No abstract available.
Intracranial Aneurysm*

Recently the cause of hemifacial spasm and trigeminel neuralgia is known to be vascular compression-distortion in the root exit and entry zone of each nerve. The microvascular decompression of the 5th and 7th cranial nerves is a method of refined and non-traumatic surgical treatment of these disabling diseases. 33 patients with intractable hemifacial spasm and 7 patients with trigeminal neuralgia were treated by microvascular decompression and the follow-up results were evaluated. The surgical results in 33 cases of hemifacial spasm were as follow: Excellent-18, Good-7, Fair-6, Poor-2. Disturbance of hearing as a complication appeared in 6 cases, but improved gradually except one case. The surgical finding and results in 7 cases of trigeminal neuralgia were as follow: In 6 cases the causative vessel was SCA and in one case SCV indented the nerve root. All 7 patients with trigeminal neuralgia were relieved from facial pain after surgery.
Cranial Nerves ; Facial Nerve* ; Facial Pain ; Follow-Up Studies ; Hearing ; Hemifacial Spasm ; Humans ; Microvascular Decompression Surgery* ; Neuralgia ; Trigeminal Neuralgia

No abstract available.
Aneurysm*

No abstract available.

OBJECTIVE: Direct revascularization surgery is regarded as the most effective method of treatment of adults with moyamoya disease. These patients, however, have a higher risk of perioperative ischemic complications than do patients with atherosclerotic stroke, and are at risk for ischemic complications in the hemisphere contralateral to the one operated on. We investigated the incidence and risk factors for ischemic stroke in the contralateral hemisphere after surgical treatment of adults with moyamoya disease. METHODS: We retrospectively reviewed the medical records and results of neuroimaging studies on 79 hemispheres of 73 consecutive patients with adult moyamoya disease (mean+/-SD age, 37.96+/-11.27 years; range, 18-62 years) who underwent direct bypass surgery over 6 years. RESULTS: Ischemic complications occurred in 4 of 79 (5.1%) contralateral hemispheres, one with Suzuki stage 3 and three with Suzuki stage 4. Three patients showed posterior cerebral artery (PCA) involvement by moyamoya vessels. Advanced stage of moyamoya disease (Suzuki stages 4/5/6; p=0.001), PCA involvement (p=0.001) and postoperative hypotension (mean arterial blood pressure <80% of preoperative mean arterial blood pressure) on the first (p<0.0001) and second (p=0.003) days after surgery were significantly correlated with postoperative contralateral ischemic complications. CONCLUSION: In patients with advanced moyamoya disease and involvement of the PCA, intentional hypotension can result in ischemic stroke in the hemisphere contralateral to the one operated on. Careful control of perioperative blood pressure is crucial for good surgical results.
Adult ; Arterial Pressure ; Blood Pressure ; Cerebral Revascularization ; Humans ; Hypotension ; Incidence ; Medical Records ; Moyamoya Disease ; Neuroimaging ; Passive Cutaneous Anaphylaxis ; Perioperative Period ; Posterior Cerebral Artery ; Retrospective Studies ; Risk Factors ; Stroke

The treatment of stroke is undergoing a revolution, which is reflected in the wide spread use of the term "Brain Attack". Our understanding of the pathophysiology of cerebral ischemia, and our ability to effectively intervene in the clinical setting have changed the way patients at risk of or suffering from a stroke are managed.
Brain Ischemia ; Brain* ; Humans ; Stroke

No abstract available.
Vasospasm, Intracranial*

OBJECTIVES: The best results of treating intracranial aneurysms can be achieved with treating aneurysm before they rupture. Some recent reports about the risk of the bleeding of the unruptured intracranial aneurysm(UIA) being too low(0.05% per year) compared with 1~2% of the previously reported bleeding probability, casts the question about the need for treatment of the UIAs. The purpose of this report is to review the recent reports about the risk of rupture of the UIAs and to assess the morbidity and mortality associated with surgical treatment for UIAs.
Aneurysm ; Hemorrhage ; Intracranial Aneurysm ; Mortality ; Rupture

No abstract available.
Radiosurgery* ; Trigeminal Neuralgia*

Middle cerebral artery aneuryms account for aporoximately 20 percent of all intracranial aneurysms. The majority are located at the bbifurcation of M1 segment insylvian fissure. Incidence of formation of intracerebral hematoma with ruptured aneurysm and giant and infectious aneurysms are more common than with aneurysm in other locations. Clinical presentation of the MCA aneurysms are associated with symptoms of subarachnoid hemorrhage and mass effect. Symptoms of subarachnoid hemorrhage such as headache are indistinguishable from that associated with SAH from rupture of an aneurysm in any other location. But mass effect of large aneurysm, temporal lobe epilepsy and transient ischemic attack occur more frequently with aneurysms of the MCA. Complications of MCA aneurysm surgery can be divided into two group, one related to subarachnoid hemorrhage with aneurysmal rupture and the other to surgical procedure. Vasospasm is major cause of morbiduty and medical complications such as hypertension, cardiac arrhythmia, pneumonia and GI bleeding are frequently encountered. Operative complications include occlusion of MCA branch by improperly placed clip, retraction injury, intraoperative rupture.
Aneurysm ; Aneurysm, Ruptured ; Arrhythmias, Cardiac ; Epilepsy, Temporal Lobe ; Headache ; Hematoma ; Hemorrhage ; Hypertension ; Incidence ; Intracranial Aneurysm* ; Ischemic Attack, Transient ; Middle Cerebral Artery* ; Pneumonia ; Rupture ; Subarachnoid Hemorrhage