Catastrophic cerebral infarction during extracorporeal life support due to a rare anomaly in the circle of Willis

2019 ◽  
Vol 29 (5) ◽  
pp. 816-817 ◽  
Author(s):  
Aiko Sonobe ◽  
Hideyuki Kato ◽  
Bryan J Mathis ◽  
Yuji Hiramatsu
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Cerebral Infarction ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Circle Of Willis ◽  
Neurological Injury ◽  
The Right

Abstract During extracorporeal life support (ECLS) in infants, cannulation of the right common carotid artery may result in a devastating ischaemic neurological injury. Herein, we present a case of an infant who encountered bilateral cerebral infarction during ECLS via the right carotid artery due to a rare and tragic anomaly of the circle of Willis. The magnetic resonance angiography complemented computed tomography in diagnosing the infarction and identifying this unique anatomy.

Carotid Artery Dissection Following Neck Cannulation for Extracorporeal Life Support

2016 ◽  
Vol 8 (3) ◽  
pp. 414-416 ◽  
Author(s):  
Lindsay M. Ryerson ◽  
Carlos Sanchez-Glanville ◽  
Christa Huberdeau ◽  
Mohammed Al Aklabi
Keyword(s):  
Computed Tomography ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
False Lumen ◽  
Artery Dissection ◽  
Transverse Arch ◽  
Computed Tomography Angiogram ◽  
The Right

A term neonate was cannulated for venoarterial extracorporeal life support (ECLS) via the right neck for non-postoperative junctional ectopic tachycardia. Initial echocardiogram demonstrated an echogenic strand in the transverse arch. Computed tomography angiogram confirmed arterial dissection of the right common carotid artery that extended into the proximal transverse arch. Dissection flap was repaired at the time of ECLS decannulation without cardiopulmonary bypass. Follow-up computed tomography angiogram revealed a segment of narrowing of approximately 50% of the right common carotid artery without false lumen or aneurysm.

Computed tomography and magnetic resonance angiography in the evaluation of aberrant origin of the external carotid artery branches

2012 ◽  
Vol 34 (5) ◽  
pp. 393-399 ◽  
Author(s):  
Salvatore Cappabianca ◽  
Assunta Scuotto ◽  
Francesco Iaselli ◽  
Nicoletta Pignatelli di Spinazzola ◽  
Fabrizio Urraro ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
External Carotid Artery ◽  
External Carotid

scholarly journals Role of multi-parametric ultrasound in transient perivascular inflammation of the carotid artery syndrome

Ultrasound ◽  
2019 ◽  
Vol 27 (2) ◽  
pp. 77-84 ◽  
Author(s):  
Vasileios Rafailidis ◽  
Ioannis Chryssogonidis ◽  
Thomas Tegos ◽  
Sasan Partovi ◽  
Afroditi Charitanti-Kouridou ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Contrast Enhancement ◽  
Computed Tomography Angiography ◽  
Imaging Modality ◽  
Power Doppler ◽  
Luminal Narrowing ◽  
Perivascular Inflammation

Introduction The term “carotidynia” has been used to describe a symptom or a nosologic entity characterized by pain in the lateral neck region and over the carotid bifurcation. Recent advances in diagnostic imaging and the introduction of diagnostic criteria have led to the adoption of term “Transient perivascular inflammation of the carotid artery” (TIPIC) syndrome. Method A retrospective analysis of the Radiology Department’s database was performed to identify cases with the diagnosis of TIPIC syndrome. The purpose was to identify ultrasound images including B-mode technique, colour, power Doppler technique and contrast-enhanced ultrasound (CEUS). Findings In total, five patients with the diagnosis of TIPIC syndrome are presented in this review. TIPIC syndrome is a clinic-radiologic entity characterized by pain over the carotid area, a symptom referring to a wide differential diagnosis where imaging plays a crucial role for proper diagnosis and treatment. Characteristic imaging findings on conventional ultrasound and CEUS are presented in this review. Discussion TIPIC syndrome can be investigated with virtually any imaging modality. Ultrasound typically reveals perivascular infiltration and a hypoechoic intimal plaque, while no significant luminal narrowing is appreciated. Computed tomography angiography and magnetic resonance angiography also demonstrate these vascular wall changes primarily affecting the distal common carotid artery, the carotid bulb and possibly the internal carotid artery proximal part. Contrast enhancement is a very characteristic and constant finding of TIPIC lesions, suggestive of the inflammatory nature of the disease and can be appreciated on computed tomography angiography and magnetic resonance angiography. CEUS has been recently used and successfully observed contrast enhancement of the lesions, similar to computed tomography angiography and magnetic resonance angiography. Conclusion Ultrasound remains the first-line modality for the evaluation of TIPIC syndrome, capable of providing all the information needed, especially if supplemented with the administration of microbubbles so that the enhancement of lesions can be evaluated.

scholarly journals Diagnosis of a tympanic paraganglioma with CT perfusion imaging: a technical note and case description

2017 ◽  
Vol 31 (3) ◽  
pp. 324-327
Author(s):  
Christoph J Maurer ◽  
Antje Aschendorff ◽  
Horst Urbach
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Perfusion Imaging ◽  
Sigmoid Sinus ◽  
Resonance Imaging ◽  
Computed Tomography Perfusion ◽  
Computed Tomography Perfusion Imaging

Paragangliomas can be diagnosed accurately using magnetic resonance imaging and dynamic four-dimensional magnetic resonance angiography. Four-dimensional imaging uses the highly vascularised structure of these tumours, which results in a homogenous capillary blush and usually, due to the arteriovenous shunting, in an early draining vein. By these features the tumour can be differentiated from other neoplasms. The authors describe a case of a paraganglioma localised in the middle ear of an elderly patient. Magnetic resonance contraindications led to preoperative diagnostics with high resolution computed tomography of the temporal bone and additionally computed tomography perfusion imaging instead of magnetic resonance imaging with four-dimensional magnetic resonance angiography. Using the computed tomography perfusion dataset, regions of interest were placed in the carotid artery, the sigmoid sinus and the tympanic mass. In the computer-assisted analysis the tumour showed late arterial enhancement and delayed wash-out compared to the enhancement curves of the carotid artery and the sigmoid sinus. This corresponded to the highly vascularised nature of a paraganglioma. On postoperative follow-up imaging computed tomography perfusion showed almost no enhancement of a small residual tympanic mass, which was then considered to be granulation tissue. In conclusion, in the case of magnetic resonance contraindications the preoperative diagnosis of tympanic paraganglioma can be made using computed tomography imaging criteria alone. Computed tomography perfusion imaging may be helpful in these cases to detect residual or recurrent tumour.

Extracranial internal carotid artery occlusive dissection – multimodality presentation in a case series

VASA ◽  
2019 ◽  
Vol 48 (3) ◽  
pp. 244-250 ◽  
Author(s):  
Vasileios Rafailidis ◽  
Konstantinos Notas ◽  
Evangelos Destanis ◽  
Konstantinos Kouskouras ◽  
Ioannis Chryssogonidis ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Internal Carotid ◽  
Multimodality Imaging ◽  
Case Series ◽  
Accurate Diagnosis ◽  
Carotid Dissection ◽  
Imaging Findings

Abstract. Background: Carotid dissection is a rare disease, mainly affecting young and middle-aged patients potentially ending up in stroke. Multimodality imaging plays an essential role, both in terms of prompt and accurate diagnosis and follow-up of this entity. Patients and methods: We herein present a case series of patients with internal carotid artery dissection and compare the various imaging findings of ultrasonography, multidetector computed tomography angiography and magnetic resonance angiography, with a purpose to illustrate the value of multimodality imaging in the diagnosis of carotid dissection. Results: Ultrasound represents the first-line imaging modality for the evaluation of a suspected carotid pathology. Digital subtraction angiography is considered the gold standard method for evaluation of carotid luminal abnormalities and is currently reserved for those patients selected for endovascular surgery. Nevertheless, the widespread availability of modern cross-sectional techniques such as multi-detector computed tomography angiography and magnetic resonance angiography has made angiography marginalised. Computed tomography and magnetic resonance angiography offered accurate delineation of vascular lumen and providing valuable information for the vascular wall composition. Conclusions: Careful interpretation of imaging findings on various imaging modalities can lead to early and accurate diagnosis of carotid dissection.

scholarly journals The Anatomy of the Circle of Willis Is Not a Strong Enough Predictive Factor for the Prognosis of Cross-Clamping Intolerance during Carotid Endarterectomy

2020 ◽  
Vol 9 (12) ◽  
pp. 3913
Author(s):  
Piotr Myrcha ◽  
Andrzej Lewczuk ◽  
Maciej Jakuciński ◽  
Mariusz Kozak ◽  
Dawid Siemieniuk ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
False Negative ◽  
Circle Of Willis ◽  
Negative Results ◽  
Group I ◽  
False Negative Results ◽  
Group Ii

Carotid endarterectomy (CEA) is safe and effective in reducing the risk of stroke in symptomatic severe carotid artery stenosis. Having information about cross-clamping (CC) intolerance before surgery may reduce the complication rate. The purpose of this study was to assess the usefulness of magnetic resonance angiography (MRA) and magnetic resonance angiography perfusion (P-MR) in determining the risk of CC intolerance during CEA. Material and methods: 40 patients after CEA with CC intolerance were included in Group I, and 15 with CC tolerance in Group II. All patients underwent MRA of the circle of Willis (CoW), P-MR with or without Acetazolamide; P(A)-MR in the postoperative period. Results: CoW was normal in the MRA in three cases (7.5%) in Group I, and in eight (53%) in Group II. We found P-MR abnormalities in all patients from Group I and in 40% from Group II. Using a calculated cut-off point of 0.322, the patients were classified as CC tolerant with 100% sensitivity or as CC intolerant with 95% specificity. After evaluating P-MR or MRA alone, the percentage of false negative results significantly increased. Conclusion: The highest value in predicting cross-clamping intolerance is achieved by using analysis of P(A)-MR and MRA of the CoW in combination.

Intralateral and Perilateral Ventricular Arteries on Original Axial Magnetic Resonance Angiography in Adult Moyamoya Disease

2021 ◽  
Vol 84 (2) ◽  
pp. 119-123
Author(s):  
Mami Ishikawa ◽  
Satoshi Terao ◽  
Hiroshi Kagami ◽  
Makoto Inaba ◽  
Heiji Naritaka
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Cerebral Infarction ◽  
Moyamoya Disease ◽  
Disease Onset ◽  
Time Of Flight ◽  
Unruptured Aneurysms ◽  
Tof Mra ◽  
Adult Moyamoya Disease

<b><i>Background:</i></b> Patients with moyamoya disease often develop cerebral infarction and hemorrhage, but the ischemic and hemorrhagic subtypes are difficult to diagnose prior to disease onset. We aimed to differentiate the ischemic and hemorrhagic subtypes of moyamoya disease by analyzing the intralateral and perilateral ventricular arteries on the original axial magnetic resonance angiography (MRA) images. <b><i>Methods:</i></b> We retrospectively analyzed the intralateral and perilateral ventricular arteries on the original axial time-of-flight (TOF)-MRA images of 18 patients with hemorrhagic moyamoya disease, 25 patients with ischemic moyamoya disease, and 22 control patients with unruptured aneurysms. <b><i>Results:</i></b> There were significantly more intralateral and perilateral ventricular arteries on the original axial MRA images in the patients with hemorrhagic moyamoya disease (6.3 ± 2.7) than in those with ischemic moyamoya disease (0.8 ± 0.9) and those with unruptured aneurysms (0.4 ± 0.8). <b><i>Conclusion:</i></b> The intralateral and perilateral ventricular arteries on the original axial TOF-MRA images might suggest the hemorrhagic type of moyamoya disease prior to onset.

scholarly journals Intraorbital wooden foreign body detected by computed tomography and magnetic resonance imaging

2016 ◽  
Vol 30 (1) ◽  
pp. 88-91 ◽  
Author(s):  
Alfredo Di Gaeta ◽  
Francesco Giurazza ◽  
Eugenio Capobianco ◽  
Alvaro Diano ◽  
Mario Muto
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Magnetic Resonance ◽  
Delayed Diagnosis ◽  
Clinical History ◽  
Definitive Diagnosis ◽  
Double Vision ◽  
Resonance Imaging ◽  
Wooden Foreign Body ◽  
The Right

To identify and localize an intraorbital wooden foreign body is often a challenging radiological issue; delayed diagnosis can lead to serious adverse complications. Preliminary radiographic interpretations are often integrated with computed tomography and magnetic resonance, which play a crucial role in reaching the correct definitive diagnosis. We report on a 40 years old male complaining of pain in the right orbit referred to our hospital for evaluation of eyeball pain and double vision with an unclear clinical history. Computed tomography and magnetic resonance scans supposed the presence of an abscess caused by a foreign intraorbital body, confirmed by surgical findings.

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