RESUMEN
61-year-old woman with a past medical history of dementia and Meniere's disease presents with acutely worsening dizziness and headache. The patient additionally complains of left greater than right upper extremity weakness and paresthesias.
Asunto(s)
Encéfalo/patología , Angiopatía Amiloide Cerebral/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Anciano , Encéfalo/diagnóstico por imagen , Angiopatía Amiloide Cerebral/patología , Mareo/etiología , Femenino , Humanos , Parestesia/etiología , Sensibilidad y EspecificidadRESUMEN
A 62-year-old male with controlled hypertension, coronary artery disease, and borderline diabetes presented to the emergency room after experiencing a gradual one-month progression of slurring of speech and difficulty reading. The patient maintained his vital signs throughout his ambulance ride to the hospital and was clinically stable at time of arrival to the emergency department.
Asunto(s)
Neoplasias Encefálicas , Dislexia Adquirida , Imagen por Resonancia Magnética , Neoplasias de la Próstata/diagnóstico por imagen , Trastornos del Habla/diagnóstico por imagen , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/secundario , Carcinoma de Células Pequeñas/diagnóstico por imagen , Dislexia Adquirida/diagnóstico por imagen , Dislexia Adquirida/etiología , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la NeoplasiaRESUMEN
BACKGROUND: Intracranial aneurysms (ICA) if inadequately treated may result in serious morbidity and mortality. Wide-neck; large/giant, fusiform, and dissecting aneurysms are not well treated using the conventional coil embolization technique. Recent advance in endovascular treatment and technology has introduced flow diverter devices including pipeline embolization devices (PED) and Silk stents that have been shown to be more effective in treating these more complicated aneurysms. Flow Diverter devices offer a more physiologic approach to ICA treatment. METHODS: We conducted a retrospective chart review of 23 adult patients who underwent aneurysm treatment utilizing the pipeline stent at Duke University Medical Center from July 2011 to March 2013. RESULTS: Majority of patients (19, 82.7%) showed angiographic evidence of complete obliteration of aneurysm at 6 months follow-up, with sustained clinical improvement on modified Rankin scale score. All of the patients tolerated the procedure well with no intra-operative hemorrhage or intra-operative thromboembolic complications. CONCLUSIONS: Our experience shows that use of PED offers a safe and effective strategy for treatment of complex ICA. Larger prospective studies are needed to confirm these observations.