Harvey W. Cushing and cerebrovascular surgery: Part II, vascular malformations

2004 ◽  
Vol 101 (3) ◽  
pp. 553-559 ◽  
Author(s):  
Aaron A. Cohen-Gadol ◽  
Dennis D. Spencer
Keyword(s):  
Carotid Arteries ◽  
Vascular Malformations ◽  
Radical Resection ◽  
External Carotid ◽  
Cerebral Blood Vessels ◽  
Content Type ◽  
Cortical Vein ◽  
Feeding Vessels ◽  
Radiation Treatments ◽  
Cerebrovascular Surgery

✓ The surgical treatment of cerebrovascular malformations intrigued early neurosurgeons. Cushing defined vascular malformations as tumors arising from cerebral blood vessels. He successfully resected the first arteriovenous malformation 3 years after it had been irradiated. In the absence of angiography, the pathoanatomy of these lesions remained elusive and early techniques such as cortical vein ligation proved catastrophic. Cushing demonstrated the favorable results of radiation treatments on vascular malformations and advocated decompressive craniectomy followed by radiotherapy. He ligated cortical feeding vessels and external carotid arteries with an improved understanding of the angioarchitecture of vascular malformations. He stressed the importance of preoperative diagnosis because the radical resection of nonirradiated vascular malformations challenged the limitations of the available neurosurgical armamentarium.

Management of dural arteriovenous malformations of the anterior cranial fossa

1990 ◽  
Vol 72 (5) ◽  
pp. 692-697 ◽  
Author(s):  
Neil A. Martin ◽  
Wesley A. King ◽  
Charles B. Wilson ◽  
Stephen Nutik ◽  
L. Phillip Carter ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Venous Drainage ◽  
Anterior Cranial Fossa ◽  
Venous Aneurysm ◽  
Content Type ◽  
Cortical Vein ◽  
Sagittal Sinus ◽  
Feeding Vessels ◽  
Cranial Fossa

✓ Eight patients with dural arteriovenous malformations (AVM's) of the anterior cranial fossa are presented, and the pertinent literature is reviewed. Unlike cases of dural AVM's in other locations, sudden massive intracerebral hemorrhage was the most frequent reason for presentation. Other symptoms included tinnitus, retro-orbital headache, and a generalized seizure. The malformations were supplied consistently by the anterior ethmoidal artery, usually in combination with other less prominent feeding vessels. The lesion's venous drainage was through the superior sagittal sinus via a cortical vein; in addition, in two cases a subfrontal vein drained the AVM. A venous aneurysm was encountered near the site of anastomosis with the dural feeder in most cases, and was found in all patients who presented with hemorrhage. The AVM was obliterated surgically in six patients, with favorable results achieved in five. One patient died postoperatively from a pulmonary complication. Because of their anatomy and proclivity for hemorrhage, these vascular malformations represent a unique group of dural AVM's. Surgical management of anterior fossa dural AVM's carries low morbidity, and is indicated when the lesions have caused hemorrhage or when there is an associated venous aneurysm.

External carotid-cavernous sinus fistula diagnosed by common carotid arteriography

1974 ◽  
Vol 41 (4) ◽  
pp. 494-498 ◽  
Author(s):  
Louis Wener ◽  
Giovanni Di Chiro ◽  
Robert A. Mendelsohn
Keyword(s):  
Cavernous Sinus ◽  
Carotid Arteries ◽  
External Carotid ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Carotid Cavernous Sinus Fistula ◽  
The Difference ◽  
Fine Print

✓ An external carotid-cavernous fistula diagnosed by serial common carotid arteriography is reported. The diagnosis was reached on the basis of the difference in time between filling of the distal internal and external carotid arteries and the visualization of the fistula.

Multiple intracranial aneurysms and vascular malformations in an infant

1972 ◽  
Vol 37 (3) ◽  
pp. 357-360 ◽  
Author(s):  
Hiroyuki Arai ◽  
Yoshiaki Sugiyama ◽  
Senshi Kawakami ◽  
Noboru Miyazawa
Keyword(s):  
Intracranial Aneurysms ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Vascular Malformations ◽  
Transverse Sinus ◽  
Aneurysmal Dilatation ◽  
Content Type ◽  
Angiographic Evidence ◽  
Internal Carotid Arteries ◽  
In Infants And Children

✓ A case is presented in which an infant had angiographic evidence of two aneurysms of the middle cerebral artery, arteriovenous malformations, aneurysmal dilatation of the left transverse sinus, and kinking of both internal carotid arteries. The literature on intracranial aneurysms in infants and children is reviewed; the clinical and pathological features differ greatly from those in adults.

Diagnosis and Treatment of Carotid Body Tumors

1978 ◽  
Vol 87 (5) ◽  
pp. 614-621 ◽  
Author(s):  
Paul H. Ward ◽  
Herman A. Jenkins ◽  
William N. Hanafee
Keyword(s):  
Carotid Body ◽  
Arterial Wall ◽  
Carotid Arteries ◽  
External Carotid ◽  
Graft Replacement ◽  
Arterial Anastomosis ◽  
Feeding Vessels ◽  
Carotid Body Tumors ◽  
Carotid Bulb ◽  
The Common

The diagnosis and management of carotid body tumors are discussed, including the importance of good arteriography which allows visualization of all major feeding vessels. These include the carotid bulb, internal and external carotid arteries and the often neglected but important vertebral and ascending cervical arteries. Emphasis is placed on the importance of establishing tourniquet control of the common, internal and external carotid arteries. Surgeons removing carotid body tumors should be experienced in arterial wall repair by means of vascular shunts, end-to-end arterial anastomosis, and vein graft replacement of a segment of arterial wall.

Dual cerebral and meningeal supply to giant arteriovenous malformations of the posterior cerebral hemisphere

1980 ◽  
Vol 52 (2) ◽  
pp. 153-161 ◽  
Author(s):  
Miguel A. Faria ◽  
Alan S. Fleischer
Keyword(s):  
Cerebral Hemisphere ◽  
Arteriovenous Malformations ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
External Carotid ◽  
Preoperative Embolization ◽  
Content Type ◽  
Vertebral Arteries ◽  
Feeding Vessels ◽  
Carotid And Vertebral Arteries

✓ Seven cases of giant posterior hemisphere arteriovenous malformations are described. The significance of meningeal feeding vessels from the external carotid artery in addition to the primary cerebral supply through the internal carotid and vertebral arteries to these malformations is discussed. The necessity of bilateral selective external carotid arteriography is stressed, and the value of preoperative embolization is questioned.

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.

Stump embolization from an occluded internal carotid artery

1987 ◽  
Vol 67 (4) ◽  
pp. 609-611 ◽  
Author(s):  
Patrick G. Ryan ◽  
Arthur L. Day
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
External Carotid ◽  
Transient Ischemic Attacks ◽  
Content Type ◽  
Fine Print

✓ A patient with known internal carotid artery occlusion developed transient ischemic attacks in the distribution of the occluded vessel. Arteriography demonstrated a thrombus clearly originating from the internal carotid artery stump, which was unassociated with significantly stenotic atherosclerotic disease of the ipsilateral common or external carotid arteries. Stump angioplasty and endarterectomy led to complete and sustained cessation of further symptoms.

The role of radiosurgery and particulate embolization in the treatment of dural arteriovenous fistulas

1996 ◽  
Vol 84 (5) ◽  
pp. 804-809 ◽  
Author(s):  
Michael J. Link ◽  
Robert J. Coffey ◽  
Douglas A. Nichols ◽  
Deborah A. Gorman
Keyword(s):  
Latency Period ◽  
Venous Drainage ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Arteriovenous Fistulas ◽  
Ocular Symptoms ◽  
Dural Arteriovenous Fistulas ◽  
Feeding Vessels ◽  
Cortical Venous Drainage

✓ Over the past 5 years 29 patients with dural arteriovenous fistulas (AVFs) were treated by the authors using the Leksell radiosurgical gamma knife unit. Within 2 days after radiosurgery, 17 patients with AVFs that exhibited retrograde pial or cortical venous drainage (12 patients) and/or produced intractable bruit (eight patients) underwent particulate embolization of external carotid feeding vessels. The rationale for this treatment strategy was that radiosurgery was expected to cause obliteration of most fistulas after 12 to 36 months. In patients with bruit, ocular symptoms, or in those at risk for hemorrhage, treatment with embolization after radiosurgery kept the fistulas angiographically visible for radiosurgical targeting yet offered palliation of symptoms and temporary, partial protection from hemorrhage during the latency period. In 12 patients, preobliteration embolization immediately reduced (10 patients) or eliminated (two patients) retrograde pial venous drainage. To date, no lesion has hemorrhaged after treatment. Angiography 1 to 3 years posttreatment in 18 patients showed total obliteration of 13 fistulas (72%) and partial obliteration of five (28%). Radiosurgery, followed by embolization when retrograde pial venous drainage, intractable bruit, and/or major external carotid artery supply is present, appears to be a promising treatment for selected patients with symptomatic dural AVFs.

Angiographic resolution of a neonatal intracranial cavernous hemangioma coincident with steroid therapy

1973 ◽  
Vol 39 (1) ◽  
pp. 99-103 ◽  
Author(s):  
Arthur L. Prensky ◽  
Mokhtar Gado
Keyword(s):  
Steroid Therapy ◽  
Cavernous Hemangioma ◽  
Carotid Arteries ◽  
Middle Cranial Fossa ◽  
External Carotid ◽  
Content Type ◽  
Left Orbit ◽  
Cranial Fossa ◽  
Left Middle ◽  
Fine Print

✓ A case is reported in which an inoperable cavernous hemangioma present from birth and involving the left orbit and left middle cranial fossa was totally resolved as the patient was treated with large doses of steroids. During treatment the patient exhibited a persistent thrombocytosis. Serial angiographic studies indicated that resolution was accompanied by occlusion of the branches of the internal and external carotid arteries feeding the lesion.

Carotid artery stenting in a patient with an anomalous vertebral artery origin from the external carotid artery

2021 ◽  
pp. neurintsurg-2020-017075
Author(s):  
André Beer-Furlan ◽  
Stephan A Munich
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Carotid Arteries ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Surgical Interventions ◽  
Vertebral Arteries ◽  
The Common ◽  
Video Player

The existence of carotid basilar anastomoses has been well documented embryologically, anatomically, and, in the case of the persistent trigeminal and hypoglossal arteries, angiographically. Conversely, anomalous origins of the vertebral arteries (VA) are not very common with an incidence ranging from 3% to 8%. Multiple variations of the VA origin have been reported in the literature, including arising from the aortic arch, from the common, internal, or external carotid arteries and subclavian branches.1 There are only four cases reported in the literature of VA origin from the external carotid artery.2–5 We report the fifth case in which the anomalous origin was identified during the investigation of an acute ischemic stroke. Video 1 emphasizes the importance of anatomical knowledge prior to endovascular or surgical interventions. It also highlights technical nuances of carotid artery stenting in a patient with anomalous VA origin from the external carotid artery.Video 1

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