Carotid-Cavernous Fistula Associated with an Intracranial Lesion Caused by Cortical Venous Reflux

1995 ◽  
Vol 8 (6) ◽  
pp. 167-173
Author(s):  
S. Takahashi ◽  
I. Sakuma ◽  
T. Otani ◽  
K. Yasuda ◽  
N. Tomura ◽  
...  
Keyword(s):  
Signal Intensity ◽  
Venous Drainage ◽  
Brain Parenchyma ◽  
Venous Congestion ◽  
Venous Reflux ◽  
Carotid Cavernous Fistula ◽  
Abnormal Signal ◽  
Cortical Venous Reflux ◽  
Abnormal Signal Intensity ◽  
The Brain

Digital subtraction angiography (DSA) and magnetic resonance imaging (MRI) findings in 20 patients with carotid-cavernous fistula (CCF; 3 direct CCFs and 17 indirect CCFs) were retrospectively reviewed to evaluate venous drainage patterns that may cause intracerebral haemorrhage or venous congestion of the brain parenchyma. We evaluated the relationship between cortical venous reflux and abnormal signal intensity of the brain parenchyma on MRI. Cortical venous reflux was identified on DSA in 12 of 20 patients (60.0%) into the superficial middle cerebral vein (SMCV; n=4), the uncal vein (n=2), the petrosal vein (n=2), the lateral mesencephalic vein (LMCV; n=1), the anterior pontomesencephalic vein (APMV; n=1), both the APMV and the petrosal vein (n=1) and both the uncal vein and the SMCV (n=1). Features of venous congestion, such as tortuous and engorged veins, focal staining and delayed appearance of the veins, were demonstrated along the region of cortical venous reflux in the venous phase of internal carotid or vertebral arteriography in six of 20 patients (30.0%). These findings were not observed in the eight CCF patients who did not demonstrate cortical venous reflux. MRI revealed abnormal signal intensity of the brain parenchyma along the region with cortical venous reflux in four of 20 indirect CCF patients (20%). Of these four patients, one presented with putaminal haemorrhage, while the other three presented with hyperintensity of the pons, the middle cerebellar peduncle or both on T2-weighted images, reflecting venous congestion. The venous drainage routes were obliterated except for cortical venous reflux in these four patients and the patients without abnormal signal intensity on MRI had other patent venous outlets in addition to cortical venous reflux. CCF is commonly associated with cortical venous reflux. The obliteration or stenosis of venous drainage routes causes a converging venous outflow that develops into cortical venous reflux and results in venous congestion of the brain parenchyma or intracerebral haemorrhage. Hyperintensity of brain parenchyma along the region of cortical venous reflux on T2-weighted images reflects venous congestion and is the crucial finding that indicates concentration of venous drainage into cortical venous reflux.

scholarly journals Carotid-Cavernous Fistula Associated with an Intracranial Lesion Caused by Cortical Venous Reflux

2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 167-173 ◽  
Author(s):  
S. Takahashi ◽  
I. Sakuma ◽  
T. Otani ◽  
K. Yasuda ◽  
N. Tomura ◽  
...  
Keyword(s):  
Signal Intensity ◽  
Venous Drainage ◽  
Brain Parenchyma ◽  
Venous Congestion ◽  
Venous Reflux ◽  
Carotid Cavernous Fistula ◽  
Abnormal Signal ◽  
Cortical Venous Reflux ◽  
Abnormal Signal Intensity ◽  
The Brain

Digital subtraction angiography (DSA) and magnetic resonance imaging (MRI) findings in 20 patients with carotid-cavernous fistula (CCF; 3 direct CCFs and 17 indirect CCFs) were retrospectively reviewed to evaluate venous drainage patterns that may cause intracerebral haemorrhage or venous congestion of the brain parenchyma. We evaluated the relationship between cortical venous reflux and abnormal signal intensity of the brain parenchyma on MRI. Cortical venous reflux was identified on DSA in 12 of 20 patients (60.0%) into the superficial middle cerebral vein (SMCV; n=4), the uncal vein (n=2), the petrosal vein (n=2), the lateral mesencephalic vein (LMCV; n=1), the anterior pontomesencephalic vein (APMV; n=1), both the APMV and the petrosal vein (n=1) and both the uncal vein and the SMCV (n=1). Features of venous congestion, such as tortuous and engorged veins, focal staining and delayed appearance of the veins, were demonstrated along the region of cortical venous reflux in the venous phase of internal carotid or vertebral arteriography in six of 20 patients (30.0%). These findings were not observed in the eight CCF patients who did not demonstrate cortical venous reflux. MRI revealed abnormal signal intensity of the brain parenchyma along the region with cortical venous reflux in four of 20 indirect CCF patients (20%). Of these four patients, one presented with putaminal haemorrhage, while the other three presented with hyperintensity of the pons, the middle cerebellar peduncle or both on T2-weighted images, reflecting venous congestion. The venous drainage routes were obliterated except for cortical venous reflux in these four patients and the patients without abnormal signal intensity on MRI had other patent venous outlets in addition to cortical venous reflux. CCF is commonly associated with cortical venous reflux. The obliteration or stenosis of venous drainage routes causes a converging venous outflow that develops into cortical venous reflux and results in venous congestion of the brain parenchyma or intracerebral haemorrhage. Hyperintensity of brain parenchyma along the region of cortical venous reflux on T2-weighted images reflects venous congestion and is the crucial finding that indicates concentration of venous drainage into cortical venous reflux.

Unusual computerized tomography appearance of a carotid-cavernous fistula

1983 ◽  
Vol 58 (3) ◽  
pp. 435-437 ◽  
Author(s):  
Maria Antonietta Vaghi ◽  
Mario Savoiardo ◽  
Liliana Strada
Keyword(s):  
Computerized Tomography ◽  
Venous Drainage ◽  
Brain Parenchyma ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Balloon Technique ◽  
The Right ◽  
The Brain ◽  
Tomography Appearance

✓ A case of carotid-cavernous fistula characterized by an unusual computerized tomography (CT) pattern is reported. The CT study showed a hyperdense lesion in the right frontoparietal region, and angiography demonstrated an uncommonly large venous network in the same area. After embolization by a detachable balloon technique, these findings gradually resolved. The CT pattern was probably due to the unusually large venous drainage and to the related ischemia of the brain parenchyma.

Analysis of Changes in Signal Intensity of Choroid Plexus in MRI Using FLAIR-DW-EPI Pulse Sequence

2020 ◽  
Vol 3 (1) ◽  
pp. 9-15
Author(s):  
Jingyu Kim ◽  
◽  
Sang-Jin Im ◽  
Keyword(s):  
Choroid Plexus ◽  
Signal Intensity ◽  
Pulse Sequence ◽  
Signal Strength ◽  
Brain Parenchyma ◽  
Weighted Image ◽  
Diffusion Weighted ◽  
Water Signal ◽  
The Brain ◽  
Functional Problems

In this study, the signal intensity of choroid plexus, which is producing cerebrospinal fluid, is analyzed according to the FLAIR diffusion-weighted imaging technique. In the T2*-DW-EPI diffusion-weighted image, the FLAIR-DW-EPI technique, which suppressed the water signal, was additionally examined for subjects with high choroid plexus signals and compared and analyzed the signal intensity. As a result of the experiment, it was confirmed that the FLAIR-DW-EPI technique showed a signal strength equal to or lower than that of the brain parenchyma, and there was a difference in signal strength between the two techniques. As a result of this study, if the choroidal plexus signal is high in the T2 * -DW-EPI diffusionweighted image, additional examination of the FLAIR-DW-EPI technique is thought to be useful in distinguishing functional problems of the choroid plexus. In conclusion, if the choroidal plexus signal is high on the T2*-DW-EPI diffuse weighted image, it is thought that further examination of the FLAIR-DW-EPI technique will be useful in distinguishing functional problems of the choroidal plexus.

Appearance of venous malformations on magnetic resonance imaging

1988 ◽  
Vol 69 (4) ◽  
pp. 535-539 ◽  
Author(s):  
Daniele Rigamonti ◽  
Robert F. Spetzler ◽  
Burton P. Drayer ◽  
W. Michel Bojanowski ◽  
John Hodak ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Signal Intensity ◽  
Cavernous Malformation ◽  
Venous Malformation ◽  
Venous Drainage ◽  
Venous Malformations ◽  
Mr Images ◽  
Content Type ◽  
Venous Angiomas ◽  
The Brain

✓ The magnetic resonance (MR) imaging appearance of venous malformations, all angiographically verified, was evaluated in 11 patients. A venous malformation is characteristically depicted as a tubular area of decreased signal intensity in the white matter of the brain. In one patient, a histologically verified cavernous malformation was also present with a characteristic mixed signal-intensity core on the T2-weighted MR images. Care should be used when evaluating venous angiomas to exclude the presence of a lesion with associated prominent venous drainage, such as a glioma.

Donor Site Evaluation After Osteochondral Autograft Transplantation for Capitellar Osteochondritis Dissecans

2019 ◽  
Vol 47 (12) ◽  
pp. 2836-2843 ◽  
Author(s):  
Takeshi Matsuura ◽  
Yusuke Hashimoto ◽  
Takuya Kinoshita ◽  
Kazuya Nishino ◽  
Yohei Nishida ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Osteochondritis Dissecans ◽  
Signal Intensity ◽  
Donor Site ◽  
International Knee Documentation Committee ◽  
Mri Findings ◽  
Abnormal Signal ◽  
Osteochondral Autograft ◽  
Abnormal Signal Intensity ◽  
Usual Criterion

Background: Osteochondral autograft transplantation (OAT) for capitellar osteochondritis dissecans (OCD) requires harvesting of tissue from the asymptomatic knee joint. However, donor site morbidity (DSM) in such cases remains unclear. Purpose: To evaluate DSM and postoperative radiographic findings in patients undergoing OAT for advanced capitellar OCD. Study Design: Case series; Level of evidence, 4. Methods: Eighty-six juvenile athletes underwent OAT for advanced capitellar OCD. The 2000 International Knee Documentation Committee subjective score, rate of return to sports, and symptoms in the donor knee were assessed at a mean follow-up of 86 months (range, 28-185 months). Additionally, 49 of the 86 patients were assessed by radiographic and magnetic resonance imaging (MRI) findings of the knee donor site. DSM was defined according to the usual criterion (persistent symptoms for >1 year or the need for subsequent intervention) and a stricter criterion (the presence of any symptoms, such as effusion, patellofemoral complaints, crepitation, unspecified disturbance, stiffness, pain/instability during activities, and osteoarthritic change). The stricter criterion was also used to allocate patients into a DSM group and a no-DSM group. Results: Two and 11 patients were determined to have DSM according to the usual and stricter criteria, respectively. All patients returned to the competitive level of their sports. The mean International Knee Documentation Committee score was 99.0. MRI findings showed abnormal signal intensity in 17 patients (35%) and hypertrophic changes in 11 patients (22%) at the donor harvest sites. The MOCART (magnetic resonance observation of cartilage repair tissue) score was higher in the no-DSM group (mean, 68.2) than in the DSM group (mean, 52.9) ( P = .027). Conclusion: OAT for juvenile athletes with advanced capitellar OCD provided good clinical outcomes. The DSM rate was relatively low (2.3%) with the usual criterion but high (12.8%) with the stricter criterion. MRI showed an abnormal signal intensity and hypertrophy in some cases.

Longitudinal Assessment of Enhancing Foci of Abnormal Signal Intensity in Neurofibromatosis Type 1

2021 ◽  
Vol 42 (4) ◽  
pp. 766-773
Author(s):  
N. Hainc ◽  
M.W. Wagner ◽  
S. Laughlin ◽  
J. Rutka ◽  
C. Hawkins ◽  
...  
Keyword(s):  
Neurofibromatosis Type 1 ◽  
Signal Intensity ◽  
Neurofibromatosis Type ◽  
Longitudinal Assessment ◽  
Abnormal Signal ◽  
Abnormal Signal Intensity

A Case of Musicogenic Epilepsy

2021 ◽  
Author(s):  
Ankkita Sharma Bhandari ◽  
Mandaville Gourie-Devi ◽  
Praveen Kumar ◽  
Laxmi Khanna
Keyword(s):  
Temporal Lobe ◽  
Lifestyle Modification ◽  
Abnormal Signal ◽  
Recent Onset ◽  
History Of ◽  
Abnormal Signal Intensity ◽  
Musicogenic Epilepsy ◽  
Electroencephalogram Eeg ◽  
The Brain ◽  
Video Eeg

AbstractMusicogenic epilepsy is a relatively rare form of epilepsy characterized by seizures triggered by specific music experiences, with an estimated prevalence of 1/10,000,000 population. We report a case of 12-year-old boy with a history of recent onset focal seizures associated with an aura of formed visual hallucinations, feeling of familiarity (déjà vu), and impending fear lasting for seconds to a minute followed by eye blinking, oral automatisms, and unresponsiveness for almost 15 minutes. These episodes, most often, were provoked by music. Video electroencephalogram (EEG) done in our institute was suggestive of reflex musicogenic epilepsy arising from the left anterior temporal lobe. Magnetic resonance imaging of the brain 3T with epilepsy protocol confirmed video EEG findings, with an abnormal signal intensity in the left hippocampal and mesial temporal lobe. Treatment included lifestyle modification and antiepileptic drugs.

Neonatal methionine adenosyltransferase I/III deficiency with abnormal signal intensity in the central tegmental tract

2019 ◽  
Vol 41 (4) ◽  
pp. 382-388 ◽  
Author(s):  
Jun Kido ◽  
Takaaki Sawada ◽  
Ken Momosaki ◽  
Yosuke Suzuki ◽  
Hiroyuki Uetani ◽  
...  
Keyword(s):  
Signal Intensity ◽  
Methionine Adenosyltransferase ◽  
Abnormal Signal ◽  
Abnormal Signal Intensity ◽  
Central Tegmental Tract

DSA-Dynavision in pretreatment planning for coil embolization of indirect carotid–cavernous fistula

2016 ◽  
Vol 9 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Alex Botsford ◽  
Jai Jai Shiva Shankar
Keyword(s):  
Coil Embolization ◽  
Neurological Complication ◽  
Case Series ◽  
Procedure Time ◽  
Venous Reflux ◽  
Carotid Cavernous Fistula ◽  
Procedural Time ◽  
Cortical Venous Reflux ◽  
Procedural Planning ◽  
Carotid Cavernous Fistulas

IntroductionIndirect carotid cavernous fistulas are treated with coil embolization when they present with orbital/visual symptoms or if there is cortical venous reflux. Most of the time, the treatment is done by non-specifically packing the whole cavernous sinus with coils. The purpose of this case series was to examine whether DSA-Dynavision before embolization would improve treatment by shortening the procedure time, requiring fewer coils, or reducing the complication rate.Materials and method8 patients with 9 fistula sites were retrospectively identified. DSA-Dynavision and non-DSA-Dynavision patients were compared in a retrospective cohort study.ResultsMean total coil length was significantly shorter for the group who had DSA-Dynavision than for those who had non-DSA-Dynavision (130.5 cm vs 190 cm, p=0.034) and mean procedural time was significantly shorter for the DSA-Dynavision group (171.1 min vs 280.3 min, p=0.025). A transient neurological complication was seen in only one patient.ConclusionsThe use of DSA-Dynavision in pre-procedural planning facilitates selective coil embolization of the foot of the vein.

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