Transarterial N-Butyl-2-cyanoacrylate Embolization of an Intraosseous Dural Arteriovenous Fistula Associated With Acute Epidural Hematoma: Technical Case Report

2015 ◽  
Vol 11 (3) ◽  
pp. E468-E471 ◽  
Author(s):  
Shotaro Yoshioka ◽  
Kazuyuki Kuwayama ◽  
Junichiro Satomi ◽  
Shinji Nagahiro
Keyword(s):  
Epidural Hematoma ◽  
Clinical Presentation ◽  
Middle Meningeal Artery ◽  
Endovascular Embolization ◽  
External Carotid Artery ◽  
External Carotid ◽  
Maxillary Artery ◽  
Microsurgical Anatomy ◽  
The Right ◽  
Acute Epidural Hematoma

Abstract BACKGROUND AND IMPORTANCE Intraosseous dural arteriovenous fistulae (DAVF) are rare, especially those with drainage into the diploic venous system. The clinical presentation depends on the location of the lesion. This is the first report of an intraosseous DAVF associated with acute epidural hematoma. CLINICAL PRESENTATION A 25-year-old man presented with headache and nausea. Imaging of the brain revealed abnormal signals indicative of acute epidural hematoma in the right frontal convexity. Angiography demonstrated a DAVF in the region of the frontal bone. Right external carotid artery angiography showed that the DAVF was fed mainly by the right middle meningeal artery with drainage into diploic veins. Immediately after embolization of the middle meningeal and the distal internal maxillary artery with 17% N-butyl-2-cyanoacrylate, the shunt was completely occluded. The patient was discharged 4 days later without clinical complications. CONCLUSION Intraosseous DAVF can be treated by surgical resection or endovascular embolization. Curative treatment requires careful inspection of the angiographic architecture and microsurgical anatomy.

scholarly journals Endovascular Treatment of Incoercible Epistaxis and Epidural Cerebral Hematoma

2006 ◽  
Vol 12 (3) ◽  
pp. 233-236 ◽  
Author(s):  
M. Bortoluzzi ◽  
M. Pavia
Keyword(s):  
Middle Meningeal Artery ◽  
Road Accident ◽  
Facial Trauma ◽  
Maxillary Artery ◽  
Multiple Sources ◽  
Special Cases ◽  
Cerebral Hematoma ◽  
The Right ◽  
Acute Epidural Hematoma ◽  
Meningeal Artery

A young patient with a facial trauma after a road accident was admitted to our department with incoercible epistaxis. A CT scan showed a right pterional acute epidural hematoma (EDH). Angiography demonstrated multiple sources of bleeding of the right sphenopalatine arteries, cause of the epistaxis, and an intracranial leakage of the right middle meningeal artery, responsible for the EDH. The patient immediately underwent embolization of the right internal maxillary artery and right middle meningeal artery. The procedure stopped the epistaxis and no further enlargement of the EDH was observed, avoiding its surgical treatment. Endovascular surgery may be an effective procedure to stop the arterial meningeal bleeding sustaining acute EDH and may be a useful tool in the management of special cases of post traumatic EDH.

Middle Meningeal Origin of the Ophthalmic Artery

Neurosurgery ◽  
2001 ◽  
Vol 49 (2) ◽  
pp. 401-407 ◽  
Author(s):  
Qingliang Liu ◽  
Albert L. Rhoton
Keyword(s):  
Ophthalmic Artery ◽  
Middle Meningeal Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Microsurgical Anatomy ◽  
Superior Orbital Fissure ◽  
Anatomic Dissection ◽  
Retinal Artery ◽  
Arteries And Veins ◽  
Meningeal Artery

Abstract OBJECTIVE To examine the microsurgical anatomy and clinical significance of an anomalous origin of the ophthalmic artery from the middle meningeal artery. METHODS In the course of an anatomic study of the cavernous sinus, an anomalous ophthalmic artery arising from the middle meningeal artery was found. To further define the anatomy of the region, five additional skulls, in which the arteries and veins were injected with colored latex, were dissected using 3× to 40× magnification. RESULTS The anomalous ophthalmic artery arose from the frontal branch of the middle meningeal artery, passed through the superior orbital fissure, and supplied the entire contents of the orbit, as well as giving rise to the central retinal artery. This study provides the first display of this anomaly in an anatomic dissection. CONCLUSION The ophthalmic artery may infrequently arise from the middle meningeal artery. This anomaly places the ophthalmic artery at risk during procedures in which the dura is elevated from the greater and lesser wings of the sphenoid or when the sphenoid ridge is removed and during embolization procedures involving the branches of the external carotid artery.

A microsurgical study of the anatomy and course of the ophthalmic artery and its possibly dangerous anastomoses

2007 ◽  
Vol 106 (1) ◽  
pp. 142-150 ◽  
Author(s):  
Paolo Perrini ◽  
Andrea Cardia ◽  
Kenneth Fraser ◽  
Giuseppe Lanzino
Keyword(s):  
Optic Nerve ◽  
Ophthalmic Artery ◽  
Endovascular Procedures ◽  
Middle Meningeal Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Detailed Knowledge ◽  
Microsurgical Anatomy ◽  
Retinal Artery ◽  
Meningeal Artery

Object The authors studied the microsurgical anatomy of the ophthalmic artery (OphA), paying particular attention to its possibly dangerous anastomoses with the middle meningeal artery (MMA). Methods The microsurgical anatomy of the OphA and its anastomoses with the MMA were studied in 14 vessels from seven adult cadaveric heads. The origination order of the OphA branches varies in relation to whether the artery, along its intraorbital course, crosses above or below the optic nerve (ON). The central retinal artery is the first branch to course from the OphA when it crosses over the ON, and it is the second branch to course from the OphA when the artery crosses under the ON. Anastomoses between branches of the MMA and the OphA were present in the majority of the specimens examined. Conclusions Detailed knowledge of the microanatomy of the OphA and recognition of anastomoses between the external carotid artery and the OphA are critically important in avoiding disastrous complications during endovascular procedures.

scholarly journals Traumatic epidural hematoma treated with endovascular coil embolization

2021 ◽  
Vol 12 ◽  
pp. 322
Author(s):  
Michael T. Madison ◽  
Patrick C. Graupman ◽  
Jason M. Carroll ◽  
Collin M. Torok ◽  
Jillienne C. Touchette ◽  
...  
Keyword(s):  
Epidural Hematoma ◽  
Middle Meningeal Artery ◽  
Endovascular Embolization ◽  
Cerebrovascular Injury ◽  
Surgical Evacuation ◽  
Life Threatening ◽  
Endovascular Coil Embolization ◽  
Traumatic Subarachnoid Hemorrhage ◽  
The Right

Background: Traumatic cerebrovascular injury may result in epidural hematoma (EDH) from laceration of the middle meningeal artery (MMA), which is a potentially life-threatening emergency. Treatment ranges from surgical evacuation to conservative management based on a variety of clinical and imaging factors. Case Description: A 14-year-old male presented to our institution after falling from his bicycle with traumatic subarachnoid hemorrhage and a right frontotemporal EDH. The patient did not meet criteria for surgical evacuation and endovascular embolization of the right MMA was performed. Rapid resolution of the EDH was observed. Conclusion: This case corroborates the sparse existing literature for the potential role of endovascular embolization to treat acute EDH in carefully selected patients who do not meet or have borderline indications for surgical management.

scholarly journals Branchial Cyst in the Parapharyngeal Space: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Iyad Said Hamadi ◽  
Lubna Lutfi ◽  
Asma Anan Mohammed ◽  
Zahr Alkhadem
Keyword(s):  
Branchial Arch ◽  
External Carotid Artery ◽  
Cystic Mass ◽  
External Carotid ◽  
Lateral Side ◽  
Branchial Cyst ◽  
Embryonic Life ◽  
Branchial Cleft ◽  
The Right

Branchial cleft cysts are congenital anomalies that most commonly arise from a failure of fusion of the second branchial arch during embryonic life. They usually present as a swelling in the lateral side of the neck, below the mandible. In this article, we present a case of a 28-year-old female patient with a right branchial cyst measuring 7 × 6 × 5 cm, who presented with an asymptomatic, rapidly growing mass in the right anterior triangle of the neck that abutted the right external carotid artery, leading to stenosis of the vessel that is preceded by dilatation above the site of compression. She underwent excision of the cystic mass with preservation of the facial nerve and presented no active complaints on follow-up a few weeks postoperatively.

scholarly journals Embolization of Bleeding Pinna Arteriovenous Malformation after Ligation of the External Carotid Artery: A Therapeutic Challenge

2017 ◽  
Vol 01 (03) ◽  
pp. 184-189
Author(s):  
Rahul Kumar ◽  
Ankur Goyal ◽  
Ashu Bhalla ◽  
Sonia Sandip ◽  
Kapil Sikka
Keyword(s):  
Carotid Artery ◽  
Arteriovenous Malformation ◽  
Percutaneous Treatment ◽  
Endovascular Embolization ◽  
External Carotid Artery ◽  
External Carotid ◽  
Resonance Imaging ◽  
Percutaneous Embolization ◽  
History Of

AbstractA 25-year-old patient presented with bleeding of right pinna arteriovenous malformation (AVM). There was history of ipsilateral external carotid artery (ECA) ligation 10 years back. Subsequent investigations (ultrasound, magnetic resonance imaging, digital subtraction angiography) showed recruitment of complex collaterals from the ipsilateral subclavian artery and vertebral artery feeding the recurrent nidus. The patient underwent two sessions of endovascular embolization and one session of percutaneous embolization. We wish to highlight the feasibility of antegrade embolization in such cases via collaterals and role of direct percutaneous treatment.

scholarly journals Combined surgical treatment of arteriovenous malformation of the lower jaw

2020 ◽  
Vol 34 (4) ◽  
pp. 95-104
Author(s):  
D.V. Shchehlov ◽  
V.M. Zahorodnii ◽  
I.V. Altman ◽  
N.V. Kiselyova ◽  
I.I. Kashkish
Keyword(s):  
Arteriovenous Malformation ◽  
Cerebral Angiography ◽  
Combined Treatment ◽  
The Body ◽  
Facial Artery ◽  
External Carotid ◽  
Maxillary Artery ◽  
Terminal Branch ◽  
Lower Jaw ◽  
The Right

The objective – to presents the observation of combined treatment of a patient with arteriovenous malformation of the lower jaw.A man, 21 years old, was hospitalized in the Scientific-Practical Center of Endovascular Neuroradiology NAMS of Ukraine with complaints of bleeding from a tooth socket after an attempt to remove the 6th tooth (first painter) of the lower jaw on the left. According to the performed survey radiography of the lower jaw, an aneurysmal bone cyst was revealed in the body of the lower jaw on the left, corresponding to the localization of bleeding. According to cerebral angiography, an arteriovenous malformation of the lower jaw was revealed on the left, the afferent arteries of which were: the right facial artery (a branch of the right external carotid artery (ECA)), the left facial artery (a branch of the left ECA), the lower alveolar artery, the superior-posterior alveolar artery (branches of the maxillary artery ‒ the terminal branch of the left ECA) with drainage into a vein, which was located in the body of the lower jaw. In order to exclude the malformation from the bloodstream and prevent bleeding, a controlled embolization of the malformation was performed using non-spherical emboli – polyvinyl alcohol (PVA) particles from Cook, USA. Using a transfemoral approach, a guide catheter was inserted into the orifice of the ECA, then a Headway 27 microcatheter (Microvention, USA) was passed through it along a Traxes 14 guide wire (Microvention, USA), the afferent arteries of the malformation were selectively cathete-rized in turn, and embolization was performed after superselective angiography. The patient was discharged in a satisfactory condition. Two weeks after the operation, the bleeding resumed. The performed control cerebral angiography revealed a relapse of the malformation with a change in its angioarchitectonics ‒ the filling of the malformation in the late arterial and venous phases of cerebral blood flow was noted. Re-embolization was performed using PVA emboli (Cook), which was supplemented by transcutaneous puncture of the drainage vein in the mandible and its embolization with histoacryl (B. Braun, Germany) and lipiodol (Guerbet, France) in a 1 : 1 ratio. Results. As a result of using this technique, it was possible to turn off the malformation completely. For 6 months from the moment of surgery, no bleeding was noted, and subsequently the patient had a tooth removed without complications.Conclusions. The proposed method for treating arteriovenous malformation of the lower jaw, proposed in this case, showed the effectiveness of a combination of endovascular embolization in combination with transcutaneous embolization of the draining vein and can be successfully used to treat this pathology.

Ganglioglioma Presenting as a Meningioma: Case Report and Review of the Literature

Neurosurgery ◽  
2002 ◽  
Vol 50 (5) ◽  
pp. 1133-1136 ◽  
Author(s):  
Khawar Siddique ◽  
Michael Zagardo ◽  
Meena Gujrati ◽  
William Olivero
Keyword(s):  
Histological Analysis ◽  
Clinical Presentation ◽  
Middle Meningeal Artery ◽  
Vascular Supply ◽  
Catheter Angiography ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Axial Mass ◽  
Posterior Division ◽  
The Right

Abstract OBJECTIVE AND IMPORTANCE: Gangliogliomas are intra-axial, avascular masses located predominately in the temporal lobe. A ganglioglioma that mimics a meningioma in that it is extra-axial and has a significant extracranial vascular supply has not been reported previously. CLINICAL PRESENTATION: A 12-year-old girl presented with a right temporoparietal mass. A neurological examination revealed nothing abnormal, and the girl's symptoms were limited to headaches. INTERVENTION: Magnetic resonance imaging revealed an extra-axial mass, and cerebral catheter angiography revealed a blood supply mainly from the posterior division of the right middle meningeal artery. Intraoperative findings confirmed the extra-axial location of the tumor, and histological analysis revealed that the tumor was a ganglioglioma. CONCLUSION: This report confirms that gangliogliomas can present as extra-axial, vascular masses that are similar to meningiomas.

Unusual Clinical Presentation of a Presumed Pineal Germinoma with Two Disseminated Lesions

Neurosurgery ◽  
1988 ◽  
Vol 23 (2) ◽  
pp. 235-236 ◽  
Author(s):  
Shinichi Nakano ◽  
Hisao Uehara ◽  
Kazuo Kinoshita
Keyword(s):  
Clinical Presentation ◽  
External Carotid Artery ◽  
Primary Lesion ◽  
Pineal Body ◽  
External Carotid ◽  
Initial Symptom ◽  
Resonance Imaging ◽  
Inferior Surface ◽  
Computed Tomographic ◽  
Pineal Germinoma

ABSTRACT We report a case of a presumed pineal germinoma in a 28-year-old man. Although the pineal body, the presumed primary lesion, was small, there were two disseminated tumors, one in the posterior fossa and the other in the left parietal region. The initial symptom was cerebellar ataxia. These two disseminated tumors had attachments to the inferior surface of the cerebellar tentorium and the dura mater of the parietal convexity, respectively, and they were fed by external carotid artery branches, like meningiomas. Neither angiography nor magnetic resonance imaging could provide the differential diagnosis between germinoma and meningioma. Computed tomographic scanning revealed slight enlargement of the pineal body suggestive of a germinoma.

Direct carotid sinus approach to treatment of bilateral carotid-cavernous fistulas

1988 ◽  
Vol 69 (6) ◽  
pp. 942-944 ◽  
Author(s):  
Pedro Albert ◽  
Manuel Polaina ◽  
Francisco Trujillo ◽  
José Romero
Keyword(s):  
Carotid Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Occipital Artery ◽  
Lateral Sinus ◽  
Direct Puncture ◽  
Content Type ◽  
Bilateral Carotid ◽  
The Right ◽  
Carotid Cavernous Fistulas

✓ The authors present a patient with a complex vascular malformation composed of bilateral spontaneous carotid-cavernous fistulas (CCF's). The abnormality was supplied on the right side by the right external carotid artery (ECA) and the right internal carotid artery (ICA), and on the left side only by the left ICA. There was also an arteriovenous communication between the right ECA and the lateral sinus. Surgical embolization of both cavernous sinuses with oxidized cellulose was achieved on one side by direct puncture and on the other through one of its venous affluents, successfully occluding both CCF's and preserving the patency of both ICA's without any neurological deficit. The arteriovenous communication between the right ECA and the lateral sinus was occluded by embolization of the occipital artery and ligation of the right ECA.

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