MyMedR

Unruptured anterior communicating artery aneurysm in a 2-year-old child

Syahrilfazli AJ, Nursharmizam MB, Azizi AB, Zurin AA

Pediatr Neurosurg, 2005 Sep-Oct;41(5):283-4.

PMID: 16195685

Matched MeSH terms: Intracranial Aneurysm/pathology*

Microsuture repair of intra-operative ruptures of cerebral aneurysms of the internal carotid artery

Vashu R, Tan S, Wong AS

J Clin Neurosci, 2009 Jul;16(7):960-2.

PMID: 19346131 DOI: 10.1016/j.jocn.2008.09.013

We report on two patients with intra-operative rupture of cerebral aneurysms that were managed by microsuturing. This is one of only a few reports of successful direct repair using suturing. We found that stitching remains an option to repair a tear of a saccular part of an aneurysm and a torn neck of a blister-like aneurysm, and thus this technique can be considered before sacrificing the artery.

Matched MeSH terms: Intracranial Aneurysm/pathology*

Fulltext Automated microaneurysm detection in diabetic retinopathy using curvelet transform

Ali Shah SA, Laude A, Faye I, Tang TB

J Biomed Opt, 2016 Oct;21(10):101404.

PMID: 26868326 DOI: 10.1117/1.JBO.21.10.101404

Microaneurysms (MAs) are known to be the early signs of diabetic retinopathy (DR). An automated MA detection system based on curvelet transform is proposed for color fundus image analysis. Candidates of MA were extracted in two parallel steps. In step one, blood vessels were removed from preprocessed green band image and preliminary MA candidates were selected by local thresholding technique. In step two, based on statistical features, the image background was estimated. The results from the two steps allowed us to identify preliminary MA candidates which were also present in the image foreground. A collection set of features was fed to a rule-based classifier to divide the candidates into MAs and non-MAs. The proposed system was tested with Retinopathy Online Challenge database. The automated system detected 162 MAs out of 336, thus achieved a sensitivity of 48.21% with 65 false positives per image. Counting MA is a means to measure the progression of DR. Hence, the proposed system may be deployed to monitor the progression of DR at early stage in population studies.

Matched MeSH terms: Aneurysm/pathology

Sudden death in a young adult due to coronary artery aneurysm secondary to suspected Kawasaki disease

Subramaniam S, Boo K

Malays J Pathol, 1992 Jun;14(1):49-51.

PMID: 1469919

A healthy 17-year-old Chinese male suddenly collapsed and died during a game of badminton. The autopsy examination revealed a solitary calcified aneurysm of the left common coronary artery with marked stenosis of the orifices of the anterior descending and circumflex branches. Histology of the aneurysm was non-specific with hyalinised scar tissue and foci of calcification. The only illness of significance in the past was an episode of 'pyrexia of unknown origin' at the age of 8 months. A review of the notes of that hospital admission revealed that the illness was most probably Kawasaki disease.

Matched MeSH terms: Coronary Aneurysm/pathology

Fulltext A ten-year review of ruptured sinus of valsalva: clinico-pathological and echo-Doppler features

Shah RP, Ding ZP, Ng AS, Quek SS

Singapore Med J, 2001 Oct;42(10):473-6.

PMID: 11874151

Rupture of the sinus of valsalva (RSOV) is an uncommon condition with a variety of manifestations ranging from an asymptomatic murmur to cardiogenic shock. This retrospective 10-year review (1985-1995) of 18 patients from a single institution revealed that 6 (33%) were female and 12 (67%) were male with a mean age of 37.6 +/- 13.4 years and that 72% were Chinese by ethnic descent with the remaining 28% being Malay. Eight patients (44.4%) presented with an asymptomatic murmur, 4 (22.2%) with acute chest pain, 4 (22.2%) with mild heart failure, 2 (11.1%) with severe heart failure, and 2 (11.1%) with cardiogenic shock. Rupture of the right aneurysmal coronary cusp (RCC) made up 15 (83.3%) while those of the non-coronary cusp (NCC) made up the remaining. Most of the RCC ruptures were directed into the right ventricle and all of the NCC ruptures were into the right atrium. Ventricular septal defects (VSDs) were found in 9 (50%) of the patients, (although detected by echocardiography in only one third of those patients), aortic regurgitation in 6 (33.3%) and aortic valve vegetations in 2 (11.1%). Echocardiography was found to be accurate in diagnosing RSOVs with 100% diagnostic accuracy after 1990 with four misdiagnoses before 1990. Of these four patients, two were misdiagnosed as having VSDs, one as having a coronary arteriovenous fistula and one as having a patent ductus arteriosus. The anatomical structure of the "windsock" was seen in 64% of the patients who were correctly diagnosed. The pattern of colour flow and spectral Doppler was seen in all patients and helped to localise the site of rupture and the direction of flow. In summary, echocardiography is a simple and accurate way of diagnosing and defining RSOVs and is the imaging modality of choice.

Matched MeSH terms: Aortic Aneurysm/pathology*

Fulltext Giant serpentine middle cerebral artery aneurysm

Pany A, Sobri M, Valarmathi S, Latif AZ

Med J Malaysia, 2004 Aug;59(3):422-4.

PMID: 15727392

A rare case of partially thrombosed giant serpentine right middle cerebral artery aneurysm presented. A 26 year old man initially presented with headache and 3 months later developed neurological deficit. Various stages of clot with patent residual lumen seen on neuroimaging, led to the diagnosis. Catheter angiography is the investigation of choice for evaluating the location, flow dynamics and extent of the serpentine aneurysm. The patient had embolisation done for the giant serpentine aneurysm.

Matched MeSH terms: Intracranial Aneurysm/pathology*

Thoracic aortic dissection. Death may not always be due to rupture with haemorrhage. Unusual complications which can be missed at autopsy

Subramaniam K, Sheppard MN

J Forensic Leg Med, 2018 Feb;54:127-129.

PMID: 29413954 DOI: 10.1016/j.jflm.2018.01.005

OBJECTIVES: Aortic dissection (AD) can be a challenging diagnosis. At autopsy, the aorta may not be dilated and intimal tears may be missed or found without obvious rupture or haemorrhage. We report our experience of AD at a tertiary referral centre with review of 32 cases and discuss 2 unusual complications.

METHODS/RESULTS: 32 cases of which 12 females and 20 male and 18 out of 32 cases were aged below 40. All of the cases were examined macroscopically and microscopically. 30 out of 32 cases (93%) died due to rupture associated with the AD. Two unusual complications were proximal extension of AD into left coronary artery (CA) with intramural haematoma blocking the vessel and AD involving the ostium of the right CA resulting in avulsion of the right CA from the aorta. Mode of death in both these cases were myocardial ischemia. Sections of the aorta in all cases confirmed extensive cystic medial degeneration with disorganisation, fragmentation and disappearance of the elastin fibres with increased collagen and smooth muscle nuclear degeneration.

CONCLUSION: Pathologists should be thorough when examining the aorta, the aortic valve and root in AD. When a rupture site cannot be found it is important to look for unusual complications involving the CAs. Histology plays an important role to corroborate the cause of death.

Matched MeSH terms: Aortic Aneurysm/pathology*

Fulltext Massive small bowel infarction and duodenal perforation due to abdominal polyarteritis nodosa: a case report

Tun M, Malik AK

Malays J Pathol, 1994 Jun;16(1):75-8.

PMID: 16329580

A 37-year-old Chinese male presented with an acute abdomen. Surgical exploration revealed duodenal perforation, extensive small bowel infarction and peritonitis. Histopathology of the resected bowel showed characteristic features of classic polyarteritis nodosa. The latter also involved mesenteric arteries in the form of tiny aneurysms. Steroids could not be started due to: (i) overwhelming microbial infections and (ii) fear of more perforations in other areas of the bowel. Such a presentation of polyarteritis nodosa is uncommon. Its recognition prior to surgery, management and prognosis is discussed.

Matched MeSH terms: Aneurysm/pathology

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