone scaffolds using secondary ion mass spectrometry.

    PubMed

    Wang, Daming; Poologasundarampillai, Gowsihan; van den Bergh, Wouter; Chater, Richard J; Kasuga, Toshihiro; Jones, Julian R; McPhail, David S

    2014-02-01

    Understanding the distribution of critical elements (e.g. silicon and calcium) within silica-based bone scaffolds synthesized by different methods is central to the optimization of these materials. Time-of-flight secondary ion mass spectrometry (ToF-SIMS) has been used to determine this information due to its very high surface sensitivity and its ability to map all the elements and compounds in the periodic table with high spatial resolution. The SIMS image data can also be combined with depth profiles to construct three-dimensional chemical maps. However, the scaffolds have interconnected pore networks, which are very challenging structures for the SIMS technique. To overcome this problem two experimental methodologies have been developed. The first method involved the use of the focused ion beam technique to obtain clear images of the regions of interest and subsequently mark them by introducing fiducial marks; the samples were then analysed using the ToF-SIMS technique to yield the chemical analyses of the regions of interest. The second method involved impregnating the pores using a suitable reagent so that a flat surface could be achieved, and this was followed by secondary ion mapping and 3D chemical imaging with ToF-SIMS. The samples used in this work were sol-gel 70S30C foam and electrospun fibres and calcium-containing silica/gelatin hybrid scaffolds. The results demonstrate the feasibility of both these experimental methodologies and indicate that these methods can provide an opportunity to compare various artificial bone scaffolds, which will be of help in improving scaffold synthesis and processing routes. The techniques are also transferable to many other types of porous material. PMID:24457328

  15. Meat and bone meal as secondary fuel in fluidized bed combustion

    SciTech Connect

    L. Fryda; K. Panopoulos; P. Vourliotis; E. Kakaras; E. Pavlidou

    2007-07-01

    Meat and Bone Meal (MBM) was co-fired in a laboratory scale fluidized bed combustion (FBC) apparatus with two coals. Several fuel blends were combusted under different conditions to study how primary fuel substitution by MBM affects flue gas emissions as well as fluidized bed (FB) agglomeration tendency. MBM, being a highly volatile fuel, caused significant increase of CO emissions and secondary air should be used in industrial scale applications to conform to regulations. The high N-content of MBM is moderately reflected on the increase of nitrogen oxides emissions which are reduced by MBM derived volatiles. The MBM ash, mainly containing bone material rich in Ca, did not create any noteworthy desulphurization effect. The observed slight decrease in SO{sub 2} emissions is predominantly attributed to the lower sulphur content in the coal/MBM fuel mixtures. The SEM/EDS analysis of bed material samples from the coal/MBM tests revealed the formation of agglomerates of bed material debris and ash with sizes that do not greatly exceed the original bed inventory and thus not problematic. 37 refs., 9 figs., 3 tabs.

  16. Secondary alveolar bone grafting in cleft of the lip and palate patients

    PubMed Central

    Walia, Abhilashaa

    2011-01-01

    Aim: The aim was to restore the function and form of both arches with a proper occlusal relationship and eruption of tooth in the cleft area. Materials and Methods: Eleven patients were selected irrespective of sex and socio-economic status and whose age was within the mixed dentition period. Iliac crest is grafted in cleft area and subsequently evaluated for graft success using study models, and periapical and occlusal radiographs. Results: At the time of evaluation teeth were erupted in the area and good alveolar bone levels were present. Premaxilla becomes immobile with a good arch form and arch continuity. There are no major complications in terms of pain, infection, paraesthesia, hematoma formation at donor site without difficulty in walking. There is no complication in terms of pain, infection, exposure of graft, rejection of graft, and wound dehiscence at the recipient site. Discussion: It is evident that secondary alveolar grafting during the mixed dentition period is more beneficial for patients at the donor site as well as the recipient site. Conclusion: Long-term follow-up is required to achieve maximum advantage of secondary alveolar grafting; the age of the patient should be within the mixed dentition period, irrespective of sex, socio-economic status. It may be unilateral or bilateral. PMID:22090755

  17. How Is an Aneurysm Treated?

    MedlinePlus

    ... NHLBI on Twitter. How Is an Aneurysm Treated? Aortic aneurysms are treated with medicines and surgery. Small aneurysms ... doing your normal daily activities Treatment for an aortic aneurysm is based on its size. Your doctor may ...

  18. Giant syphilitic aortic aneurysm: a case report and review of the literature.

    PubMed

    Tomey, Matthew I; Murthy, Venkatesh L; Beckman, Joshua A

    2011-10-01

    Thoracic aortic aneurysm formation is a known complication of late syphilis. Large aneurysms may cause symptoms via mass effect. When aneurysms compress the pulmonary artery, pulmonary arterial hypertension and right heart failure may result. We report the case of a 76-year-old man who presented with right heart failure secondary to an 11-cm syphilitic thoracic aortic aneurysm, and discuss the evolving epidemiology, complications, diagnosis and management of syphilitic aortitis. PMID:21844068

  19. Ruptured Gastric Aneurysm in α-1 Antitrypsin Deficiency

    PubMed Central

    Spanuchart, Ittikorn; Scott Gallacher, T.

    2016-01-01

    We present a unique vascular complication of α-1 antitrypsin deficiency (AATD) in a patient with an acute onset of epigastric pain and hemodynamic instability. Abdominal computed tomography angiography detected hemoperitoneum and hematoma within the gastrohepatic ligament with active extravasation. Abdominal angiography revealed left gastric aneurysms. An association between AATD and vascular aneurysms has been suggested to be secondary to unopposed proteolytic activity against arterial structural proteins. The aneurysm formation in aortic, superior mesenteric, inferior mesenteric, and splenic arteries has been reported. We report the first case with ruptured gastric artery aneurysm as a complication of AATD. PMID:27622197

  20. Ruptured Gastric Aneurysm in α-1 Antitrypsin Deficiency.

    PubMed

    Jaruvongvanich, Veeravich; Spanuchart, Ittikorn; Scott Gallacher, T

    2016-07-01

    We present a unique vascular complication of α-1 antitrypsin deficiency (AATD) in a patient with an acute onset of epigastric pain and hemodynamic instability. Abdominal computed tomography angiography detected hemoperitoneum and hematoma within the gastrohepatic ligament with active extravasation. Abdominal angiography revealed left gastric aneurysms. An association between AATD and vascular aneurysms has been suggested to be secondary to unopposed proteolytic activity against arterial structural proteins. The aneurysm formation in aortic, superior mesenteric, inferior mesenteric, and splenic arteries has been reported. We report the first case with ruptured gastric artery aneurysm as a complication of AATD. PMID:27622197

  1. Cerebral aneurysm (image)

    MedlinePlus

    ... loss of nerve function may indicate that an aneurysm may be causing pressure on adjacent brain tissue. ... changes or other neurological changes can indicate the aneurysm has ruptured and is bleeding into the brain. ...

  2. Abdominal aortic aneurysm

    MedlinePlus

    ... to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ... blood pressure Male gender Genetic factors An abdominal aortic aneurysm is most often seen in males over age ...

  3. Celiac Artery Aneurysm

    PubMed Central

    McMullan, D. Michael; McBride, Michael; Livesay, James J.; Dougherty, Kathryn G.; Krajcer, Zvonimir

    2006-01-01

    Aneurysm of the celiac artery is an uncommon clinical problem; fewer than 180 cases have been reported in the world medical literature. Most patients are symptomatic at the time of diagnosis. However, occasionally such aneurysms are detected incidentally during diagnostic imaging for other diseases. We present the case of a 72-year-old man who had an asymptomatic celiac artery aneurysm detected by computed tomographic angiography after endoluminal exclusion of an infrarenal aortic aneurysm. The patient underwent successful resection of the aneurysm and revascularization of the aorta–common hepatic and splenic arteries with use of an autologous saphenous vein graft. PMID:16878636

  4. [Idiopathic pulmonary trunk aneurysm].

    PubMed

    Uehara, Mayuko; Kuroda, Yosuke; Ohori, Syunsuke; Mawatari, Toru; Morishita, Kiyofumi

    2010-07-01

    Pulmonary trunk aneurysm is generally associated with congenital cardiac defects, pulmonary hypertension, or infection. Idiopathic pulmonary trunk aneurysm without any associated diseases is a rare lesion and has seldom been reported. Here, we report a case of a 68-year-old woman with idiopathic pulmonary trunk aneurysm. The maximum diameter of the aneurysm was 53 mm while she was 142 cm in height. We successfully performed aneurysmorrhaphy and her postoperative course was uneventful. Aneurysmorrhaphy was an effective technique for idiopathic pulmonary trunk aneurysm without pulmonary hypertention. PMID:20662238

  5. Embolization of Brain Aneurysms and Fistulas

    MedlinePlus

    ... Professions Site Index A-Z Embolization of Brain Aneurysms and Arteriovenous Malformations/Fistulas Embolization of brain aneurysms ... Aneurysms and Fistulas? What is Embolization of Brain Aneurysms and Fistulas? Embolization of brain aneurysms and arteriovenous ...

  6. Aortic aneurysm repair - endovascular- discharge

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000236.htm Aortic aneurysm repair - endovascular - discharge To use the sharing features ... enable JavaScript. AAA repair - endovascular - discharge; Repair - aortic aneurysm - endovascular - discharge; EVAR - discharge; Endovascular aneurysm repair - discharge ...

  7. Cardiac ventricular aneurysm

    PubMed Central

    Harley, Hugh R. S.

    1969-01-01

    A case of successful excision of a ventricular aneurysm due to myocardial infarction is presented. The aetiology, incidence, pathogenesis, pathology, clinical features, and diagnosis of the condition are discussed. An account is given of the haemodynamic upset caused by aneurysms of the ventricle. The prognosis of untreated aneurysms is discussed. Although there is difference of opinion, it is concluded that a ventricular aneurysm adversely affects the prognosis after myocardial infarction. The indications for, and the mortality and results of, resection of ventricular aneurysms are discussed. The conclusion is drawn that persistent cardiac failure and angina can be relieved and the risk of systemic embolism reduced by the excision of expansile ventricular aneurysms of a fibrous nature. It is possible that excision may also reduce the incidence of subsequent acute myocardial infarction. Images PMID:5821618

  8. Abdominal Aortic Aneurysms

    PubMed Central

    Fortner, George; Johansen, Kaj

    1984-01-01

    Aneurysms are common in our increasingly elderly population, and are a major threat to life and limb. Until the advent of vascular reconstructive techniques, aneurysm patients were subject to an overwhelming risk of death from exsanguination. The first successful repair of an abdominal aortic aneurysm using an interposed arterial homograft was reported by Dubost in 1952. A milestone in the evolution of vascular surgery, this event and subsequent diagnostic, operative and prosthetic graft refinements have permitted patients with an unruptured abdominal aortic aneurysm to enjoy a better prognosis than patients with almost any other form of major systemic illness. Images PMID:6702193

  9. Bronchial Aneurysms Mimicking Aortic Aneurysms: Endovascular Treatment in Two Patients

    SciTech Connect

    Vernhet, Helene; Bousquet, Claudine; Jean, Betty; Lesnik, Alvian; Durand, Gerard; Giron, Jacques; Senac, Jean Paul

    1999-05-15

    Bronchial artery dilatation and aneurysm formation is a potential complication of local inflammation, especially in bronchiectasis. When the bronchial artery has an ectopic origin from the inferior segment of the aortic arch, aneurysms may mimick aortic aneurysms. Despite this particular location, endovascular treatment is possible. We report two such aneurysms that were successfully embolized with steel coils.

  10. Gelatinous bone marrow transformation secondary to unusual eating habits and drastic weight loss

    PubMed Central

    Rafiullah; Islam, Rezwan; Mahmood, Ruth; Sitwala, Kajal V

    2013-01-01

    Gelatinous bone marrow transformation (GMT), also known as starvation bone marrow, has been reported in a number of chronic illnesses, eating disorders (anorexia nervosa) and malignancies. We report the case of a 37-year-old man with a history of bipolar disorder and obesity (weighing >300 pounds) who presented due to recently developing a deep yellow colour to his skin. Over the past 2 years, through diet and exercise, he lost over 150 pounds. He reported running 6–8 miles per day and eating ‘lots of squash’. We made the diagnosis of starvation hepatitis and bone marrow degeneration, and referred the patient to a dietician and haematologist/oncologist, where improvements were observed at 4 weeks follow-up. PMID:23861277

  11. Gelatinous bone marrow transformation secondary to unusual eating habits and drastic weight loss.

    PubMed

    Rafiullah; Islam, Rezwan; Mahmood, Ruth; Sitwala, Kajal V

    2013-01-01

    Gelatinous bone marrow transformation (GMT), also known as starvation bone marrow, has been reported in a number of chronic illnesses, eating disorders (anorexia nervosa) and malignancies. We report the case of a 37-year-old man with a history of bipolar disorder and obesity (weighing >300 pounds) who presented due to recently developing a deep yellow colour to his skin. Over the past 2 years, through diet and exercise, he lost over 150 pounds. He reported running 6-8 miles per day and eating 'lots of squash'. We made the diagnosis of starvation hepatitis and bone marrow degeneration, and referred the patient to a dietician and haematologist/oncologist, where improvements were observed at 4 weeks follow-up. PMID:23861277

  12. Abdominal aortic aneurysm.

    PubMed

    Keisler, Brian; Carter, Chuck

    2015-04-15

    Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. Diagnosis may be made by physical examination, an incidental finding on imaging, or ultrasonography. The U.S. Preventive Services Task Force released updated recommendations for abdominal aortic aneurysm screening in 2014. Men 65 to 75 years of age with a history of smoking should undergo one-time screening with ultrasonography based on evidence that screening will improve abdominal aortic aneurysm-related mortality in this population. Men in this age group without a history of smoking may benefit if they have other risk factors (e.g., family history of abdominal aortic aneurysm, other vascular aneurysms, coronary artery disease). There is inconclusive evidence to recommend screening for abdominal aortic aneurysm in women 65 to 75 years of age with a smoking history. Women without a smoking history should not undergo screening because the harms likely outweigh the benefits. Persons who have a stable abdominal aortic aneurysm should undergo regular surveillance or operative intervention depending on aneurysm size. Surgical intervention by open or endovascular repair is the primary option and is typically reserved for aneurysms 5.5 cm in diameter or greater. There are limited options for medical treatment beyond risk factor modification. Ruptured abdominal aortic aneurysm is a medical emergency presenting with hypotension, shooting abdominal or back pain, and a pulsatile abdominal mass. It is associated with high prehospitalization mortality. Emergent surgical intervention is indicated for a rupture but has a high operative mortality rate. PMID:25884861

  13. Bilateral mycotic aneurysm of the superior gluteal artery.

    PubMed

    Bouarhroum, Abdellatif; El Khloufi, Samir; El Hassani, Rachid; Bensaid, Younes

    2009-01-01

    Gluteal artery aneurysms are rare and mostly secondary to blunt or penetrating trauma. As an absolute rarity, we report an exceptional presentation of bilateral mycotic aneurysm of the superior gluteal artery in a 16-year-old boy associated with bacterial endocarditis. The left pseudoaneurysm was ruptured and treated using open surgery; 1 week later, the right location was successfully treated by embolization. PMID:19540714

  14. Aneurysm in the brain

    MedlinePlus

    ... Supplements Videos & Tools Español You Are Here: Home → ... JavaScript. An aneurysm is a weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out. When an aneurysm occurs in a blood ...

  15. Brain aneurysm repair - discharge

    MedlinePlus

    ... Supplements Videos & Tools Español You Are Here: Home → ... You had a brain aneurysm. An aneurysm is a weak area in the wall of a blood vessel that bulges or balloons out. Once it reaches a certain size, it ...

  16. Acquired Jugular Vein Aneurysm

    PubMed Central

    Hopsu, Erkki; Tarkkanen, Jussi; Vento, Seija I.; Pitkäranta, Anne

    2009-01-01

    Venous malformations of the jugular veins are rare findings. Aneurysms and phlebectasias are the lesions most often reported. We report on an adult patient with an abruptly appearing large tumorous mass on the left side of the neck identified as a jugular vein aneurysm. Upon clinical examination with ultrasound, a lateral neck cyst was primarily suspected. Surgery revealed a saccular aneurysm in intimate connection with the internal jugular vein. Histology showed an organized hematoma inside the aneurysmal sac, which had a focally thinned muscular layer. The terminology and the treatment guidelines of venous dilatation lesions are discussed. For phlebectasias, conservative treatment is usually recommended, whereas for saccular aneurysms, surgical resection is the treatment of choice. While an exact classification based on etiology and pathophysiology is not possible, a more uniform taxonomy would clarify the guidelines for different therapeutic modalities for venous dilatation lesions. PMID:20107571

  17. Aneurysm Study of Pipeline in an Observational Registry (ASPIRe)

    PubMed Central

    Kallmes, David F.; Brinjikji, Waleed; Boccardi, Edoardo; Ciceri, Elisa; Diaz, Orlando; Tawk, Rabih; Woo, Henry; Jabbour, Pascal; Albuquerque, Felipe; Chapot, Rene; Bonafe, Alain; Dashti, Shervin R.; Almandoz, Josser E. Delgado; Given, Curtis; Kelly, Michael E.; Cross, DeWitte T.; Duckwiler, Gary; Razack, Nasser; Powers, Ciaran J.; Fischer, Sebastian; Lopes, Demetrius; Harrigan, Mark R.; Huddle, Daniel; Turner, Raymond; Zaidat, Osama O.; Defreyne, Luc; Pereira, Vitor Mendes; Cekirge, Saruhan; Fiorella, David; Hanel, Ricardo A.; Lylyk, Pedro; McDougall, Cameron; Siddiqui, Adnan; Szikora, Istvan; Levy, Elad

    2016-01-01

    Background and Objective Few prospective studies exist evaluating the safety and efficacy of the Pipeline Embolization Device (PED) in the treatment of intracranial aneurysms. The Aneurysm Study of Pipeline In an observational Registry (ASPIRe) study prospectively analyzed rates of complete aneurysm occlusion and neurologic adverse events following PED treatment of intracranial aneurysms. Materials and Methods We performed a multicenter study prospectively evaluating patients with unruptured intracranial aneurysms treated with PED. Primary outcomes included (1) spontaneous rupture of the Pipeline-treated aneurysm; (2) spontaneous nonaneurysmal intracranial hemorrhage (ICH); (3) acute ischemic stroke; (4) parent artery stenosis, and (5) permanent cranial neuropathy. Secondary endpoints were (1) treatment success and (2) morbidity and mortality at the 6-month follow-up. Vascular imaging was evaluated at an independent core laboratory. Results One hundred and ninety-one patients with 207 treated aneurysms were included in this registry. The mean aneurysm size was 14.5 ± 6.9 mm, and the median imaging follow-up was 7.8 months. Twenty-four aneurysms (11.6%) were small, 162 (78.3%) were large and 21 (10.1%) were giant. The median clinical follow-up time was 6.2 months. The neurological morbidity rate was 6.8% (13/191), and the neurological mortality rate was 1.6% (3/191). The combined neurological morbidity/mortality rate was 6.8% (13/191). The most common adverse events were ischemic stroke (4.7%, 9/191) and spontaneous ICH (3.7%, 7/191). The complete occlusion rate at the last follow-up was 74.8% (77/103). Conclusions Our prospective postmarket study confirms that PED treatment of aneurysms in a heterogeneous patient population is safe with low rates of neurological morbidity and mortality. Patients with angiographic follow-up had complete occlusion rates of 75% at 8 months. PMID:27610126

  18. What You Should Know about Cerebral Aneurysms

    MedlinePlus

    ... About Stroke What You Should Know About Cerebral Aneurysms Updated:Jun 13,2014 About Cerebral Aneurysms Diagnosis ... to view an animation What is a cerebral aneurysm? An aneurysm is a weak area in a ...

  19. Functional Interference Clusters in Cancer Patients With Bone Metastases: A Secondary Analysis of RTOG 9714

    SciTech Connect

    Chow, Edward; James, Jennifer; Barsevick, Andrea; Hartsell, William; Ratcliffe, Sarah; Scarantino, Charles; Ivker, Robert; Roach, Mack; Suh, John; Petersen, Ivy; Konski, Andre; Demas, William; Bruner, Deborah

    2010-04-15

    Purpose: To explore the relationships (clusters) among the functional interference items in the Brief Pain Inventory (BPI) in patients with bone metastases. Methods: Patients enrolled in the Radiation Therapy Oncology Group (RTOG) 9714 bone metastases study were eligible. Patients were assessed at baseline and 4, 8, and 12 weeks after randomization for the palliative radiotherapy with the BPI, which consists of seven functional items: general activity, mood, walking ability, normal work, relations with others, sleep, and enjoyment of life. Principal component analysis with varimax rotation was used to determine the clusters between the functional items at baseline and the follow-up. Cronbach's alpha was used to determine the consistency and reliability of each cluster at baseline and follow-up. Results: There were 448 male and 461 female patients, with a median age of 67 years. There were two functional interference clusters at baseline, which accounted for 71% of the total variance. The first cluster (physical interference) included normal work and walking ability, which accounted for 58% of the total variance. The second cluster (psychosocial interference) included relations with others and sleep, which accounted for 13% of the total variance. The Cronbach's alpha statistics were 0.83 and 0.80, respectively. The functional clusters changed at week 12 in responders but persisted through week 12 in nonresponders. Conclusion: Palliative radiotherapy is effective in reducing bone pain. Functional interference component clusters exist in patients treated for bone metastases. These clusters changed over time in this study, possibly attributable to treatment. Further research is needed to examine these effects.

  20. Fat Embolism Syndrome Secondary to Bone Marrow Necrosis in Patients with Hemoglobinopathies.

    PubMed

    Gangaraju, Radhika; Reddy, Vishnu V B; Marques, Marisa B

    2016-09-01

    Bone marrow necrosis with subsequent embolization of the fat and necrotic tissues into the systemic circulation causing fat embolism syndrome and multiorgan failure is a rare complication of patients with hemoglobinopathies. The exact etiology of this condition is not known. Because it occurs more often in patients with compound heterozygous conditions than in sickle cell disease, some patients are unaware of their predisposition. The initial symptoms are nonspecific, such as back and/or abdominal pain, fever, and fatigue, which may rapidly progress to respiratory failure and severe neurologic compromise. Common laboratory tests reveal anemia without reticulocytosis, thrombocytopenia, leukoerythroblastic picture with immature white cells and nucleated red blood cells, increased lactate dehydrogenase, high ferritin, and, sometimes increased creatinine. The diagnosis can be delayed because of an apparent lack of awareness about bone marrow necrosis with fat embolism syndrome, its rarity, and its similarities with other conditions such as thrombotic thrombocytopenic purpura. Although a bone marrow biopsy is diagnostic, waiting for it delays definitive treatment, which appears to be essential for the recovery of end-organ damage, such as neurologic and pulmonary damage. In our experience, either multiple units of red blood cell transfusion or, preferably, red cell exchange initiated promptly, is lifesaving. PMID:27598359

  1. Distribution and length of osteophytes in the lumbar vertebrae and risk of rupture of abdominal aortic aneurysms: a study of dry bones from Chiang Mai, Thailand.

    PubMed

    Chanapa, Patcharin; Yoshiyuki, Tohno; Mahakkanukrauh, Pasuk

    2014-09-01

    Vertebral osteophytes are a characteristic feature of intervertebral disc degeneration. In the lumbar spinal region, the two major structures in close proximity anterior to the spine are the inferior vena cava and the abdominal aorta, both of which have been reported to be affected by osteophytes. The purpose of this study was to determine the distribution, classification and lengths of osteophytes in the lumbar vertebrae. One hundred and eighty lumbar columns of 90 males and 90 females from Chiang Mai, Thailand, in the age range 15 to 96 years (mean age, 63 years) were collected. The measuring length of osteophytes was assessed on vertebral body and articular facet. Statistical analysis was performed by descriptive analysis, chi-square and Pearson Correlation. Lumbar osteophytes were presented in 175 specimens (97.2%), 88 males and 87 females. The highest frequency was at L4, most were on the superior, inferior surface of body and articular facet (39.7%, 38.4%, and 22%), respectively. The greatest mean length was 3.47±2.21 mm at L5, and the longest length of anterior superior surface of body was 28.56 mm. The osteophyte length was significantly correlated directly with age (P<0.01), and males were significantly greater than females (P<0.05). The highest prevalence of osteophytes was on the anterior side of superior surface of body (30.4%), and the classification was traction. It can be proposed that the abdominal aorta could be damaged, especially a risk of rupture of abdominal aortic aneurysm. PMID:25276474

  2. Aneurysmal Subarachnoid Hemorrhage and Neuroinflammation: A Comprehensive Review

    PubMed Central

    Lucke-Wold, Brandon P.; Logsdon, Aric F.; Manoranjan, Branavan; Turner, Ryan C.; McConnell, Evan; Vates, George Edward; Huber, Jason D.; Rosen, Charles L.; Simard, J. Marc

    2016-01-01

    Aneurysmal subarachnoid hemorrhage (SAH) can lead to devastating outcomes including vasospasm, cognitive decline, and even death. Currently, treatment options are limited for this potentially life threatening injury. Recent evidence suggests that neuroinflammation plays a critical role in injury expansion and brain damage. Red blood cell breakdown products can lead to the release of inflammatory cytokines that trigger vasospasm and tissue injury. Preclinical models have been used successfully to improve understanding about neuroinflammation following aneurysmal rupture. The focus of this review is to provide an overview of how neuroinflammation relates to secondary outcomes such as vasospasm after aneurysmal rupture and to critically discuss pharmaceutical agents that warrant further investigation for the treatment of subarachnoid hemorrhage. We provide a concise overview of the neuroinflammatory pathways that are upregulated following aneurysmal rupture and how these pathways correlate to long-term outcomes. Treatment of aneurysm rupture is limited and few pharmaceutical drugs are available. Through improved understanding of biochemical mechanisms of injury, novel treatment solutions are being developed that target neuroinflammation. In the final sections of this review, we highlight a few of these novel treatment approaches and emphasize why targeting neuroinflammation following aneurysmal subarachnoid hemorrhage may improve patient care. We encourage ongoing research into the pathophysiology of aneurysmal subarachnoid hemorrhage, especially in regards to neuroinflammatory cascades and the translation to randomized clinical trials. PMID:27049383

  3. Hemodynamics of Cerebral Aneurysms

    PubMed Central

    Sforza, Daniel M.; Putman, Christopher M.; Cebral, Juan Raul

    2009-01-01

    The initiation and progression of cerebral aneurysms are degenerative processes of the arterial wall driven by a complex interaction of biological and hemodynamic factors. Endothelial cells on the artery wall respond physiologically to blood-flow patterns. In normal conditions, these responses are associated with nonpathological tissue remodeling and adaptation. The combination of abnormal blood patterns and genetics predisposition could lead to the pathological formation of aneurysms. Here, we review recent progress on the basic mechanisms of aneurysm formation and evolution, with a focus on the role of hemodynamic patterns. PMID:19784385

  4. Resolution of trigeminal neuralgia by coil embolization of a persistent primitive trigeminal artery aneurysm

    PubMed Central

    Ladner, Travis R; Ehtesham, Moneeb; Davis, Brandon J; Khan, Imad S; Ghiassi, Mayshan; Ghiassi, Mahan; Singer, Robert J

    2013-01-01

    The persistent primitive trigeminal artery (PTA) is a rare anastomosis between the carotid artery and basilar artery. While most PTAs are asymptomatic, lateral variants can occasionally compress the trigeminal nerve and precipitate trigeminal neuralgia. Aneurysms of the PTA are exceptionally rare in the literature and have not previously been associated with trigeminal neuralgia. We present the first case of an aneurysm of the PTA causing trigeminal neuralgia. The patient underwent coil embolization of the aneurysm which relieved her symptoms. We propose embolization as a viable therapeutic option for the resolution of trigeminal neuralgia when the condition is secondary to irritation by the high velocity pulsatile flow of an aneurysm. PMID:23625680

  5. Resolution of trigeminal neuralgia by coil embolization of a persistent primitive trigeminal artery aneurysm.

    PubMed

    Ladner, Travis R; Ehtesham, Moneeb; Davis, Brandon J; Khan, Imad S; Ghiassi, Mayshan; Ghiassi, Mahan; Singer, Robert J

    2013-01-01

    The persistent primitive trigeminal artery (PTA) is a rare anastomosis between the carotid artery and basilar artery. While most PTAs are asymptomatic, lateral variants can occasionally compress the trigeminal nerve and precipitate trigeminal neuralgia. Aneurysms of the PTA are exceptionally rare in the literature and have not previously been associated with trigeminal neuralgia. We present the first case of an aneurysm of the PTA causing trigeminal neuralgia. The patient underwent coil embolization of the aneurysm which relieved her symptoms. We propose embolization as a viable therapeutic option for the resolution of trigeminal neuralgia when the condition is secondary to irritation by the high velocity pulsatile flow of an aneurysm. PMID:23625680

  6. Resolution of trigeminal neuralgia by coil embolization of a persistent primitive trigeminal artery aneurysm.

    PubMed

    Ladner, Travis R; Ehtesham, Moneeb; Davis, Brandon J; Khan, Imad S; Ghiassi, Mayshan; Ghiassi, Mahan; Singer, Robert J

    2014-04-01

    The persistent primitive trigeminal artery (PTA) is a rare anastomosis between the carotid artery and basilar artery. While most PTAs are asymptomatic, lateral variants can occasionally compress the trigeminal nerve and precipitate trigeminal neuralgia. Aneurysms of the PTA are exceptionally rare in the literature and have not previously been associated with trigeminal neuralgia. We present the first case of an aneurysm of the PTA causing trigeminal neuralgia. The patient underwent coil embolization of the aneurysm which relieved her symptoms. We propose embolization as a viable therapeutic option for the resolution of trigeminal neuralgia when the condition is secondary to irritation by the high velocity pulsatile flow of an aneurysm. PMID:24610143

  7. Endovascular treatment of basilar aneurysms.

    PubMed

    Marlin, Evan S; Ikeda, Daniel S; Shaw, Andrew; Powers, Ciarán J; Sauvageau, Eric

    2014-07-01

    Basilar artery aneurysms account for a small percentage of intracranial aneurysms; however, they are a diverse group of lesions necessitating different treatment techniques for those that are ruptured and unruptured. Basilar apex aneurysms are the most common type and are frequently wide-necked, necessitating stent-assisted coiling or balloon remodeling. Other techniques have evolved to forego stenting in acutely ruptured wide-necked aneurysms. The prevention of delayed thromboembolic complications with dual antiplatelet therapy in patients with stents is critical. After treatment, basilar aneurysms require close follow-up to ensure complete occlusion. Basilar apex aneurysms often require delayed re-treatment, especially when previously ruptured. PMID:24994086

  8. Multiple mycotic aneurysms with a rare fungus, Aspergillus niger: a complex case report.

    PubMed

    Parameswaran, Vatsala

    2008-03-01

    The term "mycotic aneurysm" was first used by William Osler in 1885 to describe a nonsyphilitic bacterial infection of the arterial wall. It is now known that mycotic aneurysm, a rare infectious condition, can arise from a wide variety of clinical causes. The aorta is most often affected; however, such aneurysms may arise in any artery. Mycotic aneurysms are classified as primary (direct extension from surrounding area of infection), secondary (septic embolization that lodges in peripheral arteries), and cryptogenic (unknown cause). A mycotic aneurysm is a threat to life, organs, and limbs. Mycotic aneurysms of the aorta caused by fungi are rare. William Osler used the term "mycotic," referring to all infected aneurysms excluding fungal infections. Yet, the term "mycotic" by definition is a disease caused by a fungus. Only seven cases of aneurysms caused by a fungus were reported from 1966 to 1999. This article will focus on the care of a young female patient with end-stage renal disease receiving peritoneal dialysis who developed a mycotic aneurysm. She was treated with high doses of antifungal medications for the fungus Aspergillus niger. She was switched to hemodialysis from peritoneal dialysis and was later diagnosed with a primary multiple mycotic aneurysms. This article will describe the complex medical, surgical, and nursing care provided to this patient. PMID:18295164

  9. Popliteal vein aneurysm.

    PubMed

    Falkowski, A; Poncyljusz, W; Zawierucha, D; Kuczmik, W

    2006-06-01

    The incidence of a popliteal vein aneurysm is extremely low. Two cases of this rare venous anomaly are described. The epidemiology, morphology, and diagnostic methods are discussed and the potentially dangerous complications and treatment methods are presented. PMID:16796307

  10. Abdominal aortic aneurysm

    MedlinePlus

    ... main blood vessel that supplies blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs ... dissection). Symptoms of rupture include: Pain in the abdomen or back. The pain may be severe, sudden, ...

  11. Risks of secondary malignancies with heterotopic bone radiation therapy for patients younger than 40 years.

    PubMed

    Cadieux, Catherine L; DesRosiers, Colleen; McMullen, Kevin

    2016-01-01

    Heterotopic ossification (HO) of the bone is defined as a benign condition in which abnormal bone formation occurs in soft tissue. One of the most common prophylactic treatments for HO is radiation therapy (RT). This study retrospectively reviewed 20 patients younger than the age of 40 who received radiation to prevent HO in a single fraction of 7 Gray. The purpose of this study is to assess the risk of a second malignancy in these patients by recreating their treatment fields and contouring organs at risk to estimate the radiation dose absorbed by normal tissues outside the radiation treatment field. Diagnostic computed tomography (CT) scans for each patient were used to recreate treatment fields and to calculate dose to structures of interest. The distance from the field edge to each structure and its depth was recorded. Dose measurements in a water phantom were performed for the range of depths, distances, and field sizes used in the actual treatment plans. Computer-generated doses were compared to estimates based on measurement. The structure dose recorded was the higher dose generated between the 2 methods. Scatter dose was recorded to the rectum, bladder, sigmoid colon, small bowel, ovaries and utero-cervix in female patients, and prostate and gonads in male patients. In some patients, there is considerable dose received by certain organs from scatter because of their proximity to the radiation field. The average dose to the ovarian region was 4.125Gy with a range of 1.085 to 6.228Gy. The risk estimate for these patients ranged from 0.16% to 0.93%. The average total lifetime risk estimate for the bladder in all patients is 0.22% and the average total lifetime risk estimate for the remainder organs in all patients is 1.25%. In conclusions, proper shielding created from multileaf collimators (MLCs), blocks, and shields should always be used when possible. PMID:27156238

  12. Aneurysmal Subarachnoid Hemorrhage.

    PubMed

    D'Souza, Stanlies

    2015-07-01

    Aneurysmal subarachnoid hemorrhage (SAH) is a worldwide health burden with high fatality and permanent disability rates. The overall prognosis depends on the volume of the initial bleed, rebleeding, and degree of delayed cerebral ischemia (DCI). Cardiac manifestations and neurogenic pulmonary edema indicate the severity of SAH. The International Subarachnoid Aneurysm Trial (ISAT) reported a favorable neurological outcome with the endovascular coiling procedure compared with surgical clipping at the end of 1 year. The ISAT trial recruits were primarily neurologically good grade patients with smaller anterior circulation aneurysms, and therefore the results cannot be reliably extrapolated to larger aneurysms, posterior circulation aneurysms, patients presenting with complex aneurysm morphology, and poor neurological grades. The role of hypothermia is not proven to be neuroprotective according to a large randomized controlled trial, Intraoperative Hypothermia for Aneurysms Surgery Trial (IHAST II), which recruited patients with good neurological grades. Patients in this trial were subjected to slow cooling and inadequate cooling time and were rewarmed rapidly. This methodology would have reduced the beneficial effects of hypothermia. Adenosine is found to be beneficial for transient induced hypotension in 2 retrospective analyses, without increasing the risk for cardiac and neurological morbidity. The neurological benefit of pharmacological neuroprotection and neuromonitoring is not proven in patients undergoing clipping of aneurysms. DCI is an important cause of morbidity and mortality following SAH, and the pathophysiology is likely multifactorial and not yet understood. At present, oral nimodipine has an established role in the management of DCI, along with maintenance of euvolemia and induced hypertension. Following SAH, hypernatremia, although less common than hyponatremia, is a predictor of poor neurological outcome. PMID:25272066

  13. Abdominal aortic aneurysm.

    PubMed

    Setacci, Francesco; Galzerano, Giuseppe; De Donato, Gianmarco; Benevento, Domenico; Guerrieri, Massimiliano W; Ruzzi, Umberto; Borrelli, Maria P; Setacci, Carlo

    2016-02-01

    Endovascular repair of abdominal aortic aneurysms has become a milestone in the treatment of patients with abdominal aortic aneurysm. Technological improvement allows treatment in more and more complex cases. This review summarizes all grafts available on the market. A complete review of most important trial on this topic is provided to the best of our knowledge, and technical tips and tricks for standard cases are also included. PMID:26771730

  14. Aneurysmal Subarachnoid Hemorrhage

    PubMed Central

    2015-01-01

    Aneurysmal subarachnoid hemorrhage (SAH) is a worldwide health burden with high fatality and permanent disability rates. The overall prognosis depends on the volume of the initial bleed, rebleeding, and degree of delayed cerebral ischemia (DCI). Cardiac manifestations and neurogenic pulmonary edema indicate the severity of SAH. The International Subarachnoid Aneurysm Trial (ISAT) reported a favorable neurological outcome with the endovascular coiling procedure compared with surgical clipping at the end of 1 year. The ISAT trial recruits were primarily neurologically good grade patients with smaller anterior circulation aneurysms, and therefore the results cannot be reliably extrapolated to larger aneurysms, posterior circulation aneurysms, patients presenting with complex aneurysm morphology, and poor neurological grades. The role of hypothermia is not proven to be neuroprotective according to a large randomized controlled trial, Intraoperative Hypothermia for Aneurysms Surgery Trial (IHAST II), which recruited patients with good neurological grades. Patients in this trial were subjected to slow cooling and inadequate cooling time and were rewarmed rapidly. This methodology would have reduced the beneficial effects of hypothermia. Adenosine is found to be beneficial for transient induced hypotension in 2 retrospective analyses, without increasing the risk for cardiac and neurological morbidity. The neurological benefit of pharmacological neuroprotection and neuromonitoring is not proven in patients undergoing clipping of aneurysms. DCI is an important cause of morbidity and mortality following SAH, and the pathophysiology is likely multifactorial and not yet understood. At present, oral nimodipine has an established role in the management of DCI, along with maintenance of euvolemia and induced hypertension. Following SAH, hypernatremia, although less common than hyponatremia, is a predictor of poor neurological outcome. PMID:25272066

  15. Can 3D-CT angiography (3D-CTA) replace conventional catheter angiography in ruptured aneurysm surgery? Our experience with 162 cases.

    PubMed

    Matsumoto, Masato; Kasuya, Hiromichi; Sato, Taku; Endo, Yuji; Sakuma, Jun; Suzuki, Kyouichi; Sasaki, Tatsuya; Kodama, Namio

    2007-12-01

    In this communication, we studied whether 3D-CT angiography (3D CTA) gives us enough information for a safe operation without those from conventional catheter angiography (CCA) in patients with ruptured aneurysms. Between December 1996 and September 2005, we treated 162 consecutive patients with ruptured aneurysms in the acute stage based on 3D-CTA findings. One hundred sixty-two ruptured aneurysms, including 64 associated unruptured aneurysms, were detected using 3D-CTA. CCA was performed in nine (5.6%) of the 162 patients after 3D-CTA. They were four dissecting vertebral artery aneurysms, two basilar tip aneurysms, one basilar artery-superior cerebellar artery (BA-SCA), one previously clipped BA-SCA and one internal carotid-posterior communicating artery aneurysm. All ruptured aneurysms confirmed at surgery were treated successfully. The lack of information on CCA did not lead any neurological deficits or difficulties in the surgical procedure. 3D-CTA was of high diagnostic value compatible with CCA and yielded important information such as the configuration of the aneurysmal sac and neck, calcification in the aneurysmal wall, and the aneurysms' anatomic relation with adjacent vessels and bone structures. We suggest that 3D-CTA can replace CCA in the diagnosis of ruptured aneurysms and that most of ruptured aneurysms can be operated by using only 3D-CTA without CCA. PMID:18402288

  16. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) ... final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final recommendation statement applies to adults ages ...

  17. Coil Embolization for Intracranial Aneurysms

    PubMed Central

    2006-01-01

    Executive Summary Objective To determine the effectiveness and cost-effectiveness of coil embolization compared with surgical clipping to treat intracranial aneurysms. The Technology Endovascular coil embolization is a percutaneous approach to treat an intracranial aneurysm from within the blood vessel without the need of a craniotomy. In this procedure, a microcatheter is inserted into the femoral artery near the groin and navigated to the site of the aneurysm. Small helical platinum coils are deployed through the microcatheter to fill the aneurysm, and prevent it from further expansion and rupture. Health Canada has approved numerous types of coils and coil delivery systems to treat intracranial aneurysms. The most favoured are controlled detachable coils. Coil embolization may be used with other adjunct endovascular devices such as stents and balloons. Background Intracranial Aneurysms Intracranial aneurysms are the dilation or ballooning of part of a blood vessel in the brain. Intracranial aneurysms range in size from small (<12 mm in diameter) to large (12–25 mm), and to giant (>25 mm). There are 3 main types of aneurysms. Fusiform aneurysms involve the entire circumference of the artery; saccular aneurysms have outpouchings; and dissecting aneurysms have tears in the arterial wall. Berry aneurysms are saccular aneurysms with well-defined necks. Intracranial aneurysms may occur in any blood vessel of the brain; however, they are most commonly found at the branch points of large arteries that form the circle of Willis at the base of the brain. In 85% to 95% of patients, they are found in the anterior circulation. Aneurysms in the posterior circulation are less frequent, and are more difficult to treat surgically due to inaccessibility. Most intracranial aneurysms are small and asymptomatic. Large aneurysms may have a mass effect, causing compression on the brain and cranial nerves and neurological deficits. When an intracranial aneurysm ruptures and bleeds

  18. How Is an Aneurysm Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is an Aneurysm Diagnosed? If you have an aortic aneurysm but no symptoms, your doctor may find it ... a routine physical exam. More often, doctors find aneurysms during tests done for other reasons, such as ...

  19. Differential diagnosis between secondary hyperparathyroidism and aluminum intoxication in uremic patients: Usefulness of /sup 99m/Tc-pyrophosphate bone scintigraphy

    SciTech Connect

    Kinnaert, P.; Van Hooff, I.; Schoutens, A.; Bergmann, P.; Fuss, M.; Dratwa, M.; Vienne, A.; Pasteels, J.L.; van Geertruyden, J.; Vanherweghem, J.L.

    1989-03-01

    Forty-one patients in chronic end-stage renal failure and 4 patients with a functioning kidney transplant presented with spontaneous hypercalcemia or intolerance to vitamin D3 sterols and/or oral calcium supplements. Bone iliac crest biopsy with aluminum staining and Tc-pyrophosphate bone scintigraphy with determination of Fogelman score were performed in all cases. Two patients had aluminum-induced osteomalacia (AL O). Thirty-eight biopsies showed renal osteodystrophy (secondary hyperparathyroidism or various combinations of osteitis fibrosa and osteomalacia): 19 with positive staining for aluminum (RO + AL) and 19 without aluminum deposits (RO). The series also comprised 2 cases of pure osteomalacia (OM), 2 cases of osteoporosis (OP), and 1 case of osteoporosis with aluminum accumulation (OP + AL). Mean Fogelman score in RO patients (9.1 +/- 0.3) was significantly higher than in all other categories (5.9 +/- 0.5 for RO + AL, and scores ranging from 0 to 8 in the last 7 patients, p less than 0.01). Patients with massive aluminum accumulation in bone (greater than 75% of the total trabecular surface) showed no or very low uptake of the isotope by the skeleton. Fogelman scores of 9 or higher were always associated with histological secondary hyperparathyroidism. /sup 99m/Tc-pyrophosphate bone scintigraphy is helpful to distinguish aluminum intoxication from secondary hyperparathyroidism in uremic patients.

  20. Unruptured Intracranial Aneurysms:

    PubMed Central

    Raymond, J.; Nguyen, T.; Chagnon, M.; Gevry, G.

    2007-01-01

    'if a man will begin with certainties, he shall end in doubts; 'but if he will be content to begin with doubts he shall end in certainties'. Sir Francis Bacon, The Advancement of Learning Summary In the absence of level one evidence, the treatment of unruptured intracranial aneurysms is grounded on opinions. Results of the largest registry available, ISUIA (the International Study on Unruptured Intraacranial Aneurysms) suggest that surgical or endovascular treatments are rarely justified. Yet the unruptured aneurysm is the most frequent indication for treatment in many endovascular centres. In preparation for the initiation of a randomized trial, we aimed at a better knowledge of endovascular expert opinions on unruptured aneurysms. We administered a standard questionnaire to 175 endovascular experts gathered at the WFITN meeting in Val d'lsère in 2007. Four paradigm unruptured aneurysms were used to poll opinions on risks of treatment or observation, as well as on their willingness to treat, observe or propose to the patient participation in a randomized trial, using six questions for each aneurysm. Opinions varied widely among lesions and among participants. Most participants (92.5%) were consistent, as they would offer treatment only if their estimate of the ten-year risk of spontaneous hemorrhage would exceed risks of treatment. Estimates of the natural history were consistently higher than that reported by ISUIA. Conversely, treatment risks were underestimated compared to those reported in ISUIA, but within the range reported in a recent French registry (ATENA). Participants were more confident in their evaluation of treatment risks and in their skills at treating aneurysms than in their estimates of risks of rupture entailed by the presence of the lesion, the latter being anchored at or close to 1% /year. The gulf between expert opinions, clinical practices and available data from registries persist. Expert opinions are compatible with the primary hypothesis

  1. Stent-Assisted Coil Embolization of a Wide-Neck Aneurysm of a Persistent Primitive Hypoglossal Artery

    SciTech Connect

    Baldi, Sebastian Zander, Tobias; Rabellino, Martin; Maynar, Manuel

    2009-03-15

    Persistent primitive hypoglossal artery (PPHA) represents the second most common carotid-vertebrobasilar anastomosis. The association of PPHA with intracranial aneurysms is not unusual. Treatment of aneurysms located on the PPHA itself is challenging due to the increased risk of ischemic complications secondary to the hypoglossal artery often being the sole contributor of flow to the posterior circulation. We report a case of a wide-neck aneurysm in a PPHA successfully treated using a stent-assisted coil embolization technique.

  2. Impact of rapid maxillary expansion in unilateral cleft lip and palate patients after secondary alveolar bone grafting: review and case report.

    PubMed

    Yang, Chen-Jie; Pan, Xiao-Gang; Qian, Yu-Fen; Wang, Guo-Ming

    2012-07-01

    The purpose of this article was to analyze the effects and short-term stability of rapid maxillary expansion performed after secondary alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients. Two UCLP patients with severe maxillary constriction who had previous bone grafting were involved in this study. A hyrax rapid expansion appliance was placed on 4 abutment teeth and activated twice daily. An opening of the midpalatal suture was found on the posttreatment occlusal radiographs, which was clinically confirmed by the diastema. Posteroanterior cephalometric tracing analysis demonstrated significant increases in maxillary and dental arch width. No obvious radiographic alteration was observed in the grafted areas. PMID:22732853

  3. Current aortic endografts for the treatment of abdominal aortic aneurysms.

    PubMed

    Colvard, Benjamin; Georg, Yannick; Chakfe, Nabil; Swanstrom, Lee

    2016-05-01

    Endovascular Aneurysm Repair is a widely adopted method of treatment for patients with abdominal aortic aneurysms. The minimally invasive approach offered with EVAR has become popular not only among physicians and patients, but in the medical device industry as well. Over the past 25 years the global market for aortic endografts has increased rapidly, resulting in a wide range of devices from various companies. Currently, there are seven endografts approved by the FDA for the treatment of abdominal aortic aneurysms. These devices offer a wide range of designs intended to increase inclusion criteria while decreasing technical complications such as endoleak and migration. Despite advances in device design, secondary interventions and follow-up requirements remain a significant issue. New devices are currently being studied in the U.S. and abroad and may significantly reduce complications and secondary interventions. PMID:26959727

  4. Secondary closure of an extraction socket using the double-membrane guided bone regeneration technique with immediate implant placement

    PubMed Central

    Jun, Choong Man; Oh, Nam-Sik

    2011-01-01

    Purpose Immediate implantation presents challenges regarding site healing, osseointegration, and obtaining complete soft-tissue coverage of the extraction socket, especially in the posterior area. This last issue is addressed herein using the double-membrane (collagen membrane+high-density polytetrafluoroethylene [dPTFE] membrane) technique in two clinical cases of posterior immediate implant placement. Methods An implant was placed immediately after atraumatically extracting the maxillary posterior tooth. The gap between the coronal portion of the fixture and the adjacent bony walls was filled with allograft material. In addition, a collagen membrane (lower) and dPTFE membrane (upper) were placed in a layer-by-layer manner to enable the closure of the extraction socket without a primary flap closure, thus facilitating the preservation of keratinized mucosa. The upper dPTFE membrane was left exposed for 4 weeks, after which the membrane was gently removed using forceps without flap elevation. Results There was considerable plaque deposition on the outer surface of the dPTFE membrane but not on the inner surface. Moreover, scanning electron microscopy of the removed membrane revealed only a small amount of bacteria on the inner surface of the membrane. The peri-implant tissue was favorable both clinically and radiographically after a conventional dental-implant healing period. Conclusions Secondary closure of the extraction socket and immediate guided bone regeneration using the double-membrane technique may produce a good clinical outcome after immediate placement of a dental implant in the posterior area. PMID:22087417

  5. Pseudo-aneurysm of anterior tibia artery simulating a soft tissue sarcoma: a case report.

    PubMed

    Barzi, Darioush M; Sami, Sam H; Fallah, Ehsan

    2014-01-01

    A pseudo aneurysm results from leakage of blood from an artery after trauma or dehiscence or separation of a surgical anastomosis. The reported rate of pseudo aneurysm in access sites range from 0.88% to 8%. It has some cause like penetrating trauma, blunt trauma and endovascular procedure. The differential diagnoses of this lesion are hematoma, AV fistula, lymphadenopathy, lymphocele, DVT, compartment syndrome, soft tissue tumor. A 16 years old male was referred to our clinic with progressive swelling in his right leg for the past three month. In primary survey (MRI, CT, Bone Scan) patient was diagnosed with soft tissue tumor, but after biopsy and angiography he was diagnosed with pseudo aneurysm of anterior tibialis artery. Despite easy diagnosis of p aneurysm in most cases, the signs and symptoms are more likely to soft tissue mass in rare cases. So pseudo aneurysm should always be considered as one differential diagnosis for soft tissue tumors. PMID:24901729

  6. Verminous aneurysm caused by filaria.

    PubMed

    Toledo, F V; de Araújo, A P; da Cunha, A M; Sidow, J R; Pavão, S G; de Araújo, E D

    1983-06-01

    Aneurysms caused by atherosclerosis are relatively frequent, as a consequence of the high incidence of this degenerative disease of the arteries. Other types of aneurysm, for example, those of infectious etiology, are more uncommon. Bacterias and fungi are able to cause aneurysms in several parts of the arterial tree. Stengel et al (1943), in a review of world literature described 217 cases of mycotic aneurysms. The Stedman's Medical Dictionary refers to a special type of aneurysm observed in horses, caused by intra-vascular migration of a worm, the Strongylus vulgaris. It has been named verminous aneurysm and generally involves the mesenteric arteries. We haven't found in medical literature any similar observations refering to human cases. The purpose of this paper is to describe a case of aneurysm the etiology of which we have imputed to the filaria (Wuchereria bancrofti). This case was observed in Marcilio Dias Naval Hospital, Rio de Janeiro, Brazil. PMID:6346961

  7. Unexpected complication in a rat stroke model: exacerbation of secondary pathology in the thalamus by subacute intraarterial administration of human bone marrow-derived mesenchymal stem cells

    PubMed Central

    Mitkari, Bhimashankar; Kerkelä, Erja; Nystedt, Johanna; Korhonen, Matti; Jolkkonen, Jukka

    2015-01-01

    This study examined whether human bone marrow mesenchymal stromal/stem cells (BMMSCs) could alleviate the secondary pathology in the thalamus after middle cerebral artery occlusion (MCAO) in rats. Atypical accumulation of both amyloid-β (Aβ) and calcium in the thalamus was significantly higher in rats receiving the BMMSCs infusion 48 hours after MCAO as compared with the vehicle MCAO group. The elevated Aβ/calcium accumulation correlated with the level of impaired sensorimotor function. Although secondary pathology in the thalamus seems to be rodent specific, it needs to be taken into account because it may impair long-term behavioral recovery and negate therapeutic treatment effects. PMID:25564231

  8. Effects of tiludronate on bone mass, structure, and turnover at the epiphyseal, primary, and secondary spongiosa in the proximal tibia of growing rats after sciatic neurectomy.

    PubMed

    Murakami, H; Nakamura, T; Tsurukami, H; Abe, M; Barbier, A; Suzuki, K

    1994-09-01

    To evaluate the effects of tiludronate on the mass, structure, and turnover of cancellous bone regions in immobilized rat tibiae, we performed a 4 week dosing experiment. The right hindlimbs of 84 Sprague-Dawley rats (5 weeks old) wee neurectomized or sham operated. Animals were assigned to seven groups (n = 12 each); group 1 was sham operated, and groups 2-7 were neurectomized. Groups 1 and 2 were given vehicle only (distilled water), and groups 3, 4, and 5 were given tiludronate orally at doses of 25, 50, and 100 mg/kg body weight (BW)/day, respectively, throughout the experimental period. Group 6 was given 100 mg/kg BW/day of the agent for the first 2 weeks only, and group 7 received vehicle only for the first 2 weeks and then 100 mg/kg BW/day of the agent for the last 2 weeks. After tetracycline labeling was performed, the right tibiae were removed from the animals and processed to yield undecalcified sections. Histomorphometry was performed in the epiphyseal, primary, and secondary spongiosa of the proximal tibia. In group 2, trabecular bone volume (BV/TV) and trabecular number (Tb.N) were significantly decreased in the primary and secondary spongiosae, but this did not occur in the epiphyseal spongiosa. Osteoid surface (OS/BS) was decreased and osteoclast surface (Oc.S/BS) was increased in the secondary spongiosa. Tiludronate increased BV/TV and Tb.N in the primary spongiosa by reducing the values for the parameters of osteoclast surface (Oc.S/BS) and osteoclast number (Oc.N/BS). Osteoid surface in this region was not decreased by the agent. In groups 4 and 5, tiludronate prevented bone loss in the secondary spongiosa by reducing both OS/BS and Oc.S/BS. In group 6, BV/TV in the primary spongiosa was maintained at the level of group 1, but Oc.S/BS and Oc.N/BS were elevated. In the secondary spongiosa, bone mass was preserved and the reduction in these parameters was maintained. In group 7, however, BV/TV was increased in the primary spongiosa as a result of a

  9. Abdominal aortic aneurysm repair - open - discharge

    MedlinePlus

    AAA - open - discharge; Repair - aortic aneurysm - open - discharge ... You had open aortic aneurysm surgery to repair an aneurysm (a widened part) in your aorta, the large artery that carries blood to your ...

  10. Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage

    PubMed Central

    Pahl, Felix Hendrik; de Oliveira, Matheus Fernandes; Rotta, Marcus Alexandre Cavalcanti; Dias, Guilherme Marcos Soares; Rezende, André Luiz; Rotta, José Marcus

    2014-01-01

    Background: Isolated cervical anterior spinal artery aneurysms are extremely rare. Subarachnoid hemorrhage (SAH) secondary to such lesions have been described only in six cases to the best of our knowledge. Case Description: We describe an unusual clinical picture of SAH due to rupture of anterior spinal artery aneurysm in a patient with previous normal angiogram. Due to the location of the aneurysm and clinical status of the patient, conservative management was proposed, and she was discharged to further follow-up. Monthly routine angiograms revealed resolution of the aneurysm 90 days after bleeding, which was highly suggestive of vascular dissection. Conclusion: We highlight the need to consider these aneurysms in the differential diagnosis of SAH, especially when occurring in the posterior fossa and when angiography findings are inconclusive. PMID:25317354

  11. Fenestrated and Chimney Technique for Juxtarenal Aortic Aneurysm: A Systematic Review and Pooled Data Analysis

    PubMed Central

    Li, Yue; Hu, Zhongzhou; Bai, Chujie; Liu, Jie; Zhang, Tao; Ge, Yangyang; Luan, Shaoliang; Guo, Wei

    2016-01-01

    Juxtarenal aortic aneurysms (JAA) account for approximately 15% of abdominal aortic aneurysms. Fenestrated endovascular aneurysm repair (FEVAR) and chimney endovascular aneurysm repair (CH-EVAR) are both effective methods to treat JAAs, but the comparative effectiveness of these treatment modalities is unclear. We searched the PubMed, Medline, Embase, and Cochrane databases to identify English language articles published between January 2005 and September 2013 on management of JAA with fenestrated and chimney techniques to conduct a systematic review to compare outcomes of patients with juxtarenal aortic aneurysm (JAA) treated with the two techniques. We compared nine F-EVAR cohort studies including 542 JAA patients and 8 CH-EVAR cohorts with 158 JAA patients regarding techniques success rates, 30-day mortality, late mortality, endoleak events and secondary intervention rates. The results of this systematic review indicate that both fenestrated and chimney techniques are attractive options for JAAs treatment with encouraging early and mid-term outcomes. PMID:26869488

  12. Marfan syndrome presenting with headache and coincidental ophthalmic artery aneurysm.

    PubMed

    Vandersteen, Anthony Martin; Kenny, Joanna; Khan, Naheed L; Male, Alison

    2013-01-01

    A 24-year-old Ugandan woman was referred for a neurology opinion after complaining of a year long history of right-sided retro-orbital stabbing pain. Brain imaging revealed a coincidental 3 mm left ophthalmic artery aneurysm. Marfanoid habitus was noted; after further investigations she was diagnosed with mild aortic root dilatation, subtle lens dislocation and Marfan syndrome. Her symptoms were secondary to temporomandibular joint dysfunction, an under-recognised complication of Marfan syndrome. Her ophthalmic artery aneurysm is likely to be a coincidental finding. PMID:23505274

  13. An Aortoenteric Fistula Arising after Endovascular Management of a Mycotic Abdominal Aortic Aneurysm Complicated with a Psoas Abscess

    PubMed Central

    Gülcü, Aytaç; Gezer, Naciye Sinem; Uğurlu, Şevket Baran; Göktay, Ahmet Yiğit

    2016-01-01

    Mycotic aortic aneurysms account for 1–3% of all aortic aneurysms. The management of this disease is controversial. Since open surgical repair is associated with high morbidity and mortality rates, endovascular aneurysm repair is an alternative treatment method with promising early and midterm outcomes, although its long-term durability is unknown. Secondary aortoenteric fistulas may occur iatrogenically after either aortic reconstructive surgery or endovascular repair. As the number of aneurysms managed with endovascular aneurysm repair has substantially increased, cases of aortoenteric fistulas referred for endovascular repair are augmented. We report the case of an aortoduodenal fistula manifested with duodenal perforation after staged endovascular and surgical treatment of a mycotic aortic aneurysm. PMID:27365559

  14. An Aortoenteric Fistula Arising after Endovascular Management of a Mycotic Abdominal Aortic Aneurysm Complicated with a Psoas Abscess.

    PubMed

    Gülcü, Aytaç; Gezer, Naciye Sinem; Uğurlu, Şevket Baran; Göktay, Ahmet Yiğit

    2016-07-01

    Mycotic aortic aneurysms account for 1-3% of all aortic aneurysms. The management of this disease is controversial. Since open surgical repair is associated with high morbidity and mortality rates, endovascular aneurysm repair is an alternative treatment method with promising early and midterm outcomes, although its long-term durability is unknown. Secondary aortoenteric fistulas may occur iatrogenically after either aortic reconstructive surgery or endovascular repair. As the number of aneurysms managed with endovascular aneurysm repair has substantially increased, cases of aortoenteric fistulas referred for endovascular repair are augmented. We report the case of an aortoduodenal fistula manifested with duodenal perforation after staged endovascular and surgical treatment of a mycotic aortic aneurysm. PMID:27365559

  15. Hemodynamic patterns of anterior communicating artery aneurysms: a possible association with rupture

    NASA Astrophysics Data System (ADS)

    Castro, Marcelo A.; Putman, Christopher M.; Cebral, Juan R.

    2007-03-01

    The aim of this study is to characterize the different flows present at anterior communicating artery (AcoA) aneurysms and investigate possible associations with rupture. For that purpose, patient-specific computational models of 26 AcoA aneurysms were constructed from 3D rotational angiography images. Bilateral images were acquired in 15 patients who had both A1 segments of the anterior cerebral arteries and models were created by fusing the reconstructed left and right arterial trees. Computational fluid dynamics simulations were performed under pulsatile flow conditions. Visualizations of the flow velocity pattern were created to classify the aneurysms into the following flow types: A) inflow from both A1 segments, B) flow jet in the parent artery splits into three secondary jets, one enters the aneurysm and the other two are directed to the A2 segments, C) the parent artery jet splits into two secondary jets, one is directed to one of the A2 segments and the other enters the aneurysm before being directed to the other A2 segment, and D) the parent artery jet enters the aneurysm before being directed towards the A2 segments. The maximum wall shear stress in the aneurysm at the systolic peak (MWSS) was calculated. Most aneurysms in group A were unruptured and had the lowest MWSS. Group B had the same number of unruptured and ruptured aneurysms, and a low MWSS. Groups C and D had high rupture ratios, being the average MWSS significantly higher in group C. Finally, it was found that the MWSS was higher for ruptured aneurysms of all flow types.

  16. Bone histomorphometry before and after long-term treatment with cinacalcet in dialysis patients with secondary hyperparathyroidism

    PubMed Central

    Behets, Geert J; Spasovski, Goce; Sterling, Lulu R; Goodman, William G; Spiegel, David M; De Broe, Marc E; D'Haese, Patrick C

    2015-01-01

    The multicenter, single-arm BONAFIDE study characterized the skeletal response to cinacalcet in adult dialysis patients with plasma parathyroid hormone (PTH) levels of 300 pg/ml or more, serum calcium of 8.4 mg/dl or more, bone-specific alkaline phosphatase over 20.9 ng/ml and biopsy-proven high-turnover bone disease. Of 110 enrolled patients, 77 underwent a second bone biopsy with quantitative histomorphometry after 6–12 months of cinacalcet treatment. The median PTH decreased from 985 pg/ml at baseline to 480 pg/ml at the end of study (weeks 44–52). Bone formation rate/tissue area decreased from 728 to 336 μm2/mm2/day, osteoblast perimeter/osteoid perimeter decreased from 17.4 to 13.9%, and eroded perimeter/bone perimeter decreased from 12.7 to 8.3%. The number of patients with normal bone histology increased from none at baseline to 20 at 12 months. Two patients had adynamic bone at the end of study with a PTH under 150 pg/ml, and one patient with overt hypophosphatemia at baseline that reoccurred during follow-up developed osteomalacia. Thus, long-term treatment with cinacalcet substantially reduced PTH, diminished the elevated bone formation rate/tissue area, lowered several biochemical markers of high-turnover bone disease toward normal, and generally improved bone histology. Twenty patients had normal bone histology at follow-up, whereas most had mild hyperparathyroidism or mixed uremic osteodystrophy. PMID:25337774

  17. Management of Unruptured Intracranial Aneurysms.

    PubMed

    Nasr, Deena M; Brown, Robert D

    2016-09-01

    Unruptured intracranial aneurysms (UIA) occur in approximately 2-3 % of the population. Most of these lesions are incidentally found, asymptomatic and typically carry a benign course. Although the risk of aneurysmal subarachnoid hemorrhage is low, this complication can result in significant morbidity and mortality, making assessment of this risk the cornerstone of UIA management. This article reviews important factors to consider when managing unruptured intracranial aneurysms including patient demographics, comorbidities, family history, symptom status, and aneurysm characteristics. It also addresses screening, monitoring, medical management and current surgical and endovascular therapies. PMID:27443382

  18. Aneurysm of the cranial mesenteric artery in a cow.

    PubMed

    Angelos, J A; Anderson, B H; Waurzyniak, B J; Ames, T R; Turner, T A

    1995-09-01

    Exploratory laparotomy of an adult dairy cow, examined because of acute signs of persistent abdominal pain, revealed a firm pulsatile mass with associated fremitus just distal to the origin of the cranial mesenteric artery. The cow died acutely 2.5 days after surgery. A dilated, thin-walled, sacculated aneurysm, which had ruptured, was located along the proximal portion of the cranial mesenteric artery. It was postulated that the aneurysm developed secondary to structural defects in the arterial wall, but caused no clinical signs until enlargement and local tissue stretching or circulatory disturbances caused intestinal ischemia, resulting in abdominal pain. Aneurysms of visceral arteries in cattle should be considered as another differential diagnosis for signs of abdominal pain after more common causes such as severe bloat, mesenteric root volvulus, intussusception, cecal dilatation/volvulus, and uterine torsion have been excluded. PMID:7649780

  19. Unexpected skeletal histology of an ichthyosaur from the Middle Jurassic of Patagonia: implications for evolution of bone microstructure among secondary aquatic tetrapods

    NASA Astrophysics Data System (ADS)

    Talevi, Marianella; Fernández, Marta S.

    2012-03-01

    During the Mesozoic, one of the most significant evolutionary processes was the secondary adaptation of tetrapods to life in water. Several non-related lineages invaded from the terrestrial realms and from the oceans of the entire world. Among these lineages, ichthyosaurs were particularly successful. Advance parvipelvian ichthyosaurs were the first tetrapods to evolve a fish-shaped body profile. The deep skeletal modifications of their bodies, as well as their biology, depict advance ichthyosaurs as the paradigm of secondary adaptation of reptiles to marine life. Functional inferences point to them as off-shore cruising forms, similar to a living tuna, and some of them were capable of deep diving. Bone histology of some genera such as Temnodontosaurus, Stenopterygius, Ichthyosaurus, and Caypullisaurus, characterized by overall cancellous bone, is consistent with the idea of a fish-shaped ichthyosaurs as fast and far cruisers. Here, we provide histological examination of the ribs of the Middle Jurassic parvipelvian Mollesaurus. Contrasting with the bone histology of other parvipelvian, Mollesaurus ribs are characterized by a compact and thick cortex. Our data indicate that the rib cage was heavy and suggest that not all advanced ichthyosaurs were fast cruisers. The compact and dense ribs in these parvipelvian show that advance ichthyosaurs were ecologically more diverse than previously thought and that the lightening of the skeleton reversed, as also occurred in the evolution of cetacean, at least once along the evolutionary history of ichthyosaurs.

  20. Surgical and Antimicrobial Management of a Thoracic Aortic Aneurysm Due to Q Fever: A Case Report and Brief Review.

    PubMed

    Robinson, William P; Schuksz, Manuela

    2016-05-01

    Coxiella burnetii, the etiologic agent of Q fever, has been associated with vascular infection and aneurysm formation. We report the case of a 36-year-old woman from Iraq who presented with long-standing malaise as well as vague chest and shoulder discomfort and was found to have a saccular aneurysm of the descending thoracic aorta. Serology assays were positive for chronic C burnetii infection. She was treated with successful aneurysm resection and aortic replacement with a rifampin-impregnated Maquet Hemashield (TM) Dacron interposition graft interposition graft in addition to 18 months of doxycycline and hydroxychloroquine. The patient is without evidence of recurrent infection on follow-up at 3 years. To our knowledge, this is the first case of aortic aneurysm secondary to Q fever reported in the United States. We review the diagnosis, surgical management, antibiotic therapy, and surveillance of a thoracic aortic aneurysm secondary to Q fever. PMID:27075992

  1. Towards individualized follow-up protocols after endovascular aortic aneurysm repair.

    PubMed

    Laturnus, Johanna; Oliveira, Nelson; Basto Gonçalves, Frederico; Schurink, Geert W; Verhagen, Hence; Jacobs, Michael J; Mees, Barend M E

    2016-04-01

    Endovascular aneurysm repair (EVAR) has become the primary treatment option for elective abdominal aortic aneurysms. However, a significant number of patients require secondary interventions to maintain adequate aneurysm exclusion and ultimately prevent death from abdominal aortic aneurysm (AAA) rupture. To maintain success and offer timely secondary intervention, intensive image surveillance has been recommended. These rigorous surveillance regimens are costly and may have deleterious effects from radiation and contrast exposure. Improvements in patient selection, operative technique and devices have caused a decline in complications after EVAR. Therefore, there is a need to reduce surveillance after EVAR for patients at lower risk of complications and install individualized follow-up protocols. This review describes the current strategies for surveillance and clarification of risk factors and predictors for late complications and discusses proposed risk-adapted strategies for postoperative surveillance after EVAR. PMID:26745264

  2. Unique Technique for Open Surgical Repair after Failed Endovascular Aneurysm Repair with Proximal Anastomoses

    PubMed Central

    Hirota, Jun; Mori, Kazuki; Shuto, Takashi; Okamoto, Keitaro; Sato, Aiko; Wada, Tomoyuki; Anai, Hirofumi; Miyamoto, Shinji

    2016-01-01

    Endovascular aortic aneurysm repair (EVAR) has revolutionized the management of abdominal aortic aneurysms (AAAs), with lower perioperative morbidity and mortality compared to conventional surgical repair. However, late secondary re-interventions after EVAR are still needed before aneurysm rupture in many cases. A patient with impending rupture of an AAA associated with a type I endoleak 7 years after EVAR who was successfully treated with a unique technique of fixation of the proximal aortic neck taking into account the structure of the stent graft is reported. This technique offers a safe solution to late open conversion after failed EVAR. PMID:27375808

  3. Late onset aneurysm development following radiosurgical obliteration of a cerebellopontine angle meningioma

    PubMed Central

    Kellner, Christopher Paul; McDowell, Michael M; Connolly, E Sander; Sisti, Michael B; Lavine, Sean D

    2014-01-01

    The development of de novo intracranial aneurysms following stereotactic radiosurgery for intracranial pathology is a rare complication secondary to vascular injury. Typically, these aneurysms develop within the first few years after radiation surgery. We present the first case of an aneurysm developing 10 years after radiosurgery for a cerebellopontine angle meningioma. This case highlights the importance of careful long-term follow-up of patients who undergo radiosurgery for lesions abutting major vessels and/or who suffer post-radiation complications. PMID:24827655

  4. 21 CFR 882.5200 - Aneurysm clip.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Aneurysm clip. 882.5200 Section 882.5200 Food and... NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5200 Aneurysm clip. (a) Identification. An aneurysm clip is a device used to occlude an intracranial aneurysm (a balloonlike sac formed on a blood...

  5. 21 CFR 882.5200 - Aneurysm clip.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Aneurysm clip. 882.5200 Section 882.5200 Food and... NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5200 Aneurysm clip. (a) Identification. An aneurysm clip is a device used to occlude an intracranial aneurysm (a balloonlike sac formed on a blood...

  6. 21 CFR 882.5200 - Aneurysm clip.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Aneurysm clip. 882.5200 Section 882.5200 Food and... NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5200 Aneurysm clip. (a) Identification. An aneurysm clip is a device used to occlude an intracranial aneurysm (a balloonlike sac formed on a blood...

  7. 21 CFR 882.5200 - Aneurysm clip.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Aneurysm clip. 882.5200 Section 882.5200 Food and... NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5200 Aneurysm clip. (a) Identification. An aneurysm clip is a device used to occlude an intracranial aneurysm (a balloonlike sac formed on a blood...

  8. 21 CFR 882.5200 - Aneurysm clip.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Aneurysm clip. 882.5200 Section 882.5200 Food and... NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5200 Aneurysm clip. (a) Identification. An aneurysm clip is a device used to occlude an intracranial aneurysm (a balloonlike sac formed on a blood...

  9. Presentation and management of aneurysms.

    PubMed Central

    Wyatt, A. P.

    1976-01-01

    The aetiology and pathology of aneurysms, their sites of occurrence, and their general management are outlined. Since the abdominal aortic aneurysm is the type most commonly encountered by the surgeon its presentation, assessment, and operative and postoperative management are discussed in detail. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 8 Fig. 9 PMID:1259327

  10. Ten-Year Follow-Up of Endovascular Aneurysm Treatment with Talent Stent-Grafts

    SciTech Connect

    Pitton, Michael B. Scheschkowski, Tobias; Ring, Markus; Herber, Sascha; Oberholzer, Katja; Leicher-Dueber, Annegret; Neufang, Achim; Schmiedt, Walther; Dueber, Christoph

    2009-09-15

    The purpose of this study was to evaluate the clinical results, complications, and secondary interventions during long-term follow-up after endovascular aneurysm repair (EVAR) and to investigate the impact of endoleak sizes on aneurysm shrinkage. From 1997 to March 2007, 127 patients (12 female, 115 male; age, 73.0 {+-} 7.2 years) with abdominal aortic aneurysms were treated with Talent stent-grafts. Follow-up included clinical visits, contrast-enhanced MDCT, and radiographs at 3, 6, and 12 months and then annually. Results were analyzed with respect to clinical outcome, secondary interventions, endoleak rate and management, and change in aneurysm size. There was no need for primary conversion surgery. Thirty-day mortality was 1.6% (two myocardial infarctions). Procedure-related morbidity was 2.4% (paraplegia, partial infarction of one kidney, and inguinal bleeding requiring surgery). Mean follow-up was 47.7 {+-} 34.2 months (range, 0-123 months). Thirty-nine patients died during follow-up; three of the deaths were related to aneurysm (aneurysm rupture due to endoleak, n = 1; secondary surgical reintervention n = 2). During follow-up, a total of 29 secondary procedures were performed in 19 patients, including 14 percutaneous procedures (10 patients) and 15 surgical procedures (12 patients), including 4 cases with late conversion to open aortic repair (stent-graft infection, n = 1; migration, endoleak, or endotension, n = 3). Overall mean survival was 84.5 {+-} 4.7 months. Mean survival and freedom from any event was 66.7 {+-} 4.5 months. MRI depicted significantly more endoleaks compared to MDCT (23.5% vs. 14.3%; P < 0.01). Patients in whom all aneurysm side branches were occluded prior to stent-grafting showed a significantly reduced incidence of large endoleaks. Endoleaks >10% of the aneurysm area were associated with reduced aneurysm shrinkage compared to no endoleaks or <10% endoleaks ({Delta} at 3 years, -1.8% vs. -12.0%; P < 0.05). In conclusion, endovascular

  11. True aneurysm of brachial artery.

    PubMed

    Hudorović, Narcis; Lovričević, Ivo; Franjić, Dario Bjorn; Brkić, Petar; Tomas, Davor

    2010-10-01

    True upper extremity peripheral artery aneurysms are a rarely encountered arterial disorder. Following computer-tomography angiographic (CT-a) imaging examination, true saccular aneurysm, originating from the left brachial artery was diagnosed in the 77-year-old female without history of trauma. The aneurysm was resected by surgical intervention, and primary repair of the brachial artery was performed by interposition of a part of great saphenous vein harvested from the left groin and creation of two end-to-end anastomoses between interposition graft and previously resected part of brachial artery. No complication was observed during the follow-up. Surgical intervention for upper extremity aneurysms should be initiated without delay. Factors combined with minimal morbidity associated with repair suggest that surgical repair should be performed routinely for true upper extremity arterial aneurysms. PMID:20865459

  12. Personalized Medicine in Cerebrovascular Neurosurgery: Precision Neurosurgical Management of Cerebral Aneurysms and Subarachnoid Hemorrhage

    PubMed Central

    Achrol, Achal Singh; Steinberg, Gary K.

    2016-01-01

    Cerebral aneurysms are common vascular lesions. Little is known about the pathogenesis of these lesions and the process by which they destabilize and progress to rupture. Treatment decisions are motivated by a desire to prevent rupture and the devastating morbidity and mortality associated with resulting subarachnoid hemorrhage (SAH). For patients presenting with SAH, urgent intervention is required to stabilize the lesion and prevent re-rupture. Those patients fortunate enough to survive a presenting SAH and subsequent securing of their aneurysm must still face a spectrum of secondary sequelae, which can include cerebral vasospasm, delayed ischemia, seizures, cerebral edema, hydrocephalus, and endocrinologic and catecholamine-induced systemic dysfunction in cardiac, pulmonary, and renal systems. Increased focus on understanding the pathophysiology and molecular characteristics of these secondary processes will enable the development of targeted therapeutics and novel diagnostics for improved patient selection in personalized medicine trials for SAH. In unruptured cerebral aneurysms, treatment decisions are less clear and currently based solely on treating larger lesions, using rigid aneurysm size cutoffs generalized from recent studies that are the subject of ongoing controversy. Further compounding this controversy is the fact that the vast majority of aneurysms that come to clinical attention at the time of a hemorrhagic presentation are of smaller size, suggesting that small aneurysms are indeed not benign lesions. As such, patient-specific biomarkers that better predict which aneurysms represent high-risk lesions that warrant clinical intervention are of vital importance. Recent advancements in genomic and proteomic technologies have enabled the identification of molecular characteristics that may prove useful in tracking aneurysm growth and progression and identifying targets for prophylactic therapeutic interventions. Novel quantitative neuroimaging

  13. Vein graft aneurysms following popliteal aneurysm repair are more common than we think.

    PubMed

    Sharples, Alistair; Kay, Mark; Sykes, Timothy; Fox, Anthony; Houghton, Andrew

    2015-10-01

    True infrainguinal vein graft aneurysms are reported infrequently in the literature. We sought to identify the true incidence of these graft aneurysms after popliteal aneurysm repair and identify factors which may increase the risk of such aneurysms developing. Using a prospectively compiled database, we identified patients who underwent a popliteal aneurysm repair between January 1996 and January 2011 at a single district general hospital. Patients were routinely followed up in a graft surveillance programme. Out of 45 patients requiring repair of a popliteal aneurysm over a 15-year period, four (8.8%) patients developed aneurysmal graft disease. Of the patients who developed graft aneurysms, all had aneurysmal disease at other sites compared with 18 (45.0%) patients who did not develop graft aneurysms. Patients with graft aneurysms had a mean of 1.60 aneurysms elsewhere compared to 0.58 in patients with non-aneurysmal grafts (P = 0.005). True vein graft aneurysms occur in a significant number of patients following popliteal aneurysm repair. Our data would suggest this to be more likely in patients who have aneurysms elsewhere and therefore a predisposition to aneurysmal disease. It may be appropriate for patients with aneurysms at other sites to undergo more prolonged post-operative graft surveillance. PMID:25331071

  14. Aneurysm-osteoarthritis syndrome with visceral and iliac artery aneurysms

    PubMed Central

    van der Linde, Denise; Verhagen, Hence J. M.; Moelker, Adriaan; van de Laar, Ingrid M. B. H.; Van Herzeele, Isabelle; De Backer, Julie; Dietz, Harry C.; Roos-Hesselink, Jolien W.

    2014-01-01

    Objective Aneurysms-osteoarthritis syndrome (AOS), caused by SMAD3 mutations, is a recently described autosomal-dominant syndrome characterized by arterial aneurysms, tortuosity, and aortic dissections in combination with osteoarthritis. Our objective was to evaluate the AOS-related vascular consequences in the visceral and iliac arteries and raise awareness for this aggressive syndrome among vascular specialists. Methods All AOS patients were monitored regularly according to our clinical AOS protocol. The study included those with one or more visceral aneurysms or tortuosity, or both. Clinical and surgical data were obtained from record abstraction. Results The study included 17 AOS patients (47% men) aged 47 ± 13 years. A total of 73 aneurysms were encountered, of which 46 were located in the abdomen. The common iliac artery was most commonly affected (37%), followed by the superior mesenteric artery (15%), celiac trunk (11%), and splenic artery (9%). Rapid aneurysm growth ≤1 year was found in three arteries (gastric, hepatic, and vertebral artery). Furthermore, arterial tortuosity was noted in 94% of patients. Four patients underwent six elective (endo) vascular interventions for aneurysms in the iliac, hepatic, gastric, or splenic artery, without major perioperative or postoperative complications. Conclusions AOS predisposes patients to widespread visceral and iliac artery aneurysms and extreme arterial tortuosity. Early elective aneurysm repair should be considered because the risk of aneurysm rupture is estimated to be very high and elective (endo) vascular interventions were not complicated by fragility of arterial tissue. Given the aggressive behavior of AOS, it is of utmost importance that vascular specialists are aware of this new syndrome. PMID:22975338

  15. Characterization of the spatial arrangement of secondary osteons in the diaphysis of equine and canine long bones.

    PubMed

    Shahar, Ron; Lukas, Carolin; Papo, Sharon; Dunlop, John W C; Weinkamer, Richard

    2011-07-01

    The blood supply of bone cells in compact bone is provided primarily by blood vessels located within Haversian canals forming the centre of osteons. Mid-diaphysial cross-sections of radii and third metacarpal bones from two horses and radii from two mature dogs were studied using reflective light microscopy to quantify the spatial ordering of canals and compared to a computational model. The distributions of canals were analyzed using: 1) the autocorrelation function (ACF), which describes the probability of finding two canals separated by a given distance and 2) the shortest distance distribution (SDD), which describes the probability that a site within bone is located at a given distance from the nearest canal. The order in the investigated horse radii, as characterized by the oscillations of the ACF, was found to be independent of the anatomical location although, in the metacarpal bone the order was higher in the lateral than in the cranial location. Among the dogs, marked differences were only found in the ACF. An analysis of the SDD demonstrates that ordering of canals minimizes the distance of osteocytes from a blood vessel. This suggests that the efficiency of the blood supply can be adapted through differences in the order of the Haversian canals. In our model, the ordering of canals is achieved via an exclusion zone around each canal, imposed upon newly formed osteons. Simulations demonstrate that differences in the observed order can be explained by either a larger size or a larger variability of this exclusion zone. PMID:21618437

  16. Left Atrial Appendage Aneurysm.

    PubMed

    Hosseini, Saeid; Hashemi, Arash; Saedi, Sedigheh; Jalili, Farshad; Maleki, Majid; Jalalian, Rozita; Rezaei, Yousef

    2016-09-01

    Left atrial appendage aneurysms (LAAA) are extremely rare. This condition is usually diagnosed incidentally or after the occurrence of thrombotic events or cardiac tachyarrhythmias in the second to fourth decades of life. It can predispose to hazardous adverse events, including atrial fibrillation, myocardial infarction, and systemic thromboembolism. We report a case of LAAA in a 68-year-old woman presenting with atypical chest pain, exertional dyspnea, and episodes of sudden-onset palpitation. Aneurysmectomy with the patient under cardiac arrest with cardiopulmonary bypass was performed. In addition, we explore the diagnosis, management, and prognosis of this entity through a meticulous literature review. PMID:27549544

  17. A Multicenter Study Using the SWAG Scale to Compare Secondary Alveolar Bone Graft Outcomes for Patients With Cleft Lip and Palate.

    PubMed

    Russell, Kathleen; Long, Ross E; Daskalogiannakis, John; Mercado, Ana; Hathaway, Ronald; Semb, Gunvor; Shaw, William

    2016-03-01

    Objective To assess secondary alveolar bone graft (ABG) outcomes using the standardized way to assess grafts, or SWAG scale, for patients with cleft lip and palate (CLP). Design Retrospective cohort study. Setting Four cleft centers with different protocols. Methods One hundred sixty maxillary occlusal radiographs taken 3 to 18 months after secondary ABG for sequentially treated patients with CLP were assessed using the SWAG scale. Radiographs were scanned, standardized, blinded, and rated by six orthodontists using the SWAG scale. Randomized radiographs were rated twice, 24 hours apart, by the same raters. Main Outcomes Intrarater and interrater reliabilities were assessed. Means and SDs were calculated for ABG ratings using analysis of variance and Tukey tests (P < .05). Result The mean ABG age was 9.1 years (range = 7 to 10.1 years) and the mean follow-up age was 12.4 years (range = 8.2 to 20.4 years). Intrarater and interrater reliabilities were good (intrarater = 0.788, interrater = 0.705), and higher than published methods. Mean ABG ratings for the cleft centers were 4.53, 2.9, 3.63, and 5.0 and differed significantly. The two centers with the highest ABG ratings showed higher ratings for all thirds decreasing from apical to coronal. The two centers with lower ABG ratings showed poorer ABG ratings for all thirds, and the middle third received the highest ratings. Conclusions The SWAG scale overcomes the challenges of age and bone location. The SWAG method was validated for showing intercenter differences for overall bone fill as well as in vertical thirds. Surgical technique, timing, and expertise/volume were identified as possible factors related to outcome. PMID:25898149

  18. Spontaneous thrombosis in giant intracranial aneurysms.

    PubMed Central

    Whittle, I R; Dorsch, N W; Besser, M

    1982-01-01

    Twelve patients in a series of 22 with giant intracranial aneurysms demonstrated neuroradiological features of partial or total spontaneous intra-aneurysmal thrombosis. The presence of this intra-aneurysmal clot significantly altered the computed tomographic appearance of the giant aneurysm. Massive intra-aneurysmal thrombosis did not protect against subarachnoid haemorrhage and the likelihood of rupture of a clot containing giant aneurysm was not significantly different from that of a non-thrombosed giant aneurysm. Although parent artery occlusion from a thrombosed giant aneurysm, and massive aneurysmal thrombosis leading to the formation of giant serpentine aneurysm were documented, these are rare epiphenomena. The risk of embolisation from a partially thrombosed giant aneurysm, which was documented in one case, would appear to be greater than that from a non-thrombosed giant aneurysm. The findings in this series, and a review of literature, suggest that the presence of intra-aneurysmal clot in giant intracranial aneurysms has little prognostic significance and does not alter the management or outcome after treatment. Images PMID:7175528

  19. Traumatic aortic aneurysm diagnosed by computed tomography angiography in a 22-year-old man presenting with progressive dyspnea and dysphagia.

    PubMed

    Ma, Xiang; Ma, Yi-Tong; Liu, Ai-Hong; Wang, Yan-Lin

    2016-08-01

    Traumatic aortic aneurysm is a rare and potentially fatal complication that can occur secondary to acute chest trauma. However, early diagnosis of this complication is often neglected due to the presence of severe chest and abdominal trauma. We report a case of delayed traumatic aortic aneurysm that was diagnosed by computed tomography angiography on day 13 after a traffic accident. PMID:27209281

  20. Fluid-fluid level: a nonspecific finding in tumors of bone and soft tissue.

    PubMed

    Tsai, J C; Dalinka, M K; Fallon, M D; Zlatkin, M B; Kressel, H Y

    1990-06-01

    Fluid-fluid levels have commonly been reported to occur in aneurysmal bone cysts but have also been seen in telangiectatic osteosarcoma, chondroblastoma, and giant cell tumor of bone. The authors reviewed their experience with nine bone and three soft-tissue tumors that showed fluid-fluid levels on computed tomographic or magnetic resonance images. The bone tumors included fibrous dysplasia, simple bone cyst, recurrent malignant fibrous histiocytoma of bone, two classical osteosarcomas, and four aneurysmal bone cysts. The soft-tissue tumors included soft-tissue hemangioma and two synovial sarcomas. Except for aneurysmal bone cysts, these types of tumors have not been reported to be associated with fluid-fluid levels. Radiologic-pathologic correlation was available in seven patients; in all seven, the fluid-fluid levels indicated prior hemorrhage. The authors conclude that the presence of fluid-fluid levels in bone or soft-tissue tumors cannot be considered diagnostic of any particular tumor. PMID:2160676

  1. Effects of a triphasic combination oral contraceptive containing norgestimate/ethinyl estradiol on biochemical markers of bone metabolism in young women with osteopenia secondary to hypothalamic amenorrhea.

    PubMed

    Grinspoon, S K; Friedman, A J; Miller, K K; Lippman, J; Olson, W H; Warren, M P

    2003-08-01

    This multicenter, double-blind, placebo-controlled, randomized study of 45 patients evaluated the short-term effects of an oral contraceptive [Ortho Tri-Cyclen, 180-250 micro g of norgestimate (NGM) and 35 microg of ethinyl estradiol (EE)] on biochemical markers of bone resorption, formation, and osteoprotegerin in young women (mean age +/- SD, 26.5 +/- 6.3 yr) with hypothalamic amenorrhea and osteopenia. Body fat, endocrine, and cognitive function were evaluated as secondary endpoints. Biomarkers of bone metabolism were measured at baseline and after three cycles of NGM/EE or placebo. There were significant decreases in mean values of N-telopeptide [mean (SD), -13.4 (13.4) vs. 1.2 (23.8) nmol bone collagen equivalents (BCE)/mmol creatinine (Cr); P = 0.001] and deoxypyridinoline [-1.2 (2.9) vs. -0.5 (1.5) nmol deoxypyridinoline/mmol Cr; P = 0.021] as well as significant decreases in bone specific alkaline phosphatase [-5.1 (3.5) vs. 0.4 (3.1) ng/ml; P < 0.001], osteocalcin [-5.9 (3.6) vs. -2.9 (3.7); P = 0.016], and procollagen of type I propeptide [-35.2 (44.6) vs. -0.2 (30.0) ng/ml; P = 0.025], but not osteoprotegerin [0.39 (1.46) vs. -0.2 (0.49) pmol/liter; P = 0.397] in the NGM/EE vs. placebo group. There were no significant differences between groups with respect to changes in cognitive function, mood, body weight, body mass index, body fat, percentage of body fat, and all endocrine levels except FSH, [-3.7 (3.8) vs. -0.6 (2.1) IU/liter; P < 0.001, NGM/EE vs. placebo]. No serious adverse events were reported in either group. These results suggest that NGM/EE decreases bone turnover in osteopenic premenopausal women with hypothalamic amenorrhea. Further studies are needed to determine whether estrogen will increase bone density in this population. PMID:12915650

  2. Micromanaging abdominal aortic aneurysms.

    PubMed

    Maegdefessel, Lars; Spin, Joshua M; Adam, Matti; Raaz, Uwe; Toh, Ryuji; Nakagami, Futoshi; Tsao, Philip S

    2013-01-01

    The contribution of abdominal aortic aneurysm (AAA) disease to human morbidity and mortality has increased in the aging, industrialized world. In response, extraordinary efforts have been launched to determine the molecular and pathophysiological characteristics of the diseased aorta. This work aims to develop novel diagnostic and therapeutic strategies to limit AAA expansion and, ultimately, rupture. Contributions from multiple research groups have uncovered a complex transcriptional and post-transcriptional regulatory milieu, which is believed to be essential for maintaining aortic vascular homeostasis. Recently, novel small noncoding RNAs, called microRNAs, have been identified as important transcriptional and post-transcriptional inhibitors of gene expression. MicroRNAs are thought to "fine tune" the translational output of their target messenger RNAs (mRNAs) by promoting mRNA degradation or inhibiting translation. With the discovery that microRNAs act as powerful regulators in the context of a wide variety of diseases, it is only logical that microRNAs be thoroughly explored as potential therapeutic entities. This current review summarizes interesting findings regarding the intriguing roles and benefits of microRNA expression modulation during AAA initiation and propagation. These studies utilize disease-relevant murine models, as well as human tissue from patients undergoing surgical aortic aneurysm repair. Furthermore, we critically examine future therapeutic strategies with regard to their clinical and translational feasibility. PMID:23852016

  3. Endovascular management of ruptured common iliac mycotic aneurysm in an HIV-positive patient.

    PubMed

    Aziz, Aamir; Mooka, Busi; Clarke Moloney, Mary; Kavanagh, Eamon

    2013-01-01

    Isolated iliac artery aneurysms are a rare entity. The majority of cases are asymptomatic and often escape detection. Mortality rates after sudden rupture and emergent surgery for iliac artery aneurysm are very high. We report a case of a 56-year-old man who presented with right hip pain masquerading as septic arthritis or psoas abscess. CT showed ruptured right common iliac artery aneurysm with extensive active extravasation into psoas with a retroperitoneal haematoma. Aneurysm was repaired using an endovascular technique. Postoperative recovery was eventful with the patient experiencing severe back pain radiating down the leg accompanied with fever. CT showed persistent, right iliopsoas haematoma and pelvic haematoma with secondary hydronephrosis. Viral screen for hepatitis B, C and HIV returned positive. The patient was started on intravenous meropenem. Fever and pain settled. Repeated CT scan showed decrease in retroperitoneal pelvic haematoma. PMID:23917370

  4. Ductus arteriosus aneurysm presenting as hoarseness: successful repair with an endovascular approach.

    PubMed

    De Freitas, Simon; Connolly, Caoilfhionn; Neary, Colm; Sultan, Sherif

    2016-01-01

    An aneurysm of the ductus arteriosus is a rare finding, particularly in the adult population. These saccular aneurysms arise at the site of an incompletely obliterated ductus arteriosus along the lesser curvature of the aortic arch. Left untreated, it is associated with a high risk of potentially life-threatening complications including rupture, infection and thromboembolism. As a result, surgical correction is recommended. Previously, options were limited to open repair but as endovascular experience grows, novel techniques afford safer and less invasive alternatives. In contrast, neonatal ductus arteriosus aneurysms may regress spontaneously and expectant treatment can be justified. We present the case of a 74-year-old woman who presented with hoarseness secondary to a ductus arteriosus aneurysm; a diagnosis consistent with Ortner's syndrome. The patient underwent an uncomplicated endovascular repair using the chimney-graft technique. PMID:27141045

  5. Ductus arteriosus aneurysm presenting as hoarseness: successful repair with an endovascular approach

    PubMed Central

    De Freitas, Simon; Connolly, Caoilfhionn; Neary, Colm; Sultan, Sherif

    2016-01-01

    An aneurysm of the ductus arteriosus is a rare finding, particularly in the adult population. These saccular aneurysms arise at the site of an incompletely obliterated ductus arteriosus along the lesser curvature of the aortic arch. Left untreated, it is associated with a high risk of potentially life-threatening complications including rupture, infection and thromboembolism. As a result, surgical correction is recommended. Previously, options were limited to open repair but as endovascular experience grows, novel techniques afford safer and less invasive alternatives. In contrast, neonatal ductus arteriosus aneurysms may regress spontaneously and expectant treatment can be justified. We present the case of a 74-year-old woman who presented with hoarseness secondary to a ductus arteriosus aneurysm; a diagnosis consistent with Ortner’s syndrome. The patient underwent an uncomplicated endovascular repair using the chimney-graft technique. PMID:27141045

  6. Ventricular Aneurysm Following Myocardial Infarction

    PubMed Central

    Walters, M. B.

    1966-01-01

    Cineradiographic examination appears to be the best method for the study of cardiac pulsations. Fifty consecutive patients, who had sustained transmural myocardial infarction at least six months previously, were studied by this technique. Thirty-six had some abnormality of pulsation and eight had dynamic ventricular aneurysm. Six of the eight had suffered severe infarct. Functional recovery in those with aneurysm was not as complete as in the rest of the group. Two made a poor functional recovery, two a fair recovery, and four a moderately good recovery. Clinically, there were no systemic emboli in the patients with dynamic aneurysms. Five of the 50 had persistent ST-segment elevation and “coving” of the T waves; three of these patients had aneurysms. There was no good correlation between the electrocardiographic site of the infarct and the site of the abnormal pulsation. ImagesFig. 1 PMID:5928534

  7. [Venous aneurysm as a therapeutic problem: various management strategies in selected patients: our experience].

    PubMed

    Dorobisz, A T; Korta, K; Milnerowicz, A; Iznerowicz, A; Dorobisz, T A

    2012-10-01

    Venous system aneurysms appear relatively rarely, and are even more rarely diagnosed, especially if asymptomatic. In the material of our clinic we provide a variety of practices in three patients with venous aneurysms depending on the location, symptoms and main disease. In some patients the occurrence of pulmonary embolism is the first symptom of venous aneurysms, having influence on the selection of further diagnostics, conservative treatment, as well as on endovascular or operating procedure. The proper diagnosis of a venous aneurysm takes place in case of doubling or tripling of the diameter of the basic dimension of the lumen, often with the presence of thrombotic material. Asymptomatic venous aneurysms are usually detected during routine pre-operative diagnosis also including duplex-Doppler studies. In the presence of pulmonary embolism positive angio-CT and scintigraphy raise the suspicion of venous aneurysm unless any other reason is apparent. There is no standard treatment of venous aneurysms. This has to do with the relatively low epidemiology, diversity of location, difficulties in determining the proper primary and secondary aetiology, anatomy and coexisting diseases. Despite the many unknowns a few issues should be considered before appropriate treatment is undertaken. Undoubtedly, the shape itself, the location and size of the aneurysm with the presence or not of thrombotic material are of great value in evaluating the risk of complications, including possibly lethal pulmonary embolism, local symptoms of venous hypertension and possible complications of surgery. In this paper we present 3 patients treated for venous aneurysms located in different regions: popliteal vein, brachial vein and iliac internal vein. PMID:23136107

  8. The expanding realm of endovascular neurosurgery: flow diversion for cerebral aneurysm management.

    PubMed

    Krishna, Chandan; Sonig, Ashish; Natarajan, Sabareesh K; Siddiqui, Adnan H

    2014-01-01

    The worldwide prevalence of intracranial aneurysms is estimated to be between 5% and 10%, with some demographic variance. Subarachnoid hemorrhage secondary to ruptured intracranial aneurysm results in devastating neurological outcomes, leaving the majority of victims dead or disabled. Surgical clipping of intracranial aneurysms remained the definitive mode of treatment until Guglielmi detachable coils were introduced in the 1990s. This revolutionary innovation led to the recognition of neurointervention/neuroendovascular surgery as a bona fide option for intracranial aneurysms. Constant evolution of endovascular devices and techniques supported by several prospective randomized trials has catapulted the endovascular treatment of intracranial aneurysms to its current status as the preferred treatment modality for most ruptured and unruptured intracranial aneurysms. We are slowly transitioning from the era of coils to the era of flow diverters. Flow-diversion technology and techniques have revolutionized the treatment of wide-necked, giant, and fusiform aneurysms, where the results of microsurgery or conventional neuroendovascular strategies have traditionally been dismal. Although the Pipeline Embolization Device (ev3-Covidien, Irvine, CA) is the only flow-diversion device approved by the Food and Drug Administration for use in the United States, others are commercially available in Europe and South America, including the Silk (Balt Extrusion, Montmorency, France), Flow-Redirection Endoluminal Device (FRED; MicroVention, Tustin, CA), Surpass (Stryker, Kalamazoo, MI), and p64 (Phenox, Bochum, Germany). Improvements in technology and operator experience and the encouraging results of clinical trials have led to broader acceptance for the use of these devices in cerebral aneurysm management. Continued innovation and refinement of endovascular devices and techniques will inevitably improve technical success rates, reduce procedure-related complications, and broaden the

  9. The Expanding Realm of Endovascular Neurosurgery: Flow Diversion for Cerebral Aneurysm Management

    PubMed Central

    Krishna, Chandan; Sonig, Ashish; Natarajan, Sabareesh K.; Siddiqui, Adnan H.

    2014-01-01

    The worldwide prevalence of intracranial aneurysms is estimated to be between 5% and 10%, with some demographic variance. Subarachnoid hemorrhage secondary to ruptured intracranial aneurysm results in devastating neurological outcomes, leaving the majority of victims dead or disabled. Surgical clipping of intracranial aneurysms remained the definitive mode of treatment until Guglielmi detachable coils were introduced in the 1990s. This revolutionary innovation led to the recognition of neurointervention/neuroendovascular surgery as a bona fide option for intracranial aneurysms. Constant evolution of endovascular devices and techniques supported by several prospective randomized trials has catapulted the endovascular treatment of intracranial aneurysms to its current status as the preferred treatment modality for most ruptured and unruptured intracranial aneurysms. We are slowly transitioning from the era of coils to the era of flow diverters. Flow-diversion technology and techniques have revolutionized the treatment of wide-necked, giant, and fusiform aneurysms, where the results of microsurgery or conventional neuroendovascular strategies have traditionally been dismal. Although the Pipeline™ Embolization Device (ev3-Covidien, Irvine, CA) is the only flow-diversion device approved by the Food and Drug Administration for use in the United States, others are commercially available in Europe and South America, including the Silk (Balt Extrusion, Montmorency, France), Flow-Redirection Endoluminal Device (FRED; MicroVention, Tustin, CA), Surpass (Stryker, Kalamazoo, MI), and p64 (Phenox, Bochum, Germany). Improvements in technology and operator experience and the encouraging results of clinical trials have led to broader acceptance for the use of these devices in cerebral aneurysm management. Continued innovation and refinement of endovascular devices and techniques will inevitably improve technical success rates, reduce procedure-related complications, and broaden

  10. Hemodynamic Intervention of Cerebral Aneurysms

    NASA Astrophysics Data System (ADS)

    Meng, Hui

    2005-11-01

    Cerebral aneurysm is a pathological vascular response to hemodynamic stimuli. Endovascular treatment of cerebral aneurysms essentially alters the blood flow to stop them from continued growth and eventual rupture. Compared to surgical clipping, endovascular methods are minimally invasive and hence rapidly gaining popularity. However, they are not always effective with risks of aneurysm regrowth and various complications. We aim at developing a Virtual Intervention (VI) platform that allows: patient-specific flow calculation and risk prediction as well as recommendation of tailored intervention based on quantitative analysis. This is a lofty goal requiring advancement in three areas of research: (1). Advancement of image-based CFD; (2) Understanding the biological/pathological responses of tissue to hemodynamic factors in the context of cerebral aneurysms; and (3) Capability of designing and testing patient-specific endovascular devices. We have established CFD methodologies based on anatomical geometry obtained from 3D angiographic or CT images. To study the effect of hemodynamics on aneurysm development, we have created a canine model of a vascular bifurcation anastomosis to provide the hemodynamic environment similar to those in CA. Vascular remodeling was studied using histology and compared against the flow fields obtained from CFD. It was found that an intimal pad, similar to those frequently seen clinically, developed at the flow impingement site, bordering with an area of `groove' characteristic of an early stage of aneurysm, where the micro environment exhibits an elevated wall shear stresses. To further address the molecular mechanisms of the flow-mediated aneurysm pathology, we are also developing in vitro cell culture systems to complement the in vivo study. Our current effort in endovascular device development focuses on novel stents that alters the aneurysmal flow to promote thrombotic occlusion as well as favorable remodeling. Realization of an

  11. Aneurysm of the Splenic Artery

    PubMed Central

    Bedford, P. D.; Lodge, Brian

    1960-01-01

    This paper records an incidence of 10·4% of aneurysm of the splenic artery in 250 consecutive routine post-mortem examinations. Medial degeneration seemed to be the commonest cause of such aneurysms and although a number were associated with other intraabdominal pathology, including portal hypertension, the association may be fortuitous and not causal. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6 PMID:13688586

  12. Vascular diseases: aortitis, aortic aneurysms, and vascular calcification.

    PubMed

    Ladich, Elena; Yahagi, Kazuyuki; Romero, Maria E; Virmani, Renu

    2016-01-01

    Inflammatory diseases of the aorta broadly include noninfectious and infectious aortitis, periaortitis, atherosclerosis, and inflammatory atherosclerotic aneurysms. Aortitis is uncommon but is increasingly recognized as an important cause of aortic aneurysms and dissections. Abdominal (AAA) and thoracic aortic aneurysms (TAA) have different pathologies and etiologies. AAAs are the most common type of aortic aneurysm, and the vast majority of these are atherosclerotic. The causes of TAA vary depending on the site of involvement, but medial degeneration is a common pathologic substrate, regardless of etiology, and genetic influences play a prominent role in TAA expression. Standardized classification schemes for inflammatory and degenerative diseases of the aorta have only recently been added to the pathology literature. A brief overview of the new histopathologic classifications for aortic inflammatory and degenerative diseases has recently been published by the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology as a consensus document on the surgical pathology of the aorta. Vascular calcification is a highly regulated biologic process, and the mechanisms leading to vascular calcification are under investigation. Calcification may occur in the intima (atherosclerotic) or in the media secondary to metabolic disease. Rarely, vascular calcification may be associated with genetic disorders. PMID:27526100

  13. Left Main Coronary Artery Aneurysm

    PubMed Central

    Doustkami, Hossein; Maleki, Nasrollah; Tavosi, Zahra

    2016-01-01

    Aneurysms of the left main coronary artery are exceedingly rare clinical entities, encountered incidentally in approximately 0.1% of patients who undergo routine angiography. The most common cause of coronary artery aneurysms is atherosclerosis. Angiography is the gold standard for diagnosis and treatment. Depending on the severity of the coexisting coronary stenosis, patients with left main coronary artery aneurysms can be effectively managed either surgically or pharmacologically. We herein report a case of left main coronary artery aneurysm in a 72-year-old man with a prior history of hypertension presenting to our hospital because of unstable angina. The electrocardiogram showed ST-segment depression and T-wave inversion in the precordial leads. All the data of blood chemistry were normal. Echocardiography showed akinetic anterior wall, septum, and apex, mild mitral regurgitation and ejection fraction of 45%. Coronary angiography revealed a saccular aneurysm of the left main coronary artery with significant stenosis in the left anterior descending, left circumflex, and right coronary artery. The patient immediately underwent coronary artery bypass grafting and ligation of the aneurysm. At six months’ follow-up, he remained asymptomatic. PMID:27403190

  14. Aortic Angiosarcoma: A Rare Cause for Leaking Thoracic Aneurysm

    SciTech Connect

    Hales, S. L. Locke, R.; Sandison, A.; Jenkins, M.; Hamady, M.

    2011-02-15

    Primary malignant tumours of the aorta are rare. They present with aneurysm formation, arterial occlusion, and embolic phenomenon. We report the case of a 56-year-old man whose initial presentation and investigations lead to emergency endovascular stenting of a descending thoracic aneurysm with a contained leak. Initial response was favourable, yet the patient presented again with worsening symptoms. The circum-aortic haematoma expanded by 50% on subsequent imaging, but no endoleak was identified. When altered bone marrow signal was identified on magnetic resonance imaging, the possibility of malignancy was considered. A metastatic skin lesion was then biopsied, which demonstrated morphological and immunohistochemical features consistent with metastases from a pleomorphic sarcoma of the aorta.

  15. Treatment of Visceral Aneurysm Using Multilayer Stent: Two-Year Follow-Up Results in Five Consecutive Patients

    SciTech Connect

    Balderi, Alberto Antonietti, Alberto Pedrazzini, Fulvio Sortino, Davide Vinay, Claudia Grosso, Maurizio

    2013-10-15

    Purpose: The present study was performed to analyze the midterm results (five consecutive patients, 2-year follow-up) of the endovascular management of visceral artery aneurysms using the Cardiatis Multilayer Flow Modulator (CMFM) (Cardiatis, Isnes, Belgium), a self-expandable stent. Materials and Methods: From August 2009 to January 2011, we implanted five CMFMs in five patients (all men; mean age 73 years) to treat two common hepatic artery aneurysms, one celiac trunk aneurysm, one splenic artery aneurysm, and one superior mesenteric artery aneurysm (diameter 25-81 mm). The primary end point was technical success. The secondary end point was stent patency, absence of aneurysm rupture or reperfusion, and shrinking of the sac at 6-, 12-, and 24-month follow-up using computed tomography angiography. Follow-up ranged from 24 to 48 months (mean 31.2). Results: Technical success was achieved in all patients. Complete exclusion of the aneurysm with sac shrinking was achieved in two patients. Two stents became occluded at 6- and 24-month follow-up, respectively; both patients were asymptomatic and were not retreated. One patient developed sac reperfusion due to incomplete aneurysm exclusion. Conclusion: Long-term results in a wider population are needed to validate the effectiveness of the CMFM.

  16. Aseptic lysis L2-L3 as complication of abdominal aortic aneurysm repair.

    PubMed

    Mancini, Federico; Ascoli-Marchetti, Andrea; Garro, Luca; Caterini, Roberto

    2014-12-01

    Osteolytic vertebral erosion is usually related to tumours, spondylitis or spondylodiscitis. Few reports in the literature describe lytic lesions of anterior lumbar vertebral bodies resulting from abdominal aortic aneurysm or false aneurysm. We report a case of abdominal aortic false aneurysm that caused lytic lesions of the second and third vertebral bodies in an 80-year-old man who underwent endovascular aneurysm repair. Fluoroscopy guided biopsy excluded infection or tumour. We performed a posterior spinal fusion and decompression because of bone loss of the second and third lumbar vertebral bodies and central stenosis. Postoperatively the patient showed satisfactory relief in low-back and thigh pain but, unfortunately, he died 1 month after surgery because of respiratory complications. This case suggests that when a lytic lesion of a lumbar vertebral body is discovered in a patient who has undergone endovascular aneurysm repair, an abdominal aortic false aneurysm may be the cause of the vertebral erosion even in cases without infective pathogenesis. PMID:25017025

  17. When Blood Vessels Bulge: All About Aneurysms

    MedlinePlus

    ... Vessels Bulge When Blood Vessels Bulge All About Aneurysms An aneurysm—a balloon-like bulge in an artery—can ... for years without causing any symptoms. But an aneurysm is a silent threat to your health. If ...

  18. Aneurysms - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Aneurysms URL of this page: https://medlineplus.gov/languages/aneurysms.html Other topics A-Z A B ...

  19. Aneurysms - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Aneurysms URL of this page: https://www.nlm.nih.gov/medlineplus/languages/aneurysms.html Other topics A-Z A B ...

  20. Aneurysmal femoral neck cyst: Report of a paediatric case and review of literature

    PubMed Central

    Ndour, Oumar; Boseba, Rodia; Damipi, Jacque Barre; Nibagora, Juvenal; Fall, Aimée Lakh Faye; Ngom, Gabriel; Ndoye, Mamadou

    2016-01-01

    The aneurysmal bone cyst (ABC) is a benign tumour of children and young adults. It represents approximately 1-2% of all bone tumours. The ABC may develop on all skeletal bones, but the proximal end of the femur is the most common location. The authors report a ABC femoral neck in a child of 13 years. This location is pretty special. Indeed, the fragility of the femoral neck due partly to the pathology itself and secondarily curettage requires a judicious attitude surgical (excisional curettage + bone graft + screw) to prevent the risk of high local recurrence and pathological fracture. PMID:27251662

  1. Endovascular Exclusion of Renal Artery Aneurysm

    SciTech Connect

    Andersen, Poul Erik Rohr, Nils

    2005-06-15

    A patient who was operated for an abdominal aortic aneurysm 7 years earlier presented with recently discovered iliac and renal artery aneurysms. The renal artery had an angulation of 90{sup o}, but the aneurysm was successfully excluded using a covered vascular stent graft placed over an extrastiff guidewire. Even in cases of complex anatomy of a renal aneurysm, endovascular treatment should be considered. With development of more flexible and low-profile endoprosthesis with accurate deployment, these have become more usable.

  2. Thoracoabdominal aortic aneurysm repair: current endovascular perspectives

    PubMed Central

    Orr, Nathan; Minion, David; Bobadilla, Joseph L

    2014-01-01

    Thoracoabdominal aneurysms account for roughly 3% of identified aneurysms annually in the United States. Advancements in endovascular techniques and devices have broadened their application to these complex surgical problems. This paper will focus on the current state of endovascular thoracoabdominal aneurysm repair, including specific considerations in patient selection, operative planning, and perioperative complications. Both total endovascular and hybrid options will be considered. PMID:25170271

  3. Vertebral destruction due to abdominal aortic aneurysm

    PubMed Central

    Jiménez Viseu Pinheiro, J.F.; Blanco Blanco, J.F.; Pescador Hernández, D.; García García, F.J.

    2014-01-01

    Introduction Low back pain is a common cause of medical consultation, and usually supposes a non-malignant prognostic. Presentation of case We report an atypical appearance of low back pain associated to shock and pulsatile abdominal mass that made us diagnose an abdominal aortic aneurysm as reason of vertebral lysis and pain. Discusion Surgical repair of contained AAA should be directed to secondary re-rupture prevention, with an approximate survival near to 100% at selected patients for elective surgery. Consequently, orthopedic surgery for back spine stabilization has to be elective in those cases when vertebral destruction is above 30% and clinic is directly related to spine instability. Conclusion We should consider AAA as other cause of low back pain and routinely examine the abdomen and seek complementary imaging proves when risk factors for AAA are present. PMID:25569196

  4. IGF-I Signaling in Osterix-Expressing Cells Regulates Secondary Ossification Center Formation, Growth Plate Maturation, and Metaphyseal Formation During Postnatal Bone Development.

    PubMed

    Wang, Yongmei; Menendez, Alicia; Fong, Chak; ElAlieh, Hashem Z; Kubota, Takuo; Long, Roger; Bikle, Daniel D

    2015-12-01

    To investigate the role of IGF-I signaling in osterix (OSX)-expressing cells in the skeleton, we generated IGF-I receptor (IGF-IR) knockout mice ((OSX)IGF-IRKO) (floxed-IGF-IR mice × OSX promoter-driven GFP-labeled cre-recombinase [(OSX)GFPcre]), and monitored postnatal bone development. At day 2 after birth (P2), (OSX)GFP-cre was highly expressed in the osteoblasts in the bone surface of the metaphysis and in the prehypertrophic chondrocytes (PHCs) and inner layer of perichondral cells (IPCs). From P7, (OSX)GFP-cre was highly expressed in PHCs, IPCs, cartilage canals (CCs), and osteoblasts (OBs) in the epiphyseal secondary ossification center (SOC), but was only slightly expressed in the OBs in the metaphysis. Compared with the control mice, the IPC proliferation was decreased in the (OSX)IGF-IRKOs. In these mice, fewer IPCs invaded into the cartilage, resulting in delayed formation of the CC and SOC. Immunohistochemistry indicated a reduction of vessel number and lower expression of VEGF and ephrin B2 in the IPCs and SOC of (OSX)IGF-IRKOs. Quantitative real-time PCR revealed that the mRNA levels of the matrix degradation markers, MMP-9, 13 and 14, were decreased in the (OSX)IGF-IRKOs compared with the controls. The (OSX)IGF-IRKO also showed irregular morphology of the growth plate and less trabecular bone in the tibia and femur from P7 to 7 weeks, accompanied by decreased chondrocyte proliferation, altered chondrocyte differentiation, and decreased osteoblast differentiation. Our data indicate that during postnatal bone development, IGF-I signaling in OSX-expressing IPCs promotes IPC proliferation and cartilage matrix degradation and increases ephrin B2 production to stimulate vascular endothelial growth factor (VEGF) expression and vascularization. These processes are required for normal CC formation in the establishment of the SOC. Moreover, IGF-I signaling in the OSX-expressing PHC is required for growth plate maturation and osteoblast differentiation in

  5. Structural studies of human alkaline phosphatase in complex with strontium: Implication for its secondary effect in bones

    PubMed Central

    Llinas, Paola; Masella, Michel; Stigbrand, Torgny; Ménez, André; Stura, Enrico A.; Le Du, Marie Hélène

    2006-01-01

    Strontium is used in the treatment of osteoporosis as a ranelate compound, and in the treatment of painful scattered bone metastases as isotope. At very high doses and in certain conditions, it can lead to osteomalacia characterized by impairment of bone mineralization. The osteomalacia symptoms resemble those of hypophosphatasia, a rare inherited disorder associated with mutations in the gene encoding for tissue-nonspecific alkaline phosphatase (TNAP). Human alkaline phosphatases have four metal binding sites—two for zinc, one for magnesium, and one for calcium ion—that can be substituted by strontium. Here we present the crystal structure of strontium-substituted human placental alkaline phosphatase (PLAP), a related isozyme of TNAP, in which such replacement can have important physiological implications. The structure shows that strontium substitutes the calcium ion with concomitant modification of the metal coordination. The use of the flexible and polarizable force-field TCPEp (topological and classical polarization effects for proteins) predicts that calcium or strontium has similar interaction energies at the calcium-binding site of PLAP. Since calcium helps stabilize a large area that includes loops 210–228 and 250–297, its substitution by strontium could affect the stability of this region. Energy calculations suggest that only at high doses of strontium, comparable to those found for calcium, can strontium substitute for calcium. Since osteomalacia is observed after ingestion of high doses of strontium, alkaline phosphatase is likely to be one of the targets of strontium, and thus this enzyme might be involved in this disease. PMID:16815919

  6. Endovascular treatment of intracranial aneurysms.

    PubMed

    Diaz, Orlando; Rangel-Castilla, Leonardo

    2016-01-01

    Intracranial aneurysms are abnormal dilations of the intracranial vessels, in which all the layers of the vascular wall are affected by degenerative changes that lead to distension of the vessel. Intracranial aneurysms can be classified based on their anatomic location, size, and morphology. Subarachnoid hemorrhage is the most devastating clinical presentation. The goal of preventing hemorrhage or rehemorrhage can only be achieved by excluding the aneurysm from the cerebral circulation. Endovascular or surgical clipping can achieve this goal. Multiple surgical and endovascular approaches have been described for treatment of intracranial aneurysm. Surgical approaches for anterior-circulation intracranial aneurysms include: pterional, orbitozygomatic, and lateral supraorbital craniotomies. Modern microsurgical techniques involve skull base dissection to achieve adequate exposure with minimal brain retraction. Endovascular techniques can be divided into: parent artery reconstruction with coil deposition (primary coil, balloon-assisted coiling, stent-assisted coiling, and other new techniques such as neck reconstruction devices and intraluminal occlusion devices); reconstruction with flow diversion; and deconstructive techniques with involving parent artery sacrifice with or without bypass. PMID:27430470

  7. Expression of CDKN1C in the bone marrow of patients with myelodysplastic syndrome and secondary acute myeloid leukemia is associated with poor survival after conventional chemotherapy.

    PubMed

    Radujkovic, Aleksandar; Dietrich, Sascha; Andrulis, Mindaugas; Benner, Axel; Longerich, Thomas; Pellagatti, Andrea; Nanda, Kriti; Giese, Thomas; Germing, Ulrich; Baldus, Stefan; Boultwood, Jacqueline; Ho, Anthony D; Dreger, Peter; Luft, Thomas

    2016-09-15

    We tested the hypothesis that proliferative activity of hematopoietic stem cells has impact on survival in newly diagnosed patients with myelodysplastic syndrome (MDS) and secondary acute myeloid leukemia (AML). RNA expression profiles of CD34(+) cells were analyzed in 125 MDS patients and compared to healthy controls. Prognostic impact on overall survival (OS) of mRNA proliferation signatures established for solid tumor cells was analyzed retrospectively. For validation on the protein level, immunofluorescence and immunohistochemistry analyses in bone marrow (BM) biopsies were performed, and an independent cohort of 223 MDS and secondary AML patients was investigated. Lower proliferative activity correlated with the expression of cyclin-dependent kinase inhibitor 1C (CDKN1C) and with shorter OS (p < 0.001). In multivariable analysis, higher CDKN1C expression was associated with worse OS (p = 0.02). On the BM level, a total of 84 (38%) patients showed CDKN1C protein expression before start of treatment. Patient, disease and treatment characteristics did not differ between CDKN1C-positive and -negative patients. Positive CDKN1C BM status was associated with shorter OS in multivariable analysis (HR 1.54, p = 0.04). There was an interaction between CDKN1C BM status and subsequent treatment with negative impact on OS being most pronounced in patients receiving conventional cytotoxic chemotherapy (n = 83, 2-year OS 30% versus 58%, p = 0.002). In conclusion, low-proliferative phenotype and CDKN1C expression were associated with shorter OS. CDKN1C protein expression in the BM of newly diagnosed, treatment-naïve MDS and secondary AML patients was identified as a prognostic factor for poor survival in patients treated with antiproliferative chemotherapy. PMID:27170453

  8. Extracellular Matrix Defects in Aneurysmal Fibulin-4 Mice Predispose to Lung Emphysema

    PubMed Central

    Ramnath, Natasja W. M.; van de Luijtgaarden, Koen M.; van der Pluijm, Ingrid; van Nimwegen, Menno; van Heijningen, Paula M.; Swagemakers, Sigrid M. A.; van Thiel, Bibi S.; Ridwan, Ruziedi Y.; van Vliet, Nicole; Vermeij, Marcel; Hawinkels, Luuk J. A. C.; de Munck, Anne; Dzyubachyk, Oleh; Meijering, Erik; van der Spek, Peter; Rottier, Robbert; Yanagisawa, Hiromi; Hendriks, Rudi W.; Kanaar, Roland; Rouwet, Ellen V.; Kleinjan, Alex; Essers, Jeroen

    2014-01-01

    Background In this study we set out to investigate the clinically observed relationship between chronic obstructive pulmonary disease (COPD) and aortic aneurysms. We tested the hypothesis that an inherited deficiency of connective tissue might play a role in the combined development of pulmonary emphysema and vascular disease. Methods We first determined the prevalence of chronic obstructive pulmonary disease in a clinical cohort of aortic aneurysms patients and arterial occlusive disease patients. Subsequently, we used a combined approach comprising pathological, functional, molecular imaging, immunological and gene expression analysis to reveal the sequence of events that culminates in pulmonary emphysema in aneurysmal Fibulin-4 deficient (Fibulin-4R) mice. Results Here we show that COPD is significantly more prevalent in aneurysm patients compared to arterial occlusive disease patients, independent of smoking, other clinical risk factors and inflammation. In addition, we demonstrate that aneurysmal Fibulin-4R/R mice display severe developmental lung emphysema, whereas Fibulin-4+/R mice acquire alveolar breakdown with age and upon infectious stress. This vicious circle is further exacerbated by the diminished antiprotease capacity of the lungs and ultimately results in the development of pulmonary emphysema. Conclusions Our experimental data identify genetic susceptibility to extracellular matrix degradation and secondary inflammation as the common mechanisms in both COPD and aneurysm formation. PMID:25255451

  9. Surgical Resection of a Giant Coronary Aneurysm.

    PubMed

    Mehall, John R; Verlare, Jordan L

    2015-06-01

    Coronary aneurysms are quite uncommon, and those qualifying as giant aneurysms are even more so. Currently, no standardized treatment protocol exists. We report the case of a 46-year-old man presenting with clinical signs and symptoms of acute myocardial infarction who was found to have a giant coronary aneurysm. The patient was initially evaluated with a computed tomography angiogram, which revealed a 9-cm aneurysm of the left circumflex coronary artery. Surgical resection of the aneurysm, ligation of the proximal circumflex artery, and bypass using the left internal mammary artery to vascularize the proximal circumflex artery was performed. PMID:26046882

  10. Iatrogenic cortical aneurysm post-craniotomy.

    PubMed

    Zanini, Marco Antonio; Borges, Rodrigo Almeida; Nunes Aquino, Gustavo Henrique; de Freitas, Carlos Clayton Macedo

    2010-04-01

    Taking into account the number of craniotomies performed every day around the world, iatrogenic aneurysm post-craniotomy is extremely rare with only anecdotal cases reported in literature. We report an iatrogenic aneurysm affecting a cortical vessel which probably developed during dural closure of a conventional craniotomy. The aneurysm was discovered 6 months after surgery on a routine control angiography. The patient was successfully treated by trapping the parent vessel and excising the aneurysm. Histopathological findings were compatible with a true type of traumatic aneurysm. The possibility of this rare condition occurring highlights the risk of arterial injury during craniotomy. PMID:20121386