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 Local Hemodynamic Changes Immediately after Correction of an Aberrant Right Subclavian Artery in a Dog: A Contrast Computed Tomographic Study

2021 ◽  
Vol 8 (6) ◽  
pp. 104
Author(s):  
Yohei Mochizuki ◽  
Shoma Mikawa ◽  
Kenji Kutara ◽  
Keisuke Sugimoto ◽  
Hirosei Sakoya ◽  
...  
Keyword(s):  
Subclavian Artery ◽  
Computed Tomographic Angiography ◽  
Aberrant Right Subclavian Artery ◽  
Hemodynamic Changes ◽  
Surgical Ligation ◽  
Computed Tomographic ◽  
Vertebral Arteries ◽  
The Right ◽  
Tomographic Angiography ◽  
Abnormal Expansion

A 1-year-old female Akita dog was referred for intermittent regurgitation. Computed tomographic angiography (CTA) showed an aberrant right subclavian artery (ARSA), resulting in constriction of the esophagus. After surgical ligation of the ARSA, CTA showed that the ARSA was not enhanced by contrast medium, and that sufficient collateral circulation of the right forelimb was supplied through the vertebral artery. Furthermore, the right and left vertebral arteries merged into the basilar artery at the level of the atlas, and no abnormal expansion of the ventral spinal artery was observed. Overall, we demonstrated the importance of post-surgical CTA for identification of surgical complications, including the formation of abnormal vessel alterations.

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.

scholarly journals Capabilities of Imaging Methods in Preoperative Planning for the Elimination of Acquired Maxillofacial Defects

2021 ◽  
pp. 67-75
Author(s):  
A. A. Trefilov ◽  
E. V. Kryukov ◽  
V. N. Troyan ◽  
S. V. Tereshhuk ◽  
V. A. Suharev ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Doppler Ultrasound ◽  
Preoperative Planning ◽  
Computed Tomographic Angiography ◽  
Imaging Methods ◽  
Computed Tomographic ◽  
Exact Location ◽  
Anatomical Localization ◽  
Perforator Vessels ◽  
Tomographic Angiography

In this work a comparative analysis of the possibilities and efficiency of lower extremities perforator vessels visualization using the methods of Doppler ultrasound (DUS) and computed tomographic angiography (CTA) is carried out. As a result, it is shown that DUS has a number of advantages over CTA, allowing to obtain a clearer image of perforator vessels, to determine the exact location of their anatomical localization.

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.

Abstract T P177: Non-dominant Vertebral Artery With Higher Resistance Flow Pattern Is A Risk Factor For Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Leonard yeo ◽  
Amit Batra ◽  
Ashley Tan ◽  
Song Majinyang ◽  
Darren Low ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Flow Pattern ◽  
Posterior Inferior Cerebellar Artery ◽  
Computed Tomographic Angiography ◽  
Mean Flow ◽  
Computed Tomographic ◽  
Vertebral Arteries ◽  
Cerebellar Artery ◽  
Intracranial Arteries ◽  
Tomographic Angiography

Background and aims: The diameters of the vertebral arteries (VAs) are very often unequal and the larger artery is called ‘dominant’. We investigated whether the hemodynamic parameters differ between the ‘dominant’ and ‘non-dominant’ variants. Methods: Consecutive patients who underwent computed tomographic angiography (CTA) of cervical and intracranial arteries, cervical duplex (CDU) and transcranial Doppler (TCD) ultrasonography were included. VA diameters (cervical and intracranial segments) were measured on CTA. Flow velocities recorded were peak systolic (PSV), end-diastolic (EDV), mean flow (MFV). Pulsatility index (PI) and ratio of distal-to-proximal VAs were computed. Results: Of the total 501 patients admitted during 2012 with acute ischemic stroke, both CTA and ultrasound data were available for VAs for 161 (32%). The dominant VA was more frequent on the left side (p<0.01). Non-dominant VAs were found to have lower MFV (27cm/s versus 38cm/s; p<0.01) and higher PI (1.27 versus 1.0; p<0.01) as compared to the dominant variant. In most patients, proximal basilar artery was noted to be on the side of non-dominant artery. Posterior inferior cerebellar artery territory infarcts and lateral medullary infarcts were noted in 38 (7.6%) patients. These infarcts were noted more commonly on the same side as the non-dominant intracranial VA side (p<0.01), especially when associated with low MFV (p<0.01) and high PI (p<0.01). Conclusions: The risk of ischemic stroke in VA territory is higher with the non-dominant artery, especially when it is associated with higher-resistance flow pattern.

A Rare Case of a Pedicled Mobile Thrombus in Right Atrium

2016 ◽  
Vol 19 (6) ◽  
pp. 269 ◽  
Author(s):  
Xiaodong Li ◽  
Liping Chen ◽  
Xiumei Duan ◽  
Xiaocong Wang
Keyword(s):  
Right Atrium ◽  
Histopathological Examination ◽  
Rare Condition ◽  
Computed Tomographic Angiography ◽  
Right Atrial ◽  
Atrial Thrombus ◽  
Computed Tomographic ◽  
Right Atrial Thrombus ◽  
The Right ◽  
Tomographic Angiography

Pedicled mobile thrombus in the right atrium is an extremely rare condition. Here, we described a case of a 42-year-old male hospitalized with complaints of chest pain and hemoptysis. Computed tomographic angiography of the pulmonary artery showed signs of embolism, and thoracic echocardiography indicated a pedicled mobile cloudy echo in the right atrium, which was initially suspected to be a myxoma. However, it was confirmed to be a thrombus by histopathological examination. Postoperatively, the patient was treated with anticoagulant therapy comprising of low molecular heparin and warfarin, and the patient recovered well. Thoracic echocardiography performed 3 months after surgery ruled out any recurrence of right atrial thrombus.

scholarly journals Uncommon Cause of Paradoxical Embolism in a Case of Scimitar Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Fortune O. Alabi ◽  
Fred Umeh ◽  
Maximo Lama ◽  
Francis G. Christian
Keyword(s):  
Inferior Vena ◽  
Vena Cava ◽  
Computed Tomographic Angiography ◽  
Paradoxical Embolism ◽  
Scimitar Syndrome ◽  
Computed Tomographic ◽  
Anomalous Pulmonary Venous Return ◽  
Asymptomatic Adult ◽  
The Right ◽  
Tomographic Angiography

Scimitar syndrome, a rare congenital cardiopulmonary condition, presents in both pediatric and adult populations as an anomalous pulmonary venous return of most of the right lung to the inferior vena cava. Recently, asymptomatic adult cases have been diagnosed with advances in imaging studies. We report the case of an asymptomatic 43-year-old male, with a complex variant scimitar syndrome diagnosed by computed tomographic angiography.

scholarly journals Middle cerebral O2 delivery during the modified Oxford maneuver increases with sodium nitroprusside and decreases during phenylephrine

2013 ◽  
Vol 304 (11) ◽  
pp. H1576-H1583 ◽  
Author(s):  
Julian M. Stewart ◽  
Marvin S. Medow ◽  
Andrew DelPozzi ◽  
Zachary R. Messer ◽  
Courtney Terilli ◽  
...  
Keyword(s):  
Sodium Nitroprusside ◽  
Doppler Ultrasound ◽  
Transcranial Doppler ◽  
Near Infrared ◽  
Cerebral Blood Flow Velocity ◽  
Transcranial Doppler Ultrasound ◽  
Venous Occlusion ◽  
Sample Volume ◽  
Total Hemoglobin ◽  
The Right

The modified Oxford maneuver is the reference standard for assessing arterial baroreflex function. The maneuver comprises a systemic bolus injection of 100 μg sodium nitroprusside (SNP) followed by 150 μg phenylephrine (PE). On the one hand, this results in an increase in oxyhemoglobin and total hemoglobin followed by a decrease within the cerebral sample volume illuminated by near-infrared spectroscopy (NIRS). On the other hand, it produces a decrease in cerebral blood flow velocity (CBFv) within the middle cerebral artery (MCA) during SNP and an increase in CBFv during PE as measured by transcranial Doppler ultrasound. To resolve this apparent discrepancy, we hypothesized that SNP dilates, whereas PE constricts, the MCA. We combined transcranial Doppler ultrasound of the right MCA with NIRS illuminating the right frontal cortex in 12 supine healthy subjects 18–24 yr old. Assuming constant O2 consumption and venous saturation, as estimated by partial venous occlusion plethysmography, we used conservation of mass (continuity) equations to estimate the changes in arterial inflow (ΔQa) and venous outflow (ΔQv) of the NIRS-illuminated area. Oxyhemoglobin and total hemoglobin, respectively, increased by 13.6 ± 1.6 and 15.2 ± 1.4 μmol/kg brain tissue with SNP despite hypotension and decreased by 6 ± 1 and 7 ± 1 μmol/kg with PE despite hypertension. SNP increased ΔQa by 0.36 ± .03 μmol·kg−1·s−1 (21.6 μmol·kg−1·min−1), whereas CBFv decreased from 71 ± 2 to 62 ± 2 cm/s. PE decreased ΔQa by 0.27 ± .2 μmol·kg−1·s−1 (16.2 μmol·kg−1·min−1), whereas CBFv increased to 75 ± 3 cm/s. These results are consistent with dilation of the MCA by SNP and constriction by PE.

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