Fluttering cord-like thrombus in the aortic arch: a case report

Abstract BackgroundOptimal treatment for aortic thrombus remains to be determined, but surgical treatment is indicated when there is a risk for thromboembolism. Case PresentationA 47-year-old male presented with weakness in his left arm upon awakening. Contrast-enhanced computed tomography and transesophageal echocardiography revealed a mobile pedunculated object suggestive of a thrombus arising from the ascending aorta and extending to the left common carotid artery. It was removed under hypothermic circulatory arrest and direct cannulation of the left carotid artery to avoid carotid thromboembolism. Histopathological examination revealed that the object was a thrombus. The patient had an uneventful postoperative course and was discharged 9 days after surgery. ConclusionWhen a thrombus in the aortic arch extends to the neck arteries, direct cannulation of the neck arteries with selective cerebral perfusion via cervical incision is a useful technique.

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Imaging spectrum and prevalence of variant branching pattern of aortic arch

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191345 ◽

2019 ◽

Vol 7 (4) ◽

pp. 1313

Author(s):

Vipin Krishnan K. V. ◽

Varun Narayan ◽

Niyaz Ibrahim ◽

John Mathew ◽

Sheen Maria James

Keyword(s):

Computed Tomography ◽

Aortic Arch ◽

Subclavian Artery ◽

Aberrant Right Subclavian Artery ◽

Left Vertebral Artery ◽

Branching Pattern ◽

Contrast Enhanced ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography ◽

Variant Anatomy

Background: Variant branching patterns of the aortic arch are not infrequent but are commonly under reported. This study was conducted to determine the spectrum of Variant branching pattern of aortic arch and their prevalence using contrast enhanced computed tomography (CECT) images of the cases from a tertiary care centre.Methods: Contrast enhanced computed tomography (CECT) images of aortic arch region from 1116(629 male and 487 female) cases from 18 to 85 years of age were examined retrospectively. The images were reviewed for normal and variant anatomy of aortic arch and the results were analyzed statistically.Results: Of 1116 patients, 878 (78.6%) cases showed normal and 238 (21.3%) cases had variant branching pattern of the aortic arch. The most common variation was the common origin of brachiocephalic trunk (BCT) and the left common carotid artery (LCCA) which was observed in 160 (14.3%) cases. In 8 (0.7%) cases, BCT and LCCA took origin from a single common trunk arising from the aortic arch. In 60(5.4%) cases, the left vertebral artery (LVA) originated directly from the aortic arch between the origin of the LCCA and left subclavian artery (SCA). 8 (0.7%) cases had aberrant right subclavian artery. Two (0.2%) cases showed right aortic arch.Conclusions: Interventional radiologists and surgeons should be well aware of variant anatomy of aortic arch. Contrast CT is a highly reliable imaging method for demonstrating anatomical features and variations of the arch.

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Asymptomatic floating thrombus in the ascending aorta depicted on four-dimensional computed tomography

SAGE Open Medical Case Reports ◽

10.1177/2050313x20971894 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2097189

Author(s):

Takamasa Nishimura ◽

Eijun Sueyoshi ◽

Yuichi Tasaki ◽

Masataka Uetani

Keyword(s):

Computed Tomography ◽

Unusual Case ◽

Ascending Aorta ◽

Mural Thrombus ◽

4D Ct ◽

Floating Thrombus ◽

Contrast Enhanced ◽

Aortic Thrombus ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography

Aortic mural thrombi of the ascending aorta are rare. If an aortic mural thrombus is dislodged, it can cause various embolic complications, which can sometimes be fatal. Although contrast-enhanced computed tomography (CT) and transesophageal echography are useful for diagnosing aortic mural thrombi, four-dimensional CT (4D-CT) is one of the most useful modalities for both diagnosis and treatment selection in such cases. 4D-CT can be used to evaluate the morphology and mobility of thrombi. Furthermore, it is minimally invasive. To the best of our knowledge, there have not been any reports about 4D-CT being used to depict an asymptomatic ascending aortic thrombus. We report a very unusual case, involving an aortic mural thrombus of the ascending aorta.

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Location of hemorrhage with nontraumatic acute subdural hematoma due to ruptured microaneurysm

Surgical Neurology International ◽

10.25259/sni_210_2021 ◽

2021 ◽

Vol 12 ◽

pp. 401

Author(s):

Taro Yanagawa ◽

Keiichi Yamashita ◽

Yoichi Harada ◽

Toru Hatayama ◽

Takuji Kono

Keyword(s):

Ct Scan ◽

Subdural Hematoma ◽

Distal Part ◽

Clinical Course ◽

Histopathological Examination ◽

Acute Subdural Hematoma ◽

Contrast Enhanced ◽

Traumatic Pseudoaneurysm ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography

Background: Nontraumatic acute subdural hematoma (ASDH) may be caused by rupture of a microaneurysm of a cortical artery. In some cases, microaneurysms may have been caused by earlier trauma. Although it is difficult to detect microaneurysms on contrast-enhanced computed tomography (CT) angiography or digital subtraction angiography, it may be suspected based on the plain CT scan results and the clinical course. Case Description: We experienced three cases presumed to be ASDH due to rupture of a microaneurysm. Plain CT scan showed that the midline shift was smaller than the hematoma thickness, and we judged from the clinical course that there was no trauma immediately before the onset. All three patients had decreased consciousness after arrival and underwent craniotomy for hematoma removal. The source of hemorrhage was in the distal part of the cortical artery, and a microaneurysm was found. In one case, histopathological examination was performed, and traumatic pseudoaneurysm was diagnosed. The postoperative course was good in all three cases. Conclusion: If nontraumatic ASDH is suspected, the source of hemorrhage may be located more distally to the middle cerebral artery than in traumatic ASDH; hence, extensive craniotomy is required to search for the location of hemorrhage.

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Evaluation of carotid artery plaques by black blood magnetic resonance imaging and contrast enhanced computed tomography: correlation of the two methods

Nosotchu ◽

10.3995/jstroke.32.229 ◽

2010 ◽

Vol 32 (3) ◽

pp. 229-235 ◽

Cited By ~ 2

Author(s):

Chikage Inukai ◽

Takashi Inukai ◽

Naoki Matsuo ◽

Teruhide Takagi ◽

Takahiro Nakura ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Carotid Artery ◽

Black Blood ◽

Resonance Imaging ◽

Contrast Enhanced ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography

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A case of atypical leiomyoma mimicking as endometrial cancer

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205814 ◽

2020 ◽

Vol 10 (1) ◽

pp. 416

Author(s):

Priyanka Bhadana ◽

Abha Kiran ◽

Kriti Bhakuni ◽

Veena G. Malla

Keyword(s):

Histopathological Examination ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Lower Abdomen ◽

Contrast Enhanced ◽

Mitotic Figures ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography ◽

Nuclear Enlargement

Atypical leiomyoma or leiomyoma with bizarre nucleus is diagnosed on histopathological examination characterized by severe cytological atypia in the form of nuclear enlargement, multi nucleation, hyperchromasia, coarse chromatin and prominent nuclei. These tumours do not have typical features of necrosis or mitotic figures to characterize them as leiomyosarcoma. There are 2% risk of these tumours to convert to leiomyosarcoma. 50-year P3L3A1 postmenopausal for past 6 years presented to gynaecology outpatient department (GOPD) with complains of pain in lower abdomen for past 1 year. Patient was examined and investigated. On clinical examination there was no apparent finding. On radiological examination a well-defined hypoechoic lesion of 6.4×5.7 cm2 was found arising from uterus. Contrast enhanced computed tomography (CECT) abdomen showed heterogenous mass involving endometrium and myometrium likely neoplastic. Total abdominal hysterectomy with bilateral salpingoophrectomy was done. Histopathological examination (HPE) report revealed features of atypical leiomyoma. Patient is under follow up in GOPD.

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