Intracranial internal carotid artery aneurysm with metastatic carcinoma

Unruptured intracranial aneurysm can be picked up incidentally on cranial angiography screening for other cause. However, with increasing use of neuroimaging led to increasing rate of pickup and many such incidentally detected cases are treated with endovascular treatment, or craniotomy and clipping of aneurysm or uncommonly a very small aneurysm unsuitable for retreatment by currently available modality may be observed as wait and watch policy. Extremely uncommonly a patient undergoing investigation for suspected subarachnoid hemorrhage following aneurismal rupture, computed tomography scan revealed presence of subarachnoid hemorrhage associated with sellar mass. Such association was previously unreported. In extensive Pubmed search by authors could find a case reported by Yang et al., a case of known surgically resected gastric carcinoma developing secondary in sella, CT angiography of the intracranial artery revealed an aneurysm of ICA located at the inner edge of the siphon segment

Use of heparin in neurointervention: A review of the literature

Background: The use of heparin is routine in endovascular procedures as a strategy in many centers that perform neurointerventional procedures to prevent occlusion of the catheters, but the use of this drug carries risks such as heparin-induced thrombocytopenia.Objective: The purpose of this paper is to present a review of the literature.Material and methods: We conducted an extensive search and review of published papers about heparin and neurointerventional procedures.Results: The evidence in the literature is weak in relation to the use of heparin and the reduction of embolic effects associated with their use in endovascular procedures.Conclusion: The evidence on the use of heparin for the prevention of thromboembolic events in endovascular procedures are of low quality. There is insufficient evidence to conclude a potential benefit of heparin is useful in neurointerventional procedures. Prospective studies are needed to determine the effectiveness of heparin and avoid exposing patients to potential risks

Ventriculoperitoneal shunt related meningioma: A case report

Meningiomas are the most common primary, non-glial tumours of the brain and spine, and represent the most common extra-axial lesions. The typical meningioma is a dural-based, markedly enhancing extra-axial mass; they exhibit cortical buckling with trapped cerebrospinal fluid clefts or cortical vessels. There are factors strongly associated with risk of developing meningioma, as in the case of exposure to ionizing radiation, or exogenous or endogenous hormones, as in this case, the presence of shunt material as a foreign body may have contributed to oncogenesis on the basis of a chronic inflammatory reaction. The aim of this report is to present the clinical case of a meningioma, which enveloped the proximal catheter of ventriculoperitoneal shunt valve

Biomarkers in acute brain trauma: A narrative review

Biomarkers have been used to diagnose, prognose, evaluate, and identify the severity and outcomes in traumatic brain injury (TBI) patients. This study explored if it is possible to predict the outcome of TBI patients by estimating the biomarkers in cerebrospinal fluid and serum. We searched data bases and literature about biomarkers, and found forty epidemiologic studies from 92 potentially relevant articles. However, limited data are available about postanoxic encephalopathy. It showed that presently, neurofilament, S100B, glial fibrillary acidic protein, and ubiquitin carboxyl terminal hydrolase-L1 seemed to have the best potential as diagnostic biomarkers for distinguishing focal and diffuse injury, whereas C-Tau, neuron-specific enolase, S100B, glial fibrillary acidic protein, and spectrin breakdown products appear to be candidates for reflective biomarkers of TBI. Point-of-care biomarkers are needed in TBI which is one of the most important additional risk factors in road traffic injuries. In a holistic approach, more researches about biomarkers of TBI are required. These biomarkers are very useful for treatment of patients with TBI