scholarly journals Multiple Venous Malformations as a Cause of Pulsatile Tinnitus

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Ayham Al Afif ◽  
Uthman Alamoudi ◽  
Ahmed A. Al-Sayed ◽  
Manohar Bance
Keyword(s):  
Head And Neck ◽  
Ct Scanning ◽  
Computed Tomographic Angiography ◽  
Low Flow ◽  
Pulsatile Tinnitus ◽  
Venous Malformations ◽  
Computed Tomographic ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
Tomographic Angiography

Introduction. Pulsatile tinnitus is a relatively common presentation in otolaryngology clinics, most cases of which have a treatable cause. This presentation warrants a thorough workup to identify treatable, and rule out life-threatening, etiologies. We present a case of a patient with pulsatile tinnitus arising from multiple dilated venous channels in the head and neck. Case Presentation. We present the case of a 65-year-old Caucasian female with a two-year history of progressive, bilateral pulsatile tinnitus, which had become debilitating. Computed-tomographic angiography (CTA) studies ruled out an intracranial vascular cause for her symptoms. However, computed tomography (CT) scanning and magnetic resonance imaging (MRI) revealed multiple dilated bilateral, low-flow, venous channels throughout the head and neck. The proximity of such dilated venous channels to the temporal bone provides a route for sound to be transmitted to the inner ear. Conclusion. Arterial, venous, and systemic etiologies can cause pulsatile tinnitus. Arteriovenous malformations (AVMs) of the head and neck represent less than 1% of cases. In our patient, dilated low-flow venous malformations are the likely source of her symptoms, which is the first reported case in the literature.

scholarly journals Vascular Trauma in the Head and Neck and Endovascular Neurointerventional Management

2020 ◽  
Vol 10 ◽  
pp. 44
Author(s):  
Jeet Patel ◽  
Thien J. Huynh ◽  
Dinesh Rao ◽  
Grzegorz Brzezicki
Keyword(s):  
Head And Neck ◽  
Computed Tomographic Angiography ◽  
Vascular Trauma ◽  
Vascular Injuries ◽  
Computed Tomographic ◽  
Pictorial Essay ◽  
Life Threatening ◽  
Initial Imaging ◽  
Tomographic Angiography ◽  
Work Up

Traumatic vascular injuries of the head and neck can pose life-threatening emergencies, and therefore, the detection and accurate characterization of these injuries by the radiologist is essential. Computed tomographic angiography (CTA) is commonly performed as part of the initial imaging work-up of patients who have sustained blunt or penetrating craniocervical injuries and are suspected to have or are at risk for vascular injuries. This pictorial essay reviews the CTA and conventional angiographic imaging appearance of various vascular injuries that can occur from trauma in the head and neck and also explores the neurointerventional management of these types of injuries.

scholarly journals Carotid Cavernous Sinus Fistula with Contralateral Feed Not Diagnosed by Virtual Assessment or by Non-Invasive Vascular Imaging

2021 ◽  
Vol 12 (2) ◽  
pp. 712-716
Author(s):  
Edsel Ing ◽  
Felix Tyndel ◽  
Joyce Tang ◽  
Thomas R. Marotta
Keyword(s):  
Vision Loss ◽  
Contralateral Side ◽  
Computed Tomographic Angiography ◽  
Low Flow ◽  
Computed Tomographic ◽  
Non Invasive ◽  
Carotid Cavernous Sinus Fistula ◽  
The Right ◽  
Tomographic Angiography ◽  
Ocular Signs

A 67-year-old woman had delayed initial diagnosis of her right low flow carotid cavernous fistula (CCF) during the coronavirus disease (COVID-19) pandemic due to difficulty detecting ocular signs via online virtual examinations. Her right eye conjunctival erythema and proptosis with medial rectus enlargement on computed tomography scan was initially misdiagnosed as euthyroid thyroid-associated orbitopathy without lid retraction. She developed vision loss, and increasing episcleral venous congestion and CCF was suspected. Computed tomographic angiography did not show an obvious fistula. Digital subtraction angiography revealed the right-sided low flow CCF, which was fed from vessels from the contralateral side.

Intraoperative Gutter Leaks That Merit Our Attention

2017 ◽  
Vol 51 (8) ◽  
pp. 555-561 ◽  
Author(s):  
Adam Tanious ◽  
Mathew Wooster ◽  
Marcelo Giarelli ◽  
Paul A. Armstrong ◽  
Martin R. Back ◽  
...  
Keyword(s):  
De Novo ◽  
Computed Tomographic Angiography ◽  
High Flow ◽  
High Rate ◽  
Low Flow ◽  
Stent Grafts ◽  
Index Procedure ◽  
Computed Tomographic ◽  
Tomographic Angiography

Introduction: The natural history and potential morbidity of gutter endoleaks are unclear. We present our experience with intraoperative gutter endoleaks and strategies to determine which of these require intervention. Methods: This is a retrospective review of all patients treated with parallel stent grafts from January 2010 to September 2015. We reviewed all operative records and intraoperative angiograms as well as all postoperative imaging and secondary interventions. All gutter leaks were classified as low-flow/nonsac-enhancing gutter endoleaks or high-flow/sac-enhancing gutter endoleaks. Adjunctive interventions to manage the gutter leaks were noted, as were all subsequent interventions for gutter leak and endoleak management. Results: Seventy-eight patients had 144 parallel stents placed over a 5-year period with an average of 1.8 stents per patient. Twenty-eight patients (36%) had gutter endoleaks diagnosed intraoperatively. Seventeen patients had adjunctive procedures to reduce gutter leaks prior to leaving the operating room (OR). Patients selected for treatment had gutters filling early during completion angiography and/or contrast enhancement of the aneurysm sac. Twenty-two patients (28%) left the OR with low-flow/delayed/nonsac-enhancing gutter endoleaks. At 30 days, a total of 6 persistent gutter endoleaks were diagnosed on computed tomographic angiography. This gives a 73% rate of resolution for low-flow/nonaneurysm sac-enhancing endoleaks. There were 2 de novo endoleaks not detected at the index procedure diagnosed at 6-month follow-up. Of the 8 total postoperative endoleaks, 5 required additional intervention with a 100% success rate. Multivariate analysis revealed that the only significant predictor of having a postoperative endoleak is leaving the OR with an endoleak. Conclusions: Intraoperative treatment of gutter endoleaks has an acceptable rate of resolution. It does have a high rate of converting high-flow endoleaks to low-flow endoleaks. Low-flow/nonsac-enhancing gutter endoleaks have a high rate of spontaneous resolution. Intraoperative gutter endoleaks are not predictive of future aneurysm sac growth.

Multidetector Computed Tomographic Angiography Imaging of Congenital Pulmonary Venous Anomalies: A Pictorial Review

2017 ◽  
Vol 68 (1) ◽  
pp. 66-76 ◽  
Author(s):  
Aysel Türkvatan ◽  
Alper Güzeltaş ◽  
Hasan Tahsin Tola ◽  
Yakup Ergül
Keyword(s):  
Venous Return ◽  
Imaging Modality ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Venous Anomalies ◽  
Pictorial Review ◽  
Anomalous Pulmonary Venous Return ◽  
Life Threatening ◽  
Dual Source ◽  
Tomographic Angiography

Congenital pulmonary venous anomalies are not uncommon that can occur either in isolation or in association with different forms of congenital heart disease. Clinical presentation of these anomalies may vary from the relatively benign single anomalous partial pulmonary venous return to life-threatening critical obstructed total anomalous pulmonary venous return. Accurate delineation of these anomalies and accompanied cardiovascular anomalies are crucial to guide decision making in these patients. Low-dose high-pitch dual-source 256-detector multidetector computed tomographic angiography is a fast and reliable imaging modality allowing comprehensive noninvasive anatomic imaging in neonates and children with congenital pulmonary venous anomalies with lower radiation doses and should be preferred for these patients after transthoracic echocardiography.

Onyx Pulmonary Artery Embolization After Treatment of a Low-Flow Dural Arteriovenous Fistula: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 68 (5) ◽  
pp. E1497-E1500 ◽  
Author(s):  
Bryan A. Pukenas ◽  
Sudhakar R. Satti ◽  
Robert Bailey ◽  
John B. Weigele ◽  
Robert W. Hurst ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Transarterial Embolization ◽  
Treatment Options ◽  
Computed Tomographic Angiography ◽  
Low Flow ◽  
Computed Tomographic ◽  
Arteriovenous Fistulas ◽  
Definitive Therapy ◽  
Tomographic Angiography

Abstract BACKGROUND AND IMPORTANCE: Endovascular management of dural arteriovenous fistulas (DAVFs) has become an accepted primary and often definitive therapy. We present the first documented case of Onyx pulmonary embolism after embolization of a low-flow DAVF. CLINICAL PRESENTATION: A 63-year-old man presented with subarachnoid hemorrhage secondary to a DAVF. Computed tomographic angiography, magnetic resonance imaging, and initial conventional angiogram were negative. A repeat angiogram demonstrated a DAVF, which was cured with Onyx embolization. A routine chest computed tomography after intervention revealed an asymptomatic Onyx embolization cast in a subsegmental pulmonary artery. CONCLUSION: Endovascular treatment options include transarterial embolization with microcoils, polyvinyl alcohol particles, n-butyl-2cyanoacrylate, and Onyx (ev3 Neurovascular, Irvine, California). Complications associated with the use of Onyx are low but include embolizate pulmonary embolism. Patients often remain asymptomatic, but for symptomatic patients, conservative treatment options usually result in resolution of symptoms.

scholarly journals Unruptured Multiple Sinus of Valsalva Aneurysms

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Demian J. Omeh ◽  
Amgad N. Makaryus
Keyword(s):  
Color Doppler ◽  
Computed Tomographic Angiography ◽  
Surgical Reconstruction ◽  
Sinus Of Valsalva ◽  
Cross Sectional ◽  
Computed Tomographic ◽  
Cardiac Condition ◽  
English Medical Literature ◽  
Magnetic Resonance Imaging Mri ◽  
Tomographic Angiography

Sinus of Valsalva aneurysm (SVA) is a rare cardiac condition occurring in about 0.09% of the general population, with potential for grave complications. Unruptured sinus of Valsalva aneurysms of all three sinuses in the same patient are even more rare. There are congenital, inherited, or acquired causes. Noninvasive cross-sectional imaging modalities, consisting of color Doppler echocardiography, cardiac computed tomographic angiography (CCTA), and cardiac magnetic resonance imaging (MRI), make the diagnosis. Treatment is mainly by open surgical reconstruction. However, transcatheter techniques are gaining popularity with noninferior outcomes in selected cases. We report the diagnosis and successful management of a patient with an unusual presentation of multiple unruptured SVAs of all three sinuses, and we conducted a review of the English medical literature.

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