EXTRACRANIAL ANEURYSM OF THE POSTERIOR INFERIOR CEREBELLAR ARTERY WITH AN ABERRANT ORIGINATION

Neurosurgery ◽  
2007 ◽  
Vol 61 (5) ◽  
pp. E1097-E1098 ◽  
Author(s):  
Seyed Ali Fakhr Tabatabai ◽  
Mehdi Zeinali Zadeh ◽  
Ali Tayebi Meybodi ◽  
Mohammad Hashemi
Keyword(s):  
Posterior Inferior Cerebellar Artery ◽  
Computed Tomographic Angiography ◽  
Sudden Onset ◽  
Anterior Inferior Cerebellar Artery ◽  
Computed Tomographic ◽  
Suboccipital Craniectomy ◽  
Cerebellar Artery ◽  
Upper Cervical ◽  
The Right ◽  
Tomographic Angiography

Abstract OBJECTIVE Aneurysms of the extracranially originating posterior inferior cerebellar artery are very rare. An anatomic insight of its possible course and variations is necessary when confronting such extraordinary lesions. CLINICAL PRESENTATION A 19-year-old man presented with the sudden onset of severe headaches. A physical examination was positive only for neck rigidity. Computed tomographic scans of the brain depicted intraventricular hemorrhage. TECHNIQUE AND INTERVENTION Four-vessel brain digital subtraction angiography revealed an extracranial posterior inferior cerebellar artery arising extradurally from the right vertebral artery between the C1 and C2 vertebrae, bearing a saccular aneurysm in an upper cervical intradural location. An anterior inferior cerebellar artery-posterior inferior cerebellar artery variant was also found on the left side. Computed tomographic angiography failed to unmask the lesion. The aneurysm was clipped through a suboccipital craniectomy and C1 laminectomy. CONCLUSION The patient did well after surgery and was discharged from the hospital without neurological deficit. One can conclude that a comprehensive diagnostic approach oriented to the patient history and clinical data is mandatory to preclude such lesions evading the vigilant surgeon.

Abstract T P177: Non-dominant Vertebral Artery With Higher Resistance Flow Pattern Is A Risk Factor For Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Leonard yeo ◽  
Amit Batra ◽  
Ashley Tan ◽  
Song Majinyang ◽  
Darren Low ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Flow Pattern ◽  
Posterior Inferior Cerebellar Artery ◽  
Computed Tomographic Angiography ◽  
Mean Flow ◽  
Computed Tomographic ◽  
Vertebral Arteries ◽  
Cerebellar Artery ◽  
Intracranial Arteries ◽  
Tomographic Angiography

Background and aims: The diameters of the vertebral arteries (VAs) are very often unequal and the larger artery is called ‘dominant’. We investigated whether the hemodynamic parameters differ between the ‘dominant’ and ‘non-dominant’ variants. Methods: Consecutive patients who underwent computed tomographic angiography (CTA) of cervical and intracranial arteries, cervical duplex (CDU) and transcranial Doppler (TCD) ultrasonography were included. VA diameters (cervical and intracranial segments) were measured on CTA. Flow velocities recorded were peak systolic (PSV), end-diastolic (EDV), mean flow (MFV). Pulsatility index (PI) and ratio of distal-to-proximal VAs were computed. Results: Of the total 501 patients admitted during 2012 with acute ischemic stroke, both CTA and ultrasound data were available for VAs for 161 (32%). The dominant VA was more frequent on the left side (p<0.01). Non-dominant VAs were found to have lower MFV (27cm/s versus 38cm/s; p<0.01) and higher PI (1.27 versus 1.0; p<0.01) as compared to the dominant variant. In most patients, proximal basilar artery was noted to be on the side of non-dominant artery. Posterior inferior cerebellar artery territory infarcts and lateral medullary infarcts were noted in 38 (7.6%) patients. These infarcts were noted more commonly on the same side as the non-dominant intracranial VA side (p<0.01), especially when associated with low MFV (p<0.01) and high PI (p<0.01). Conclusions: The risk of ischemic stroke in VA territory is higher with the non-dominant artery, especially when it is associated with higher-resistance flow pattern.

Aneurysm of the Distal Anterior Inferior Cerebellar Artery Unrelated to the Cerebellopontine Angle: Case Report

Neurosurgery ◽  
1991 ◽  
Vol 28 (6) ◽  
pp. 899-903 ◽  
Author(s):  
Katsumaro Oana ◽  
Toshiharu Murakami ◽  
Takaaki Beppu ◽  
Akira Yamaura ◽  
Haruyuki Kanaya
Keyword(s):  
Case Report ◽  
Cerebellopontine Angle ◽  
Lateral Position ◽  
Sudden Onset ◽  
Uneventful Recovery ◽  
Anterior Inferior Cerebellar Artery ◽  
Computed Tomographic ◽  
Suboccipital Craniectomy ◽  
Cerebellar Artery ◽  
Operative Findings

Abstract This is a case report of an unusual aneurysm of the distal anterior inferior cerebellar artery. A 44-year-old woman had a severe frontal headache and vomiting of sudden onset. On the day after admission, the patient began to demonstrate nuchal rigidity and difficulty with upward gaze bilaterally. There were no complaints at this time suggestive of a syndrome of the cerebellopontine angle. A computed tomographic scan revealed an intraventricular hemorrhage of the 3rd and 4th ventricles; however, multiple attempts at four-vessel angiography were required before an aneurysm could be demon-strated. On the 28th hospital day, a suboccipital craniectomy using the retromastoid approach in the lateral position was performed. A saccular aneurysm with a surrounding hematoma in the distal anterior inferior cerebellar artery was found and clipped. The operative findings revealed that the aneurysm was unrelated to the cerebellopontine angle. After surgery, the patient had an uneventful recovery and complete resolution of symptoms.

High-Grade Stenosis of a Traumatic Brachiocephalic Pseudoaneurysm and the Change in Cerebral Blood Flow Assessed With Transcranial Doppler Ultrasound

2021 ◽  
pp. 154431672110023
Author(s):  
Winnie Nguyen ◽  
Tammy Albanese ◽  
Vanessa Tran ◽  
Anne Moore ◽  
Laligam Sekhar
Keyword(s):  
Doppler Ultrasound ◽  
Transcranial Doppler ◽  
Transcranial Doppler Ultrasound ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Vertebral Arteries ◽  
Luminal Narrowing ◽  
Basilar Arteries ◽  
The Right ◽  
Tomographic Angiography

This is a case report of a 35-year-old female pedestrian struck by a semi-truck. computed tomographic angiography (CTA) revealed a pseudoaneurysm at the proximal brachiocephalic artery measuring 1.8 cm in cranio-caudal length and 1.2 × 0.6 cm transverse. Just distal to the pseudoaneurysm, there was severe luminal narrowing caused by either a dissection flap or mural thrombus. Due to profound left-sided weakness, transcranial Doppler ultrasound was performed which demonstrated “hesitant” waveforms in the right middle cerebral and right vertebral arteries secondary to proximal obstruction. Hesitant waveforms display mid-systolic velocity deceleration and may also be referred to as the “bunny” waveform. Emboli monitoring of the right middle cerebral and basilar arteries were positive for active embolization

scholarly journals Carotid Cavernous Sinus Fistula with Contralateral Feed Not Diagnosed by Virtual Assessment or by Non-Invasive Vascular Imaging

2021 ◽  
Vol 12 (2) ◽  
pp. 712-716
Author(s):  
Edsel Ing ◽  
Felix Tyndel ◽  
Joyce Tang ◽  
Thomas R. Marotta
Keyword(s):  
Vision Loss ◽  
Contralateral Side ◽  
Computed Tomographic Angiography ◽  
Low Flow ◽  
Computed Tomographic ◽  
Non Invasive ◽  
Carotid Cavernous Sinus Fistula ◽  
The Right ◽  
Tomographic Angiography ◽  
Ocular Signs

A 67-year-old woman had delayed initial diagnosis of her right low flow carotid cavernous fistula (CCF) during the coronavirus disease (COVID-19) pandemic due to difficulty detecting ocular signs via online virtual examinations. Her right eye conjunctival erythema and proptosis with medial rectus enlargement on computed tomography scan was initially misdiagnosed as euthyroid thyroid-associated orbitopathy without lid retraction. She developed vision loss, and increasing episcleral venous congestion and CCF was suspected. Computed tomographic angiography did not show an obvious fistula. Digital subtraction angiography revealed the right-sided low flow CCF, which was fed from vessels from the contralateral side.

scholarly journals Successful recanalization using the Embolus Retriever with Interlinked Cage for acute stroke due to calcified cerebral emboli

2018 ◽  
Vol 24 (6) ◽  
pp. 674-677 ◽  
Author(s):  
Hyo S Kwak ◽  
Jung S Park
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Thrombolytic Agent ◽  
Mechanical Thrombectomy ◽  
Computed Tomographic Angiography ◽  
Sudden Onset ◽  
Aspiration Thrombectomy ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Left Middle

Mechanical thrombectomy is a safe and effective treatment in patients with acute ischemic stroke caused by large vessel occlusions. However, in rare cases, the procedure may be challenging due to the composition of the embolus. We describe a case of a mechanical thrombectomy with the Embolus Retriever with Interlinked Cage (ERIC) device in a patient with an acute ischemic stroke due to calcified cerebral emboli in the middle cerebral artery. The procedure was done after a failed recanalization attempt with manual aspiration thrombectomy. An 82-year-old woman presented to the emergency department with a sudden onset of right-sided weakness. A computed tomographic angiography showed left middle cerebral (M1 branch) calcified emboli. After the administration of an intravenous thrombolytic agent, the patient was transferred to the angiographic suite for a mechanical thrombectomy. After failure to recanalize the vessel with manual aspiration thrombectomy, successful recanalization was achieved via mechanical thrombectomy using the ERIC device. Mechanical thrombectomy with an ERIC device can be a useful option in cases of acute ischemic stroke caused by calcified cerebral emboli.

scholarly journals Eaglov sindrom

2017 ◽  
Vol 86 ◽  
Author(s):  
Mladen Gasparini ◽  
Primož Praček ◽  
Jani Muha ◽  
Uroš Tomić
Keyword(s):  
Average Length ◽  
Cranial Nerves ◽  
Styloid Process ◽  
Computed Tomographic Angiography ◽  
Measurement Tool ◽  
Computed Tomographic ◽  
Elongated Styloid Process ◽  
Eagle Syndrome ◽  
The Right ◽  
Tomographic Angiography

Background: In the present article we present the characteristics of Eagle syndrome, which is an often overlooked cause of chronic pain in the neck and head. The syndrome is caused by the compression of an elongated styloid process on the adjacent cranial nerves or the carotid arteries. Since there are disparate data in the literature regarding the proportion of people with an elongated styloid process, we conducted a survey to determine the percentage of patients with an elongated styloid process in a group of subjects who underwent computed tomographic imaging of the neck vessels in our institution.Methods: We analyzed the images of 104 patients who were referred to our institution for computed tomographic angiography of the neck between the years 2014 and 2016. With the help of a software measurement tool, we determined the length of the styloid processes and compared the length of the processes on both sides and in both genders. Patients with an elongated styloid process were reviewed for any symptoms of Eagle syndrome.Results: The average age of the reviewed patients was 67.1 years. Both genders were equally represented (51 % men and 49 % women). The average length of the styloid process was 23.8 (7.0) mm, with 23 patients (22.1 %) having a styloid process longer than 30 mm. In one third of those patients the styloid process was elongated bilaterally. There were no differences in the average length of the styloid process between men and women and between the left and the right side. Among patients with an elongated styloid process, only one (4.3 %) had symptoms attributable to the Eagle syndrome.Conclusions: Eagle syndrome should be suspected in a patient with repetitive, dull pain in the throat and neck, which worsens during speaking, chewing or swallowing. The diagnosis is confirmed by computed tomography which could demonstrate an elongated styloid process and exclude other causes for neck pain. With regard to the results of our study, an elongated styloid process is found in a relatively high percentage of patients but the condition is only rarely symptomatic.

A Rare Case of a Pedicled Mobile Thrombus in Right Atrium

2016 ◽  
Vol 19 (6) ◽  
pp. 269 ◽  
Author(s):  
Xiaodong Li ◽  
Liping Chen ◽  
Xiumei Duan ◽  
Xiaocong Wang
Keyword(s):  
Right Atrium ◽  
Histopathological Examination ◽  
Rare Condition ◽  
Computed Tomographic Angiography ◽  
Right Atrial ◽  
Atrial Thrombus ◽  
Computed Tomographic ◽  
Right Atrial Thrombus ◽  
The Right ◽  
Tomographic Angiography

Pedicled mobile thrombus in the right atrium is an extremely rare condition. Here, we described a case of a 42-year-old male hospitalized with complaints of chest pain and hemoptysis. Computed tomographic angiography of the pulmonary artery showed signs of embolism, and thoracic echocardiography indicated a pedicled mobile cloudy echo in the right atrium, which was initially suspected to be a myxoma. However, it was confirmed to be a thrombus by histopathological examination. Postoperatively, the patient was treated with anticoagulant therapy comprising of low molecular heparin and warfarin, and the patient recovered well. Thoracic echocardiography performed 3 months after surgery ruled out any recurrence of right atrial thrombus.

scholarly journals Uncommon Cause of Paradoxical Embolism in a Case of Scimitar Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Fortune O. Alabi ◽  
Fred Umeh ◽  
Maximo Lama ◽  
Francis G. Christian
Keyword(s):  
Inferior Vena ◽  
Vena Cava ◽  
Computed Tomographic Angiography ◽  
Paradoxical Embolism ◽  
Scimitar Syndrome ◽  
Computed Tomographic ◽  
Anomalous Pulmonary Venous Return ◽  
Asymptomatic Adult ◽  
The Right ◽  
Tomographic Angiography

Scimitar syndrome, a rare congenital cardiopulmonary condition, presents in both pediatric and adult populations as an anomalous pulmonary venous return of most of the right lung to the inferior vena cava. Recently, asymptomatic adult cases have been diagnosed with advances in imaging studies. We report the case of an asymptomatic 43-year-old male, with a complex variant scimitar syndrome diagnosed by computed tomographic angiography.

The Normal Anatomy and Variations of the Bronchial Arteries: Evaluation with Multidetector Computed Tomography

2015 ◽  
Vol 66 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Özlem Yener ◽  
Aysel Türkvatan ◽  
Gökhan Yüce ◽  
Ali Ümit Yener
Keyword(s):  
Bronchial Artery ◽  
Computed Tomographic Angiography ◽  
Arterial System ◽  
Normal Anatomy ◽  
Bronchial Arteries ◽  
Tomographic Images ◽  
Computed Tomographic ◽  
Road Map ◽  
The Right ◽  
Tomographic Angiography

Introduction In this study, we aimed to reveal the normal anatomy and variations of the bronchial arterial system and to determine the sex distribution of these variations by retrospectively reviewing the images of patients who underwent thoracal multidetector computed tomographic angiography for various reasons. Materials and Methods Multidetector computed tomographic images of a total of 208 patients (151 men; mean age, 59 years) were retrospectively reviewed to assess the normal anatomy and variations of the bronchial arterial system. Results A total of 531 bronchial arteries (median, 3; minimum, 1; maximum, 5; mean, 2.5) were detected. The number (mean diameter) of the right bronchial arteries were higher than the left bronchial arteries (290 [1.43 mm] and 241 [1.26 mm], respectively; P < .05 for both number and diameter). The mean number (diameter) of the bronchial arteries were higher with men than with women (2.58 [1.45 mm] and 2.47 [1.32 mm], respectively; P < .05 for both number and diameter). The most common (24%) branching pattern was the combination of 1 right intercostal-bronchial trunk and 1 left bronchial artery, and, secondarily (13.46%), the combination of 2 right (1 intercostal-bronchial trunk and 1 bronchial artery) and 1 left bronchial arteries. Seventy-eight ectopic bronchial arteries were detected in 59 cases (28.3%). They most commonly originated from the aortic arch (37.2%), the descending aorta below the level of T6 (35.9%), or the aortic branches (16.7%). The number of right ectopic bronchial arteries was significantly higher than the left ectopic bronchial arteries (50 [64%] vs 28 [36%]; P < .01). The incidence of ectopic bronchial arteries was statistically higher with men versus women (45 [29.8%] vs 14 [24.6%]; P < .05). Conclusion The origins, numbers, diameters, and courses of the bronchial arteries can vary substantially among individuals. Multidetector computed tomographic angiography enables a detailed road map of the bronchial arterial system to interventional radiologists and thoracic surgeons.

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