The anatomy of the convergence of major deep cerebral veins in the pineal region: a computed tomography angiography study

2020 ◽  
Author(s):  
Karolina Brzegowy ◽  
Bernard Solewski ◽  
Michał P. Zarzecki ◽  
Agata Musiał ◽  
Tomasz Kasprzycki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Pineal Region ◽  
Cerebral Veins ◽  
Deep Cerebral Veins

Computed tomography angiography accuracy in brain death diagnosis

2020 ◽  
Vol 133 (4) ◽  
pp. 1220-1228
Author(s):  
Sergio Brasil ◽  
Edson Bor-Seng-Shu ◽  
Marcelo de-Lima-Oliveira ◽  
Fabio Silvio Taccone ◽  
Gabriel Gattás ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Brain Death ◽  
Computed Tomography Angiography ◽  
Circulatory Arrest ◽  
Cerebral Veins ◽  
Clinical Trial Registration ◽  
Bilateral Absence ◽  
Internal Cerebral Veins ◽  
Cerebral Circulatory Arrest

OBJECTIVEThe present study was designed to answer several concerns disclosed by systematic reviews indicating no evidence to support the use of computed tomography angiography (CTA) in the diagnosis of brain death (BD). Therefore, the aim of this study was to assess the effectiveness of CTA for the diagnosis of BD and to define the optimal tomographic criteria of intracranial circulatory arrest.METHODSA unicenter, prospective, observational case-control study was undertaken. Comatose patients (Glasgow Coma Scale score ≤ 5), even those presenting with the first signs of BD, were included. CTA scanning of arterial and venous vasculature and transcranial Doppler (TCD) were performed. A neurological determination of BD and consequently determination of case (BD group) or control (no-BD group) was conducted. All personnel involved with assessing patients were blinded to further tests results. Accuracy of BD diagnosis determined by using CTA was calculated based on the criteria of bilateral absence of visualization of the internal cerebral veins and the distal middle cerebral arteries, the 4-point score (4PS), and an exclusive criterion of absence of deep brain venous drainage as indicated by the absence of deep venous opacification on CTA, the venous score (VS), which considers only the internal cerebral veins bilaterally.RESULTSA total of 106 patients were enrolled in this study; 52 patients did not have BD, and none of these patients had circulatory arrest observed by CTA or TCD (100% specificity). Of the 54 patients with a clinical diagnosis of BD, 33 met the 4PS (61.1% sensitivity), whereas 47 met the VS (87% sensitivity). The accuracy of CTA was time related, with greater accuracy when scanning was performed less than 12 hours prior to the neurological assessment, reaching 95.5% sensitivity with the VS.CONCLUSIONSCTA can reliably support a diagnosis of BD. The criterion of the absence of deep venous opacification, which can be assessed by use of the VS criteria investigated in this study, can confirm the occurrence of cerebral circulatory arrest.Clinical trial registration no.: 12500913400000068 (clinicaltrials.gov)

Microsurgical anatomy of the great cerebral vein of Galen and its tributaries

2003 ◽  
Vol 99 (6) ◽  
pp. 1028-1038 ◽  
Author(s):  
Patrick Chaynes
Keyword(s):  
Venous Drainage ◽  
Pineal Region ◽  
Surgical Approaches ◽  
Cerebral Vein ◽  
Cerebral Veins ◽  
Microsurgical Anatomy ◽  
Vein Of Galen ◽  
Content Type ◽  
Deep Cerebral Veins ◽  
Fine Print

Object. The deep cerebral veins may pose a major obstacle in operative approaches to deep-seated lesions, especially in the pineal region where multiple veins converge on the great cerebral vein of Galen. Because undesirable sequelae may occur from such surgery, the number of veins and branches to be sacrificed during these approaches should kept to a minimum. The purpose of this study was to examine venous drainage into the vein of Galen with a view to surgical approaches. If a vein hampering surgical access must be sacrificed, it can therefore be selected according to the smallest draining territory. Methods. The deep cerebral veins and their surrounding neural structures were examined in 50 cerebral hemispheres from 25 adult cadavers in which the arteries and veins had been perfused with red and blue silicone, respectively. Special consideration was given to the size and location of drainage of the vein of Galen and its tributaries. Conclusions. When a surgeon approaches the pineal region, several veins may hamper the access route. From posterior to anterior, these include the following: the superior vermian and the precentral or superior cerebellar veins, which drain into the posteroinferior aspect of the vein of Galen; and the tectal and pineal veins, which drain into its anterosuperior aspect. The internal occipital vein is the main vessel draining into the lateral aspect of the vein of Galen. It may be joined by the posterior pericallosal vein, and in that case has an extensive territory. To avoid intraoperative venous infarction, it is important to use angiography to determine the venous organization before surgery and to estimate the permeability and size of the branches of the deep venous system.

Mid-aortic syndrome: computed tomography angiography depicting extensive collateral circulation in an 11-year-old patient with thoracoabdominal aortic coarctation

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 132-135 ◽  
Author(s):  
Krohn ◽  
Gebauer ◽  
Hübler ◽  
Beck
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Collateral Circulation ◽  
Intestinal Ischemia ◽  
Clinical Presentation ◽  
Lower Limbs ◽  
Upper Body ◽  
Descending Aorta ◽  
Before And After ◽  
Blood Pressures

The mid-aortic syndrome is an uncommon clinical condition characterized by severe narrowing of the descending aorta, usually with involvement of its renal and visceral branches, presenting with uncontrollably elevated blood pressures of the upper body, renal and cardiac failure, intestinal ischemia, encephalopathy symptoms and claudication of the lower limbs, although clinical presentation is variable. In this article we report the case of an eleven-year-old patient with the initial diagnosis of a mid-aortic syndrome and present the computed tomography angiography pictures and reconstructions before and after surgical therapy.

Computed Tomography Angiography (CTA) Evaluation of Spontaneous Subarachnoid Hemorrhage

2020 ◽  
Vol 6 (2) ◽  
pp. 78-81
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Chowdhury ◽  
Mohammad Sadekur Rahman Sarkar ◽  
KM Ahasan Ahmed ◽  
Md Nazmul Kabir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Computed Tomography Angiography ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multiple Aneurysm ◽  
Traumatic Subarachnoid Hemorrhage ◽  
One Year ◽  
Spontaneous Subarachnoid Hemorrhage

Background: In evaluation of non-traumatic subarachnoid hemorrhage CT angiography (CTA) has 97-98% sensitivity and near 100% specificity. Objective: This study was conducted to evaluate the CTA findings of CT positive non traumatic subarachnoid hemorrhage. Methodology: This is an observational cross sectional study performed in Neurology department of National Institute of Neurosciences and Hospital, Dhaka over one year period (January 2019 to December 2019). Total 87 CT positive subarachnoid hemorrhage cases were purposively included in this study. All CT positive patients underwent CTA of Cerebral vessels for further evaluation. The angiography were evaluated by competent neuro-radiologists blinded about the study. Result: Among 87 patients, 40.2% were male and 59.8% were female. The average age was 53.33±11.1 years. Among the studied patient the source of bleeding was found 78.16% aneurysmal and 21.84% non-aneurysmal. 85.30% patients had single aneurysm and 14.70% had multiple aneurysm. The highest number of patient had Acom aneurysm (41.17%) followed by MCA (22.05%), ICA (13.23%), ACA (7.35%) and vertebral artery (1.14%) in order of frequency. Among the multiple aneurysm group most of the patients had combination of Acom, MCA and ICA aneurysm. Conclusion: From this study, we can conclude that CTA can be used as the primary diagnostic tool in evaluation of spontaneous SAH. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 78-81

Dual energy computed tomography angiography of a pulmonary embolized port catheter fragment

2011 ◽  
Vol 12 (1) ◽  
pp. 62-63 ◽  
Author(s):  
Thomas Henzler ◽  
Steffen Diehl ◽  
Susanne Jochum ◽  
Tim Sueselbeck ◽  
Stefan O Schoenberg ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Dual Energy ◽  
Port Catheter ◽  
Dual Energy Computed Tomography
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