Fusiform aneurysms of the basilar artery are extremely unusual. Most show signs of a posterior fossa mass. One case is reported which presented with recurrent transient ischemic attacks suggesting carotid vascular disease. Failure of an appropriate endarterectomy to relieve the symptoms, and later brain stem infarction, led to the correct diagnosis. Whenever recurrent or new symptoms appear following carotid vascular surgery, other diagnoses must be considered.

Basilar Artery↗

PubMedDate not supplied

Intracranial aneurysms: flow analysis of their origin and progression.

PURPOSE: To explain the origin and growth of intracranial aneurysms using the hemodynamic data obtained from a computer simulation. MATERIALS AND METHODS: Pulsatile flow in an intracranial aneurysm cavity was numerically simulated based on physiologic pulsatile flow observed in the aorta. A finite element method was applied to solve the equations of motion and the non-Newtonian viscosity of blood was taken into account in the analysis. An angiogram of a middle cerebral artery segment with aneurysm was used for the computer modeling of blood flow within the aneurysm cavity. Local shear stress and pressure on the wall at the neck of the aneurysm as well as blood flow motions inside the cavity were calculated as a function of time for various stages in the development of the aneurysm. FINDINGS: Blood moves into the aneurysm cavity along the proximal wall of the cavity and emerges along the distal wall during the acceleration period of systole; however, during the deceleration period of systole and diastole, blood changes its flow direction, entering along the distal wall of the cavity and leaving along the proximal cavity wall. Rapid changes of blood flow direction result in rapid changes in wall shear stress and pressure at the proximal and distal walls of the cavity, rendering continuous damage to the intima at the cavity neck. These hemodynamic stresses relate to the anatomy of a particular vessel may be responsible for the initiation of aneurysm formation and subsequent progression, thrombosis and/or rupture. CONCLUSION: Computer modeling can further our understanding of factors that determine the origin and progression of intracranial aneurysms.

Blood Flow Velocity↗

PubMedDate not supplied

Balloon occlusion of the carotid artery prior to surgery for neck tumors.

We present the results of presurgical balloon occlusion of the carotid artery in 22 patients with cervical lymphadenopathy stage N3. The procedure was found to be extremely useful in preventing rupture of the carotid artery, considered the most dangerous complication of neck cancer surgery. Complications of the balloon procedure were few (10%) when compared with surgical ligation of the carotid artery (41-54% stroke frequency and 32-60% mortality). This procedure also allows testing of the collateral circulation before final detachment of the balloon, a maneuver that prevents stroke in many patients.

Carotid Artery Diseases↗

PubMedDate not supplied

Vertebral artery dissection after rapid head turning.

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Adult↗