scholarly journals Spinal arteriovenous fistulae in patients with hereditary hemorrhagic telangiectasia: A case report and systematic review of the literature

2016 ◽  
Vol 22 (3) ◽  
pp. 354-361 ◽  
Author(s):  
Waleed Brinjikji ◽  
Deena M Nasr ◽  
Harry J Cloft ◽  
Vivek N Iyer ◽  
Giuseppe Lanzino
Keyword(s):  
Systematic Review ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Endovascular Embolization ◽  
Review Of The Literature ◽  
Type Iv ◽  
Detachable Coils ◽  
History Of ◽  
Spinal Arteriovenous Malformations ◽  
One Year ◽  
Surgical Treatments

Background Although rare, spinal arteriovenous malformations (AVMs) are thought to be more prevalent in the hereditary Hereditary Hemorrhagic Telangiectasia (HHT) population. Methods We report a case of a spinal AVM in a 37-year-old female with HHT treated with endovascular embolization. In addition, we report findings from a systematic review of the literature on the clinical characteristics, angioarchitecture, and clinical outcomes of HHT patients with spinal AVMs. Results The patient is a 37 year-old female with definite HHT who presented with a one-year history of progressive gait difficulty. The spinal fistula was incidentally detected on chest computed tomography (CT). Spinal angiography demonstrated a large perimedullary arteriovenous fistula was supplied by a posterolateral spinal artery. The fistula was treated with detachable coils. The patient made a complete neurological recovery. Our systematic review yielded 25 additional cases of spinal AVMs in HHT patients. All fistulae were perimedullary (100.0%). Treatments were described in 24 of the 26 lesions. Endovascular-only treatment was performed in 16 cases (66.6%) and surgical-only treatment was performed in five cases (20.8%). Complete or near-complete occlusion rates were 86.7% (13/15) for endovascular treated cases, 100.0% (4/4) for surgery and 66.6% (2/3) for combined treatments. Overall, 80.0% of patients (16/20) reported improvement in function following treatment, 100.0% (5/5) in the surgery group and 84.6% (11/13) reported improvement in the endovascular group. Conclusions Spinal fistulae in HHT patients are usually type IV perimedullary fistulae. Both endovascular and surgical treatments appeared to be effective in treating these lesions. However, it is clear that endovascular therapy has become the preferred treatment modality.

scholarly journals Initial assessment in the management of adult epistaxis: systematic review

2017 ◽  
Vol 131 (12) ◽  
pp. 1035-1055 ◽  
Author(s):  
M Khan ◽  
K Conroy ◽  
K Ubayasiri ◽  
J Constable ◽  
M E Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Search Strategy ◽  
First Aid ◽  
Initial Assessment ◽  
Review Of The Literature ◽  
Co Morbidity ◽  
Recurrent Epistaxis ◽  
History Of ◽  
Anticoagulant Medication ◽  
Ice Pack

AbstractBackground:The initial assessment of epistaxis patients commonly includes: first aid measures, observations, focused history taking, and clinical examinations and investigations. This systematic review aimed to identify evidence that informs how the initial assessment of these patients should be conducted.Method:A systematic review of the literature was performed using a standardised methodology and search strategy.Results:Seventeen articles were included. Factors identified were: co-morbidity, intrinsic patient factors, coagulation screening and ice pack use. Hypertension and anticoagulant use were demonstrated to adversely affect outcomes. Coagulation screening is useful in patients on anticoagulant medication. Four studies could not be accessed. Retrospective methodology and insufficient statistical analysis limit several studies.Conclusion:Sustained ambulatory hypertension, anticoagulant therapy and posterior bleeding may be associated with recurrent epistaxis, and should be recorded. Oral ice pack use may decrease severity and can be considered as first aid. Coagulation studies are appropriate for patients with a history of anticoagulant use or bleeding diatheses.

scholarly journals Uncommon Site of Metastasis and Prolonged Survival in Patients with Anaplastic Thyroid Carcinoma: A Systematic Review of the Literature

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2585
Author(s):  
Aurora Mirabile ◽  
Matteo Biafora ◽  
Leone Giordano ◽  
Gianluigi Arrigoni ◽  
Maria Giulia Cangi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Thyroid Carcinoma ◽  
Thyroid Tumor ◽  
Anaplastic Thyroid Carcinoma ◽  
Review Of The Literature ◽  
Malignant Thyroid Tumor ◽  
One Year

Anaplastic thyroid carcinoma (ATC) is a very rare, highly aggressive malignant thyroid tumor with an overall survival from 3 to 5 months in most of the cases. Even the modern and intensive treatments seem not to be enough to provide a cure, also for the resectable ones, and the role of chemotherapy is still unclear but does not seem to prolong survival. Nevertheless, some patients survive longer and have a better outcome, even in the presence of metastasis, than what the literature reports. We present the case of a 64-year-old female affected by ATC, treated on February 2018 with surgery followed by chemoradiation. One year after surgery, the patient developed a subcutaneous recurrence that was radically resected and is still alive 29 months after the diagnosis. We propose a systematic review of the literature to deepen the knowledge of the prognostic factors of ATC with the aim to recognize and select the patients with a better outcome, even if metastatic, and to describe a very uncommon site of metastatization.

The natural history of monoamniotic twin pregnancies: a case series and systematic review of the literature

2015 ◽  
Vol 35 (3) ◽  
pp. 274-280 ◽  
Author(s):  
Federico Prefumo ◽  
Anna Fichera ◽  
Giorgio Pagani ◽  
Daria Marella ◽  
Adriana Valcamonico ◽  
...  
Keyword(s):  
Systematic Review ◽  
Natural History ◽  
Case Series ◽  
Review Of The Literature ◽  
History Of ◽  
Twin Pregnancies

Endovascular Treatment for Ruptured Cerebral Aneurysms in Acute Stage

1999 ◽  
Vol 5 (1_suppl) ◽  
pp. 195-198
Author(s):  
J. Ueno ◽  
K. Sugiyama ◽  
H. Naitou ◽  
N. Hirota ◽  
S. Karasawa ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Endovascular Embolization ◽  
Acute Stage ◽  
Technical Problems ◽  
Improved Outcomes ◽  
Detachable Coils ◽  
Grade Ii ◽  
Older Subjects ◽  
One Year ◽  
Definition Of

Since the introduction of endovascular embolization with Guglielmi Detachable Coils (GDC)1–3in April 1997, we have performed 56 endovascular treatments for ruptured cerebral aneurysms in the acute stage based on our definition of candidates for this modality. Overall outcomes are as follows. 1) Rebleeding within one year was limited to one case (2.5%). 2) Vasospasm occurrences: four cases (7.1%) infarction and three cases (5.4%) as transient ischemia. 3) H&K Grade IV; 60% of cases resulted in improved outcomes. 4) H&K Grade II: One case of rupture during an operation. 5) Three out of five older subjects (over 80 years old) resulted in GR or MD. In this study, we reviewed endovascular embolization in acute stage in terms of candidates and technical problems.

scholarly journals Chronic Recanalization of Dissection of the Distal Anterior Cerebral Artery: Case Report and Review of the Literature

2009 ◽  
Vol 2009 ◽  
pp. 1-5
Author(s):  
Shuichiro Asano ◽  
Tetsuo Hara
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Acute Stage ◽  
Review Of The Literature ◽  
History Of ◽  
One Year ◽  
Distal Anterior Cerebral Artery

The natural history of atraumatic idiopathic dissection of the distal anterior cerebral artery is still unclear. We present a 38-year-old man who had dissection of the leftA2segment of this vessel associated with subintimal hematoma and infarction. Because of complete stroke in acute stage, he did not undergo surgery. About three months later, administration of aspirin (100 mg/day) was started. At nine months, magnetic resonance angiography revealed complete recanalization of theA2dissection. To assess the outcome of dissection, we should observe the patient for at least one year.

Small bowel intussusception in pregnant women with a history of a Roux-en-Y gastric bypass: a case series and a systematic review of the literature

2020 ◽  
Vol 16 (10) ◽  
pp. 1603-1613 ◽  
Author(s):  
Daniëlle S. Bonouvrie ◽  
Loes Janssen ◽  
Hendrik J. Niemarkt ◽  
Judith O.E.H. van Laar ◽  
Wouter K.G. Leclercq ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastric Bypass ◽  
Small Bowel ◽  
Pregnant Women ◽  
Case Series ◽  
Review Of The Literature ◽  
Small Bowel Intussusception ◽  
History Of
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