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2.1
Dissecting Aneurysm
Aneurysm Dissecting

Presentation

Our review found that the clinical course of patients presenting with ischemia differed from that of patients presenting with pure bleeding. Most of the patients with ischemia underwent progressive deterioration. [ncbi.nlm.nih.gov]

Cardiovascular

  • Chest Pain

    He presented with dyspnea, chest pain and amazing symptom of superior vena cava syndrome. The patient underwent open heart surgery with resection of ascending aorta aneurysm with classic Bentall operation. [ncbi.nlm.nih.gov]

    Chest Pain Accreditation On June 16, 2005, Good Samaritan was given official Chest Pain Center designation by the Society of Chest Pain Centers and recognized for offering state-of-the-art heart care to its patients. [chihealthgoodsamaritan.org]

    At 3 weeks after admission, her blood pressure and pulse rate had normalized and her chest pain had fully subsided. [kjim.org]

    Patients that experience sudden symptoms such as chest pain, characterized as a tearing sensation, or back pain, nausea, vomiting, a fast heart beat and possibly the feeling of impending doom, may be experiencing a tear or dissection of the aorta. [bcm.edu]

  • Pulse Deficit

    […] diastolic murmur over the aortic area Compression of the true aortic lumen: systolic murmur over any part of the aorta Pulse deficits: a difference of 20mmHg or more in blood pressure between arms, a weaker central or peripheral pulse compared to the [rcemlearning.co.uk]

    Sudden chest or back pain accompanied by pulse deficits, aortic regurgitation, or neurological manifestations should alert the clinician to the diagnosis of acute aortic dissection. [circ.ahajournals.org]

    Neurological deficit due to carotid artery involvement. Pulse deficit may be present initially, may develop, or may occur transiently. There is a difference in blood pressure in limbs on the right and left side of the body. [patient.info]

Eyes

  • Diplopia

    A 61-year old woman presented with vomiting and diplopia with preceding headache. Magnetic resonance imaging (MRI) showed fresh infarction of the left lateral medulla and a vertebral artery dissecting aneurysm of the left vertebral artery. [ncbi.nlm.nih.gov]

    hemianesthesia/no recurrence 15 56/M P1-2 junction(L) small SAH PAO Complete None 3 No GOS = 5, no symptom 16 51/F P2(R) large Hemiparesis, hemianesthesia (L) PAO Complete None 6 No GOS = 4, mild hemiparesis but return to work 17 47/M P2 (L) large diplopia [cnjournal.biomedcentral.com]

Musculoskeletal

  • Back Pain

    She was admitted to hospital with a new onset of back pain. Computed tomography revealed a new dissection tear originating from the distal side of the subclavian artery orifice. [ncbi.nlm.nih.gov]

    Still, you might have: Back pain A deep pain on the side of your abdomen A throbbing sensation near your navel If the aneurysm ruptures, you might feel sick to your stomach, or suddenly develop an intense pain in your back or abdomen. [webmd.com]

    […] of aortic dissection usually appear suddenly and may include: Severed, sudden, constant chest pain and/or upper back pain, sometimes described as “ripping” or “tearing” Pain that feels like it is moving from one place to another Unusually pale skin Faint [marfan.org]

    Patients that experience sudden symptoms such as chest pain, characterized as a tearing sensation, or back pain, nausea, vomiting, a fast heart beat and possibly the feeling of impending doom, may be experiencing a tear or dissection of the aorta. [bcm.edu]

Face, Head & Neck

  • Wide Neck

    Cerebral angiography showed a dissecting wide neck aneurysm at the anterior pontomesencephalic segment of the right SCA (diameter 1 mm). The patient was treated with coiling assisted by an LVIS Jr. stent. [ncbi.nlm.nih.gov]

    We propose double stent placement as a new, feasible technique for the occlusion of intracranial wide-neck aneurysms, especially pseudoaneurysms. [ajnr.org]

    Second, a stent supports coiling by "remodeling" the neck of an aneurysm and by preventing migration of coil loops from aneurysms, especially from wide neck aneurysms that otherwise could represent an obstacle to treatment. [scielo.br]

Neurologic

  • Cerebellar Ataxia

    Physical and neurological examinations found headache, vomiting, right perceptive deafness, and right cerebellar ataxia. [ncbi.nlm.nih.gov]

    The patient was discharged with slight cerebellar ataxia. We suggest that some dissecting vertebral aneurysms may induce subarachnoid hemorrhage and infarction coincidentally. [jstage.jst.go.jp]

Workup

Patients with valvular heart disease undergo workups with echocardiography or coronary angiography. [emedicine.medscape.com]

This time a real workup was done. CT Angiogram shows “filling defect” inside the left middle cerebral artery — filling defect is something inside the artery that shouldn’t be there. [neuroangio.org]

Treatment

We report the case of a patient with a recurrent anterior cerebral artery (ACA) dissecting aneurysm after endovascular treatment. [ncbi.nlm.nih.gov]

Prognosis

prognosis. 10 Fig. 7 A Hamasaki/2014[62] 56/M 5 Proximal endovascular occlusion,. [medsci.org]

BACKGROUND: Management of intracranial basilar dissecting aneurysms has been controversial and challenging, and surgical and conservative treatments usually have a bad prognosis. [ncbi.nlm.nih.gov]

CT scanning may be used to confirm the diagnosis but is less helpful in complications and prognosis. [patient.info]

Prognosis evaluated at 3 months after the ictus with the GOS revealed that 21 of 32 patients (66%) in the bleeding group showed poor prognosis, whereas only 2 of 17 patients (12%) of the ischemic group showed poor prognosis. [ahajournals.org]

Etiology

The etiology and location of the lesion and distal flow to the lesion should be taken into consideration when planning the treatment. [ncbi.nlm.nih.gov]

Etiology Although the specific cause of the disease is not known, the lesion that generally is accepted as being precedent to dissecting aneurysm of the aorta is medial degeneration. [mdedge.com]

Classification by location and etiology. In general, the etiology and pathophysiology of aortic aneurysms are site dependent. [tele.med.ru]

Epidemiology

Aortic dissection: epidemiology, pathophysiology, clinical presentation, and medical and surgical management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 81. [nlm.nih.gov]

He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]

Epidemiology The incidence is approximately 3-4 per 100,000 per year. [ 2 ] Aortic dissection is the most common emergency affecting the aorta. The male:female ratio varies - in one study, almost 70% of cases were in males. [patient.info]

Pathophysiology

Aortic dissection: epidemiology, pathophysiology, clinical presentation, and medical and surgical management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 81. [nlm.nih.gov]

[…] subclavian artery Svensson (defines type of acute aortic syndrome) classic dissection with true and false lumen intramural haematoma or haemorrhage subtle dissection without haematoma atherosclerotic penetrating ulcer iatrogenic or traumatic dissection PATHOPHYSIOLOGY [lifeinthefastlane.com]

Prevention

Because an angulated SMA trunk and compressed true lumen by the dilated false lumen prevented the insertion of a guidewire into the SMA via the transfemoral artery, transmesenteric approach under laparotomy was selected. [ncbi.nlm.nih.gov]

How to prevent heart disease at any age. American Heart Association. https://www.heart.org/en/healthy-living/healthy-lifestyle/how-to-help-prevent-heart-disease-at-any-age. Accessed May 11, 2021. Related Associated Procedures News from Mayo Clinic [mayoclinic.org]

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