Intracranial aneurysm is the primary cause of nontraumatic subarachnoid hemorrhage. To assess aneurysm metabolism, we present a method of intra-operatively collecting blood samples from the aneurysm neck, as well as the proximal and distal responsible vessels, using microcatheters. Through these paired comparisons, we can eliminate the interpatient variation usually observed in plasma samples taken from the peripheral vein. We utilized 39 plasma samples from 13 intracranial patients to characterize the metabolite profiles using untargeted liquid chromatography-mass spectrometry. Our findings revealed that L-tyrosine is upregulated at relatively high levels at the aneurysm neck than the proximal and distal aneurysm, whereas phenylpyruvic acid, L-cystine, and L-ornithine are downregulated. Based on this, there was also a significant decrease in arginine within small aneurysm of the internal carotid artery. The 6-month follow-up indicated that patients who experienced good recovery had lower levels of biliverdin, bilirubin, and metabolites of coenzyme Q within the aneurysm. In conclusion, our investigation provides a comprehensive overview of plasma metabolites in patients with intracranial aneurysms, shedding light on potential pathogenetic mechanisms in unruptured intracranial aneurysms. Moreover, the study proposes innovative ideas for establishing postoperative follow-up timelines for flow diverter devices.
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http://dx.doi.org/10.1038/s41598-024-70309-6 | DOI Listing |
Cureus
December 2024
Infectious Disease, Tan Tock Seng Hospital, Singapore, SGP.
Nontyphoidal is a common cause of gastroenteritis but can also lead to bacteremia and extraintestinal infections, including meningitis (more frequent in children and infants), endovascular infections (e.g., endocarditis and infected aneurysms), urinary tract infections, and bone or bone marrow infections (e.
View Article and Find Full Text PDFCureus
December 2024
Department of Neurological Surgery, Ryofukai Satoh Neurosurgical Hospital, Fukuyama, Hiroshima, JPN.
Coil embolization of cerebral aneurysms often encounters challenges in achieving complete filling of the aneurysm sac due to complex shapes and hemodynamic factors, frequently resulting in the formation of a residual cavity (RC) at the aneurysm neck. The hemodynamic mechanisms underlying RC formation and growth, however, remain poorly understood. Computational fluid dynamics (CFD) analysis, combined with silent MRA free from contrast agents and metal artifacts, offers a promising approach to elucidate these mechanisms, potentially enhancing the clinical management of cerebral aneurysms post-coiling.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, 15355, Ansan, Gyeonggi-do, South Korea.
Although many institutions increasingly perform endovascular coiling instead of microsurgical clipping as the primary treatment for ruptured aneurysms, there remains ongoing debate regarding the optimal treatment strategy for ruptured middle cerebral artery (MCA) aneurysms. Therefore, we compared the outcomes of clipping and coiling for treating ruptured MCA aneurysms. A total of 155 ruptured MCA aneurysms that were deemed eligible for both clipping and coiling were retrospectively reviewed.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Department of Neurointervention, The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, Henan, China.
To evaluate the safety and efficacy of staged coiling followed by flow diverter (FD) in the treatment of ruptured intracranial aneurysms(RIAs). A retrospective analysis was conducted on 20 patients with RIAs treated with staged coiling followed by FD at a single center, between April 2015 and September 2024. Patient demographics, aneurysm characteristics, clinical and imaging outcomes were reviewed.
View Article and Find Full Text PDFActa Neurochir (Wien)
January 2025
Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street , Boston, MA, 02215, USA.
Background: Variability in long-term endovascular treatment outcomes for intracranial aneurysms has prompted questions regarding the effects of these treatments on aneurysm hemodynamics. Endovascular techniques disrupt aneurysmal blood flow and shear, but their influence on intra-aneurysmal pressure remains unclear. A better understanding of aneurysm pressure effects may aid in predicting outcomes and guiding treatment decisions.
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