No shinkei geka. Neurological surgery
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Case Reports
[An Endovascular Approach for Ruptured Aneurysms of the Basilar Trunk Perforating Artery].
Aneurysms of the basilar trunk perforating artery are rarely described in the literature. Only 13 cases have been reported previously. ⋯ Microsurgical clipping or wrapping has the disadvantage of the deep and narrow operative area and the difficult skull-base technique. Here, we report a case of basilar trunk perforating rupture aneurysm and its treatment with endovascular coil embolization.
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Radiation-induced vasculopathy is a complication of radiation therapy. Most reports regarding post-irradiation ischemic stroke with intracranial tumors are restricted to pediatric cases. ⋯ Although radiation-induced ischemic stroke in adults is relatively uncommon, it is possible that the morbidity rate of radiation-induced stroke in malignant glioma patients will increase with prolonged survival due to advances in therapy. Therefore, regular evaluation of intracranial vasculature following radiation therapy is necessary.
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With new neuroimaging techniques, the detection rate of unruptured intracranial aneurysms has increased. While most detected aneurysms are small and left untreated because of the low risk of rupture, we still encounter many cases of small aneurysm rupture. Middle cerebral artery(MCA)aneurysms have lower risk of rupture compared to those in the anterior cerebral or internal carotid-posterior communicating arteries. ⋯ A tiny aneurysm can rupture if the aneurysmal wall is fragile. Therefore, the fragility of the aneurysmal wall is an important predictive factor of rupture. Presently, however, it is difficult to determine when an operation for an unruptured tiny aneurysm is indicated; new neuroimaging techniques that detect the fragility of the aneurysmal wall are needed.