Search Results

You are looking at 1 - 10 of 5,926 items for :

  • "dissection" x
  • All content x
Clear All
Restricted access

Yuhei Yoshimoto, Katsumi Hoya, Yoshihiro Tanaka, and Takanori Uchida

S pontaneous dissection of the VA is an increasingly recognized cause of stroke. 4, 5, 8, 9, 11, 16, 29 Recent observations indicate that many patients presenting with ischemic symptoms have a relatively favorable outcome, unless the dissection extends to the BA. 11, 29 Nonetheless, a high death rate has been reported in patients with a ruptured VA dissection. Furthermore, a tendency toward recurrent hemorrhage has been noted in this group. 16 The clinical manifestations of BA dissections are more varied than those for VA dissections, including SAH, 2–4, 14

Restricted access

Juergen Piek, Joachim Oertel, and Michael Robert Gaab

A major goal in surgical procedures is the reduction of intraoperative blood loss and parenchymal trauma. Each conventional method, such as laser surgery, thermal coagulation, and ultrasonic aspiration, has its own disadvantages (for example, thermal damage to the surrounding tissue). 26 Research to develop an instrument that combines highly precise parenchymal dissection and preservation of the surrounding tissue with easy handling in the operating theater is ongoing. Waterjet dissection represents a promising method for intraoperative tissue resection

Restricted access

Wouter I. Schievink, Eelco F. M. Wijdicks, and James D. Kuiper

S pontaneous cervical artery dissections are recognized as being an important cause of ischemic stroke, particularly in young and middle-aged adults. 12, 16 They may also cause isolated head or neck pain, Horner's syndrome, pulsatile tinnitus, and cranial nerve palsies. 4, 12, 16 In spite of the increased recognition of spontaneous cervical artery dissections over the last decade, their cause and pathogenesis remain largely unknown. An underlying arteriopathy clearly plays a role in a significant proportion of patients, 21–23, 25 whereas the common

Restricted access

Jürgen Piek, Christian Wille, Rolf Warzok, and Michael-Robert Gaab

O ne of the difficulties in the performance of brain surgery is the control of bleeding during dissection. A variety of instruments have been developed to aid in the blunt dissection of brain tumors. For example, the ultrasonic aspirator is used to debulk soft to moderately firm tumors, but has the disadvantage of its large handpiece and inflexibility. Mono- and bipolar coagulation as well as different lasers may help to control bleeding during surgery but they cause thermal damage to the surrounding tissue. 24 To overcome these problems a new device for

Restricted access

Wouter I. Schievink, Reid C. Thompson, and William H. Yong

T he cause and pathogenesis of cerebral and cervical artery dissections are poorly understood, but an underlying arteriopathy is frequently suspected. We report on two patients with spontaneous cerebral and cervical artery dissections who had angiolipomatosis, a previously unreported association. The tunica media of the arteries of the head and neck are derived from neural crest cells, 1, 3, 8, 16 and angiolipomatosis has been associated with various tumors of neural crest derivation, 2, 5, 9 indicating that a neural crest disorder may be the underlying

Restricted access

Won-Ki Yoon, Young-Woo Kim, Sang-Don Kim, Ik-Seong Park, Min-Woo Baik, and Seong-Rim Kim

, vascular tortuousness, and a small lumen diameter. 25 In addition, IVUS catheters are not thin and soft enough to be suitable for intracranial navigation. However, extracranial vessels are larger and less tortuous than intracranial ones, do not require strong trackability, and are safe and suitable for IVUS navigation during the endovascular procedures. Parent artery dissection sometimes occurs during angiography or endovascular treatment. 10 The extracranial VA is prone to iatrogenic dissection because of its long course, relatively small lumen diameter, and

Restricted access

Akira Kurata, Hidehiro Oka, Taketomo Ohmomo, Hitoshi Ozawa, Sachio Suzuki, Kiyotaka Fujii, Shinichi Kan, Yoshio Miyasaka, and Harue Arai

common neurovascular complication in EDS Type IV cases is the spontaneous direct CCF. 1, 2, 4, 6, 7, 14 Carotid artery dissection, fistula formation, and intracranial aneurysm rupture are other typical disorders. All of these vascular complications are very life-threatening. Nevertheless, diagnostic angiography, 3, 4, 14 endovascular surgery, 4, 6, 14 and surgical intervention 3 should be avoided if at all possible because of associated high morbidity and mortality rates. 2–5, 14 Case Report History and Examination This 44-year-old man reported weakness

Full access

Taichi Ikedo, Kazuhito Nakamura, Noritaka Sano, Manabu Nagata, Yumiko Okada, Taichiro Kawakami, and Takaho Murata

D issection of the extracranial internal carotid artery (ICA) is not a common cause of embolic cerebral infarction, accounting for only 0.4%–2.5% of all strokes. 15 Some atraumatic ICA dissections are the result of rapid or prolonged exertion of the neck. Other cases are attributable to diseases that cause vulnerability of the arterial wall, including hypertension, 9 fibromuscular dysplasia, 2 Marfan’s syndrome, 4 Ehlers-Danlos syndrome, 4 and cystic medial necrosis. 18 A few cases of ICA dissection have been related to repeated compression by deformed

Full access

Clemens M. Schirmer, Basar Atalay, and Adel M. Malek

I nternal carotid artery dissection occurs spontaneously or in the setting of trauma and can lead to ischemic and hemorrhagic stroke through thromboembolic complications or hemodynamic compromise. Internal carotid artery dissection accounts for a small proportion of strokes overall but is a more common cause of stroke in the younger population. The natural history is not very well understood. Some reports point to stroke due to ICAD that is unexpectedly benign in some cases, 15 , 23 , 29 while others have suggested possible major transient or permanent

Restricted access

Atsuhiro Nakagawa, Takayuki Hirano, Hidefumi Jokura, Hiroshi Uenohara, Tomohiro Ohki, Tokitada Hashimoto, Viren Menezes, Yasuhiko Sato, Yasuko Kusaka, Hideki Ohyama, Tsutomu Saito, Kazuyoshi Takayama, Reizo Shirane, and Teiji Tominaga

A lthough various instruments have been used for dissection in neuroendoscopic surgery, including high-frequency current (using monopolar or bipolar electrodes), 26 thermal lasers, 7 ultrasonic probes, 20, 21, 27 and mechanical dissection techniques, 4 it is still difficult to perform controlled dissection without causing bleeding and thermal damage in surrounding tissue. 2, 11 Over the past two decades waterjet dissection has been introduced into medical use, 22 and various experiments and in vivo studies have demonstrated its superiority over