Intraoperative color-flow Doppler imaging of AVM's and aneurysms

1988 ◽  
Vol 68 (4) ◽  
pp. 635-639 ◽  
Author(s):  
Keith L. Black ◽  
Jonathan M. Rubin ◽  
William F. Chandler ◽  
John E. McGillicuddy

✓ The use of intraoperative color-flow Doppler sonography to image cerebral and spinal arteriovenous malformations (AVM's) and a giant aneurysm is reported in 10 patients. The technique is a useful adjunct in localizing vascular lesions, identifying feeding or draining vessels, and confirming intraoperative surgical excision of AVM's or ligation of giant aneurysms. Imaging of lesions deeper than 4 to 5 cm is, however, limited with the equipment design now commercially available.

2021 ◽  
pp. 104063872199206
Author(s):  
Niora J. Fabian ◽  
Michael Y. Esmail ◽  
Lauren Richey ◽  
Sureshkumar Muthupalani ◽  
Jennifer L. Haupt ◽  
...  

Cutaneous leiomyosarcomas are malignant mesenchymal tumors of smooth muscle origin and are reported occasionally in avian species. A 14-y-old male laboratory White Carneau pigeon ( Columba livia) was presented for surgical excision of a cervical soft tissue mass. Ultrasonography with color flow Doppler imaging revealed multiple cavitations of mixed echogenicity within the mass and vascularization. Histologically, the dermis and subcutis were expanded by a densely cellular multinodular mass comprised of fusiform cells forming haphazardly arranged broad streams and short interwoven bundles, often surrounding blood vessels and variably sized cavitations. Neoplastic cells were strongly immunopositive for desmin and α–smooth muscle actin, and negative for pancytokeratin, S100, and von Willebrand factor. Based on histopathology and IHC findings, the cutaneous mass was diagnosed as leiomyosarcoma (LMS). The pigeon died 312 d post-operatively. Postmortem examination revealed masses infiltrating the left and right pulmonary airways and one hepatic nodule, but no regrowth at the surgical site. Histologic and IHC evaluation of the pulmonary and hepatic masses were consistent with LMS, representing metastatic foci from the primary cutaneous LMS. Our case highlights the malignant behavior and histomorphologic features of cutaneous LMS in an avian species.


1994 ◽  
Vol 81 (6) ◽  
pp. 934-936 ◽  
Author(s):  
Alok Ranjan ◽  
Thomas Joseph

✓ This forty-five-year-old woman presented with a history suggestive of an intracranial hemorrhage. Clinical examination indicated mild right pyramidal signs and neck stiffness. Computerized tomography demonstrated contrast enhancement in the region of a left frontal intraparenchymal hematoma with an adjacent subdural hematoma. Angiography revealed the presence of a giant aneurysm on the left anterior ethmoidal artery. Surgical evacuation of the hematoma with excision of the aneurysm and coagulation of the feeding artery was achieved. Postoperative recovery was uneventful. Vascular lesions of the anterior ethmoidal artery and the rarity of a giant aneurysm at this site are discussed.


1989 ◽  
Vol 70 (6) ◽  
pp. 832-836 ◽  
Author(s):  
Michael K. Morgan ◽  
W. Richard Marsh

✓ Dura-based spinal arteriovenous malformations (AVM's) are being diagnosed with increasing frequency. The optimal management of such lesions remains a topic of discussion. In an effort to guide this discussion, the authors review their experience with 17 cases of spinal dural AVM treated between January, 1984, and July, 1987. All patients presented with a slowly progressive paraparesis. The abnormalities were initially identified on myelography and confirmed by selective spinal angiography. Fourteen patients underwent endovascular embolization as a primary treatment, and a total of 18 embolization procedures were performed. After all but two of these, obliteration was confirmed at angiography. Patients' symptoms improved following 15 or these procedures but early improvement was not sustained in 10 instances; patients were unchanged after two procedures and worse after one. Follow-up angiography was performed at varying intervals after 15 of the 18 procedures, and recanalization of the previously obliterated spinal dural AVM was demonstrated in 13 instances. Eight patients ultimately underwent surgical treatment of their dura-based spinal AVM. No patient suffered deterioration of symptoms following operation. While embolization may allow angiographic obliteration of a spinal dural AVM and early clinical improvement, for the majority of patients these are not sustained. The average time to treatment failure was 5 months. Newer embolization materials will be necessary to effect permanent treatment in many of these patients.


1987 ◽  
Vol 66 (6) ◽  
pp. 830-834 ◽  
Author(s):  
John L. Doppman ◽  
Giovanni Di Chiro ◽  
Andrew J. Dwyer ◽  
Joseph L. Frank ◽  
Edward H. Oldfield

✓ Magnetic resonance imaging (MRI) was performed on 12 patients with spinal arteriovenous malformations (AVM's). Six lesions were intramedullary, five were dural, and one was in a posterior extramedullary location. Serpentine filling defects similar to the classic myelographic findings were demonstrated within the high-signal cerebrospinal fluid on T2-weighted coronal scans. The intramedullary nidus was identified by MRI as an area of low-signal intensity within the cord in all six intramedullary AVM's. Neither the dural nor the posterior extramedullary lesions showed intramedullary components. It is concluded that MRI may noninvasively provide the initial diagnosis of a spinal AVM and distinguish intramedullary from dural and extramedullary lesions.


2007 ◽  
Vol 48 (6) ◽  
pp. 628-634 ◽  
Author(s):  
M. Loy ◽  
E. Perra ◽  
A. Melis ◽  
M. E. Cianchetti ◽  
M. Piga ◽  
...  

Background: Amiodarone-induced thyrotoxicosis (AIT) may be caused by excessive thyroidal hormone synthesis and release (type 1) or by a destructive process (type 2). This differentiation is considered essential for therapeutic choice. Purpose: To evaluate the utility of color-flow Doppler sonography (CFDS) in the differential diagnosis and management of AIT. Material and Methods: The clinical and laboratory data, thyroid sonography (grayscale sonography [GSS], CFDS), thyroid radioiodine uptake (RAIU) and thyroid scintigraphy, treatment, and clinical outcome were retrospectively reviewed in 21 AIT patients. The CFDS pattern of thyroid nodules was separately described from that of the perinodular parenchyma, and AIT was classified as type 1 (increased blood flow) or type 2 (low/no blood flow). Type 1 AIT patients were treated with methimazole (alone or associated with potassium perchlorate), while type 2 patients were treated with prednisone or amiodarone withdrawal alone. Results: Eleven patients with increased blood flow were considered as type 1, and 10 with low/no blood flow as type 2. Ten of the 11 patients in the first group showed a hypervascular nodular pattern, while one showed a hypervascular parenchymal pattern. Clinical diagnoses were toxic nodular goiter and Graves' disease, respectively. Of the 10 patients with low/no blood flow, six had normal thyroid volume, three small diffuse goiter, and one small multinodular goiter. The clinical outcome showed that 20 of the 21 patients were treatment responsive. Conclusion: CFDS is a useful tool in the differential diagnosis of AIT. This differentiation appeared to be of clinical relevance as regards therapeutic choice. Separate evaluation of parenchymal blood flow from that of nodules may prove beneficial in the diagnosis of underlying thyroid diseases in patients with type 1 AIT.


1994 ◽  
Vol 26 (1) ◽  
pp. 93-97 ◽  
Author(s):  
Mustafa Salih ◽  
Sümer Baltaci ◽  
Sahir Kiliç ◽  
Kadri Anafarta ◽  
Yaşar Bedük

1980 ◽  
Vol 52 (5) ◽  
pp. 705-708 ◽  
Author(s):  
Laurence D. Cromwell ◽  
A. Basil Harris

✓ It is believed that surgical excision of arteriovenous malformations is the best treatment when technically feasible without causing significant damage to adjacent brain. The introduction of polymers or particulate emboli by catheter has been used either alone or as an adjunct in attempts to reduce the size of these lesions prior to surgery; however, it is seldom possible to embolize the entire malformation. The authors have used direct injection of a 50% mixture of bucrylate and iophendylate into the feeding arteries supplying the area at craniotomy, with success in three cases. The cases are described to illustrate the method.


Sign in / Sign up

Export Citation Format

Share Document