Recurrent retinal ischemia beyond cervical carotid occlusions

1981 ◽  
Vol 55 (4) ◽  
pp. 532-542 ◽  
Author(s):  
Roger W. Countee ◽  
Thurairasah Vijayanathan ◽  
Pamela Chavis
Keyword(s):  
Carotid Artery ◽  
Ophthalmic Artery ◽  
Clinical History ◽  
Retinal Ischemia ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Anticoagulant Drug ◽  
Nonsurgical Patients ◽  
Fine Print

✓ Seventeen patients with persistent amaurosis fugax ipsilateral to angiographically documented internal carotid artery (ICA) occlusions in the neck have been treated by the authors over the past 5 years. Complete cerebral arteriography in each case demonstrated that the symptomatic ophthalmic artery was perfused exclusively by the ipsilateral external carotid artery (ECA), which invariably had an obstructive and/or ulcerative lesion at its origin, and/or an adjacent residual “stump” of the occluded ICA. In nine patients, retinal artery branch emboli were visible on funduscopy. One patient had angiographic evidence of intracranial embolization via the ophthalmic artery from the ECA. Although ipsilateral superficial temporal-middle cerebral artery anastomosis in one patient, and endarterectomy of a contralateral carotid stenosis in another patient, failed to relieve symptoms, endarterectomy of the ECA with resection of the “stump” of the occluded ICA effectively terminated symptoms in 10 of 11 patients. Anticoagulant drug therapy promptly abolished symptoms in four nonsurgical patients as well as in two patients with failed operations. It is concluded that recurrent retinal ischemia beyond cervical carotid occlusions frequently results from microembolism via the ipsilateral ECA. Patients with this mechanism of postocclusion recurrent ischemia can be identified on the basis of clinical history, ophthalmological examinations, and complete cerebral arteriography. Termination of embolic phenomena should be the major treatment goal in these individuals, and ECA endarterectomy is recommended. Anticoagulant drugs are an effective alternative treatment in patients who are poor surgical risks.

External carotid-cavernous fistula treated by arterial embolization

1974 ◽  
Vol 40 (1) ◽  
pp. 110-114 ◽  
Author(s):  
M. Stephen Mahalley ◽  
Stephan C. Boone
Keyword(s):  
Carotid Artery ◽  
Successful Treatment ◽  
Arterial Embolization ◽  
External Carotid Artery ◽  
External Carotid ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Unusual Occurrence ◽  
Fine Print

✓ The unusual occurrence of a carotid-cavernous fistula supplied entirely by branches of the external carotid artery is presented, and its successful treatment by arterial embolization described.

Arteriovenous malformation in the posterior fossa supplied by the external carotid circulation

1974 ◽  
Vol 41 (4) ◽  
pp. 502-507 ◽  
Author(s):  
Carl J. Graf ◽  
Arnold H. Menezes
Keyword(s):  
Carotid Artery ◽  
Arteriovenous Malformation ◽  
Posterior Fossa ◽  
Blood Supply ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Carotid Circulation ◽  
Fine Print

✓ The authors report a case in which the blood supply of a posterior fossa arteriovenous malformation was derived entirely from the external carotid artery.

Intraparenchymal arteriovenous malformations with predominant external carotid artery contribution

1974 ◽  
Vol 41 (6) ◽  
pp. 681-687 ◽  
Author(s):  
Raymond E. Dahl ◽  
David G. Kline
Keyword(s):  
Carotid Artery ◽  
Blood Supply ◽  
Arteriovenous Malformations ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Cerebral Parenchyma ◽  
Fine Print

✓ Arteriovenous malformations located within cerebral parenchyma are usually supplied by intracranial vessels. An extracranial blood supply to these lesions is rare. The authors report their experience with two such cases and discuss the 21 comparable reports.

Lateral sinus pericranii

1983 ◽  
Vol 58 (1) ◽  
pp. 139-140 ◽  
Author(s):  
Jesús Vaquero ◽  
Rafael G. de Sola ◽  
Roberto Martínez
Keyword(s):  
Differential Diagnosis ◽  
Carotid Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Lateral Sinus ◽  
Content Type ◽  
Sinus Pericranii ◽  
Fine Print

✓ A case of lateral sinus pericranii in a 49-year-old woman is presented. These extraordinarily rare lesions should be considered in the differential diagnosis of epicranial tumors. The lack of filling on external carotid artery angiograms may lead to the error of dismissing the possibility of a vascularized lesion.

Internal carotid artery stump angioplasty for the treatment of cerebrovascular occlusive disease

1986 ◽  
Vol 65 (4) ◽  
pp. 461-464 ◽  
Author(s):  
Edward C. Benzel ◽  
Kevin M. Sittig ◽  
Mansour Mirfakhraee
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
Occlusive Disease ◽  
External Carotid ◽  
Content Type ◽  
Cerebrovascular Occlusive Disease ◽  
Intracranial Vasculature ◽  
Fine Print

✓ Nineteen patients underwent a total of 21 stump angioplasty procedures for an occluded internal carotid artery. Indications for surgery included the preparation of the donor vessel for a subsequent extracranial-intracranial bypass procedure, the occurrence of emboli to the intracranial vasculature from the external carotid artery circulation, and the association with symptomatic occlusive disease of the external carotid artery accompanying occlusion of the ipsilateral internal carotid artery. The technique utilized and the results obtained in these 19 patients are presented. In select patients, the removal of an occluded internal carotid artery stump via a stump angioplasty is beneficial in preventing the catastrophic sequela of embolic cerebrovascular disease.

Subselective preoperative embolization for meningiomas

1984 ◽  
Vol 60 (3) ◽  
pp. 506-511 ◽  
Author(s):  
Evelyn Teasdale ◽  
James Patterson ◽  
Douglas McLellan ◽  
Peter Macpherson
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Computerized Tomography ◽  
Tumor Necrosis ◽  
External Carotid Artery ◽  
External Carotid ◽  
Preoperative Embolization ◽  
Content Type ◽  
Tumor Specimen ◽  
Fine Print

✓ Over a 2-year period the authors have studied the effects of preoperative subselective embolization of meningiomas. Thirty-six consecutive patients shown by computerized tomography (CT) to have a meningioma underwent selective internal and external carotid artery angiography, and any significant external carotid artery feeders were embolized (27 cases). It was found that CT and dynamic radioisotope scan findings were unable to predict the degree of vascularity of the tumor or its suitability for embolization. Furthermore, these tests, repeated after embolization, were unreliable in detecting either the extent of necrosis or reduction in blood flow. The effects of embolization upon surgery were recorded, and the excised tumor specimen examined for evidence of thrombosis and infarction. Subselective embolization was determined to be a simple, safe, and effective method of producing tumor necrosis and intraoperative hemostasis in selected patients.

Persistent proatlantal artery with carotid-vertebral anastomosis

1975 ◽  
Vol 43 (4) ◽  
pp. 499-501 ◽  
Author(s):  
T. Surya Rao ◽  
Prahlad K. Sethi
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Foramen Magnum ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Proatlantal Artery ◽  
Fine Print

✓ The authors describe the occurrence of proatlantal artery as an incidental angiographic observation in a young Indian soldier. This primitive anastomotic channel is seen extending from near the origin of the external carotid artery to the suboccipital region, traversing the foramen magnum and coursing beyond like a vertebral artery. The developmental and roentgenological aspects of carotid-basilar and carotid-vertebral anastomosis are discussed, along with a review of four similar cases reported previously.

Cerebral monitoring by means of oximetry and somatosensory evoked potentials during carotid endarterectomy

1998 ◽  
Vol 89 (4) ◽  
pp. 533-538 ◽  
Author(s):  
Hun Cho ◽  
Edwin M. Nemoto ◽  
Howard Yonas ◽  
Jeffrey Balzer ◽  
Robert J. Sclabassi
Keyword(s):  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Evoked Potentials ◽  
Carotid Endarterectomy ◽  
Somatosensory Evoked Potentials ◽  
External Carotid Artery ◽  
Cerebral Oximetry ◽  
External Carotid ◽  
Content Type ◽  
Fine Print

Object. Cerebral ischemia that occurs during carotid endarterectomy is commonly monitored by means of somatosensory evoked potentials (SSEPs) and electroencephalography (EEG). The authors conducted this study to determine whether cerebral ischemia could also be reliably detected by cerebral oximetry. Methods. Twenty-nine patients who underwent carotid endarterectomy were monitored by means of SSEPs, EEG, and cerebral oximetry with a model NIRO500 (20 patients) or INVOS3100A (nine patients) oximeter. Changes in amplitude of SSEPs were graded as follows: 0, no change; 1, decrease of less than 50%; 2, decrease of greater than 50%; and 3, 100% decrease. As measured with the NIRO500 oximeter, closing the common caro-tid artery decreased mean oxyhemoglobin levels twice as much (p < 0.005) in the group with SSEPs of 1 to 3 (−13.11 ± 5.59 µM [mean ± standard deviation], 12 patients) as in the group with SSEPs of 0 (−6.22 ± 5.59 µM, eight patients). The rise in deoxyhemoglobin was also greater (p < 0.05). Two of nine patients monitored with the INVOS3100A oximeter had SSEPs of 1 and 3, and their regional saturation of oxygen (rSO2) values fell by −11.50 and −11.51, respectively. In the remaining seven patients with SSEPs of 0, the rSO2 ranged between −2.00 and −6.10 with no overlap with the group with SSEPs of 1 to 3. The increase in oxyhemoglobin monitored using the NIRO500 oximeter and rSO2 monitored using the INVOS3100A machine after opening the external carotid artery was less than that seen after opening the internal carotid artery. Both types of oximeters could detect cerebral ischemia but whereas false negatives occurred with the NIRO500, none was observed with the INVOS3100A. Extracranial contamination was also four times less frequent with the INVOS3100A than with the NIRO500 monitor. Conclusions. The results indicate that at least as measured with the INVOS3100A instrument, a decrease in rSO2 of −10 or more or a decrease below an rSO2 of 50 is indicative of cerebral ischemia of sufficient severity to decrease the amplitude of SSEPs.

Presurgical transfemoral catheter embolization to reduce operative blood loss

1974 ◽  
Vol 41 (3) ◽  
pp. 396-398 ◽  
Author(s):  
Ruben E. M. Hekster ◽  
Bartolomeo Matricali ◽  
Willem Luyendijk
Keyword(s):  
Carotid Artery ◽  
Blood Loss ◽  
External Carotid Artery ◽  
Total Blood Loss ◽  
External Carotid ◽  
Operative Blood Loss ◽  
Total Blood ◽  
Content Type ◽  
Technical Details ◽  
Fine Print

✓The authors report the technical details of a case in which, to reduce operative hemorrhage, branches of the external carotid artery feeding a large convexity meningioma were preoperatively embolized with Gelfoam plugs. The total blood loss during the successful resection of the tumor was 500 ml.

Tentorial arteriovenous malformation presenting as an intracerebral hematoma

1981 ◽  
Vol 55 (6) ◽  
pp. 976-978 ◽  
Author(s):  
Raeph Fardoun ◽  
Yves Adam ◽  
Philippe Mercier ◽  
Gilles Guy
Keyword(s):  
Carotid Artery ◽  
Arteriovenous Malformation ◽  
External Carotid Artery ◽  
Intracerebral Hematoma ◽  
External Carotid ◽  
Content Type ◽  
Cortical Vein ◽  
Fine Print

✓ A case of a tentorial arteriovenous aneurysm is reported in a 54-year-old man. This malformation, fed by branches of the external carotid artery, was drained exclusively by a parieto-occipital cortical vein. The rupture of this vein was responsible for the presenting intracerebral hematoma.

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