Bronchialarterienembolisation bei Hämoptysen: Das Nutzen-Risiko-Verhältnis sorgfältig abwägen

2020 ◽  
Vol 8 (3) ◽  
pp. 144-145
Author(s):  
Simon-Dominik Herkenrath
Keyword(s):  
Lung Transplantation ◽  
Bronchial Artery ◽  
Computed Tomographic Angiography ◽  
Diaphragmatic Paralysis ◽  
Massive Hemoptysis ◽  
Low Grade ◽  
Thoracic Pain ◽  
Computed Tomographic ◽  
First Case ◽  
The Right

Background: Massive hemoptysis is a serious complication in Cystic Fibrosis (CF), occurring commonly in older patients. Bronchial artery embolization (BAE) can be performed to stop the bleeding. BAE is generally safe and effective, but can sometimes lead to serious complications. We report the first case of temporary unilateral diaphragmatic paralysis associated to lung consolidation following BAE in a pediatric CF female patient. This complication worsened the lung function of the patient who underwent lung transplantation after 9 months. Case presentation: A 14 years old female CF patient followed by the CF center of Florence presented low-grade fever, cough increase and recurrent episodes of major hemorrhages such as to carry out a BAE. Within 24 h the patient started to complain of severe thoracic pain in the right hemithorax, increased dyspnea and fever. A computed tomographic angiography and a dynamic fluoroscopic evaluation revealed the right diaphragmatic paralysis, not present before the procedure. After 4 days the clinical condition and radiological imaging had improved with restored mobility of the right hemidiaphragm. Nine months later, she required mechanical ventilation, and subsequently the initiation of extracorporeal membrane oxygenation (ECMO) for a pulmonary exacerbation with septic shock. Lung transplantation in ECMO was performed with success. Conclusion: Clinicians should be aware of the possibility of phrenic nerve injury with BAE in pediatric CF patients.

The Normal Anatomy and Variations of the Bronchial Arteries: Evaluation with Multidetector Computed Tomography

2015 ◽  
Vol 66 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Özlem Yener ◽  
Aysel Türkvatan ◽  
Gökhan Yüce ◽  
Ali Ümit Yener
Keyword(s):  
Bronchial Artery ◽  
Computed Tomographic Angiography ◽  
Arterial System ◽  
Normal Anatomy ◽  
Bronchial Arteries ◽  
Tomographic Images ◽  
Computed Tomographic ◽  
Road Map ◽  
The Right ◽  
Tomographic Angiography

Introduction In this study, we aimed to reveal the normal anatomy and variations of the bronchial arterial system and to determine the sex distribution of these variations by retrospectively reviewing the images of patients who underwent thoracal multidetector computed tomographic angiography for various reasons. Materials and Methods Multidetector computed tomographic images of a total of 208 patients (151 men; mean age, 59 years) were retrospectively reviewed to assess the normal anatomy and variations of the bronchial arterial system. Results A total of 531 bronchial arteries (median, 3; minimum, 1; maximum, 5; mean, 2.5) were detected. The number (mean diameter) of the right bronchial arteries were higher than the left bronchial arteries (290 [1.43 mm] and 241 [1.26 mm], respectively; P < .05 for both number and diameter). The mean number (diameter) of the bronchial arteries were higher with men than with women (2.58 [1.45 mm] and 2.47 [1.32 mm], respectively; P < .05 for both number and diameter). The most common (24%) branching pattern was the combination of 1 right intercostal-bronchial trunk and 1 left bronchial artery, and, secondarily (13.46%), the combination of 2 right (1 intercostal-bronchial trunk and 1 bronchial artery) and 1 left bronchial arteries. Seventy-eight ectopic bronchial arteries were detected in 59 cases (28.3%). They most commonly originated from the aortic arch (37.2%), the descending aorta below the level of T6 (35.9%), or the aortic branches (16.7%). The number of right ectopic bronchial arteries was significantly higher than the left ectopic bronchial arteries (50 [64%] vs 28 [36%]; P < .01). The incidence of ectopic bronchial arteries was statistically higher with men versus women (45 [29.8%] vs 14 [24.6%]; P < .05). Conclusion The origins, numbers, diameters, and courses of the bronchial arteries can vary substantially among individuals. Multidetector computed tomographic angiography enables a detailed road map of the bronchial arterial system to interventional radiologists and thoracic surgeons.

scholarly journals Bronchial Artery Aneurysm due to Pulmonary Tuberculosis: Detection with Multidetector Computed Tomographic Angiography

2011 ◽  
Vol 1 ◽  
pp. 26 ◽  
Author(s):  
Saurabh Karmakar ◽  
Alok Nath ◽  
Zafar Neyaz ◽  
Hira Lal ◽  
Rajendra V Phadke
Keyword(s):  
Pulmonary Tuberculosis ◽  
Bronchial Artery ◽  
Artery Aneurysm ◽  
Computed Tomographic Angiography ◽  
Massive Hemoptysis ◽  
Mdct Angiography ◽  
Artery Embolization ◽  
Bronchial Artery Aneurysm ◽  
Computed Tomographic ◽  
Tomographic Angiography

A case of bronchial artery aneurysm due to pulmonary tuberculosis is reported. The patient presented with massive hemoptysis and the diagnosis was made using multidetector computed tomographic (MDCT) angiography. Selective bronchial arteriogram confirmed the MDCT findings and bronchial artery embolization was successfully performed with cessation of hemoptysis. Our article emphasizes the value of MDCT angiography in the diagnosis and management of such cases.

High-Grade Stenosis of a Traumatic Brachiocephalic Pseudoaneurysm and the Change in Cerebral Blood Flow Assessed With Transcranial Doppler Ultrasound

2021 ◽  
pp. 154431672110023
Author(s):  
Winnie Nguyen ◽  
Tammy Albanese ◽  
Vanessa Tran ◽  
Anne Moore ◽  
Laligam Sekhar
Keyword(s):  
Doppler Ultrasound ◽  
Transcranial Doppler ◽  
Transcranial Doppler Ultrasound ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Vertebral Arteries ◽  
Luminal Narrowing ◽  
Basilar Arteries ◽  
The Right ◽  
Tomographic Angiography

This is a case report of a 35-year-old female pedestrian struck by a semi-truck. computed tomographic angiography (CTA) revealed a pseudoaneurysm at the proximal brachiocephalic artery measuring 1.8 cm in cranio-caudal length and 1.2 × 0.6 cm transverse. Just distal to the pseudoaneurysm, there was severe luminal narrowing caused by either a dissection flap or mural thrombus. Due to profound left-sided weakness, transcranial Doppler ultrasound was performed which demonstrated “hesitant” waveforms in the right middle cerebral and right vertebral arteries secondary to proximal obstruction. Hesitant waveforms display mid-systolic velocity deceleration and may also be referred to as the “bunny” waveform. Emboli monitoring of the right middle cerebral and basilar arteries were positive for active embolization

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.

Disrupting the right pars opercularis with electrical stimulation frees the song: case report

2015 ◽  
Vol 123 (6) ◽  
pp. 1401-1404 ◽  
Author(s):  
Guillaume Herbet ◽  
Gilles Lafargue ◽  
Fabien Almairac ◽  
Sylvie Moritz-Gasser ◽  
François Bonnetblanc ◽  
...  
Keyword(s):  
Language Production ◽  
Inferior Frontal Gyrus ◽  
Awake Surgery ◽  
Low Grade ◽  
Speech Impairment ◽  
First Case ◽  
Pars Opercularis ◽  
The Right

The authors report the first case of a strikingly unusual speech impairment evoked by intraoperative electrostimulation in a 36-year-old right-handed patient, a well-trained singer, who underwent awake surgery for a right fronto-temporo-insular low-grade glioma. Functionally disrupting the pars opercularis of the right inferior frontal gyrus led the patient to automatically switch from a speaking to a singing mode of language production. Given the central role of the right pars opercularis in the inhibitory control network, the authors propose that this finding may be interpreted as possible evidence for a competitive and independent neurocognitive subnetwork devoted to the melodically intoned articulation of words (normal language-based vs singing-based) in subjects with high expertise. From a more clinical perspective, such data may have implications for awake neurosurgery, especially to preserve the quality of life for singers.

scholarly journals Low-Grade Fibromyxoid Sarcoma of the Lateral Skull Base: Presentation of Two Cases

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Evgenia Chetverikova ◽  
Priit Kasenõmm
Keyword(s):  
Malignant Tumour ◽  
Low Grade ◽  
Loss Of Consciousness ◽  
First Case ◽  
Clinical Presentations ◽  
Lateral Skull Base ◽  
Fibromyxoid Sarcoma ◽  
Gag Reflex ◽  
The Right ◽  
Slow Growing

Low-grade fibromyxoid sarcoma (LGFMS) is a rare slow-growing malignant tumour with a deceptively benign histologic appearance. Herein, we report two cases of LGFMS with variable clinical presentations. The first case was a 17-year-old female who referred to our department due to deaf ear on the right together with ipsilateral gag reflex impairment and globus sensation in the pharynx. The second case was a 35-year-old female with recurrent LGFMS, suffering from headaches, vertigo, and episodes of loss of consciousness. LGFMS of the temporal bone is a rare pathology, and to the best of our knowledge, no such cases have been reported before.

Sustained regression of a primary choroidal melanoma under the influence of a therapeutic melanoma vaccine.

1994 ◽  
Vol 12 (2) ◽  
pp. 396-401 ◽  
Author(s):  
M S Mitchell ◽  
P E Liggett ◽  
R L Green ◽  
J Kan-Mitchell ◽  
A L Murphree ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Cutaneous Melanoma ◽  
Specific Immunotherapy ◽  
Choroidal Melanoma ◽  
Ct Scanning ◽  
Melanoma Vaccine ◽  
Computed Tomographic ◽  
Active Specific Immunotherapy ◽  
First Case ◽  
The Right

PURPOSE To determine whether active specific immunotherapy with lysates of cutaneous melanoma cells, administered with immunologic adjuvant DETOX (Ribi ImmunoChem Research, Inc, Hamilton, MT), is effective in shrinking a primary choroidal melanoma, in an elderly patient already blind in the nontumorous eye. An 81-year-old man was referred with a primary choroidal melanoma of the left eye, with virtual blindness of the right eye due to macular degeneration. He was begun on active specific immunotherapy with an experimental melanoma vaccine (melanoma theraccine) and DETOX on weeks 1, 2, 3, 4, and 6, respected after a hiatus of 2 weeks. After a response was noted, monthly injections were given. RESULTS The patient had a significant shrinkage of his choroidal melanoma from a height of 4.2 mm to 2.4 mm within 2 months. This was sustained by continual treatment for 21 months until September 1991. After the patient failed to return for 9 months while recuperating from a stroke, the lesion regrew to a height of 3.7 mm and developed an additional lobe. On resumption of monthly treatments, the lesion shrank to 3.4 mm within 3 months, lost the additional lobe, and has since remained stable. No metastases have been found over a period of nearly 4 years on quarterly computed tomographic (CT) scanning of the chest and abdomen, and magnetic resonance imaging of the head. CONCLUSION Active specific immunotherapy with cutaneous melanoma lysates has caused a clinically useful protracted regression of a primary choroidal melanoma in an elderly patient in whom surgery and radiation therapy were contraindicated. This may represent the first case of a primary choroidal melanoma, and perhaps the only primary tumor, successfully treated with systemic immunotherapy alone. A formal trial of active specific immunotherapy for primary choroidal melanoma in selected patients may be warranted.

scholarly journals First case of nasal transitional carcinoma in a goat infected with Enzootic Nasal Tumor Virus in Belgium

2020 ◽  
Vol 89 (4) ◽  
pp. 226-230
Author(s):  
A. Delaude ◽  
E. Raes ◽  
C. Leroux ◽  
K. Chiers ◽  
L. Sonck
Keyword(s):  
Nasal Passage ◽  
Neoplastic Tissue ◽  
Computed Tomographic ◽  
First Case ◽  
Enzootic Nasal Tumor Virus ◽  
Tumor Virus ◽  
Nasal Tumor ◽  
Retrobulbar Space ◽  
Polymerase Chain ◽  
The Right

An eleven-year-old, female goat was presented for evaluation of breathing difficulties and epistaxis. Radiographs and computed tomographic (CT) examination of the head revealed the presence of a space-occupying lesion involving the right nasal passage and invading the cranial vault and retrobulbar space. Histologic examination and detection of viral genome from the nasal mass led to the diagnosis of nasal transitional carcinoma with concomitant infection with Enzootic Nasal Tumor Virus (ENTV-2). In this case report, the presence of a nasal transitional carcinoma is described in a goat; a very rare tumor which, to the authors’ knowledge, has not been previously reported in goats. Reverse transcription polymerase chain reaction (RT-PCR) detected the genome of ENTV-2 within the neoplastic tissue, suggesting an infectious etiology.

scholarly journals Eaglov sindrom

2017 ◽  
Vol 86 ◽  
Author(s):  
Mladen Gasparini ◽  
Primož Praček ◽  
Jani Muha ◽  
Uroš Tomić
Keyword(s):  
Average Length ◽  
Cranial Nerves ◽  
Styloid Process ◽  
Computed Tomographic Angiography ◽  
Measurement Tool ◽  
Computed Tomographic ◽  
Elongated Styloid Process ◽  
Eagle Syndrome ◽  
The Right ◽  
Tomographic Angiography

Background: In the present article we present the characteristics of Eagle syndrome, which is an often overlooked cause of chronic pain in the neck and head. The syndrome is caused by the compression of an elongated styloid process on the adjacent cranial nerves or the carotid arteries. Since there are disparate data in the literature regarding the proportion of people with an elongated styloid process, we conducted a survey to determine the percentage of patients with an elongated styloid process in a group of subjects who underwent computed tomographic imaging of the neck vessels in our institution.Methods: We analyzed the images of 104 patients who were referred to our institution for computed tomographic angiography of the neck between the years 2014 and 2016. With the help of a software measurement tool, we determined the length of the styloid processes and compared the length of the processes on both sides and in both genders. Patients with an elongated styloid process were reviewed for any symptoms of Eagle syndrome.Results: The average age of the reviewed patients was 67.1 years. Both genders were equally represented (51 % men and 49 % women). The average length of the styloid process was 23.8 (7.0) mm, with 23 patients (22.1 %) having a styloid process longer than 30 mm. In one third of those patients the styloid process was elongated bilaterally. There were no differences in the average length of the styloid process between men and women and between the left and the right side. Among patients with an elongated styloid process, only one (4.3 %) had symptoms attributable to the Eagle syndrome.Conclusions: Eagle syndrome should be suspected in a patient with repetitive, dull pain in the throat and neck, which worsens during speaking, chewing or swallowing. The diagnosis is confirmed by computed tomography which could demonstrate an elongated styloid process and exclude other causes for neck pain. With regard to the results of our study, an elongated styloid process is found in a relatively high percentage of patients but the condition is only rarely symptomatic.

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