Two-stage reconstructive overlapping stent LEO+ and SILK for treatment of intracranial circumferential fusiform aneurysms in the posterior circulation.

Intracranial circumferential fusiform aneurysms of the posterior circulation involving arterial branches or perforating vessels are difficult to treat. This article shows an endovascular reconstruction technique not yet described, using a telescoping self-expandable stent (LEO+) and flow-diverter device (SILK) at different surgical times. Two patients with circumferential fusiform aneurysm, one being an aneurysm of the segments P2 and P3 of the posterior cerebral artery, diagnosed after a headache, and the other a partially thrombosed aneurysm of the lower basilar artery, diagnosed following ischemia of the brain stem.

[High flow"true" posterior communicating artery aneurysm due to hemodynamic effect in a patient with subclavian artery occlusion treated with angioplasty].

True posterior communicating artery aneurysms are extremely rare with incidence ranges from 0.1% to 2.8% of all aneurysms.

[Dissecting aneurysm of the intracranial fenestrated vertebral artery submited to endovascular treatment: case report].

Dissecting aneurysms of the vertebral artery at its intracranial segment are uncommon lesions, mainly when associated to subarachnoid hemorrhage, being also rare fenestrations of the vertebral artery. They present high morbidity and mortality, with high rebleeding rate and difficulty of surgical approach. We present a 19 years old man who was victim of physical aggression in the occipto-cervical region, presenting subarachnoid hemorrhage and a dissecting aneurysm of the right vertebral artery, which had a fenestration, being submitted to endovascular treatment.

Giant intrathoracic meningoceles associated with cutaneous neurofibromatosis type I: case report.

Background: Intrathoracic meningocele is a rare pathology, almost always associated with neurofibromatosis type I and with a few cases related in the literature. In the majority of cases cysts are small or asymptomatic, and the surgery is indicated when big or symptomatic cysts are present. We report a case of giant intrathoracic cysts surgically extirpated through out thoracotomy.

[Cerebral aneurysms diagnosis by three-dimensional CT angiography].

Three-dimensional computerized tomography angiography is a fast diagnosis method and low invasive that passed to be used recently in the cases of intracranial aneurysms. This method presents a 100% specificity and can reach 95% of sensibility in the evaluation of the aneurysms in the circle of Willis, substituting the digital angiography but not in all of the cases. We report our experience in evaluation of the three-dimensional angiotomography exams in a period of 2 years between June of 1997 and June of 1999, were accomplished for detection of intracranial aneurysms in 136 patients, being 118 just with three-dimensional angiotomography and in 18 cases they were accomplished besides three-dimensional angiotomography also the conventional digital angiography.

[Aneurysm of the anterior inferior cerebellar artery: case report].

The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA) are considered rare, can cause cerebello pontine angle (CPA) syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA.

[Intraoperative rupture in the aneurysmal neck: suggestion for surgical management].

The per operative rupture of the aneurysm during dissection impairs the delicate microsurgical procedure and increases the risk of a bad evolution for the patient. During operation the aneurysm generally ruptures in its belly but it could happen just in its colon, between the main vessel and the sac. This brings a serious problem to the neurosurgeon once the placement of a clip at this place will increase the bleeding.

[Giant cavernous angioma: report of two cases].

Cavernous angiomas or haemangiomas or yet cavernomas are malformations of the central nervous system classified as occult vascular brain lesions. These rare lesions are clinically silent. They are defined by the presence of abnormally large vascular cavities or sinusoids channels of variable size, with sharp walls, located inside but not invading the brain parenchyma.

[Thalamic intracerebral schwannoma: case report].

The intracranial schwannomas cover about 8% of all the brain tumors, although, those localized inside the encephalic parenchyma are rare only 55 cases being reported in the literature. The histopathologic diagnosis is based on the cellular type and arrangement common to the nervous sheath tumors, the immunohistochemical findings (GFAP, S-100 protein, EMA) and electronmicroscopic findings as well. The clinical presentation related to the intraparenchimatous schwannoma is variable, depending on its localization, the image diagnosis does not show any typical aspect.