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Intracranial Internal Carotid Artery Pseudoaneurysm: A Narrative Review and Update for Otolaryngology Residents.

Indian J Otolaryngol Head Neck Surg

January 2025

Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences (AIIMS), Room 4057, 4th Floor, Academic Block, New Delhi, India.

Massive epistaxis due to rupture of Intracranial Internal carotid artery (ICA) pseudoaneurysm is rarely encountered in Otolaryngology emergency but when it does, it requires immediate action. To provide an update on the approach toward diagnosis and management of patients with ruptured intracranial ICA pseudoaneurysm from an otolaryngologist perspective. The PubMed library was searched for previously published reviews, systematic reviews, or meta-analyses for intracranial ICA pseudoaneurysm, and a narrative review was formulated with a focus on Otolaryngology practice.

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Objective: To estimate the prevalence of true knot of the umbilical cord (TKUC) and identify associated adverse maternal and neonatal outcomes.

Study Design: A multicenter retrospective cohort study was conducted, including all women with singleton pregnancies who delivered between 24 and 42 weeks of gestation from 2005 to 2021 at two large obstetrical centers. Gross pathological examinations of the placenta and umbilical cord were routinely performed immediately after delivery.

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Background: Pseudoaneurysms are rare vascular lesions that can form following injury to an artery. Damage to the artery can result in a hematoma surrounded by a layer of coagulation products. Intracranial pseudoaneurysms are particularly uncommon, comprising less than 1% of all aneurysms, and are often associated with traumatic brain injuries.

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Intracranial aneurysm (IA) poses a significant health risk due to morbidity and mortality associated with aneurysm rupture. However, the molecular mechanisms underlying IA development remain unclear, and a suitable mouse model is required. A mouse model of IA was established by ligating the pterygopalatine artery (PPA) to induce additive hemodynamic changes, combined with hypertension induction.

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Introduction: Following endovascular treatment (EVT) or microsurgical treatment (MT) of intracranial aneurysms (IA), radiological follow-up is performed to assess for recurrence and to determine the need for re-treatment. There is a paucity of evidence describing the long-term results of EVT and MT for IA and therefore data to inform the design of follow-up protocols are lacking. The overarching aim of the META study is to determine the clinically relevant long-term outcomes of EVT and MT for IA, and use this data to create evidence based radiological and clinical follow-up protocols for these aneurysms.

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