scholarly journals Spontaneous Thrombosis of the Pseudoaneurysm of Right SCA after an Attempt at Embolisation

2002 ◽  
Vol 8 (2) ◽  
pp. 205-208 ◽  
Author(s):  
M. Szajner ◽  
T. Jargiello ◽  
T. Trojanowski ◽  
M. Szczerbo-Trojanowska
Keyword(s):  
Intracranial Aneurysms ◽  
Technical Problem ◽  
Distal Segment ◽  
Regional Hospital ◽  
Cerebellar Hemisphere ◽  
Digital Subtraction ◽  
Spontaneous Thrombosis ◽  
Main Trunk ◽  
Digital Subtraction Angiogram ◽  
The Right

Spontaneous thrombosis of intracranial aneurysms rare, mostly affecting giant aneurysms with narrow necks. We present the case of 34 y/o man with pseudoaneurysm that developed in the course of SAH. The initial CT scan showed an isolated, well-defined hematoma within the right cerebellar hemisphere, digital subtraction angiogram (DSA) performed in a regional hospital showed an irregular shaped aneurysm of the distal segment of the right SCA. The patient was sent to our department, where diagnostic DSA, performed before embolisation revealed an entirely different morphology of the aneurysm. It became larger, round and no other functional branches distal to it were found (picture of “a balloon on a string”). During supraselective catheterization, when microcatheter and microguidewire were already in the right SCA a technical problem of our angio-machine occurred, so the intervention had to be postponed. A week later, a second attempt at embolisation was made. This time an initial DSA showed a lack of filling of the aneurysm sac and thrombosis of the main trunk of the right SCA. The patient remained clinically stable. He was discharged from our hospital five days later.

scholarly journals Woven-like change following intracoronary thrombosis recanalization: a case report

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wei Wen ◽  
Haibo Liu ◽  
Jimin Li ◽  
Qi Zhang
Keyword(s):  
Coronary Artery ◽  
Coronary Intervention ◽  
Distal Segment ◽  
Main Trunk ◽  
Diagnostic Modality ◽  
Spider Web ◽  
Coronary Thrombus ◽  
Definition Of ◽  
Lotus Root Appearance ◽  
The Right

Abstract Background A woven coronary artery is a rare congenital coronary anomaly and incidentally found in coronary angiogram. Coronary angiography is the major diagnostic modality, which shows the main trunk of coronary divides into several channels which later reconnect with normal blood flow (J Int Cardiol 113:121-123 2006). However, some cases and reviews inferred that this characteristic might be mimicked by recanalized coronary thrombus, which occurs following thrombotic occlusion. In some case, the multiple intraluminal channels have a ‘Swiss cheese’, a ‘Spider web-like’, a ‘Honeycomb’ or a ‘Lotus root’ appearance and most of them appear in local segment (Int J Cardiol 186: 239–240, 2015). As these images are nonspecific findings, there is no angiographic uniform definition of intracoronary thrombus. More information about the characteristics and the development of this woven-like structure is needed. Case presentation A 67-year-old male patient was admitted to our hospital because of chest pain. Coronary artery angiogram revealed that the right coronary artery (RCA) divided into multiple thin channels from proximal to distal, which was similar to the so-called woven coronary artery. Compared with his prior coronary angiograms which showed a tiny hazy lesion in distal segment of RCA, we found the woven-like phenomena should be caused by a late-stage recanalized coronary thrombus. Percutaneous coronary intervention (PCI) was performed to restore the RCA flow, and the angina symptom was extremely improved during clinical follow-up. Conclusions The diagnostic criteria of woven coronary artery was based on angiographic image. However, some cases and reviews inferred that thrombotic recanalization might also share the same characteristic. In this case, we collected the baseline angiograms and intracoronary images then successfully diagnosed the woven-like RCA as thrombotic recanalization. For this kind of woven-like coronary artery, PCI could be a better treatment strategy. Detailed history collection and intracoronary image techniques should be emphasized in future clinical practice in the differentiating and treatment of woven-like phenomena.

CURATIVE ENDOVASCULAR RECONSTRUCTION OF CEREBRAL ANEURYSMS WITH THE PIPELINE EMBOLIZATION DEVICE

Neurosurgery ◽  
2009 ◽  
Vol 64 (4) ◽  
pp. 632-643 ◽  
Author(s):  
Pedro Lylyk ◽  
Carlos Miranda ◽  
Rosana Ceratto ◽  
Angel Ferrario ◽  
Esteban Scrivano ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Cerebral Aneurysms ◽  
Digital Subtraction ◽  
Pipeline Embolization Device ◽  
Large N ◽  
Cranial Neuropathies ◽  
Digital Subtraction Angiogram ◽  
Age Range ◽  
Mean Time

Abstract OBJECTIVES The Pipeline embolization device (PED) (Chestnut Medical Technologies, Inc., Menlo Park, CA) is a new microcatheter-delivered endovascular construct designed to achieve the curative reconstruction of the parent arteries giving rise to wide-necked and fusiform intracranial aneurysms. We present our initial periprocedural experience with the PED and midterm follow-up results for a series of 53 patients. METHODS Patients harboring large and giant wide-necked, nonsaccular, and recurrent intracranial aneurysms were selected for treatment. All patients were pretreated with dual antiplatelet medications for at least 72 hours before surgery and continued taking both agents for at least 6 months after treatment. A control digital subtraction angiogram was typically performed at 3, 6, and 12 months. RESULTS Fifty-three patients (age range, 11–77 years; average age, 55.2 years; 48 female) with 63 intracranial aneurysms were treated with the PED. Small (n = 33), large (n = 22), and giant (n = 8) wide-necked aneurysms were included. A total of 72 PEDs were used. Treatment was achieved with a single PED in 44 aneurysms, with 2 overlapping PEDs in 17 aneurysms, and with 3 overlapping PEDs in 2 aneurysms. The mean time between the treatment and last follow-up digital subtraction angiogram was 5.9 months (range, 1–22 months). Complete angiographic occlusion was achieved in 56%, 93%, and 95% of aneurysms at 3 (n = 42), 6 (n = 28), and 12 (n = 18) months, respectively. The only aneurysm that remained patent at the time of the 12-month follow-up examination had been treated previously with stent-supported coiling. The presence of a preexisting endoluminal stent may have limited the efficacy of the PED reconstruction in this aneurysm. No aneurysms demonstrated a deterioration of angiographic occlusion during the follow-up period (i.e., no recanalizations). No major complications (stroke or death) were encountered during the study period. Three patients (5%), all with giant aneurysms, experienced transient exacerbations of preexisting cranial neuropathies and headache after the PED treatment. All 3 were treated with corticosteroids, and these symptoms resolved within 1 month. CONCLUSION Endovascular reconstruction with the PED represents a safe, durable, and curative treatment of selected wide-necked, large and giant cerebral aneurysms. The rate of complete occlusion at the time of the 12-month follow-up examination approached 100% in the present study. To date, no angiographic recurrences have been observed during serial angiographic follow-up.

scholarly journals Flow diverter neuroendovascular stents – Reconstructive endovascular treatment of intracranial aneurysms – Single centre experience

2013 ◽  
Vol 02 (02) ◽  
pp. 182-188 ◽  
Author(s):  
Krzysztof Kadzioloka ◽  
Laurent Estrade ◽  
Laurent Pierot ◽  
Girish Rajpal
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Antiplatelet Agents ◽  
Flow Diverter ◽  
Digital Subtraction ◽  
Anterior Circulation ◽  
Complete Occlusion ◽  
Digital Subtraction Angiogram ◽  
Age Range

AbstractFlow diverter stents (FDS) are new neuroendovascular tools able to achieve the complete and curative treatment of aneurysm by reconstruction of the parent arteries from which the aneurysm arises. We present our initial experience with flow diverter embolization devices and follow-up results.Patients with large, giant and wide necked aneurysms, saccular, fusiform and recurrent aneurysms were selected for the treatment. All patients were pretreated with dual antiplatelet agents at least for 7 days before procedure and continued taking both agents for 3 months after treatment. A MRI was done after 3 months of treatment and digital subtraction angiogram was performed at 4 months of treatment. After 1 year both MRI and digital subtraction angiogram was performed.11 patients (age range 37 year to 79 year, mean 51.1) with 11 intracranial aneurysms were treated with 15 flow diverter stents. 9 aneurysm were located on the anterior circulation and 2 on posterior circulation. 8 aneurysms were large (10-25 mm), 2 were small (<10 mm) and 1 was giant (>25 mm) with mean largest diameter of 13.22 mm. 9 were saccular aneurysm and 2 were fusiform, out of these 3 were remnant of the previously treated aneurysm. Treatment was achieved with 10 Silk stents in 7 patients and 5 Pipeline embolization devices in 4 patients. The mean time between treatment and follow up was 9.6 months (range 4-12 months). One mortality was noted due to rebleed after 3 weeks of treatment. Complete angiographic occlusion was achieved in 9 (90%) patients after 4 months and 1 (10%) patient had near complete occlusion at 12 months. All the patients were stable clinically during follow up period.Endovascular treatment with FDS is safe, easy, and permanent treatment for the selected group of aneurysms. The complete occlusion rate in follow-up study approaches 100% with no angiographic recurrence in this study.

scholarly journals Reduced Interhemispheric Coherence in Cerebellar Kainic Acid-Induced Lateralized Dystonia

2020 ◽  
Vol 11 ◽  
Author(s):  
Elena Laura Georgescu Margarint ◽  
Ioana Antoaneta Georgescu ◽  
Carmen Denise Mihaela Zahiu ◽  
Stefan-Alexandru Tirlea ◽  
Alexandru Rǎzvan Şteopoaie ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Kainic Acid ◽  
Primary Motor Cortex ◽  
Low Frequency ◽  
Muscular Activity ◽  
Cerebellar Hemisphere ◽  
Interhemispheric Coherence ◽  
General Locomotor Activity ◽  
Complex Circuits ◽  
The Right

The execution of voluntary muscular activity is controlled by the primary motor cortex, together with the cerebellum and basal ganglia. The synchronization of neural activity in the intracortical network is crucial for the regulation of movements. In certain motor diseases, such as dystonia, this synchrony can be altered in any node of the cerebello-cortical network. Questions remain about how the cerebellum influences the motor cortex and interhemispheric communication. This research aims to study the interhemispheric cortical communication between the motor cortices during dystonia, a neurological movement syndrome consisting of sustained or repetitive involuntary muscle contractions. We pharmacologically induced lateralized dystonia to adult male albino mice by administering low doses of kainic acid on the left cerebellar hemisphere. Using electrocorticography and electromyography, we investigated the power spectral densities, cortico-muscular, and interhemispheric coherence between the right and left motor cortices, before and during dystonia, for five consecutive days. Mice displayed lateralized abnormal motor signs, a reduced general locomotor activity, and a high score of dystonia. The results showed a progressive interhemispheric coherence decrease in low-frequency bands (delta, theta, beta) during the first 3 days. The cortico-muscular coherence of the affected side had a significant increase in gamma bands on days 3 and 4. In conclusion, lateralized cerebellar dysfunction during dystonia was associated with a loss of connectivity in the motor cortices, suggesting a possible cortical compensation to the initial disturbances induced by cerebellar left hemisphere kainate activation by blocking the propagation of abnormal oscillations to the healthy hemisphere. However, the cerebellum is part of several overly complex circuits, therefore other mechanisms can still be involved in this phenomenon.

Cerebral angiography during operation for intracranial aneurysms and arteriovenous malformations

1971 ◽  
Vol 34 (5) ◽  
pp. 706-708 ◽  
Author(s):  
Martin L. Lazar ◽  
Clark C. Watts ◽  
Bassett Kilgore ◽  
Kemp Clark
Keyword(s):  
Cerebral Angiography ◽  
Arteriovenous Malformations ◽  
Intracranial Aneurysms ◽  
Operative Procedure ◽  
Superficial Temporal Artery ◽  
Technical Problem ◽  
Temporal Artery ◽  
Content Type ◽  
Actual Operation ◽  
Fine Print

✓ Angiography during the operative procedure is desirable, but is often difficult because of the problem of maintaining a needle or cannula in an artery for long periods of time. Cannulation of the superficial temporal artery avoids this technical problem. The artery is easily found, cannulation is simple, and obliteration of the artery is of no consequence. Cerebral angiography then provides a means for prompt evaluation of the surgical procedure at any time during the actual operation.

Magnetic resonance imaging of primary cerebral gliosarcoma: a report of 15 cases

2008 ◽  
Vol 49 (9) ◽  
pp. 1058-1067 ◽  
Author(s):  
L. Han ◽  
X. Zhang ◽  
S. Qiu ◽  
X. Li ◽  
W. Xiong ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Clinical Information ◽  
Cerebellar Hemisphere ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Mr Images ◽  
Peripheral Location ◽  
Pathology Reports ◽  
The Right ◽  
Radiologic Features

Background: Gliosarcomas are rare tumors with mixed glial and mesenchymal components. Many of their radiologic features resemble those of other primary brain malignancies. Purpose: To investigate the magnetic resonance (MR) imaging features of gliosarcomas. Material and Methods: We retrospectively reviewed the MR images, pathology reports, and clinical information of 11 male and four female patients aged 15–71 years to evaluate the location, morphology, enhancement, and other features of their pathologically confirmed gliosarcomas. Results: Apart from one tumor in the right cerebellar hemisphere, all were supratentorial. Two tumors were intraventricular, and four involved the corpus callosum. The tumors were well demarcated, with an inhomogeneous or cystic appearance and moderate-to-extensive surrounding edema. Thick walls with strong rim and ring-like enhancement were observed in 13 (87%). Seven (47%) showed intratumoral paliform enhancement. Conclusion: Gliosarcoma demonstrates certain characteristic MR features, such as supratentorial and peripheral location, well-demarcated, abutting a dural surface, uneven and thick-walled rim-like or ring enhancement, as well as intratumoral strip enhancement. These findings, combined with patient age, can aid the differential diagnosis of gliosarcomas from more common primary brain tumors.

scholarly journals Spontaneous Thrombosis of an Orbital Arteriovenous Malformation Revealing Hereditary Haemorrhagic Telangiectasia (Rendu-Osler-Weber Disease)

2011 ◽  
Vol 17 (4) ◽  
pp. 466-471 ◽  
Author(s):  
C. Van Went ◽  
A. Ozanne ◽  
G. Saliou ◽  
G. Dethorey ◽  
I. De Monchy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Arteriovenous Malformation ◽  
Genetic Disorder ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Spontaneous Thrombosis ◽  
Vein Thrombosis ◽  
Recurrent Epistaxis ◽  
The Right ◽  
Central Retinal Vein

Hereditary Haemorrhagic Telangiectasia (HHT) is a genetic disorder responsible for cutaneous or mucosal telangiectasia and arteriovenous malformations (AVMs). The most frequent locations are lung and brain. In contrast, orbital AVMs are very rare. We describe a case of symptomatic orbital arteriovenous malformation due to spontaneous thrombosis. A 65-year-old woman was referred for chronic right eye proptosis associated with dilation of conjunctival vessels with a jellyfish pattern. Right visual acuity was 20/40 and intraocular pressure was 40 mmHg. Personal and familial history of recurrent epistaxis, associated with multiple telangiectasia within lips and palate, led to the diagnosis of HHT. Magnetic resonance imaging (MRI) completed with cerebral angiography found a giant and occluded AVM within the right orbit. Other AVMs were also found in brain and chest, confirming the diagnosis. Antiglaucomatous eyedrops were added to reduce intraocular pressure and a steroid therapy was begun. Two months later, visual acuity decreased in the right eye, due to a central retinal vein thrombosis. In conclusion, Most brain or pulmonary AVM can be treated by embolization. By contrast, this treatment in case of orbital location can lead to central retinal artery and/or central retinal vein occlusion, which may also appear as a spontaneous complication of the orbital AVM. Therapeutic management of orbital AVM is thus not standardized, and the balance between spontaneous and iatrogenic risk of visual loss has to be taken into account.

Intraoperative digital subtraction angiography and the surgical treatment of intracranial aneurysms and vascular malformations

1990 ◽  
Vol 73 (4) ◽  
pp. 526-533 ◽  
Author(s):  
Neil A. Martin ◽  
John Bentson ◽  
Fernando Viñuela ◽  
Grant Hieshima ◽  
Murray Reicher ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Intracranial Aneurysms ◽  
Vascular Malformations ◽  
Operating Table ◽  
Digital Subtraction ◽  
Intraoperative Angiography ◽  
Content Type ◽  
Head Holder ◽  
Cerebral Embolization ◽  
Leg Ischemia

✓ Intraoperative digital subtraction angiography using commercially available equipment was employed to confirm the precision of the surgical result in 105 procedures for intracranial aneurysms or arteriovenous malformations (AVM's). Transfemoral selective arterial catheterization was performed in most of these cases. A radiolucent operating table was used in all cases, and a radiolucent head-holder in most. In five of the 57 aneurysm procedures, clip repositioning was required after intraoperative angiography demonstrated an inadequate result. In five of the 48 AVM procedures, intraoperative angiography demonstrated residual AVM nidus which was then located and resected. In two cases intraoperative angiography failed to identify residual filling of an aneurysm which was seen later on postoperative angiography, and in one case the intraoperative study failed to demonstrate a tiny residual fragment of AVM which was seen on conventional postoperative angiography. Two complications resulted from intraoperative angiography: one patient developed aphasia from cerebral embolization and one patient developed leg ischemia from femoral artery thrombosis. This technique appears to be of particular value in the treatment of complex intracranial aneurysms and vascular malformations.

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