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Ulger O, Eş I, Proctor CM, Algin O. Stroke studies in large animals: Prospects of mitochondrial transplantation and enhancing efficiency using hydrogels and nanoparticle-assisted delivery. Ageing Res Rev 2024; 100:102469. [PMID: 39191353 DOI: 10.1016/j.arr.2024.102469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 08/08/2024] [Accepted: 08/21/2024] [Indexed: 08/29/2024]
Abstract
One of the most frequent reasons for mortality and disability today is acute ischemic stroke, which occurs by an abrupt disruption of cerebral circulation. The intricate damage mechanism involves several factors, such as inflammatory response, disturbance of ion balance, loss of energy production, excessive reactive oxygen species and glutamate release, and finally, neuronal death. Stroke research is now carried out using several experimental models and potential therapeutics. Furthermore, studies are being conducted to address the shortcomings of clinical care. A great deal of research is being done on novel pharmacological drugs, mitochondria targeting compounds, and different approaches including brain cooling and new technologies. Still, there are many unanswered questions about disease modeling and treatment strategies. Before these new approaches may be used in therapeutic settings, they must first be tested on large animals, as most of them have been done on rodents. However, there are several limitations to large animal stroke models used for research. In this review, the damage mechanisms in acute ischemic stroke and experimental acute ischemic stroke models are addressed. The current treatment approaches and promising experimental methods such as mitochondrial transplantation, hydrogel-based interventions, and strategies like mitochondria encapsulation and chemical modification, are also examined in this work.
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Affiliation(s)
- Oner Ulger
- Department of Mitochondria and Cellular Research, Gulhane Health Sciences Institute, University of Health Sciences, Ankara 06010, Turkiye; Gulhane Training and Research Hospital, University of Health Sciences, Ankara 06010, Turkiye.
| | - Ismail Eş
- Department of Engineering Science, Institute of Biomedical Engineering (IBME), University of Oxford, Oxford OX3 7DQ, UK
| | - Christopher M Proctor
- Department of Engineering Science, Institute of Biomedical Engineering (IBME), University of Oxford, Oxford OX3 7DQ, UK
| | - Oktay Algin
- Interventional MR Clinical R&D Institute, Ankara University, Ankara 06100, Turkiye; Department of Radiology, Medical Faculty, Ankara University, Ankara 06100, Turkiye; National MR Research Center (UMRAM), Bilkent University, Ankara 06800, Turkiye
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Otsu Y, Yamakawa Y, Eto T, Yamashita S, Kuramoto T, Sakata K, Tanoue S, Hirohata M, Morioka M. Rare Segmental Agenesis of Internal Carotid Artery without Rete-Like Collaterals: A Case Report. JOURNAL OF NEUROENDOVASCULAR THERAPY 2024; 18:245-249. [PMID: 39309172 PMCID: PMC11412773 DOI: 10.5797/jnet.cr.2024-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 06/18/2024] [Indexed: 09/25/2024]
Abstract
Objective Internal carotid artery (ICA) agenesis has been classified into six types: A-F. Type F demonstrates distal reconstitution of the ICA via anastomosis with distal branches of the external carotid artery. Herein, we report the ICA agenesis of type F without rete-like collaterals, which has not been previously reported. Case Presentation An 80-year-old woman presented with segmental agenesis of the right ICA accompanied by an unruptured intracranial aneurysm. Stent-assisted coil embolization was successfully performed. Digital subtraction angiography showed segmental agenesis of the right ICA from the cervical to the ascending foramen lacerum segment, which was preoperatively supplied with collateral blood flow by a dilated right accessory meningeal artery (AMA) anastomosed with the inferolateral trunk (ILT)-posteromedial branch. Based on the segmental concept, the case was diagnosed with segment 7 (horizontal intracavernous portion until ICA branches off the ILT) agenesis, which may have resulted in secondary regression of the ICA proximal to segment 7. According to the ICA agenesis classification, this was of type F because the case showed collateral flow to the distal ICA via transcranial anastomoses from the AMA without carotid rete-like collaterals. Conclusion These findings suggest that the carotid rete-like collaterals did not form because the AMA was first developed during embryonic development.
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Affiliation(s)
- Yusuke Otsu
- Department of Neurosurgery, Omuta City Hospital, Kurume, Fukuoka, Japan
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoh Yamakawa
- Department of Neurosurgery, Omuta City Hospital, Kurume, Fukuoka, Japan
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Tomoko Eto
- Department of Neurosurgery, Omuta City Hospital, Kurume, Fukuoka, Japan
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shin Yamashita
- Department of Neurosurgery, Omuta City Hospital, Kurume, Fukuoka, Japan
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Terukazu Kuramoto
- Department of Neurosurgery, Omuta City Hospital, Kurume, Fukuoka, Japan
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shuichi Tanoue
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Masaru Hirohata
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Kossorotoff M, Grévent D, Roux CJ, Brunelle F. Development of Collateral Vessels after Anterior Circulation Large Vessel Occlusion in Pediatric Arterial Ischemic Stroke Relates to Stroke Etiology: A Longitudinal Study. AJNR Am J Neuroradiol 2024; 45:271-276. [PMID: 38388687 DOI: 10.3174/ajnr.a8114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/01/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND AND PURPOSE The characteristics of large vessel occlusion (LVO) in the acute phase of pediatric arterial ischemic stroke and their natural history according to stroke etiology are poorly explored. This studied aimed at describing the prevalence and the radiological evolution of LVO in pediatric AIS. MATERIALS AND METHODS This single-center retrospective study included consecutive non-neonate children with acute arterial ischemic stroke, intracranial proximal LVO in the anterior circulation (MCA, anterior cerebral artery, and/or ICA), and clinical and imaging follow-up for at least 18 months, during a 9-year period. RESULTS Intracranial LVO was observed in 24.8% of patients with anterior circulation arterial ischemic stroke and adequate follow-up (n = 26/105), with a median age of 4.2 years (IQR 0.8-9), sex ratio 1.16. The main stroke etiology associated with LVO was unilateral focal cerebral arteriopathy (n = 12, 46%). During follow-up, a specific pattern of unilateral poststroke anastomotic bridge was observed in 8/26 patients, with the poststroke development of nonperforating collaterals forming a bridge in bypass of the LVO site with visible distal flow, within a median delay of 11 months. The development of unilateral poststroke anastomotic bridge was only observed in patients with unilateral focal cerebral arteriopathy. No patient with this pattern experienced stroke recurrence or further progressive vascular modifications. CONCLUSIONS After stroke, the development of unilateral poststroke anastomotic bridge is specifically observed in children with focal cerebral arteriopathy, appearing in the first year after stroke. This clinical-radiologic pattern was not associated with stroke recurrence or arterial worsening, differentiating it from progressive intracranial arteriopathy, such as Moyamoya angiopathy.
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Affiliation(s)
- Manoëlle Kossorotoff
- From the French Center for Pediatric Stroke (M.K., C.-J.R.), Paris, France
- Pediatric Neurology Department (M.K.), APHP University Hospital Necker-Enfants Malades, Paris, France
- INSERM U1266 (M.K.), Paris, France
| | - David Grévent
- Pediatric Radiology Department (D.G., C.-J.R., F.B.), APHP University Hospital Necker-Enfants Malades, Paris, France
| | - Charles-Joris Roux
- From the French Center for Pediatric Stroke (M.K., C.-J.R.), Paris, France
- Pediatric Radiology Department (D.G., C.-J.R., F.B.), APHP University Hospital Necker-Enfants Malades, Paris, France
| | - Francis Brunelle
- Pediatric Radiology Department (D.G., C.-J.R., F.B.), APHP University Hospital Necker-Enfants Malades, Paris, France
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Takamiya S, Yoshimoto T, Maruichi K. Cerebral Aneurysms with Internal Carotid Artery Agenesis: A Unique Case Similar to Moyamoya Disease and Literature Review. Neurol Med Chir (Tokyo) 2021; 61:321-333. [PMID: 33854002 PMCID: PMC8120097 DOI: 10.2176/nmc.oa.2020-0358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Internal carotid artery (ICA) agenesis/aplasia is occasionally accompanied with cerebral aneurysms caused by hemodynamic stress. If the aneurysms are located around the circle of Willis, they are managed with clipping or coil embolization. Herein, we report a case of ICA agenesis with perforating artery aneurysms treated successfully with revascularization. Moreover, a literature review of ICA agenesis with cerebral aneurysms was performed to compare with the current case. We conducted a literature review using data from PubMed. A secondary search was also performed by reviewing the references of each article previously searched. In our case, the aneurysms shrank and disappeared after direct and indirect bypass surgeries, and indirect bypass developed as in moyamoya disease (MMD). The epidemiological and clinical features of aneurysms accompanied with ICA agenesis were identified via a literature review. Aneurysms with ICA agenesis categorized as type F based on the Lie classification system, or referred to as rete mirabile, are occasionally located in an untreatable site; hence, they cannot be treated with clipping or coil embolization. Moreover, results showed that previous studies did not use revascularization for the treatment of aneurysm. In conclusion, if an aneurysm with ICA agenesis is difficult to approach directly or via an endovascular procedure, revascularization can be a treatment option.
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Affiliation(s)
- Soichiro Takamiya
- Department of Neurosurgery, Kashiwaba Neurosurgical Hospital.,Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Tetsuyuki Yoshimoto
- Department of Neurosurgery, Kashiwaba Neurosurgical Hospital.,Department of Neurosurgery, Hokkaido Neurosurgical Memorial Hospital
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Twig-like middle cerebral arteries: Clinical and radiological findings. Clin Imaging 2020; 73:31-37. [PMID: 33296771 DOI: 10.1016/j.clinimag.2020.11.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 10/26/2020] [Accepted: 11/24/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND PURPOSE Aplastic or twig-like middle cerebral artery (MCA) is a rare vascular anomaly characterized by replacement of the M1 segment by a plexiform network of small vessels. Though rare, familiarity with this entity and ability to differentiate it from radiological mimics such as moyamoya changes and steno-occlusive diseases are important. We review the clinical and radiological manifestations of patients diagnosed with twig-like MCA on cerebral angiograms over a five-year period. MATERIALS AND METHODS Retrospective review of all patients diagnosed with twig-like MCA on cerebral angiograms was performed from January 2015 to January 2020. This was the inclusion criterion for this retrospective study. For each patient, demographic data, clinical presentation, imaging findings and management strategies were reviewed. RESULTS AND CONCLUSIONS Between January 2015 and January 2020, three patients with twig-like MCA were identified from 657 patients who underwent four-vessel diagnostic cerebral angiograms (0.45%). In all three cases, the involvement was unilateral (two left-sided and one right- sided). Two patients were male, and one was female. Patients ages were 25, 26 and 46 years. Two of the three patients presented with headache and the third patient with pulsatile tinnitus. There were otherwise no ischemic or hemorrhagic changes. No other vascular anomaly was identified. Twig-like MCA is a rare anatomical variant in which a plexiform network of small vessels replaces the M1 segment of the MCA. Accurate diagnosis and distinguishing this entity from radiological mimics such as moyamoya and steno-occlusive diseases are important for appropriate management and to prevent unnecessary investigations.
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Shin Y, Lee KM, San Lee J, Kim EJ, Kim HG, Yeon EK. Isolated Trochlear Nerve Palsy in a Patient with Superior Cerebellar Rete Mirabile. World Neurosurg 2019; 130:546-549. [PMID: 31181360 DOI: 10.1016/j.wneu.2019.05.244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/29/2019] [Accepted: 05/29/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rete mirabile is a very rare vascular malformation and superior cerebellar artery (SCA) rete mirabile is not reported previously. We report a new case of rete mirabile of SCA initially detected by magnetic resonance imaging and transfemoral cerebral angiography. CASE DESCRIPTION This report illustrates the case of a 58-year-old man who presented with vertical diplopia. Brain magnetic resonance angiography and transfemoral cerebral angiography revealed a rete mirabile of SCA and 3-dimensional volume isotropic turbo spin echo acquisition, brain magnetic resonance imaging sequence, demonstrated that the cisternal segment of the ipsilateral trochlear nerve was compressed by this vascular malformation. We assumed that his cranial nerve palsy was caused by the rete mirabile of the right SCA. During the 8 weeks presence of diplopia, the patient was observed and the symptom was relieved spontaneously. CONCLUSIONS We provide a first report in the literature of rete mirabile involving the SCA and suggest a descriptive knowledge of rete mirabile for clinicians during decision-making of treatment.
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Affiliation(s)
- Yeji Shin
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Kyung Mi Lee
- Department of Radiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea.
| | - Jin San Lee
- Department of Neurology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Eui Jong Kim
- Department of Radiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Hyug-Gi Kim
- Department of Radiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Eung Koo Yeon
- Department of Radiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
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Turk Y, Alicioglu B. Unilateral cervical and petrosal segment agenesis of the internal carotid artery with rete mirabile. Clin Imaging 2019; 57:25-29. [PMID: 31102779 DOI: 10.1016/j.clinimag.2019.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 04/14/2019] [Accepted: 04/22/2019] [Indexed: 11/17/2022]
Abstract
The carotid rete mirabile (RM) is a physiological network between the internal and external carotid arterial systems. In this paper, an extremely rare case is presented, in which internal-external carotid artery anastomoses and a dilated ascending pharyngeal artery, due to unilateral agenesis of the cervical and petrous segments of the internal carotid artery (ICA), is presented.
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Affiliation(s)
- Yasar Turk
- Radiology Department of Namik Kemal University, Medical Faculty, Tekirdag, Turkey
| | - Banu Alicioglu
- Radiology Department of Zonguldak Bulent Ecevit University, Medical Faculty, Zonguldak, Turkey.
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Requejo F, Strawich FR, Mouratian DM, Krings T. Isolation of right internal carotid artery, persistent proatlantal 1 artery and rete mirabile in a child with 22q11 deletion syndrome. Childs Nerv Syst 2018; 34:2509-2513. [PMID: 30014308 DOI: 10.1007/s00381-018-3910-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
Abstract
We report a case of a 2-year-old girl with 22q11 deletion syndrome who underwent studies for cardiac murmur. Ultrasound, computed tomography angiography and digital subtraction angiography revealed an aberrant right subclavian artery and an isolated right internal carotid artery (ICA) originating from the right pulmonary artery. A right carotid rete mirabile (CRM) and a proatlantal (Pa) type 1 artery were also found. We hypothesize that Pa type 1 persistence and CRM development are secondary to the reversal of flow of the isolated ICA.
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Affiliation(s)
- Flavio Requejo
- Section Interventional Neuroradiology, Hospital de Pediatria JP Garrahan, Combate de los Pozos 1881, 1245, Buenos Aires, Argentina.
| | | | | | - Timo Krings
- Toronto Western Hospital, UHN Division of Neuroradiology, University of Toronto, Toronto, Ontario, Canada
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Giragani S, Pavunesan SK, Balasubramaniam A, Agrawal V, Alwala S, Kumar A. Rete mirabile of posterior inferior cerebellar artery: A rare cause of subarachnoid hemorrhage. Interv Neuroradiol 2018; 24:662-665. [PMID: 29973082 DOI: 10.1177/1591019918782147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Rete mirabile is a congenital aberrant arterial collateral network resulting from abnormal embryonic activity during native vessel formation. Even though frequently observed in mammals, this entity is rare in humans except when there is hypoplasia, aplasia or narrowing of native vessels. Rete mirabile is reported involving internal carotid and vertebral arteries. Rete mirabile of the posterior inferior cerebellar artery (PICA) is not described in the literature. We report the clinical presentation, imaging findings and management of PICA rete mirabile formation with subarachnoid hemorrhage.
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Affiliation(s)
- Suresh Giragani
- 1 Department of Vascular and Interventional Radiology, Yashoda Super Specialty Hospitals, Secunderabad, Telangana, India
| | - Santhosh K Pavunesan
- 1 Department of Vascular and Interventional Radiology, Yashoda Super Specialty Hospitals, Secunderabad, Telangana, India
| | - Anandh Balasubramaniam
- 2 Department of Neurosurgery, Yashoda Super Specialty Hospitals, Secunderabad, Telangana, India
| | - Vikas Agrawal
- 3 Department of Neurology, Yashoda Super Specialty Hospitals, Secunderabad, Telangana, India
| | - Surendar Alwala
- 4 Department of Radiodiagnosis, Yashoda Super Specialty Hospitals, Secunderabad, Telangana, India
| | - Anjani Kumar
- 4 Department of Radiodiagnosis, Yashoda Super Specialty Hospitals, Secunderabad, Telangana, India
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Paschoal EHA, Yamaki VN, Júnior FMP, Piske RL, Teixeira MJ, Bor-Seng-Shu E. Carotid rete mirabile associated with subarachnoid hemorrhage from intracranial aneurysm: A case report and systematic review. Interv Neuroradiol 2015; 21:55-60. [PMID: 25934776 PMCID: PMC4757198 DOI: 10.15274/inr-2014-10107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Carotid rete mirabile (CRM) is a rare physiological vascular network in humans that is most often found in Eastern populations. This paper describes a CRM associated with an aneurysmal subarachnoid hemorrhage (aSAH) and discusses the details of the patient's treatment. A 28-year-old woman was admitted to our service with clinical signs and symptoms of a spontaneous aSAH. Computed tomography revealed a diffuse and extensive SAH (Fisher group IV), while an angiogram showed an abnormal collateral network in the right carotid system and a hypoplastic aspect to the internal carotid artery (ICA) on the same side. In addition, a saccular aneurysm with a diameter of 9.5 mm was present in the ophthalmic segment of the left ICA. This case is extremely uncommon. To avoid rebleeding in the patient, we successfully treated the patient by clipping the aneurysmal lesion. No procedure was performed for the CRM.
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Affiliation(s)
| | - Vitor Nagai Yamaki
- Division of Neurosurgery, Hospital Ophir Loyola, Federal University of Para, Belem, Brazil
| | | | - Ronie Leo Piske
- Division of Neuroradiology, Hospital Beneficência Portuguesa de São Paulo, São Paulo, Brazil
| | | | - Edson Bor-Seng-Shu
- Division of Neurosurgery, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
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Paschoal EHA, Yamaki VN, Júnior FMP, Piske RL, Teixeira MJ, Bor-Seng-Shu E. Carotid rete mirabile associated with subarachnoid hemorrhage from intracranial aneurysm: A case report and systematic review. Interv Neuroradiol 2015. [DOI: 10.1177/inr-2014-10107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Albuquerque Paschoal EH, Yamaki VN, Mendes Paschoal Jr F, Piske RL, Teixeira MJ, Bor-Seng-Shu E. Carotid Rete Mirabile Associated with Subarachnoid Hemorrhage from Intracranial Aneurysm. Interv Neuroradiol 2015. [DOI: 10.15274/inr-2015-10108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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