Persistent Hypoglossal Artery in Combination with Multifocal Arteriovenous Malformations of the Brain: Case Report

Neurosurgery ◽  
1990 ◽  
Vol 26 (5) ◽  
pp. 871-876 ◽  
Author(s):  
Romaá Garza-Mercado ◽  
Elisamaria Cavazos ◽  
Gabriel Urrutia

Abstract The persistence of embryonic cerebral vessels in the adult is not a frequent occurrence, neither is the presence of multifocal arteriovenous malformations (AVMs) of the brain. The most commonly reported type of persistent carotid-basilar anastomosis is the primitive trigeminal artery, followed by the primitive hypoglossal artery (PHA). In this report. a 30-year-old, right-handed woman hospitalized because of subarachnoid hemorrhage and harboring an intracerebral-intraventricular hematoma resulting from the rupture of one of two independent AVMs of the left cerebral hemisphere, was found also to have a right persistent PHA. One AVM was intraventricular and had ruptured: the other was subcortical, intact in the parietal lobe. The PHA originated as a large anomalous branch of the right internal carotid artery in the neck and joined the basilar artery after entering the posterior fossa through the ipsilateral anterior condyloid foramen, which was enlarged. At craniotomy, the two AVMs were successfully excised with the aid of microsurgical technique. These two independently rare conditions, namely, multifocal cerebral AVMs and persistent PHA, warrant our desire to report this case.

2013 ◽  
Vol 52 (189) ◽  
pp. 272-274
Author(s):  
Kalyan Paudel ◽  
Anand Venugopal

Dyke-Davidoff-Masson syndrome refers to atrophy of one cerebral hemisphere (hemiatrophy) due to an insult to the brain in fetal or early childhood period. This is an uncommon condition. We present a case of a nine month- old female presented with seizure and weakness of the right upper and lower extremities and subsequently computed tomography was performed and showed hemiatrophy of the left fronto-parietal lobe with degenerative changes in the left cerebral peduncle. Keywords: Dyke-Davidoff-Masson syndrome; hemiatrophy; hemiplegia.


Neurosurgery ◽  
1984 ◽  
Vol 14 (1) ◽  
pp. 78-82 ◽  
Author(s):  
Robert A. Solomon ◽  
Jost W. Michelsen

Abstract We report the case of a patient with a large left subfrontal arteriovenous malformation (AVM) that was supplied by the right internal carotid artery. The anomalous blood supply developed because of complete occlusion of the left internal carotid artery. When the AVM was removed, the patient experienced a hemorrhage into the right basal ganglia. The possibility that this hemorrhage was related to a defect of autoregulation in blood vessels that lie proximal to a large AVM is discussed. Even though this is a unique case, the pathophysiological events that are documented are relevent to the preoperative preparation and surgical management of all patients with AVMs.


Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S74-S82 ◽  
Author(s):  
R. Webster Crowley ◽  
Andrew F. Ducruet ◽  
Cameron G. McDougall ◽  
Felipe C. Albuquerque

Abstract Arteriovenous malformations (AVMs) of the brain represent unique challenges for treating physicians. Although these lesions have traditionally been treated with surgical resection alone, advancements in endovascular and radiosurgical therapies have greatly expanded the treatment options for patients harboring brain AVMs. Perhaps no subspecialty within neurosurgery has seen as many advancements over a relatively short period of time as the endovascular field. A number of these endovascular innovations have been designed primarily for cerebral AVMs, and even those advancements that are not particular to AVMs have resulted in substantial changes to the way cerebral AVMs are treated. These advancements have enabled the embolization of cerebral AVMs to be performed either as a stand-alone treatment, or in conjunction with surgery or radiosurgery. Perhaps nothing has impacted the treatment of brain AVMs as substantially as the development of liquid embolics, most notably Onyx and n-butyl cyanoacrylate. However, of near-equal impact has been the innovations seen in the catheters that help deliver the liquid embolics to the AVMs. These developments include flow-directed catheters, balloon-tipped catheters, detachable-tipped catheters, and distal access catheters. This article aims to review some of the more substantial advancements in the endovascular treatment of brain AVMs and to discuss the literature surrounding the expanding indications for endovascular treatment of these lesions.


1990 ◽  
Vol 48 (2) ◽  
pp. 188-194 ◽  
Author(s):  
Luciano Ribeiro Pinto Jr. ◽  
Sylvio Saraiva ◽  
Wilson Luiz Sanvito

Twenty patients with unilateral neglect syndrome were studied. They were 10 males and 10 females, and they ranged from 29 to 76 years of age. All were submitted to a CAT scan of the brain. Based on the findings in our sample we drew the following conclusions: the extinction phenomenon was a constant manifestation of unilateral neglect; the line crossing test proved to be most efficient for the identification of visual neglect; the right parietal lobe was the anatomical region most often involved in the unilateral neglect syndrome.


2017 ◽  
Vol 16 (04) ◽  
pp. 239-242
Author(s):  
Gunnar Buyse ◽  
Lieven Lagae ◽  
Philippe Demaerel ◽  
Frank Kesteloot ◽  
Ingele Casteels ◽  
...  

AbstractWyburn–Mason syndrome is a rare condition that is characterized by ipsilateral arteriovenous malformations affecting the eye, brain, and facial skin. A conjunctival vascular dilation can be a rare ocular presenting sign. We report a 6-year-old boy who attended the hospital because of the sudden appearance of a conjunctival vascular lesion in his right eye. Inspection of his facial skin showed a subtle discoloration along the right trigeminal nerve and a vascular structure of the conjunctiva. Fundoscopy showed dilated and tortuous retinal vessels. Brain magnetic resonance imaging (MRI) revealed a large arteriovenous malformation involving the thalamus and perimesencephalic area. Ophthalmologic and neuroradiologic findings were consistent with the diagnosis of Wyburn–Mason syndrome. The sudden emergence of a vascular malformation in the conjunctiva should alert the clinician to perform an ophthalmoscopy, and in our patient, this finding was the clue to diagnosis of Wyburn–Mason syndrome. Because of the association between retinal and intracranial arteriovenous malformations, an MRI of the brain is strongly recommended in all patients with ocular arteriovenous malformations.


1983 ◽  
Vol 58 (3) ◽  
pp. 440-442 ◽  
Author(s):  
Mamoru Taneda ◽  
Akatsuki Wakayama ◽  
Koji Ozaki ◽  
Kazuo Kataoka ◽  
Toru Hayakawa ◽  
...  

✓ An unusual case of delayed ischemia following rupture of an aneurysm of the left internal carotid artery is reported. Symptoms occurred twice after clipping the aneurysm and removing most of the subarachnoid blood on the left side the day after subarachnoid hemorrhage (SAH). Initial ischemia due to vasospasm occurred on the left side of the brain on the 8th day after SAH and responded favorably to induced hypervolemia. After complete recovery, a second episode due to vasospasm occurred on the 16th day after SAH on the right side of the brain from which the subarachnoid blood had not been removed. This caused a massive lesion and permanent severe neurological deficits. This case suggests that removal of subarachnoid blood may affect the severity and time course of vasospasm, and emphasizes the necessity of extensive removal of subarachnoid blood for prevention of severe delayed ischemic symptoms.


2018 ◽  
Vol 44 (1) ◽  
pp. 7
Author(s):  
Juliana Voll ◽  
Rui Campos

Background: Trachemys scripta elegans, in Brazil, has been considered an exotic and invasive turtle; it competes with autochthon species for habitat and food, threatening biodiversity. These animals have been exported to Brazil as pets; however, despite of the commercial interest in the last years, there are only few reports about the turtle central nervous system vascularization. Therefore, this study had the objective to describe and systematize the middle cerebral artery at the brain surface of the turtle (Trachemys scripta elegans), determining a standard model of irrigation and the main ramifications and territory, in this species.Materials, Methods & Results: Thirty turtles received pre-anesthetic medication composed of ketamine (80 mg/kg) and midazolam (2 mg/kg) followed by euthanasia with a sodium thiopental (100 mg/kg) overdose. The aortic arches were cannulated through the single ventricle, the cranial cava veins were incised and the vascular system washed with saline solution and heparin, and then filled with latex. Pieces remained immersed in running water and a bone window was opened in the cranial vault. Samples were fixed with formaldehyde and each brain with a spinal cord segment was removed from the cranial vault, the duramater was removed and the arteries dissected. Results were recorded and it was observed that the middle cerebral artery, collateral branch of the rostral branch of the internal carotid artery, varied between one to three components. These vessels anastomosed, originating a net that was projected from the base of the brain dorsorostralwards, reaching the convex surface of the olfactory bulb. Their lateral ramifications formed the convex hemispheric arteries, which ascended to the convex surface of the cerebral hemisphere and reached, caudally, the proximities of the caudal pole, anastomosing with the occipital hemispheric branches of the caudal cerebral artery and, dorsally, anastomosed with the caudal medial hemispheric branches of the caudal inter-hemispheric artery. Rostrally, its terminal branches, dorsal and ventral, formed a vascular ring around the coronal sulcus, which separated the cerebral hemisphere from the sessile olfactory bulb together with the rostral medial hemispheric branches of the rostral inter-hemispheric artery, branch of the rostral cerebral artery. The arteries of the olfactory bulb were originated from this ring. The middle cerebral artery in 63.4% of the samples to the right and in 56.7% to the left was double. But in 33.3% to the right and 20% to the left was triple, whereas in 3.3% to the right and in 23.3% to the left was a single vessel.Discussion: Authors reported that the middle cerebral artery, in reptiles, was originated as a single trunk, which subdivided into several arteries or was formed from several short trunks that ramified towards the convex surface of the cerebral hemisphere. In a study about turtles, the middle cerebral artery presented single origin and was emitted from the rostral branch of the internal carotid artery, emitting secondary branches that irrigated a portion of the dorsolateral surface of the cerebral hemispheres. In alligators, the rostral branch of the internal carotid artery originated a large middle cerebral artery, which emitted secondary branches towards the lateral surface of the cerebral hemisphere, continuing as rostral cerebral artery. In Cayman, the middle cerebral artery consisted of a formation of a net originated from one to five vessels, which was projected in sequence as collateral branches of the rostral branch of the internal carotid artery. This pattern of the middle cerebral artery was also observed in Trachemys, however, the net formation of the middle cerebral artery was after the emission of one to three vessels.


2019 ◽  
Vol 39 (01) ◽  
pp. 016-017
Author(s):  
Benedito Jamilson Araújo Pereira ◽  
Radmila Agra Cariry Targino de Holanda ◽  
José Targino Neto ◽  
Luciano Ferreira de Holanda

AbstractA 79-year-old patient was admitted to the emergency room with transitory monoparesis in the left hand and dysphasia. The brain computed tomography (CT) and magnetic resonance imaging (MRI) showed a spontaneous right convexity subarachnoid hemorrhage (cSAH). Digital subtraction angiography (DSA) confirmed an asymptomatic occlusion of the right internal carotid artery (ICA) . Cases related to stenosis have already been described, but there is no similar report of a case related to occlusion, even though the pathophysiology of both entities is similar. Atraumatic SAH has been associated with intracranial and extracranial artery stenosis.


1990 ◽  
Vol 3 (3) ◽  
pp. 143-151 ◽  
Author(s):  
Atsushi Yamadori ◽  
Yukio Osumi ◽  
Masayasu Tabuchi ◽  
Etsuro Mori ◽  
Takashi Yoshida ◽  
...  

We describe a new right hemispheric behavioural syndrome for which we propose the name “hyperlalia”. In a typical case an apparently unconcerned and expressionless patient is easily prompted to remarkable volubility with a content which is loose and incoherent. The voice is low and monotonous. All the lesions confirmed by computed tomography of the brain overlapped in the perisylvian area in the territory of the right middle cerebral artery. Loss of a subtle balance between the left hemispheric speech area and the corresponding area in the right hemisphere caused by acute damage of the right perisylvian area may have resulted in disinhibition of the speech function. Similarities and dissimilarities with the known pathology of talkativeness are also discussed.


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