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Medicina
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Intracranial Aneurysms: Pathophysiology, Treatment Strategies, and Tailored Approaches
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Intracranial Aneurysms: Pathophysiology, Treatment Strategies, and Tailored Approaches

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 8254

Special Issue Editors

Dr. Sabino Luzzi

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Guest Editor
Associate Professor, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
Interests: intracranial aneurysms; cerebral revascularization techniques; brain arteriovenous malformations; cerebral cavernous malformations; dural arteriovenous fistula
Dr. Alice Giotta Lucifero

E-Mail Website
Guest Editor
Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
Interests: pathophysiology of intracranial aneurysms; subarachnoidhemorrhage; stroke; vascular neuroimaging; skull base anatomy and approaches
Dr. Alfio Spina

E-Mail Website
Guest Editor
Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
Interests: neurosurgery; neuroncology; skull base; spine; pain; hydrocephalus; chiari malformation

Special Issue Information

Dear Colleagues,

Intracranial aneurysms represent a topical subject in neurosurgery, interventional neuroradiology, neurology, anesthesiology, and neurorehabilitation. Furthermore, aneurysmal subarachnoid hemorrhage and vasospasm gather great attention in neuroscience from a clinical and research standpoint because of their complex pathophysiology and challenging prevention and management.

The decision-making process at the base of the management of intracranial aneurysms considers a wide series of treatment options, but also the mandatory need for a multidisciplinary approach.

Medicina is launching a Special Issue entitled “Intracranial Aneurysms: Pathophysiology, Treatment Strategies, and Tailored Approaches” with the aim of gathering together accurate and up-to-date scientific information on all aspects of this pathology.

We are pleased to invite you and your co-workers to submit your original articles, systematic reviews, meta-analyses, trials, and surgical videos about the technical key aspects of surgical and endovascular management, technical advances, and the multidisciplinary approach of intracranial aneurysms.

Dr. Sabino Luzzi
Dr. Alice Giotta Lucifero
Dr. Alfio Spina
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Intracranial aneurysms
  • Subarachnoid hemorrhage
  • Cerebral vasospasm
  • Clipping Aneurysm embolization
  • Endovascular coiling
  • Flow diverters
  • Pipeline embolization device
  • Cerebral bypass

Published Papers (2 papers)

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Review

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12 pages, 3503 KiB  
Review
Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated Overview
by Alice Giotta Lucifero, Matías Baldoncini, Nunzio Bruno, Renato Galzio, Juha Hernesniemi and Sabino Luzzi
Medicina 2021, 57(8), 742; https://doi.org/10.3390/medicina57080742 - 22 Jul 2021
Cited by 15 | Viewed by 4988
Abstract
The exact molecular pathways underlying the multifactorial natural history of intracranial aneurysms (IAs) are still largely unknown, to the point that their understanding represents an imperative challenge in neurovascular research. Wall shear stress (WSS) promotes the genesis of IAs through an endothelial dysfunction [...] Read more.
The exact molecular pathways underlying the multifactorial natural history of intracranial aneurysms (IAs) are still largely unknown, to the point that their understanding represents an imperative challenge in neurovascular research. Wall shear stress (WSS) promotes the genesis of IAs through an endothelial dysfunction causing an inflammatory cascade, vessel remodeling, phenotypic switching of the smooth muscle cells, and myointimal hyperplasia. Aneurysm growth is supported by endothelial oxidative stress and inflammatory mediators, whereas low and high WSS determine the rupture in sidewall and endwall IAs, respectively. Angioarchitecture, age older than 60 years, female gender, hypertension, cigarette smoking, alcohol abuse, and hypercholesterolemia also contribute to growth and rupture. The improvements of aneurysm wall imaging techniques and the implementation of target therapies targeted against inflammatory cascade may contribute to significantly modify the natural history of IAs. This narrative review strives to summarize the recent advances in the comprehension of the mechanisms underlying the genesis, growth, and rupture of IAs. Full article
(This article belongs to the Special Issue Intracranial Aneurysms: Pathophysiology, Treatment Strategies, and Tailored Approaches)
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Other

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10 pages, 2226 KiB  
Case Report
Microsurgical Clipping of Carotid-Ophthalmic Tandem Aneurysms: Case Report and Surgical Nuances
by Matias Costa, Matías Baldoncini, Zachary L. Tataryn, Mickaela Echavarria Demichelis, Agustin Conde, Cynthia Purves, Alice Giotta Lucifero, Juha Hernesniemi and Sabino Luzzi
Medicina 2021, 57(7), 731; https://doi.org/10.3390/medicina57070731 - 19 Jul 2021
Cited by 7 | Viewed by 2534
Abstract
Tandem intracranial aneurysms (TandIAs) are rare but inherently complex, and special technical considerations are required for their surgical management. The present case highlights the key surgical aspects of two carotid-ophthalmic TandIAs incidentally found in a 60-year-old female. Both the aneurysms were superiorly projecting, [...] Read more.
Tandem intracranial aneurysms (TandIAs) are rare but inherently complex, and special technical considerations are required for their surgical management. The present case highlights the key surgical aspects of two carotid-ophthalmic TandIAs incidentally found in a 60-year-old female. Both the aneurysms were superiorly projecting, regular in size, and involved the left ophthalmic segment of the internal carotid artery (ICA). The minimum distance between the necks was 3 mm. The patient underwent microsurgery because of the reported major complications rate of the endovascular treatment in the case of a very short minimum distance between the TandIAs. After cervical ICA exposure, both the aneurysms were excluded through a pterional approach. Intradural anterior clinoidectomy and unroofing of the optic canal allowed the mobilization of the left optic nerve. The more distal aneurysm was clipped before the opening of the distal dural ring of the ICA. The proximal aneurysm was clipped with two straight clips stacked perpendicular to the ICA. A small remnant was intentionally left to avoid the stenosis of the ophthalmic artery. Postoperative angiography showed the exclusion of both the aneurysms with a small dog-ear of the more proximal one. The patient was discharged neurologically intact and, after one year, the remnant remained stable. Microsurgical clipping is a definitive and durable treatment for carotid-ophthalmic TandIAs. In the case of a very short minimum distance between the aneurysms, the distal one should be clipped first to make the anterior clinoidectomy, opening of the distal dural ring of the ICA, and clipping of the more proximal aneurysm easier. Full article
(This article belongs to the Special Issue Intracranial Aneurysms: Pathophysiology, Treatment Strategies, and Tailored Approaches)
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