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A. Chiriac, B. Iliescu, Z. Faiyad and I. Poeata

Abstract

Traumatic intracranial aneurysms are rare conditions that can be a result of vast head trauma. Different aspects as history, etiology, histopathology, clinical manifestations, diagnosis and treatment options are discussed regarding the literature. A particular case of a pericalosal aneurysm is presented to highlight the importance of keeping in mind that this location can be a site of such aneurysms

Open access

A. Chiriac, B. Iliescu, N. Dobrin and I. Poeată

Abstract

Volume measurement techniques of intracranial aneurysms from 3D rotational angiography vary on different factor settings and, therefore, are operator-dependent. The purpose of this study was to evaluate the application and the precision of ellipsoidal approximation (mathematics and computer technique) and software methods to measure intracranial aneurysms volume starting from planar (DR and SD) and 3- dimensional (3D) angiographic images. The reliability of the methods was statistically compared in a clinical setting of 42 angiograms and 100 measurements performed by the same users. This study suggests that both techniques could be used for clinical applications with similar efficiency results.

Open access

A. Chiriac, B. Iliescu, N. Dobrin and I. Poeata

Abstract

Particular anatomical situation like wideneck aneurysms or a large neck/fundus ratio, located on an arterial bifurcation or a small artery, are still a challenge for endovascular coil occlusion. These are due to the risk of coil migration or coil protrusion into the parent vessels. In our study we describe the balloon assisted coiling technique regarding the efficacy and safety of its practice and the problems that could appear.

Open access

S. Malik, P. Bordei, A. Rusali and D. M. Iliescu

Abstract

Our study was conducted by consulting angioCT sites made on a CT GE LightSpeed VCT64 Slice CT and a CT GE LightSpeed 16 Slice CT, following the path and relationships of the descending thoracic aorta against the vertebral column, outside diameters thereof at the thoracic vertebrae T4, T7, T12 and posterior intercostal arteries characteristics. The origin of of the descending thoracic aorta we found most commonly on the left flank of the lower edge of the vertebral body T4, but I have encountered cases where it had come above the lower edge of T4 on level of intervertebral disc T4-T5 or even at the upper edge of T5 vertebral body. At thoracic vertebra T4, on a total of 30 cases, the descending thoracic aorta present a diameter of 20.0 to 32.6 mm, values that correspond to male gender and to females diameter ranging from 25.5 to 27, 4 mm. At level of T7 thoracic vertebra, thoracic aorta present a diameter of 19.6 to 29.5 mm, values found in men, in women the diameter being from 21.9 to 25.2 mm. At thoracic vertebra T12, on a total of 27 cases, the descending thoracic aorta present a diameter of 17.6 to 27.7 mm, in males the diameter was from 17.6 to 27.7 mm and females diameter ranging from 21.1 to 25.2. The length of the descending thoracic aorta was from 18.40 to 19.41 cm.

Open access

A. Tascu, R.E. Rizea, C. Pascal, A. Iliescu, A. Spatariu and A. Gheorghita

Open access

A. Tascu, A. Iliescu, R.E. Rizea, Irina Tudose and St.M. Iencean

Abstract

Congenital hydrocephalus is a health problem in many countries and in Romania the pediatric neurosurgical department of the Emergency Hospital “Bagdasar-Arseni” has a large number of such patients. This is a retrospective study and it includes the patients with congenital hydrocephalus operated between 1992 and 2012 in the pediatric neurosurgical department of the Emergency Hospital “Bagdasar-Arseni”. The functional outcome was assessed using Karnofsky Performance Scale, Hydrocephalus Outcome Questionnaire and Glasgow outcome scale. The total number of the patients was 372, with a predominance of boys (212 boys versus 160 girls) and at the time of our study 168 patients were over 16 years old. Functional outcome of the children over 16 years old assessed using Karnofsky Performance Scale, showed that 73 patients were above 80 and leading independent lives, and 95 were less than 80 points. The results would be better if all these patients would benefit from schooling for children with special needs.

Open access

A.M. Manole, D.M. Iliescu, A. Rusali and P. Bordei

Abstract

Our study was conducted by the evaluation of angioCT’s performed on a GE LightSpeed VCT64 Slice CT Scanner. The measurements were performed on the aortic arch at the following levels: at the origin of the aorta, the middle part of the ascending aorta, prior to the origin of the brachiocephalic arterial trunk and after the origin of the left subclavian artery. We measured the caliber of the aortic arch arteries and the data are correlated and reported by gender. The diameter of the ascending aorta was between 27 to 28.9 mm in females and in males from 25.8 to 37.6 mm. The diameter of the aorta within the middle segment of the ascending part was between 28-30.2 mm in females and in males from 26.1 to 34.6. The diameter of the aortic arch prior to the origin of the brachiocephalic arterial trunk was between 26.4 to 29.4 mm in females and in males from 25.8 to 37.5 mm. The diameter of the aortic arch after the origin of the left subclavian artery was in a range of 20.4 to 28.4 mm, which corresponds to the limits found in males while in females the aortic diameter was between 21.3 to 24.1 mm. The brachiocephalic trunk diameters were 8.3 to 15.5 mm in females and in males was 9.1 to 14.5 mm. The right common carotid artery had a diameter of 4-8 mm diameter in males and in females ranged from 4.7 to 5.5 mm. The right subclavian artery showed a caliber of 5.7 to 7.5 mm in females and in males from 5.9 to 10.1. The left common carotid artery diameter was 4.6 to 5.7 mm in females and males the diameter was between 5.2 to 7.4 mm. The left subclavian artery had a diameter of 6-10 mm in females and in males ranged from 7.7 to 12.8 mm. We found that the distance between the ascending part of the aorta and the descending segment ranged from 33.3 to 38.5 mm in females and in males from 40 to 68.6 mm. We measured the distance that exists at the crossing of the aortic arch with the left branch of the pulmonary trunk, finding that in females this distance is 3 to 10.3 mm and in males from 3 to 12.5 mm.

Open access

A. Tascu, Fl. Exergian, S. Daniel, A. Iliescu, C. Pascal, G. Popescu and St.M. Iencean

Abstract

Traumatic spine injuries in pediatric patients have a low incidence, mainly due to a more flexible spine and is a specific matter in comparison to spinal injury in adults. Pediatric spine fractures constitute 1 to 3% of all pediatric fractures. Between 20 % and 60% of the fractures occur in the lumbar and thoracic spine. These spine injury appeared most frequently in sport events, followed by traffic events and accidental falling. The vast majority of the children with spinal trauma had grade D and E lesions on Frankel scale and had a good recovery in 1 to 3 months after the event. Prognosis and outcome is better in children with spine trauma, reducing toward adolescence and in young adults and the death rate was extremely low compared to the adult population

Open access

Al. Cosmin Apetrei, A.Şt. Iencean, A. Iordache, B. Iliescu and Ion Poeata

Abstract

Intracranial pressure monitoring seems to be an indispensable stage in management of severe traumatic brain injured patient. Since 2009, this technique completes our trauma protocol. The study has been carried out from 2011 to 2013 in Prof. Dr. N. Oblu hospital in Iasi. There have been included in the study patients with severe craniocerebral trauma, who had traumatic brain lesions CT detected and Glasgow score between 3 and 8. The age ranged from 16 to 60, an average of 35.5 years old. 50% of the studied cases had a favorable outcome. Diagrams associated to this category of patients showed increases in intracranial pressure above normal values but without repeated values above 50 mm Hg. Most of those patients had a good evolution under medical treatment. Monitoring intracranial pressure is an extremely useful stage in treating intracranial high pressure in traumatology and it should be included in the equipment of any intensive therapy section caring traumatic patients

Open access

A. Tascu, Iulia E.B. Vapor, A. Iliescu, Irina Tudose and St.M. Iencean

Abstract

A growing skull fracture, also called posttraumatic leptomeningeal cyst, is a rare complication of skull fractures - less than 1%, usually encountered in children younger than 3 years old. Although rare, this complication must be recognized early and treated to prevent permanent neurologic deficits. We present the case of a 2 months old child who had suffered a closed head trauma in a car accident 2 weeks before he was admitted in our clinic with a left parietal growing skull fracture. He was submitted to surgery and leptomeningeal cyst was evacuated, dural defect repaired and bone fragments fixed. Child was discharged 6 days postoperative without neurologic deficits. Growing skull fractures represent a rare complication of head trauma in small children. It is imperious to be recognized and treated in early phases to prevent debilitating permanent neurologic deficits in that category of population.