Tag Archives: Facebook features

Crataegus festiva

Botanical Name : Crataegus festiva
Family: Rosaceae
Subfamily:Amygdaloideae
Tribe: Maleae
Subtribe:Malinae
Genus: Crataegus
Kingdom:Plantae
Order: Rosales

Habitat :Crataegus festiva is native to Eastern N. America. It grows on the woodland Garden Sunny Edge; Dappled Shade

Description:
Crataegus festiva is a deciduous Shrub growing to 3 m (9ft) by 3 m (9ft).
It is hardy to zone (UK) 7 and is not frost tender. The seeds ripen from Sep to October. The flowers are hermaphrodite (have both male and female organs) and are pollinated by Midges.Suitable for: light (sandy), medium (loamy) and heavy (clay) soils and can grow in heavy clay soil. Suitable pH: acid, neutral and basic (alkaline) soils. It can grow in semi-shade (light woodland) or no shade. It prefers moist or wet soil and can tolerate drought. The plant can tolerates strong winds but not maritime exposure. It can tolerate atmospheric pollution....CLICK & SEE THE PICTURES

Cultivation:
We have very little information on this species and do not know how hardy it will be in Britain. However, a tree growing in an open sunny position at Kew Botanical Gardens is healthy and bears a very good crop of fruit every year. A very easily grown plant, it prefers a well-drained moisture retentive loamy soil but is not at all fussy. Once established, it succeeds in excessively moist soils and also tolerates drought. It grows well on a chalk soil and also in heavy clay soils. A position in full sun is best when plants are being grown for their fruit, they also succeed in semi-shade though fruit yields and quality will be lower in such a position. Most members of this genus succeed in exposed positions, they also tolerate atmospheric pollution. Hybridizes freely with other members of this genus. Seedling trees take from 5 – 8 years before they start bearing fruit, though grafted trees will often flower heavily in their third year. The flowers have a foetid smell somewhat like decaying fish. This attracts midges which are the main means of fertilization. When freshly open, the flowers have more pleasant scent with balsamic undertones. Seedlings should not be left in a seedbed for more than 2 years without being transplanted.
Propagation:
Seed – this is best sown as soon as it is ripe in the autumn in a cold frame, some of the seed will germinate in the spring, though most will probably take another year. Stored seed can be very slow and erratic to germinate, it should be warm stratified for 3 months at 15°c and then cold stratified for another 3 months at 4°c. It may still take another 18 months to germinate. Scarifying the seed before stratifying it might reduce this time. Fermenting the seed for a few days in its own pulp may also speed up the germination process. Another possibility is to harvest the seed ‘green’ (as soon as the embryo has fully developed but before the seedcoat hardens) and sow it immediately in a cold frame. If timed well, it can germinate in the spring. If you are only growing small quantities of plants, it is best to pot up the seedlings as soon as they are large enough to handle and grow them on in individual pots for their first year, planting them out in late spring into nursery beds or their final positions. When growing larger quantities, it might be best to sow them directly outdoors in a seedbed, but with protection from mice and other seed-eating creatures. Grow them on in the seedbed until large enough to plant out, but undercut the roots if they are to be left undisturbed for more than two years.
Edible Uses:
Fruit – raw or cooked. About 15mm in diameter with a delicious sweet flavour and juicy though slightly mealy texture. This is a very acceptable dessert fruit that makes very enjoyable eating. The fruit can also be used in making pies, preserves, etc, and can be dried for later use. There are up to five fairly large seeds in the centre of the fruit, these often stick together and so the effect is of eating a cherry-like fruit with a single seed.
Medicinal Uses:
Cardiotonic; Hypotensive.

Although no specific mention has been seen for this species, the fruits and flowers of many hawthorns are well-known in herbal folk medicine as a heart tonic and modern research has borne out this use. The fruits and flowers have a hypotensive effect as well as acting as a direct and mild heart tonic. They are especially indicated in the treatment of weak heart combined with high blood pressure. Prolonged use is necessary for it to be efficacious. It is normally used either as a tea or a tincture.

Other Uses: 
Wood – heavy, hard, tough, close-grained. Useful for making tool handles, mallets and other small items

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.
Resources:
https://en.wikipedia.org/wiki/Crataegus
http://www.pfaf.org/user/plant.aspx?LatinName=Crataegus+festiva

Advertisements

Crataegus durobrivensis

Botanical Name : Crataegus durobrivensis
Family: Rosaceae
Genus: Crataegus
Section:Douglasia
Series: Douglasianae
Species:C. douglasii
Kingdom:Plantae
Order: Rosales

Common Name:  Caughuawaga Hawthorn

Habitat :Crataegus durobrivensis is native to North-eastern N. America.It grows in the woodland Garden Sunny Edge; Dappled Shade.

Description:
Crataegus durobrivensis is a deciduous Shrub growing to 5 m (16ft) by 5 m (16ft).
It is not frost tender. The flowers are hermaphrodite (have both male and female organs) and are pollinated by Midges.Suitable for: light (sandy), medium (loamy) and heavy (clay) soils and can grow in heavy clay soil. Suitable pH: acid, neutral and basic (alkaline) soils and can grow in very alkaline soils.

CLICK & SEE THE PICTURES
It can grow in semi-shade (light woodland) or no shade. It prefers moist or wet soil and can tolerate drought. The plant can tolerates strong winds but not maritime exposure. It can tolerate atmospheric pollution.

Cultivation:
A very easily grown plant, it prefers a well-drained moisture retentive loamy soil but is not at all fussy. Once established, it succeeds in excessively moist soils and also tolerates drought. It grows well on a chalk soil and also in heavy clay soils. A position in full sun is best when plants are being grown for their fruit, they also succeed in semi-shade though fruit yields and quality will be lower in such a position. Most members of this genus succeed in exposed positions, they also tolerate atmospheric pollution. A very hardy plant, tolerating temperatures down to about -18°c. Hybridizes freely with other members of this genus. Seedling trees take from 5 – 8 years before they start bearing fruit, though grafted trees will often flower heavily in their third year. The flowers have a foetid smell somewhat like decaying fish. This attracts midges which are the main means of fertilization. When freshly open, the flowers have more pleasant scent with balsamic undertones. Seedlings should not be left in a seedbed for more than 2 years without being transplanted. Probably a natural hybrid, C. pruinosa x C. suborbiculata.
Propagation :
Seed – this is best sown as soon as it is ripe in the autumn in a cold frame, some of the seed will germinate in the spring, though most will probably take another year. Stored seed can be very slow and erratic to germinate, it should be warm stratified for 3 months at 15°c and then cold stratified for another 3 months at 4°c. It may still take another 18 months to germinate. Scarifying the seed before stratifying it might reduce this time. Fermenting the seed for a few days in its own pulp may also speed up the germination process. Another possibility is to harvest the seed ‘green’ (as soon as the embryo has fully developed but before the seedcoat hardens) and sow it immediately in a cold frame. If timed well, it can germinate in the spring. If you are only growing small quantities of plants, it is best to pot up the seedlings as soon as they are large enough to handle and grow them on in individual pots for their first year, planting them out in late spring into nursery beds or their final positions. When growing larger quantities, it might be best to sow them directly outdoors in a seedbed, but with protection from mice and other seed-eating creatures. Grow them on in the seedbed until large enough to plant out, but undercut the roots if they are to be left undisturbed for more than two years.

Edible Uses:
Fruit – raw or cooked. A reasonable size, it is up to 15mm in diameter, and is very acceptable for raw eating. It is sweet and fairly juicy when fully ripe with a hint of apple in its flavour. The fruit can be used in making pies, preserves, etc, and can also be dried for later use. There are up to five fairly large seeds in the centre of the fruit, these often stick together and so the effect is of eating a cherry-like fruit with a single seed.
Medicinal Uses:
Cardiotonic; Hypotensive.
Although no specific mention has been seen for this species, the fruits and flowers of many hawthorns are well-known in herbal folk medicine as a heart tonic and modern research has borne out this use. The fruits and flowers have a hypotensive effect as well as acting as a direct and mild heart tonic. They are especially indicated in the treatment of weak heart combined with high blood pressure. Prolonged use is necessary for it to be efficacious. It is normally used either as a tea or a tincture.

Other Uses:
Wood – heavy, hard, tough, close-grained. Useful for making tool handles, mallets and other small items

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider. .

Resources:
https://en.wikipedia.org/wiki/Crataegus
http://www.pfaf.org/user/Plant.aspx?LatinName=Crataegus+durobrivensis

Crataegus anomala

Botanical Name : Crataegus anomala
Family: Rosaceae
Genus: Crataegus
Species:Crataegus anomala
Kingdom: Plantae
Division: Cycadophyta
Class: Magnoliopsida
Type: Rosales

Common Name : Arnold hawthorn

Habitat : Crataegus anomala is native to Eastern N. AmericaQuebec to New York. It grows on rocky banks and open woods on low limestone ridges.

Description:
Crataegus anomala is a deciduous Shrub growing to 5 m (16ft 5in).
It is not frost tender. The flowers are hermaphrodite (have both male and female organs) and are pollinated by Midges.Suitable for: light (sandy), medium (loamy) and heavy (clay) soils and can grow in heavy clay soil. Suitable pH: acid, neutral and basic (alkaline) soils and can grow in very alkaline soils….CLICK & SEE THE PICTURES
It can grow in semi-shade (light woodland) or no shade. It prefers moist or wet soil and can tolerate drought. The plant can tolerates strong winds but not maritime exposure. It can tolerate atmospheric pollution.
Cultivation:
A very easily grown plant, it prefers a well-drained moisture retentive loamy soil but is not at all fussy. Once established, it succeeds in excessively moist soils and also tolerates drought. It grows well on a chalk soil and also in heavy clay soils. A position in full sun is best when plants are being grown for their fruit, they also succeed in semi-shade though fruit yields and quality will be lower in such a position. Most members of this genus succeed in exposed positions, they also tolerate atmospheric pollution. Hybridizes freely with other members of this genus. This species is growing in a number of botanical gardens in Britain, where it is fruiting very well. Some botanists do not recognise it as a distinct species and place it as part of C. pedicellata. The flowers have a foetid smell somewhat like decaying fish. This attracts midges which are the main means of fertilization. When freshly open, the flowers have more pleasant scent with balsamic undertones. Seedling trees take from 5 – 8 years before they start bearing fruit, though grafted trees will often flower heavily in their third year. Seedlings should not be left in a seedbed for more than 2 years without being transplanted.
Propagation:
Seed – this is best sown as soon as it is ripe in the autumn in a cold frame, some of the seed will germinate in the spring, though most will probably take another year. Stored seed can be very slow and erratic to germinate, it should be warm stratified for 3 months at 15°c and then cold stratified for another 3 months at 4°c. It may still take another 18 months to germinate. Scarifying the seed before stratifying it might reduce this time. Fermenting the seed for a few days in its own pulp may also speed up the germination process. Another possibility is to harvest the seed ‘green’ (as soon as the embryo has fully developed but before the seedcoat hardens) and sow it immediately in a cold frame. If timed well, it can germinate in the spring. If you are only growing small quantities of plants, it is best to pot up the seedlings as soon as they are large enough to handle and grow them on in individual pots for their first year, planting them out in late spring into nursery beds or their final positions. When growing larger quantities, it might be best to sow them directly outdoors in a seedbed, but with protection from mice and other seed-eating creatures. Grow them on in the seedbed until large enough to plant out, but undercut the roots if they are to be left undisturbed for more than two years.

Edible Uses:
Fruit – raw or cooked. Juicy. A very nice flavour, it makes a very good dessert fruit[K]. The fruit can also be used in making pies, preserves, etc, and can be dried for later use. The fruit is up to 20mm in diameter with a thick flesh. There are up to five fairly large seeds in the centre of the fruit, these often stick together and so the effect is of eating a cherry-like fruit with a single seed.

Medicinal Uses:
Cardiotonic; Hypotensive.

Although no specific mention has been seen for this species, the fruits and flowers of many hawthorns are well-known in herbal folk medicine as a heart tonic and modern research has borne out this use. The fruits and flowers have a hypotensive effect as well as acting as a direct and mild heart tonic. They are especially indicated in the treatment of weak heart combined with high blood pressure. Prolonged use is necessary for it to be efficacious. It is normally used either as a tea or a tincture.

Other Uses:
Wood – heavy, hard, tough, close-grained. Useful for making tool handles, mallets and other small items.

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.

Resources:
https://ceb.wikipedia.org/wiki/Crataegus_anomala
http://www.pfaf.org/user/Plant.aspx?LatinName=Crataegus+anomala

Nicotiana benthamiana

Botanical Name: Nicotiana benthamiana
Family: Solanaceae
Genus: Nicotiana
Species:N. benthamiana
Kingdom:Plantae
Order: Solanales

Synonyms: Nicotiana suaveolens var. cordifolia

Common indigenous names: Tjuntiwari and Muntju. Tangungnu, Ngkwerlp-pweter, Pinapitilypa, Tjiknga, Munju, Pirnki-warnu, Turlkamula

Habitat :Nicotiana benthamiana is native to Australia.It is found amongst rocks on hills and cliffs throughout the northern regions of Australia.

Description:
Nicotiana benthamiana is an erect, sometimes sprawling, annual herbaceous plant. This short-lived herb will reach from 0.65-5 feet (0.2-1.5 m) tall. Grown in containers, the plants rarely reach over 18 inches (0.45 m) tall by about half as wide. The dark green, broadly ovate leaves will reach up to 4 inches (10 cm) wide by 5 inches (12.7 cm) long. We selected this plant to use for TMV research because it is very susceptible to all kinds of viruses. Plants are easy to grow and we always keep several different ages of plants available at all times.

CLICK & SEE THE PICTURES

Blooming: In the greenhouse, plants flower all year round, but in nature, they normally bloom from May-September. The small, white flowers are 3/8 inch (1 cm) across by 1.5 inches (3.8 cm) long.

A vigorous plant with numerous erect leafy stems. Its alternate leaves are broadly egg-shaped, dull green and soft. Except at the top of the stems, where they are stalkless, its leaves have slender stalks. Flowers are whitish, with a long, slender tube and five blunt lobes; fruits are capsules containing many pitted seeds.

This plant is a close relative of tobacco and species of Nicotiana indigenous to Australia.The plant was used by peoples of Australia as a stimulant – it contains nicotine and other alkaloids – before the introduction of commercial tobacco (N.tabacum and N.rustica). It was first collected on the north coast of Australia by Benjamin Bynoe on a voyage of the H.M.S. Beagle in 1837.

Cultivation:
Nicotiana benthamiana need full sun to partial shade using a well-drained soil mix. In the greenhouse, we use a soil mix consisting of 2 parts peat moss to 1 part loam to 1 part coarse sand or perlite. Since we grow these plants for research, they are given water on a daily basis to keep them stress free. They are fertilized weekly with a balanced fertilizer diluted to 1/2 the strength recommended on the label. Since we have to have these plants for research, once they set seed, plants are discarded. During the winter months, we use supplemental lighting to keep the plants growing strong.

Propagation: Nicotiana benthamiana is best propagated from seed.
Medicinal Uses:
The scientists have shown that transgenic versions of a plant Nicotiana benthamiana, also known as ‘Tjuntiwari’ in the native language, may be able to produce large quantities of a protein griffithsin which can be used as an anti-HIV microbicide gel.The protein has shown capabilities of neutralizing HIV as it binds to the virus molecule in such a way that the virus could not disguise itself from the immune system of humans.

Anti-HIV microbicide gel directly targets entry of the virus and averts infection at the surfaces but at present they are being produced using biologicals like bacteria E.coli, an expensive process which is not cost-effective.

The researchers from USA and UK altered the genetic nature of the plant using a tobacco mosaic virus which produced the protein griffithsin.(Published in The Times Of India)

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.

Resources:
http://en.wikipedia.org/wiki/Nicotiana_benthamiana
http://www.plantoftheweek.org/week425.shtml
http://biolinfo.org/cmkb/view.php?comname=cmkb_public&scid=412

Brain aneurysm

Definition:
Brain aneurysm is a cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel.Brain aneurysms are like tiny blisters or balloons on the surface of the arteries running through the brain. The outer wall of the vessel has a weakness, and the inner lining (like the inner tube of a tyre) bulges out. In 15 per cent of cases there are multiple aneurysms on different arteries around the brain.

CLICK & SEE THE PICTURES

A common location of brain aneurysms is on the arteries at the base of the brain, known as the Circle of Willis. Approximately 85% of cerebral aneurysms develop in the anterior part of the Circle of Willis, and involve the internal carotid arteries and their major branches that supply the anterior and middle sections of the brain. The most common sites include the anterior cerebral artery and anterior communicating artery (30-35%), the bifurcation, division of two branches, of the internal carotid and posterior communicating artery (30-35%), the bifurcation of the middle cerebral artery (20%), the bifurcation of the basilar artery, and the remaining posterior circulation arteries (5%).

The main worry with an aneurysm is that it will burst under the pressure of blood pulsing through the artery, causing a brain haemorrhage, which may be fatal.

Each year, many thousands of people around the world, often young or middle-aged, die or are left disabled because of brain aneurysms.

Symptoms:
Most brain aneurysms cause no symptoms and may only be discovered during tests for another, usually unrelated, condition. In other cases, an unruptured aneurysm will cause problems by pressing on areas within the brain. When this happens, the person may suffer from severe headaches, blurred vision, changes in speech, and neck pain, depending on the areas of the brain that are affected and the severity of the aneurysm.

Onset is usually sudden and without warning. Rupture of a cerebral aneurysm is dangerous and usually results in bleeding into the meninges or the brain itself, leading to a subarachnoid hemorrhage (SAH) or intracranial hematoma (ICH), either of which constitutes a stroke. Rebleeding, hydrocephalus (the excessive accumulation of cerebrospinal fluid), vasospasm (spasm, or narrowing, of the blood vessels), or multiple aneurysms may also occur. The risk of rupture from an unruptured cerebral aneurysm varies according to the size of an aneurysm, with the risk rising as the aneurysm size increases. The overall rate of aneurysm rupture is estimated at 1.3% per year, resulting in approximately 27,000 new cases of SAH in the United States per year. Screening for aneurysms with annual imaging is possible, but not viewed as cost effective. The risk of short term re-rupture decreases dramatically after an aneurysm has bled in about 3 days, though after approximately 6 weeks the risk returns to baseline.

Symptoms of a ruptured brain aneurysm often when come on suddenly. They may include:

*Sudden, severe headache (sometimes described as a “thunderclap” headache that is very different from any normal headache).
*Neck pain.
*Nausea and vomiting.
*Sensitivity to light.
*Fainting or loss of consciousness.
*Seizures.

If a brain aneurysm presses on nerves in your brain, it can cause signs and symptoms. These can include:

*A droopy eyelid
*Double vision or other changes in vision
*Pain above or behind the eye
*A dilated pupil
*Numbness or weakness on one side of the face or body

Causes:
Aneurysms may result from congenital defects, preexisting conditions such as high blood pressure and atherosclerosis (the buildup of fatty deposits in the arteries), or head trauma. Cerebral aneurysms occur more commonly in adults than in children but they may occur at any age.

A person may inherit the tendency to form aneurysms, or aneurysms may develop because of hardening of the arteries (atherosclerosis) and aging. Some risk factors that can lead to brain aneurysms can be controlled, and others can’t. The following risk factors may increase your risk of developing an aneurysm or, if you already have an aneurysm, may increase your risk of it rupturing:1

*Family history. People who have a family history of brain aneurysms are twice as likely to have an aneurysm as those who don’t.

*Previous aneurysm. About 20% of patients with brain aneurysms have more than one.

*Gender. Women are twice as likely to develop a brain aneurysm or to suffer a subarachnoid hemorrhage as men.

*Race. African Americans have twice as many subarachnoid hemorrhages as whites.

*Hypertension. The risk of subarachnoid hemorrhage is greater in people with a history of high blood pressure (hypertension).

*Smoking. In addition to being a cause of hypertension, the use of cigarettes may greatly increase the chances of a brain aneurysm rupturing.

Diagnosis:
Because unruptured brain aneurysms often do not cause any symptoms, many are discovered in people who are being treated for a different condition.

 

 

These images show exactly how blood flows into the brain arteries.

If your health professional believes you have a brain aneurysm, you may have the following tests:

*Computed tomography (CT) scan. A CT scan can help identify bleeding in the brain.

*Computed tomography angiogram (CTA) scan. CTA is a more precise method of evaluating blood vessels than a standard CT scan. CTA uses a combination of CT scanning, special computer techniques, and contrast material (dye) injected into the blood to produce images of blood vessels.

*Magnetic resonance angiography (MRA). Similar to a CTA, MRA uses a magnetic field and pulses of radio wave energy to provide pictures of blood vessels inside the body. As with CTA and cerebral angiography, a dye is often used during MRA to make blood vessels show up more clearly.

*Cerebral angiogram. During this X-ray test, a catheter is inserted through a blood vessel in the groin or arm and moved up through the vessel into the brain. A dye is then injected into the cerebral artery. As with the above tests, the dye allows any problems in the artery, including aneurysms, to be seen on the X-ray. Although this test is more invasive and carries more risk than the above tests, it is the best way to locate small (less than 5 mm) brain aneurysms.

Sometimes a lumbar puncture may be used if your health professional suspects that you have a ruptured cerebral aneurysm with a subarachnoid hemorrhage.

Treatment:
Emergency treatment for individuals with a ruptured cerebral aneurysm generally includes restoring deteriorating respiration and reducing intracranial pressure. Currently there are three treatment options for brain aneurysms: medical hypotensive therapy; surgical clipping or endovascular coiling. If possible, either surgical clipping or endovascular coiling is usually performed within the first 24 hours after bleeding to occlude the ruptured aneurysm and reduce the risk of rebleeding.

..

Medical Hypotensive Therapy:
Medical—hypotensive therapy for ruptured intracranial aneurysms was introduced by Paul Slosberg MD (1926 – ; currently in practice) at the Mount Sinai Hospital in 1956 and was shown superior to surgery and other treatments in the largest randomized controlled study (multinational—15 institutions) ever conducted. This was reported in the major neurologic journal Stroke years ago but was underpublicized. More recently, with modifications for unruptured brain aneurysms and review of 50 years’ results it has again been found superior to surgical and now also to endovascular treatment. The method has the extreme cost-benefit advantage of completely eliminating the need for hospitalization itself, thereby eliminating surgical costs, endovascular costs, operating room costs and recovery room costs. In addition, it enables patients to completely avoid life-threatening nosocomial i.e. hospital-based, infections especially the frequently fatal MRSA infections along with other fatal hospital-based infections now being reported. This entirely medical treatment is performed by the neurologist both early and in long-term follow-up, in a private office or outpatient hospital facility. Aneurysms have been treated successfully regardless of size(e.g. giant aneurysms are included), location, complicating medical illnesses etc. These long term clinical results are buttressed by long-term MRA and CTA radiographic results showing that instead of the expected increase in size, the aneurysms either remain the same size, decrease in size or are no longer even visualized. This entirely medical method has now been endorsed by least two aneurysm surgical groups in England, as reported in both the Journal of Neurosurgery and Lancet Neurology.

Surgical clipping:..
Surgical clipping was introduced by Walter Dandy of the Johns Hopkins Hospital in 1937. It consists of performing a craniotomy, exposing the aneurysm, and closing the base of the aneurysm with a clip chosen specifically for the site. The surgical technique has been modified and improved over the years. Surgical clipping has a lower rate of aneurysm recurrence after treatment.

In January 2009, a team of doctors at UNC Hospital in Chapel Hill, North Carolina pioneered a new approach for aneurysm treatment – clipping aneurysms through an endoscopic endonasal approach. The team was led by UNC neurosurgeon, Dr. Anand Germanwala. This procedure may be groundbreaking for patients with aneurysms near the skull base, as an approach through the nose is less invasive than traditional approaches. Two videos related to this procedure can be seen on the UNC Neurosurgery website: http://www.med.unc.edu/neurosurgery/news/germanwala-presents-first-aneurysm-patient-treated-through-nose and http://www.med.unc.edu/neurosurgery/news/video-it-takes-two-or-more.

Endovascular coiling:.……
Endovascular coiling was introduced by Guido Guglielmi at UCLA in 1991. It consists of passing a catheter into the femoral artery in the groin, through the aorta, into the brain arteries, and finally into the aneurysm itself. Once the catheter is in the aneurysm, platinum coils are pushed into the aneurysm and released. These coils initiate a clotting or thrombotic reaction within the aneurysm that, if successful, will eliminate the aneurysm. These procedures require a small incision, through which a catheter is inserted. In the case of broad-based aneurysms, a stent may be passed first into the parent artery to serve as a scaffold for the coils (“stent-assisted coiling”), although the long-term studies of patients with intracranial stents have not yet been done.

Benefits & Risk:-
At this point it appears that the risks associated with surgical clipping and endovascular coiling, in terms of stroke or death from the procedure, are the same. The ISAT trials have shown, however, that patients who have experienced aneurysmal rupture have a 7% lower mortality rate when treated by coiling than patients treated by clipping, when all other factors are equal. Coiled aneurysms, however, do have a higher recurrence rate as demonstrated by angiography. For instance, the 2007 study by Jacques Moret and colleagues from Paris, France, (a group with one of the largest experiences in endovascular coiling) indicates that 28.6% of aneurysms recurred within one year of coiling, and that the recurrence rate increased with time. These results are similar to those previously reported by other endovascular groups. For instance Jean Raymond and colleagues from Montreal, Canada, (another group with a large experience in endovascular coiling) reported that 33.6% of aneurysms recurred within one year of coiling. The most recent data from Moret’s group reveals even higher aneurysm recurrence rates, namely a 36.5% recurrence rate at 9 months (which breaks down as 31.1% for small aneurysms less than 10 mm, and 56.0% for aneurysms 10 mm or larger). However, no studies to date have shown that the higher angiographic recurrence rate equals a higher rate of rebleeding. Thus far, the ISAT trials listed above show no increase in the rate of rebleeding, and show a persistent 7% lower mortality rate in subarachnoid hemorrhage patients who have been treated with coiling. In ISAT, the need for late retreatment of aneurysms was 6.9 times more likely for endovascular coiling as compared to surgical clipping. Furthermore, data from the ISAT group in March 2008 indicates that the higher aneurysm rate of recurrence is associated with a higher rebleeding rate, given that the rebleed rate of coiled aneurysms appears to be 8 times higher than that of surgically treated aneurysms in the ISAT study.

Therefore it appears that although endovascular coiling is associated with a shorter recovery period as compared to surgical clipping, it is also associated with a significantly higher recurrence rate after treatment. The long-term data for unruptured aneurysms are still being gathered.

Patients who undergo endovascular coiling need to have several serial studies (such as MRI/MRA, CTA, or angiography) to detect early recurrences. If a recurrence is identified, the aneurysm may need to be retreated with either surgery or further coiling. The risks associated with surgical clipping of previously-coiled aneurysms are very high. Ultimately, the decision to treat with surgical clipping versus endovascular coiling should be made by a cerebrovascular team with extensive experience in both modalities.

Prognosis:
The prognosis for a patient with a ruptured cerebral aneurysm depends on the extent and location of the aneurysm, the person’s age, general health, and neurological condition. Some individuals with a ruptured cerebral aneurysm die from the initial bleeding. Other individuals with cerebral aneurysm recover with little or no neurological deficit. The most significant factors in determining outcome are grade (see Hunt and Hess grade above) and age. Generally patients with Hunt and Hess grade I and II hemorrhage on admission to the emergency room and patients who are younger within the typical age range of vulnerability can anticipate a good outcome, without death or permanent disability. Older patients and those with poorer Hunt and Hess grades on admission have a poor prognosis. Generally, about two thirds of patients have a poor outcome, death, or permanent disability.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.webmd.com/brain/tc/brain-aneurysm-topic-overview
http://www.nlm.nih.gov/medlineplus/brainaneurysm.html
http://en.wikipedia.org/wiki/Cerebral_aneurysm
http://www.bbc.co.uk/health/physical_health/conditions/brainaneurysm.shtml
http://www.nlm.nih.gov/medlineplus/ency/imagepages/17031.htm

http://www.yalemedicalgroup.org/stw/Page.asp?PageID=STW029076