Localized right convexity SAH was observed on computed tomography (CT) scan, but the origin could not be detected despite
extensive workup covering the entire head by using 3.0-Tesla magnetic resonance (MR) imaging with MR angiography and CT angiography combined with venous-phase imaging with a 320-detector row CT scanner. Subsequent digital subtraction angiography (DSA) performed 2.5 hours after Entrectinib cell line admission failed to reveal any cause of SAH; however, a right frontoparietal avascular region was suspected to be due to a newly developed intracerebral hematoma. The lesion was simultaneously confirmed by angiographic cone-beam CT imaging. Because she remained neurologically intact, we decided to perform a follow-up study later with medical management. However, she developed left hemiparesis 3 hours after DSA. CT scan demonstrated progression of the hematoma, and her symptoms gradually worsened. Emergent surgical exploration along the SAH superficial to the postcentral sulcus and hematoma evacuation were performed, with favorable functional outcome. Pathological examination confirmed cryptic vascular malformation
with several abnormally dilated arterioles within the subarachnoid space surrounded Sotrastaurin clinical trial by a thick SAH clot.
CONCLUSION: It is important to consider the possibility of ruptured cryptic vascular malformation as a cause of nontraumatic nonaneurysmal convexity SAH when recurrent hemorrhage occurs despite thorough diagnostic workup, because surgical resection may be the only curative treatment option to eliminate the risk of rebleeding and disabling symptoms.”
“Objective: To compare the outcomes of total aortic arch transposition (TAAT) vs hemi-aortic arch transposition (HAAT) for hybrid aortic arch repair.
Methods: A systematic search was performed using
PubMed between November 1998 and May 2010 by two independent observers. Studies included reporting on patients treated by TAAT or HAAT and stent grafting in a proximal landing zone 0 or 1 by Ishimaru, respectively. Further articles were identified selleck chemicals llc by following MEDLINE links, by cross-referencing from the reference lists, and by following citations for these studies. Case reports and case series of less than five patients were excluded. Primary technical and initial clinical success, perioperative, and late morbidity and mortality were extracted per study and were meta-analyzed.
Results: Fourteen studies were included in the statistical analysis. The number of reported patients totaled 130 for TAAT/zone 0 and 131 for HAAT/zone 1. The primary technical success rate was significantly higher in zone 0 than 1 (95% vs 83%; odds ratio [OR], 4.0; 95% confidence interval [CI], 1.47-10.88; P = .0069), due to significantly higher primary type I or III endoleak rates in zone 1 (15.48% vs 3.97%; P = .0050). Reintervention rates were significantly higher in zone 1 (25.81% vs 12.00%; P = .0321). Initial clinical success rates were comparable between zone 0 and 1 (88% vs 85%; OR, 1.35; 95% CI, 0.61-3.02; P = .