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PubMed1995

A role for phospholipase C activity but not ryanodine receptors in the initiation and propagation of intercellular calcium waves.

Mechanical stimulation of a single cell in an airway epithelial culture initiates an increase in intracellular Ca2+ concentration ([Ca2+]i) that propagates from cell to cell as an intercellular Ca2+ wave. These Ca2+ waves appear to require an increase in intracellular inositol 1,4,5-trisphosphate (IP3) concentration ([IP3]i) in the stimulated cell and are propagated between cells by the diffusion of IP3 through gap junctions. To test the hypothesis that the activation of phospholipase C (PLC) contributes to the elevation of [IP3]i and initiation of an intercellular Ca2+ wave, changes in [Ca2+]i induced by mechanical stimulation were measured by digital fluorescence microscopy in the presence of the PLC inhibitor, aminosteroid U73122. Following exposure to U73122 mechanical stimulation elevated [Ca2+]i of the stimulated cell, but did not initiate the propagation of an intercellular Ca2+ wave. By contrast, in the presence of U73343, a similar aminosteroid that does not inactivate PLC, mechanical stimulation increased the [Ca2+]i of the stimulated cell and initiated an intercellular Ca2+ wave. U73122 also blocked the elevation of [Ca2+]i of airway epithelial cells in response to ATP, a P2-receptor agonist that activates PLC to elevate [IP3]i and [Ca2+]i. In addition, the propagation of intercellular Ca2+ waves was not affected by the ryanodine-receptor agonists, caffeine or ryanodine. The hypotheses that: (1) an elevation of [IP3]i is required to initiate intercellular Ca2+ waves; (2) mechanical stimulation activates PLC; and (3) Ca2+ wave propagation in airway epithelial cells involves Ca2+ release from intracellular stores primarily via IP3 receptors are supported by these results.

Animals↗
PubMed2003

[Tractography of the visual pathways: routine examination in magnetic resonance imaging].

Water diffusion analysis in magnetic resonance imaging (MRI) provides an elective visualization of fiber tract orientations in cerebral white matter, especially for optic tracts. We explored 25 patients from 18 to 45 years of age, with normal MRI in 20 subjects, and radiological anomalies in five. On a 1.5 Tesla MRI apparatus, diffusion tensor acquisitions were performed in 5 minutes 58 seconds with an EPI Single Shot sequence covering the entire brain. Image displacements were precluded by patient information and adequate fixation, then digitally corrected on workstations. Volume merging and fiber tract extraction were achieved using dedicated software (Volume-One and dTV). A directional depiction was obtained for all areas in the white matter, in particular for white matter junctions. Coming from the lateral geniculate body, the optic tracts were directed posteriorly toward the occipital cortex, with numerous connections to extrastriate associative areas, and through the corpus callosum and the fornix. Diffusion tractography requires optimization of volume displacements, before and secondary to MRI acquisitions. Our diffusion tensor acquisition, with image optimization in a short-duration sequence can be routinely applied to all patients, for a specific analysis of functional connections between cortical areas of cerebral white matter.

Adolescent↗
PubMed1994

[Second toe transplantation in loss of a long finger. Indications--planning--technique].

Transplantation of the second toe is a routinely employed method in reconstructive hand surgery. Most often it is used for thumb or midhand amputations. Following partial amputations of digits distal to the MP-joints, toe transplantations are less frequently employed. However, function as well as cosmesis of the hand after partial amputation of digits can considerably be improved by toe transplantation. The length of the reconstructed finger is a most important aspect of operative planning which has influence on operative technique as well as functional and aesthetic results. A smooth junction at the base of the transplanted toe should be maintained. This can be achieved by adequate soft-tissue reduction and exclusion of the metatarsophalangeal joint. Anastomoses of the subcutaneous venous and plantar as well as dorsal arterial vascular systems are recommended.

Amputation, Traumatic↗
PubMed1990

Regulation of ciliary activity in the mammalian respiratory tract.

A computer-assisted transillumination, photoelectronic technique has been used to measure the beat frequency of cilia of rabbit tracheal cells grown in culture. When ciliated cells are mechanically stimulated with a microprobe the cells respond rapidly by increasing the beat frequency of their cilia. This mechanosensitive response is not limited to the stimulated cell, but is communicated in all directions to neighboring cells. To characterize the progression of this communicated response we used an automated computer-assisted imaging system to examine high-speed films of responding cells. The time it takes for the response to be transmitted between cells is slow (1-3 sec) with each cell responding after a lag-time that is proportional to the distance of the cell from the stimulated cell. We have confirmed that gap junctions are present between cells and that adjacent or non-adjacent ciliated, as well as non-ciliated, cells are electrically coupled. To correlate the mechanosensitive response with intracellular calcium fluxes we have used fura-2, a calcium-specific fluorescent dye, and digital video microscopy. Mechanical stimulation of the cultured ciliated cells, in the presence of extracellular calcium, resulted in an initial increase in intracellular calcium, which was communicated to neighboring cells. Without extracellular calcium, mechanosensitivity of cultured cells was lost and a small decrease in intracellular calcium was observed in the stimulated cell. However, neighboring cells still displayed an increase in intracellular calcium. The time course and general pattern of calcium increase in adjacent cells was similar to the responses in ciliary activity produced by mechanical stimulation. Ciliary beat frequency is also elevated by beta-adrenergic drugs independently of mechanosensitivity. These responses are important because they could provide a dual regulatory mechanism for the control of mucus transport. Adrenergic agonists could provide non-specific control by increasing ciliary activity throughout the airways while mechanosensitivity could provide local control by increasing activity in those regions of heavy mucus load.

Animals↗
PubMed2005

A 2-bp deletion in the GJA1 gene is associated with oculo-dento-digital dysplasia with palmoplantar keratoderma.

Oculo-dento-digital dysplasia (ODDD, OMIM no. 164210) is a pleiotropic disorder characterized mainly by ocular anomalies, varying degrees of finger and toe syndactyly, and enamel defects. It is caused by missense mutations in the gene coding for the gap junction protein connexin 43 or GJA1. Other types of mutations have so far not been reported. Here we describe a Dutch kindred with ODDD showing a new symptom, palmoplantar keratoderma, and associated with a novel 2-bp deletion mutation of GJA1. The dinucleotide deletion 780_781delTG is located in the cytoplasmic C-terminal loop and leads to a frameshift. This is predicted to lead to the production of a slightly truncated protein with 46 incorrect amino acids in the C-terminal cytoplasmic loop (C260fsX307). This novel mutation may explain the presence of skin symptoms.

Abnormalities, Multiple↗
PubMed1995

The relation between tooth eruption and alveolar crest height in a human skeletal sample.

It is commonly assumed that alveolar crest height increases with continuing tooth eruption unless affected by marginal inflammation. To test this hypothesis, the relation between eruption and alveolar crest height was examined in skulls from a sample consisting of the remains of 244 individuals from the late medieval period. The mandibular first and second molars and second premolars were analysed. The age of the skulls was determined on the basis of dental development and molar attrition. Radiographs were taken and points representing the levels of the inferior dental canal (IDC), root apices (AP), alveolar crest (AC), cementum-enamel junction (CEJ) and occlusal surface were determined on the radiographs. The level of the IDC was used as a reference not changing with age. The distances between the points were measured with a help of a computer-digitizer system. Variable IDC-AP increased with age, indicating continuous eruption of the teeth. The distance between AC and CEJ also increased while the distance between IDC and AC remained constant, showing that the alveolar crest height did not increase accordingly. The lack of inflammatory changes on the alveolar bone surface suggests that occlusal attrition may be compensated for by continuous eruption without bone growth in the alveolar margin.

Adolescent↗
PubMed1990

Flexor tendon ruptures secondary to hamate hook fractures.

Four patients with flexor tendon ruptures secondary to hook of the hamate fracture are described. None of the patients had the diagnosis of fracture made before tendon rupture. All patients were treated with excision of the fractured hook and tendon repair. The tendon repair was usually an end-to-side (Y junction) of the profundus of the small to the profundus of the ring finger. After operation, all patients were free of pain and returned to their preinjury activity levels, but most had some limitation of motion in the digit with the tendon repair. The complication of tendon rupture not uncommonly follows basilar hook of the hamate fractures. Treatment by excision of the fracture and end-to-side tendon repair produces satisfactory results. Range of motion after tendon repair seems to depend more on the patient's age and the amount of inflammation at the site of repair rather than on the method of tendon repair.

Adult↗
PubMed1999

Ureteropelvic junction obstruction: use of helical CT for preoperative assessment--comparison with intraarterial angiography.

PURPOSE: To evaluate helical computed tomography (CT) in the preoperative assessment of crossing arteries in kidneys with ureteropelvic junction (UPJ) obstruction and to compare the results with those obtained by means of angiography. MATERIALS AND METHODS: Forty-one consecutive patients with symptomatic UPJ obstruction in 42 obstructed kidneys underwent renal helical CT and renal intraarterial digital subtraction angiography (DSA; flush aortography and bilateral selective renal injections). The helical CT and DSA images were interpreted in a blinded manner by two readers, and the results were compared. RESULTS: DSA showed 126 renal arteries in the 41 patients; 56% of patients had supernumerary renal arteries. Helical CT depicted 121 (96%) of these 126 renal arteries prospectively. Retrospectively, 124 (98%) renal arteries were visible on CT images. Twelve (29%) of the 42 kidneys with UPJ obstruction had identifiable arteries crossing the UPJ on DSA images. If DSA is used as the standard of reference, CT angiography was 100% sensitive and 96.6% specific for depicting these crossing arteries. CONCLUSION: Renal helical CT seems suitable to replace intraarterial DSA in the preoperative assessment of crossing arteries in kidneys with UPJ obstruction.

Adult↗
PubMed1996

Morphological survey of the cervicothoracic junctional region.

STUDY DESIGN: Vertebral morphology of the cervicothoracic junctional region was studied using the C6 to T4 vertebrae from 51 disarticulated skeletons (26 males and 25 females). OBJECTIVES: Orientation of the facet joint pair relative to the plane of the superior endplate and the sagittal reference was recorded. A vertebral index was developed to compare the superior endplate surface area with the posterior vertebral body height. SUMMARY OF BACKGROUND DATA: Vertebral morphometry was recorded for comparison with the limited published data for this region. METHODS: The disc-facet angle was measured using a zygapophysial endplate protractor and the facet angle recorded from computer-aided digitizing of photographs of each segment. Vertebral dimensions were measured using Mitutoyo digital calipers. RESULTS: A marked change in disc-facet angle from C6 to T1 was recorded, with the incidence of right versus left asymmetry highest at the T1 level. The incidence of facet angle asymmetry greater than 10 degrees was 24% at C6, 18% at C7, and 16% at T1. The vertebral index indicated no significant gender difference. CONCLUSION: Consistent with other junctional regions of the spine, the cervicothoracic transition has significant morphological variations.

Anthropometry↗
PubMed1984

Digital avulsion injuries: the shish kebab effect of the fibrous flexor sheath.

On debriding a hand from which four fingers with all their flexor tendons had been avulsed, a sizeable quantity of 'minced' muscle was found in the palm. Further cadaver investigations showed that the avulsed flexor tendons disrupted proximal to the musculo-tendon junction, and that a significant amount of devitalized forearm muscle tissue was left in the palm as the tendons passed through the proximal fibrous flexor sheath. A case of early development of carpal tunnel syndrome following avulsion injury of the little finger is illustrated in which later surgical exploration of the palm revealed detached muscle tissue compromising the median nerve. It is suggested that exploration of the palm is indicated in all cases of proximal avulsions of the flexor tendons.

Adult↗
PubMed2005

Location of the neuromuscular junction of the human masseter muscle estimated from the low frequency component of the surface electromyogram.

The position of the neuromuscular junction of the human masseter muscle has estimated from the low frequency component of the surface electromyogram. Monopolar surface electromyograms were recorded in response to clenching from eight sites with the reference electrode placed on the tip of the nose in six healthy male subjects. Component of the slow wave was separated from the raw recordings using digital filter, and the difference of the polarity and magnitude with the sites was examined. The base line of the recordings deflected either negatively or positively depending on the recording sites. These deflections coincided with bursts of muscular action potentials. Deflection of the slow wave component was largely negative over the inferior masseter close to the mandibular ramus but shifted to positive over the superior part. The greatest magnitude of the muscular action potential coincided with the most negative deflection of the slow wave. The phase of the muscular action potential burst also reversed near the site of the polarity change of the slow wave. These findings suggest that the slow wave, as detected by this method, originates mainly from the synaptic potential at the meuromuscular junction and that this is located on the inferior part of the muscle close to the mandibular ramus.

Action Potentials↗
PubMed2002

Digital cineradiographic swallow study: our experience.

PURPOSE: Swallowing disorders can be secondary to different types of diseases in which, at least initially, patients succeed in establishing voluntary or involuntary compensatory mechanisms that enable them to maintain a sufficient nutritional state. When the compensatory mechanisms become insufficient massive food aspiration into the airways can occur and suffocation may prove to be the main pathology. It has been calculated that in the USA about 8,000-10,000 people die each year due to suffocation. The dynamic radiological examination of swallowing is considered important not only for diagnosis, but also for planning a rehabilitation therapy and type of nutrition for the patient and for verifying the results of the therapy. The aim of this study is to analyse the results of our experience in the use of the digital cineradiography system to evaluate patients with normal and pathological swallowing. MATERIALS AND METHODS: We reviewed the digital cineradiography of 220 patients that at no time had undergone surgery and presented no organic pharyngeal or oesophageal disease (excluding hiatus hernia). All the exams followed a standard protocol that included the dynamic evaluation of the larynx, soft palate, pharynx, and gastro-oesophageal junction with a cineradiographic sequence of 12 frames/second with a 512x1024 matrix. There was also an archive of the film in a post-processing console. The patients received single photograms (printed on laserfilm), videotape recordings or CD-ROM of the dynamic exam. RESULTS: 137 (62%) of the patients did not present swallowing alterations although only 7 patients had a negative examination. In 35 cases hiatus hernia was appreciable while in 69 cases the hernia was associated with gastro-oesophageal reflux. In 23 cases aspecific functional disorders of the oesophagus were demonstrated and in 3 cases achalasia. The remaining 83 patients (38%) (37 males and 46 females, average age 57.02 yrs) presented alterations of the oral and/or pharyngeal stages of swallowing: reduction in soft-palate motility (2 cases), unilateral paralysis of the vocal chords (1 case), incontinence of the bolus during the oral stage (8 cases), lingual movement anomalies (4 cases), subepiglottic penetration (62 cases), asymmetric epiglottic tilt, aspiration of the contrast medium in the airway (17 cases), reduction of laryngeal and hyoid bone movement (9 cases), bolus retained in the valleculae and pyriform sinus (13 cases), cricopharyngeal spasm (6 cases), pharyngeal paralysis (1 case); hiatus hernia was also evident in 20 cases and gastro-oesophageal reflux was associated in 13 of them. Overall, 36% of the cases presented an isolated form while 64% of the cases presented a complex dysfunction with several simultaneous alterations. DISCUSSION AND CONCLUSIONS: The videofluorographic swallow study is an important step in the diagnostic evaluation of a dysphagic patient not only as regards the analysis of the main alteration and its capacity to confirm the presence or absence of contrast medium aspiration in the airway, but also because it provides important information on rehabilitation and nutritional orientation (oral/no oral), as well as on the results of the therapy. The recent diffusion of the digital X-ray equipment has made possible its use for the study of the organic and functional diseases of the upper alimentary tract. Currently a standard protocol for the study of swallowing with digital fluorography is not available. The technique we applied, already verified in a significant number of dysphagic patients, has allowed us to distinguish patients with normal swallowing from those with disorders of the oral and pharyngeal stage, and thus to identify disturbance and establish an appropriate rehabilitation treatment.

Adolescent↗
PubMed1997

A quantitative immunofluorescence study of glomerular cell adhesion proteins in proteinuric states.

Whenever there is heavy proteinuria, the glomerular epithelial cells, the podocytes, show dramatic morphological changes which clearly demonstrate changes in cell adhesion. However, there is little information on the types of cell adhesion molecules expressed in the normal human glomerulus. Assessments of changes in cell adhesion molecules in human proteinuria have been confined to semi-quantitative immunostaining for integrins, and the results have not been entirely consistent. This study sought first to define which cell adhesion molecules are present in the normal glomerulus, using indirect immunofluorescence and a panel of antibodies directed against transmembrane adhesion proteins and against several cytoplasmic proteins which are known to be involved in adhesion. A wide variety of integrins were detected, the dominant form being alpha 3 beta 1. The cytoplasmic focal adhesion proteins vinculin, talin, paxillin, p130CAS, and pp125FAK were detected, although vinculin appeared to be confined mainly to the mesangium. The only intercellular adhesion molecule detected in the vicinity of the slit diaphragm was ZO-1; the results imply that the slit diaphragm does not bear a close relationship to any other form of intercellular junction. Changes in these adhesion components were also studied in proteinuria, using 18 cases each of minimal change nephropathy, 'early' membranous nephropathy, and normal controls. Fluorescence intensity was measured by image capture using a low light video camera and subsequent digital image analysis, an approach which demonstrated acceptable reproducibility. The most striking changes were an increase in phosphotyrosine and p130CAS in the nephrotic patients. Contrary to previous reports, little change was found in the expression of the most abundant integrins, nor did overall glomerular staining for ZO-1 alter. These results imply a controlled alteration in glomerular cell adhesion in nephrotic states in man, probable representing increased turnover of cell adhesion structures rather than the decrease which has been reported in short-term animal models. This is the first report of increased glomerular phosphotyrosine in man, which is associated with less stable adhesions and may be related to the loss of foot processes. Using human biopsy material, it was not possible to determine which proteins were phosphorylated, but the probable relationships to changes in cytoskeletal structure and slit diaphragm permeability justify further study.

Cell Adhesion↗
PubMed2004

Characterisation of glucose transporters in the intact coronary artery endothelium in rats: GLUT-2 upregulated by long-term hyperglycaemia.

AIMS/HYPOTHESIS: We have examined the effects of streptozotocin-induced type 1 diabetes on the expression and subcellular distribution of the classic sugar transporters (GLUT-1 to 5 and sodium-dependent glucose transporter-1 [SGLT-1]) in the endothelial cells of an en face preparation of septal coronary artery from Wistar rats. METHODS: The presence of the GLUT isoforms and SGLT-1 in the endothelial cell layer was determined by immunohistochemistry using wide-field fluorescence microscopy coupled to deconvolution, and was quantified by digital image analysis. RESULTS: We found that all of the transporters were expressed within these cells and that all except SGLT-1 were preferentially located on the abluminal side. The heaviest labelling was adjacent to the cell-to-cell junctions where the luminal and abluminal membranes are in close proximity, which may reflect a spatial organisation specialised for vectorial glucose transport across the thinnest part of the cytoplasm. Long-term hyperglycaemia, induced by streptozotocin, significantly downregulated GLUT-1, 3, 4 and 5 and dramatically upregulated GLUT-2, leaving SGLT-1 unchanged. CONCLUSIONS/INTERPRETATION: We conclude that the high susceptibility of endothelial cells to glucose toxicity may be the result of the subcellular organisation of their GLUTs and the increased expression of GLUT-2.

Animals↗
PubMed2003

Measurement of the motility of endothelial cells in confluent monolayers.

OBJECTIVE: The reported experiments were designed to develop and test a method to measure the motility of endothelial cells in confluent cultures. METHODS: Endothelial cell cultures were recorded by time-lapse video. Frames from the recording were digitized, and cell locations were identified at 30-minute intervals using either the centroids or nuclei. The speed of the cells was determined for distances between their successive positions. Cells were stained immunocytochemically to determine the status of their adherens junctions. RESULTS: Prior to reaching confluence cells exhibited motility unhampered by collisions. After reaching confluence, cells continued to exhibit motility that decreased with time until the cells ceased effective movement. The motility in confluent monolayers persisted in the presence of complete adherens junctions. Motility could be restored in quiescent confluent cultures by the addition of fibroblast growth factor 2 (FGF-2). Generally, cells responding to FGF-2 moved without obvious loss of adherens junctions. CONCLUSION: These experiments provide evidence that (1) endothelial cells in culture are motile, (2) they do not form circumferential adherens junctions until the culture reaches confluency, (3) the establishment of adherens junctions itself does not interdict cell motion, and (4) the immotile state is reversible by FGF-2 in the presence of adherens junctions.

Adherens Junctions↗
PubMed2002

Chiari-II malformation: a biometric analysis.

INTRODUCTION: Chiari-II malformation is a complex set of anatomic abnormalities of the posterior fossa, brainstem, and cerebellum seen in myelomeningocele. Previous studies have tried to understand this condition and its clinical consequences by studying a few fixed anatomic landmarks as dependent variables and clinical symptoms as outcome variables. These studies have led to conflicting and limited results. As a first step towards a more comprehensive study of the structural-functional relationships in Chiari-II malformation, we undertook a biometric case-series analysis of a group of individuals with MMC, using both traditional methods to study size, and thin-plate spline methodology to study shape. MATERIALS AND METHODS: The traditional analysis was a retrospective, randomly obtained case-series of 25 individuals with myelomeningocele and Chiari-II malformation. MRIs were digitized for biometric analysis of the component structures and compared to 25 controls. Landmarks on the digitized images were measured using Scion Image. Data were statistically analyzed using SPSS. The thin-plate spline analysis used a subset of these individuals (n = 14). Landmarks on digitized MRIs were identified and marked with TPSDig software. Landmark data was then imported into Splus to generate a series of shape variables. Statistical analysis using Splus was then undertaken. RESULTS: Traditional analysis revealed relationships between vermian herniation and pontomedullary junction position (p < 0.05) as well as between the height (and overall size) of the posterior fossa and degree of vermian herniation (p < 0.05). The degree of brainstem herniation/elongation did not correlate with the degree of vermian herniation. The shape analysis revealed that there is as much shape variability within the group of Chiari-II patients as there is between this group and unaffected controls. Thin-plate spline analysis shows that the position of the caudal-most aspect of the vermis is the point of greatest brain rearrangement; likewise, the opisthion is the point of greatest bony rearrangement. Partial least-squares analysis shows that in Chiari-II patients, a strong correlation (r = 0.821) exists between the extent to which the brain is warped (specifically, in regard to vermian descent) and the extent to which the bone is warped (specifically, in regard to the displacement of the opisthion) (p < 0.05). CONCLUSION: Traditional biometric analysis of size confirms that the degree of vermian herniation and cervicomedullary junction herniation are independent variables in Chiari-II malformation. Posterior fossa size is an important factor in explaining the variability of vermian herniation. The relationship between IPN position and vermian herniation suggests the possibility of a common etiology. The phenomenon of cervicomedullary junction descent appears to be independent, suggesting a different etiology. Analysis of shape indicated that shape changes in bone and brain are related, and that the Chiari-II-associated abnormalities vary greatly in their degree of abnormality. The extreme morphological variability argues against the use of mean differences as a statistical technique in analyzing morphological abnormalities in the structures we investigated.

Adolescent↗
PubMedDate not supplied

The vascularity of the flexor pollicis longus tendon.

The vascularity of ten human flexor pollicis longus tendons was studied by injection and clearing techniques. Four separate vascular systems supply the tendon from the musculotendinous junction to the osseous insertion. The proximal two systems and the distal two systems are separated by an avascular zone over the metacarpophalangeal joint. While there are differences in the vascularity of the flexor pollicis longus tendon and the other digital flexor tendons, the intrinsic vascularization is similar. Differences in vascularity alone would not account for good recovery of function following repair of flexor pollicis longus.

Humans↗
PubMedDate not supplied

Computed tomography angiography in detection and characterization of ruptured anterior cerebral artery aneurysms at uncommon location for emergent surgical clipping.

INTRODUCTION: Cerebral subarachnoid hemorrhage may result from rupture of saccular aneurysms at uncommon location [excluding the anterior communicating artery (ACOM)] of the anterior cerebral artery (ACA). The purpose of this study was to evaluate the usefulness of helical computed tomography angiography (CTA) in detection and characterization of intracranial aneurysms at such uncommon locations before emergent surgical clipping. MATERIALS AND METHODS: Between 1998 and 2003, records for 50 consecutive patients who underwent emergent surgical clipping for intracranial aneurysms were reviewed. Eighteen of these patients had aneurysms in the ACA. After those patients with unequivocal ACOM aneurysms were excluded, eight patients with eight aneurysms in an uncommon location of the ACA were recruited to this study. Plain computed tomography (CT) and CTA were performed in eight patients, and digital subtraction angiographies were done in three patients. Each aneurysm was evaluated for the detection, quantification, and characterization of the aneurysms with 2D multiplanar reformatted and 3D volume-rendering techniques. RESULTS: There were two small aneurysms arising from the A1 segment, one from the A2 segment, two at the junction of triplicated ACAs, two at the junction of A2 and A3 segments, and one at the junction of A2 and A3 segments of the azygos ACA. The average diameter of the aneurysmal sac was 4.44 mm (range, 2.7-7.0 mm), and the aneurysmal neck averaged 2.59 mm (range, 1.2-3.5 mm) in size. The smallest aneurysm measured 2.2x1.8x2.7 mm (neck, 1.2 mm) in the A1 segment of the left ACA. Three patients had intracerebral hematoma, seven had intraventricular hemorrhage, and three had acute hydrocephalus. CONCLUSION: Aneurysms in uncommon locations of ACAs exhibited characteristic features. Rupture of these aneurysms can cause intracerebral hematoma, intraventricular hemorrhage, and/or acute hydrocephalus. Noninvasive CTA can reliably detect and characterize intracranial aneurysms at such uncommon location for planning of emergent surgical intervention.

Adult↗