scholarly journals Strategy for Treating Unruptured Vertebral Artery Dissecting Aneurysms

Neurosurgery ◽  
2011 ◽  
Vol 69 (5) ◽  
pp. 1085-1092 ◽  
Author(s):  
Yutaka Kai ◽  
Toru Nishi ◽  
Masaki Watanabe ◽  
Motohiro Morioka ◽  
Teruyuki Hirano ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Vertebral Artery ◽  
Antiplatelet Therapy ◽  
Additional Treatment ◽  
The Other ◽  
Resonance Imaging ◽  
Dissecting Aneurysms

Abstract BACKGROUND The natural course of unruptured vertebral artery dissecting aneurysms (VADAs) remains unclear. OBJECTIVE The purpose of this retrospective study was to develop a strategy for treating unruptured VADAs based on long-term follow-up. METHODS Our study population consisted of 100 patients with unruptured VADAs; in 66, the initial symptom was headache only, 30 presented with ischemic symptoms and 4 with mass effect. All underwent magnetic resonance imaging and magnetic resonance angiography at the time of admission and 2 weeks and 1, 3, 6, 12, and 24 months after the onset. If the dissection site was demonstrated to be enlarged on magnetic resonance imaging and magnetic resonance angiography without the manifestation of new symptoms, the patients received additional treatment to prevent bleeding. RESULTS Of the 100 patients, 4 underwent early intervention because of symptom exacerbation. The other 96 were initially treated conservatively; during follow-up, 5 manifested lesion enlargement on magnetic resonance angiography. Nine patients received additional treatment; 1 underwent direct surgery with trapping of the dissection site, and 8 underwent coil embolization. The other 91 patients continued to be treated conservatively; the dissection site remained unchanged in 70, improved or healed in 18, and disappeared in 3 patients. We treated 38 patients with recurrent ischemic attacks with antiplatelet therapy. No patients experienced bleeding or permanent neurological deficits during follow-up. CONCLUSION The nature of an unruptured VADA is not highly aggressive. However, if the dissection site enlarges without the manifestation of new symptoms, it should be occluded. In patients with recurrent ischemic attacks antiplatelet therapy should be considered.

Magnetic Resonance Imaging Follow-Up of Large or Giant Vertebrobasilar Dissecting Aneurysms After Total Embolization on Angiography

2016 ◽  
Vol 91 ◽  
pp. 218-227 ◽  
Author(s):  
Yisen Zhang ◽  
Yanmin Wang ◽  
Binbin Sui ◽  
Youxiang Li ◽  
Shiqing Mu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Dissecting Aneurysms

BRAINSTEM LESIONS IN NEUROFIBROMATOSIS TYPE 1

Neurosurgery ◽  
2007 ◽  
Vol 61 (4) ◽  
pp. 762-767 ◽  
Author(s):  
Nicole J. Ullrich ◽  
Ali I. Raja ◽  
Mira B. Irons ◽  
Mark W. Kieran ◽  
Liliana Goumnerova
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Natural History ◽  
Neurofibromatosis Type 1 ◽  
Neurofibromatosis Type ◽  
Additional Treatment ◽  
Resonance Imaging ◽  
Brainstem Lesions

Abstract OBJECTIVE The presence of multiple, nonenhancing areas of hyperintensity without mass effect are well recognized on magnetic resonance imaging scans in children with neurofibromatosis type 1 (NF1). Focal regions of brainstem enlargement with or without contrast enhancement are considerably less frequent; the neuroimaging characteristics and natural history of these lesions in patients with NF1 are poorly understood. The objective of this study was to define the clinical and radiographic course of brainstem lesions in children with NF1. METHODS We retrospectively reviewed the neuroimaging studies of all patients with NF1 between 2000 and 2006 to determine the prevalence of brainstem lesions. Clinical features, previous treatments, and neuroimaging studies of the brainstem lesions were evaluated. RESULTS A total of 125 patients underwent neuroimaging studies; of these, 23 patients (18.4%) showed evidence of brainstem mass lesions and had follow-up magnetic resonance imaging scans available for review. Eight patients in this cohort received additional treatment with surgery, radiation, or chemotherapy. Of these, two patients underwent surgery for lesions distant from the brainstem, and six patients underwent treatment that included the brainstem and were thought to potentially affect the natural history or progression of the brainstem abnormality. With a median follow-up period of 67 months for untreated patients (17 out of 23) and 102 months for patients who received therapy (six out of 23), only one previously untreated patient experienced radiographic and clinical progression. All patients but one remain alive. CONCLUSION We conclude that brainstem lesions in NF1 are prevalent and behave in a biologically indolent nature; most do not require therapeutic intervention.

scholarly journals Familial pineal tumours in two siblings

2015 ◽  
Vol 42 (S1) ◽  
pp. S45-S45
Author(s):  
FB Maroun ◽  
R Avery ◽  
E Walsh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brain Tumours ◽  
Clinical Manifestations ◽  
The Other ◽  
Resonance Imaging ◽  
Von Hippel Lindau ◽  
Endocrine Neoplasia ◽  
Close Relationship

Background: The occurrence of familial brain tumours, particularly gliomas, hemangioblastomas in Von Hippel Lindau and other endocrine neoplasia, is well documented in the literature. On the other hand, familial pineal tumours are extremely rare and only a handful of cases have been reported. Methods and Results: Two female siblings presented at ages 12 and 15 with histories of progressive headaches. Neurological examination in each was completely normal. Magnetic Resonance Imaging confirmed the presence of cystic and solid lobulated pineal lesions with mild enhancement, consistent with pineocytoma, in both girls. Follow-up for 15 years in the first sibling and 4 years in the second showed no evolution in radiological or clinical manifestations. No active treatments have been carried out. Conclusion: The occurrence of familial pineal lesions raises the possibility of a close relationship between heredity and oncogenicity, and should be further explored.

scholarly journals Significance of the absent vertebral artery T2 flow void on cervical spine MRI in atraumatic patients without acute neurological symptoms

2019 ◽  
Vol 32 (3) ◽  
pp. 154-157
Author(s):  
Mougnyan Cox ◽  
David Kung ◽  
Robert W Hurst ◽  
Linda J Bagley ◽  
Seyed Ali Nabavizadeh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Vertebral Artery ◽  
Neurological Symptoms ◽  
Vascular Imaging ◽  
Resonance Imaging ◽  
Flow Void ◽  
Artery Flow

Purpose Loss of the T2 vertebral artery flow void can be an ominous sign in patients with trauma. However, the significance of an absent vertebral artery flow void is less clear when discovered incidentally in patients without trauma or acute neurological symptoms. The purpose of this study was to review retrospectively the results of additional imaging and clinical evaluation in atraumatic patients without acute neurological symptoms found to have an incidentally discovered absent vertebral artery flow void on magnetic resonance imaging. Materials and methods An imaging database was reviewed for absent vertebral artery flow voids in atraumatic cervical spine magnetic resonance images. Imaging and long-term clinical follow-up were recorded. Results Fifty-four patients were included in the study. All patients had clinical follow-up and 22 patients (40% of cases) had vascular imaging follow-up. Nine patients had a hypoplastic but patent vertebral artery on follow-up vascular imaging, and no further action was taken. Ten patients had evidence of stenosis or occlusion of the vertebral artery on follow-up imaging, none with acute neurological symptoms or new symptoms/subsequent change in management during follow-up. Three additional patients had vertebral artery dissections on follow-up imaging, but all of them had acute neurological symptoms at the time of imaging and acute infarcts on current or subsequent magnetic resonance imaging. The other 32 patients had clinical follow-up and remained asymptomatic throughout the study period, without change in management. Conclusion In the absence of trauma or acute neurological symptoms an absent vertebral artery flow void has a low likelihood of altering patient management.

Sign in / Sign up

Export Citation Format

Share Document