MIDTERM CLINICAL AND MAGNETIC RESONANCE IMAGING FOLLOW-UP OF LARGE AND GIANT CAROTID ARTERY ANEURYSMS AFTER THERAPEUTIC CAROTID ARTERY OCCLUSION

Neurosurgery ◽  
2007 ◽  
Vol 60 (6) ◽  
pp. 1025-1031 ◽  
Author(s):  
Anjob N. de Gast ◽  
Marieke E. Sprengers ◽  
Willem Jan van Rooij ◽  
Cristina Lavini ◽  
Menno Sluzewski ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Carotid Artery ◽  
Clinical Symptoms ◽  
Incidental Finding ◽  
Mass Effect ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Resonance Imaging

Abstract OBJECTIVE The purpose of this study was to evaluate aneurysm size and clinical symptoms midterm after therapeutic carotid artery occlusion in 39 patients with large or giant carotid artery aneurysms. METHODS Between January 1996 and August 2004, 39 patients with large or giant carotid artery aneurysms were treated with therapeutic carotid artery occlusion and had clinical and magnetic resonance imaging follow-up of at least 3 months (mean, 35.9 mo; median, 29 mo; range, 3–107 mo; 117 patient-yr). Initial clinical presentation was mass effect caused by the aneurysm in 32 (82%) of the 39 patients. Three patients presented with subarachnoid hemorrhage and one presented with epistaxis; two aneurysms were an incidental finding and one was additional to another ruptured aneurysm. RESULTS There were no early or late complications of therapeutic carotid artery occlusion. All aneurysms seemed to have thrombosed completely after carotid artery occlusion as observed on early and late magnetic resonance imaging and magnetic resonance angiographic follow-up studies. At the time of the most recent magnetic resonance imaging follow-up study, 29 (74%) of the 39 aneurysms involuted totally, two aneurysms decreased to 25% of the original diameter, two aneurysms decreased to 50%, and five aneurysms decreased to 75%. Two aneurysms remained unchanged in size after 49 and 58 months, respectively. At the most recent clinical follow-up evaluation, symptoms of mass effect were cured in 19 (60%), improved in 10 (31%), and remained unchanged in three (9%) of the 32 patients. CONCLUSION Therapeutic carotid artery occlusion was a simple, safe, and effective treatment for large and giant carotid artery aneurysms. Almost all aneurysms involute completely or substantially decrease in size. Alleviation of symptoms of mass effect was achieved in most patients.

scholarly journals In vivo evidence for long-term vascular remodeling resulting from chronic cerebral hypoperfusion in mice

2016 ◽  
Vol 37 (2) ◽  
pp. 726-739 ◽  
Author(s):  
Tom Struys ◽  
Kristof Govaerts ◽  
Wouter Oosterlinck ◽  
Cindy Casteels ◽  
Annelies Bronckaers ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Emission Tomography ◽  
Resonance Imaging ◽  
Positron Emission ◽  
Common Carotid Artery Occlusion

We have characterized both acute and long-term vascular and metabolic effects of unilateral common carotid artery occlusion in mice by in vivo magnetic resonance imaging and positron emission tomography. This common carotid artery occlusion model induces chronic cerebral hypoperfusion and is therefore relevant to both preclinical stroke studies, where it serves as a control condition for a commonly used mouse model of ischemic stroke, and neurodegeneration, as chronic hypoperfusion is causative to cognitive decline. By using perfusion magnetic resonance imaging, we demonstrate that under isoflurane anesthesia, cerebral perfusion levels recover gradually over one month. This recovery is paralleled by an increase in lumen diameter and altered tortuosity of the contralateral internal carotid artery at one year post-ligation as derived from magnetic resonance angiography data. Under urethane/α-chloralose anesthesia, no acute perfusion differences are observed, but the vascular response capacity to hypercapnia is found to be compromised. These hemispheric perfusion alterations are confirmed by water [15O]-H2O positron emission tomography. Glucose metabolism ([18F]-FDG positron emission tomography) or white matter organization (diffusion-weighted magnetic resonance imaging) did not show any significant alterations. In conclusion, permanent unilateral common carotid artery occlusion results in acute and long-term vascular remodeling, which may have immediate consequences for animal models of stroke but also vascular dementia.

Subacute Pituitary Apoplexy: Clinical and Magnetic Resonance Imaging Characteristics

Neurosurgery ◽  
1990 ◽  
Vol 27 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Roberta P. Glick ◽  
James A. Tiesi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Resonance Imaging ◽  
Mri Scan ◽  
Imaging Characteristics ◽  
Invaluable Tool ◽  
Magnetic Resonance Imaging Mri

Abstract Between 1987 and 1988, we utilized magnetic resonance imaging (MRI) in the diagnosis of seven cases of “subacute” pituitary apoplexy. that is, intra-adenomatous pituitary hemorrhage associated with clinical symptoms atypical of acute pituitary apoplexy. These symptoms lasted longer than 24 hours and included visual changes in four patients, headache in five, and seizures, endocrine dysfunction, and oculomotor palsy in one each. Estimates of the ages of the hemorrhages were also possible based on characteristics on the MRI scan and ranged from 48 hours to more than 14 days. Four of our seven patients underwent transsphenoidal decompression at which time the presence of intratumoral hemorrhage was confirmed. The remaining three patients have been followed as outpatients with serial MRI examinations and have shown improvement in clinical symptoms and stabilization of the radiological picture. From our series of patients, it is now apparent that the MRI scan is an invaluable tool in identifying this subacute form of intra-adenomatous pituitary hemorrhage and has proven especially useful as a means of therapeutic planning and follow-up care in patients presenting with symptoms not typical of classic pituitary apoplexy.

scholarly journals Intramedullary Cervical Tuberculoma: A Case Report With Note on Surgical Management

2015 ◽  
Vol 100 (1) ◽  
pp. 133-136 ◽  
Author(s):  
Hong-Bin Ju ◽  
Dong-Ming Guo ◽  
Fan-Fan Chen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Previous History ◽  
Mass Effect ◽  
Cord Compression ◽  
Cervical Cord ◽  
Resonance Imaging ◽  
Intramedullary Lesion ◽  
The Right

Abstract This study aims to report a relatively rare entity—intramedullary tuberculum of cervical spine—and describe its management and some key learning points. Intramedullary tuberculomas are rare entities. Intramedullary tuberculoma is most commonly found in the thoracic cord of a patient and is rarely seen in the cervical cord. We present an intramedullary cervical tuberculoma in a 21-year-old patient with finding of spinal cord compression. All 4 limbs were spastic, with grade 1 power on the right side and grade 3 power on the left side. Sensory deficit was found below the C6 level. Magnetic resonance imaging showed an intramedullary lesion at the C5 to C6 levels. Intramedullary tuberculoma was diagnosed based on clinical symptoms, physical examination, previous history, and magnetic resonance imaging. A C5 to C7 laminectomy was performed. Intramedullary tuberculoma was resected by microsurgery. One year after the surgery, strength returned to normal grade 5. Excellent clinical outcome was obtained with a combination of both medical and surgical treatments. Intramedullary cervical tuberculoma should be removed without delay to eliminate any mass effect on the neurons as soon as possible.

The Use of Transcutaneous Thermal Convection Analysis to Assess Shunt Function in the Pediatric Population

2011 ◽  
Vol 70 (suppl_2) ◽  
pp. ons181-ons183 ◽  
Author(s):  
Arthur E. Marlin ◽  
Sarah J. Gaskill
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Thermal Convection ◽  
Clinical Symptoms ◽  
Pediatric Population ◽  
Shunt Malfunction ◽  
Resonance Imaging ◽  
Shunt Series

ABSTRACT BACKGROUND: The diagnosis of shunt malfunction is largely made by subjective clinical history and assessment in association with neurodiagnostic imaging. OBJECTIVE: To evaluate the use of a transcutaneous thermal convection device for the diagnosis of shunt malfunction. METHODS: We present the results of a trial of a commercially available device under an Institutional Review Board--approved protocol. All patients had neurodiagnostic studies that defined their shunt function at the time of transcutaneous thermal convection measurement. Thirty-seven shunts were studied in 35 patients. To be included, patients had to be between 0 to 18 years of age, had to be due within a 3-month period for routine follow-up evaluations, and had to have neurodiagnostic imaging (computed tomography or magnetic resonance imaging) as part of this visit and a shunt series. All patients were seen in routine follow-up, and none had clinical symptoms of shunt malfunction. RESULTS: Three patients had fractured shunts. The remaining 32 patients had functioning shunts as determined by clinical criteria, computed tomography or magnetic resonance imaging scans, and, when appropriate, a shunt series. In these remaining patients, flow was initially confirmed in only 40%. After some filtering of the data, this was increased to 51%. Although these results are disappointing, they outline the current issues with the technique and the state of its utility and point to the need for further refinement. CONCLUSION: Our current research suggests that cerebrospinal fluid flow as detected by thermoconvection analysis is not a reliable indicator of shunt function in the pediatric population.

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