Posterior Tibial Artery Aneurysm Caused by Trauma: A Case Report
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ABSTRACT:
SUBMITTER: Matsubayashi Y
PROVIDER: S-EPMC10539132 | biostudies-literature | 2023 Sep
REPOSITORIES: biostudies-literature
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Project description:Posterior circumflex humeral artery (PCHA) aneurysm is a rare condition. It mostly affects young professional sports player and might be career threatening. This is the report of the case of a 28 year old volleyball player presenting with symptoms of right digital ischaemia caused by a PCHA aneurysm. Surgical treatment by resection of the aneurysm without revascularisation was performed. The post-operative course was uneventful and the patient returned to professional competition one month after surgery. A literature review is also presented in an attempt to provide recommendations for PCHA aneurysm diagnosis and management.
| S-EPMC6708986 | biostudies-literature
Project description:BackgroundA femoral aneurysm is a weakness and bulging in the femoral artery wall located in the thigh. Femoral aneurysms can burst, which may cause uncontrolled bleeding and life-threatening conditions. The aneurysm may also cause a blood clot, showering emboli, potentially resulting in leg ischemia and amputation.Case reportA 49-year-old man with hypertension presented significant swelling in his right thigh. The patient had a history of surgery for arteriovenous fistula repair. The arteriovenous fistula in the thigh was caused by a bullet injury during the war. Diagnosis of the superficial femoral artery aneurysm was determined using magnetic resonance angiogram. The aneurysm was surgically excised and a prosthetic vascular graft was inserted.DiscussionThe exact cause of femoral aneurysms is unknown, although atherosclerosis and hypertension may play a key role. Trauma to the artery may also be a contributing factor. Long-standing occult arteriovenous fistula plays a significant role in the cause of distal aneurysms.ConclusionFemoral aneurysms are usually treated surgically. A surgeon will replace the artery with a graft or create a bypass around the area of the artery where the aneurysm is present.
| S-EPMC7272507 | biostudies-literature
Project description:BackgroundFetal cerebral aneurysm other than aneurysm of vein of Galen aneurysmal malformation (VGAM) is extremely rare. This report describes prenatal features of aneurysm of the posterior cerebral artery (APCA) with rapid progression and its natural intrauterine course of the disease, which has never been reported.Case presentationThis is the first report of prenatal features of APCA, detected at 34-36 weeks of gestation, simulating choroid plexus cyst or arachnoid cyst. The diagnosis was based on color flow ultrasound with tracing along the course of cerebral arteries. Also, rendered 3D color flow ultrasound was helpful in demonstrating course of the vessels feeding the aneurysm and supporting the diagnosis. The aneurysm showed nature of rapidly progressive changes, leading to leakage resulting in intracerebral and intraventricular hemorrhage as well as high output state associated with anemia. Prenatal diagnosis and management are very challenging. This case ended up with planned delivery at 37 weeks, giving birth to a surviving male newborn, weighing 2600 g. The neonatal CT brain scans and CTA confirmed the prenatal findings. The prognosis was relatively poor because of extensive intracerebral hemorrhage with severe hydrocephalus and brain midline shift. The couple opted for neonatal palliative care without neurosurgical correction.ConclusionThis study demonstrate that the most important tool for prenatal diagnosis is color Doppler ultrasound, which will demonstrate turbulent blood flow. Three-dimension color Doppler ultrasound is helpful in supporting the diagnosis. The case presented here suggests that the disease has a natural course of rapid progression and massive brain destruction or high output congestive heart failure can be expected.
| S-EPMC10583320 | biostudies-literature
Project description:Aneurysms of meningeal middle artery (MMA) are extremely rare. These aneurysms are of two types: true aneurysm and pseudoaneurysm. The true type is usually seen with pathologic conditions. Pseudoaneurysms, on the other hand, are associated with a skull fracture. Epilepsy caused by MMA aneurysm has never been described to our knowledge. We report a case of true aneurysm isolated from MMA revealed by epilepsy.A 57-year-old patient with a history of high blood pressure developed epilepsy which was treated by valproic acid. Initial scalp electroencephalography (EEG) showed seizure activity arising from the right temporal area. Epilepsy had become drug-resistant. Cerebral angiography revealed an aneurysm of the right middle meningeal artery without any other intraparenchymal anomaly. The interrogation did not reveal any history of family aneurysm. The patient underwent surgery with coagulation of the aneurysm and the MMA. The aneurysm was intradural in contact with the temporal cortex, and the surrounding brain tissues were preserved. The operative follow-up was favorable with amelioration of convulsions with a single antiepileptic. We planned to stop antiepileptic treatment according to electroencephalograms.Aneurysms of the MMA are rare. Their mode of revelation by seizures is unusual. The factors of rupture are not known. When isolated, their physiopathology is identical to that of the aneurysms of the Willis polygon. Their management uses the same techniques as for other cerebral aneurysms.
| S-EPMC5551285 | biostudies-other
Project description:BackgroundAlthough it is well known that internal carotid-posterior communicating artery (ICA-PcomA) aneurysms compress the oculomotor nerve and cause nerve palsy, cases of ICA-PcomA aneurysms splitting the oculomotor nerve are extremely rare.Case descriptionWe present the rare case of an asymptomatic, growing, left-sided ICA-PcomA aneurysm that was confirmed to split the oculomotor nerve. We report the clinical course and discuss the underlying mechanism. The oculomotor nerve, which is an aggregate of multiple fibers, exhibits age-related loss of compactness in the arrangement of its nerve fibers.ConclusionWe speculate that injury to the nerve fibers by aneurysmal compression was avoided because of the rare phenomenon of splitting of the oculomotor nerve.
| S-EPMC7656031 | biostudies-literature
Project description:IntroductionBrucella is a genus of aerobic Gram negative bacteria that causes the disease brucellosis. It is considered a zoonotic infection transmitted to humans by ingestion of unpasteurised dairy products. Although aortic involvement is rarely seen, it can be a life threatening complication of this disease. This case report describes a ruptured aneurysm of the common iliac artery (CIA) due to secondary infection by Brucella melitensis.ReportA 79 year old man with a known isolated aneurysm of the CIA presented with acute abdominal pain. Contrast enhanced computed tomography (CT) revealed rupture of the aneurysm. The patient underwent prompt endovascular repair. Several weeks after an uneventful recovery, the patient presented with spiking fever and abdominal discomfort. CT revealed an abscess anterior to the CIA. Blood and pus cultures grew B. melitensis. In recurrent re-admissions, conservative antibiotic therapy proved to be insufficient. Eventually, neo-aorto-iliac system (NAIS) reconstruction using bilateral femoral veins was performed to provide definitive treatment four months after initial presentation.ConclusionAlthough Brucella infected aneurysms are rare, they are associated with life threatening disease. Diagnosing this type of brucellar infection can be challenging owing to the long incubation time needed for blood and tissue cultures. Definitive treatment of these aneurysms often needs open surgery and antibiotics for complete treatment. Vigilant surveillance is required to monitor for post-operative complications such as graft infection, recurrent (false) aneurysm, and abscess formation.
| S-EPMC8339252 | biostudies-literature
Project description:Objective and Importance When treating large unruptured ophthalmic artery (OA) aneurysms causing progressive blindness, surgical clipping is still the preferred method because aneurysm sac decompression may relieve optic nerve compression. However, endovascular treatment of OA aneurysms has made important progress with the introduction of stents. Although this development is welcomed, it also makes the choice of treatment strategy less straightforward than in the past, with the potential of missteps. Clinical Presentation A 56-year-old woman presented with a long history of progressive unilateral visual loss and magnetic resonance imaging showing a 20-mm left-sided OA aneurysm. Intervention Because of her long history of very poor visual acuity, we considered her left eye to be irredeemable and opted for endovascular therapy. The OA aneurysms was treated with stent and coils but continued to grow, threatening the contralateral eye. Because she failed internal carotid artery (ICA) balloon test occlusion, we performed a high-flow extracranial-intracranial bypass with proximal ICA occlusion in the neck. However, aneurysm growth continued due to persistent circulation through reversed blood flow in distal ICA down to the OA and the cavernous portion of the ICA. Due to progressive loss of her right eye vision, we surgically occluded the ICA proximal to the posterior communicating artery and excised the coiled, now giant, OA aneurysm. This improved her right eye vision, but her left eye was permanently blind. Conclusion This case report illustrates complications of the endovascular and surgical treatment of a large unruptured OA aneurysm.
| S-EPMC4242818 | biostudies-other
Project description:Posterior tibial artery pseudoaneurysms are rare and can occur in the setting of trauma. Endovascular treatment of post-traumatic pseudoaneurysms has become a viable less-invasive method particularly in young patients in whom the presence of collaterals guarantees distal vascularization. We report an unusual case of a 16-year- old patient who sustained blunt trauma to his right lower extremity due to a bicycle injury and developed a delayed symptomatic pseudoaneurysm of the posterior tibial artery in the absence of tibia fracture. Superselective endovascular treatment with Ethylene Vinyl Alcohol Copolymer based liquid embolic system (Menox) was successfully performed, achieving exclusion of the pseudoaneurysm with preservation of the remaining vascularization of the lower limb.
| S-EPMC8405942 | biostudies-literature
Project description:Patient is a 72-year-old male who presented with abdominal pain and hypertension. Through bedside point-of-care ultrasound (POCUS), patient was found to have markedly enlarged bilateral iliac artery aneurysms with signs of impending rupture, which was confirmed on computed tomography (CT) angiogram of the abdomen/pelvis. Patient was immediately taken to the operating room for emergent repair of aneurysm, and was discharged from the hospital the next day. Point-of-care ultrasound is critical in diagnosis and guiding treatment in patients in the emergency department and should be considered in those with undifferentiated abdominal pain.TopicsAbdominal pain, iliac artery aneurysm, point-of-care ultrasound.
| S-EPMC10332536 | biostudies-literature
Project description:Spontaneous spinal hemorrhage is a rare condition. We present a case in which the diagnosis was complicated by a concomitant intra-abdominal hemorrhage. The patient, taking coumarins, presented with acute back pain and abdominal pain and progressive paresis of the lower limbs. Computed tomography angiography of the abdomen showed an intra-abdominal hemorrhage and an aneurysm of the celiac trunk. MR (magnetic resonance) imaging of the spine revealed a combined subdural and epidural hemorrhage from C1 to L1. Both sites were treated conservatively. After 6 months the patient regained strength in both legs with some persistent loss of strength in the left leg. Follow-up MR imaging showed complete resolution of the spinal hemorrhage. The celiac artery aneurysm was treated conservatively. We suggest that the rupture of the celiac artery aneurysm caused increased intra-abdominal pressure leading to spinal hemorrhage. Emergency staff should be aware of the possibility of two rare but concomitant conditions.
| S-EPMC4520959 | biostudies-other