Simple Assessment of Cerebral Hemodynamics Using Single-Slab 3D Time-of-Flight MR Angiography in Patients with Cervical Internal Carotid Artery Steno-Occlusive Diseases: Comparison with Quantitative Perfusion Single-Photon Emission CT

Abstract Three rare cases of moyamoya-like diseases with moyamoya type vessels caused by spontaneous internal carotid artery occlusion, spontaneous middle cerebral artery occlusion, and internal carotid artery occlusion due to cervical irradiation are presented. They resulted in ventricular hemorrhages. One patient died and two survived. Postoperatively, the collateral circulation of the survivors was evaluated by single photon emission tomography using N-isopropyl-[123I]-p-iodoamphetamine. The effectiveness of reconstructive surgery is shown, and moyamoya-like diseases that have been reported are reviewed.

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Dissections of the internal carotid artery: three-dimensional time-of-flight MR angiography and MR imaging features.

American Journal of Roentgenology ◽

10.2214/ajr.173.1.10397114 ◽

1999 ◽

Vol 173 (1) ◽

pp. 139-143 ◽

Cited By ~ 18

Author(s):

V Bousson ◽

C Lévy ◽

L Brunereau ◽

H Djouhri ◽

J M Tubiana

Keyword(s):

Carotid Artery ◽

Mr Imaging ◽

Internal Carotid Artery ◽

Mr Angiography ◽

Internal Carotid ◽

Three Dimensional ◽

Time Of Flight ◽

Imaging Features

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Pseudostenosis of the internal carotid artery in 3D time-of-flight MR angiography: effects of a magnetization transfer contrast pulse and metallic material

European Radiology ◽

10.1007/s00330-003-1860-5 ◽

2003 ◽

Vol 13 (10) ◽

pp. 2298-2303 ◽

Cited By ~ 3

Author(s):

Shinji Naganawa ◽

Tokiko Koshikawa ◽

Kimihide Sato ◽

Toshio Katagiri ◽

Takeo Mimura ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Mr Angiography ◽

Internal Carotid ◽

Magnetization Transfer ◽

Time Of Flight ◽

Metallic Material ◽

Magnetization Transfer Contrast

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Facing a Feared Situation: Endoscopic Endonasal Approach for Petroclival Lesions With Internal Carotid Artery Encasement: 2-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opaa237 ◽

2020 ◽

Author(s):

Yury Anania ◽

Andrew S Venteicher ◽

Eric W Wang ◽

George A Zenonos ◽

Carl H Snyderman ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Single Photon ◽

Photon Emission ◽

Complete Removal ◽

Emission Computed Tomography ◽

Endoscopic Endonasal ◽

Cavernous Sinus Invasion ◽

Cranial Nerve Palsies

Abstract A 33-yr-old woman presented with diplopia due to partial III and VI cranial nerve palsies, and an magnetic resonance imaging (MRI) showed a left petroclival lesion with cavernous sinus invasion. The ipsilateral internal carotid artery (ICA) was displaced and encased by the tumor. Chondroid tumors such as this are known to be high risk for ICA injury1; however, given the patient's young age a radical resection was desirable,2 depending on the risk of such a strategy. Therefore, a preoperative balloon test occlusion (BTO) was performed to estimate the risk of stroke in case of ICA sacrifice.3 Clinical and single-photon emission computed tomography testing predicted low risk of stroke, allowing for aggressive resection. A preoperative ICA occlusion was not performed as intraoperative control was believed to be adequate and preservation is always preferable when possible due to rare inaccuracies in BTO and long term risks of occlusion. An endoscopic endonasal and right contralateral transmaxillary approach with intraoperative neurophysiology were performed to remove this lesion.4,5 During surgery, the ICA proved dehiscent, and was therefore clip sacrificed.6 An immediate postoperative digital subtraction angiography showed minimally delayed, but adequate, blood flow to the left cerebral hemisphere. Postoperative MRI showed complete removal and no significant infarct. The patient was discharged in stable neurological condition, with only a slightly worsened CN III palsy. Experience with management of ICA injury is of uttermost importance in endoscopic endonasal surgery,1,2 and requires adequate training and an experienced 2-surgeon team.7 The patient provided consent to the submission and publication of the related surgical video.

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Use of an embolic protection system during endovascular recanalization of a totally occluded cervical internal carotid artery at the chronic stage

Journal of Neurosurgery ◽

10.3171/jns.2005.102.3.0558 ◽

2005 ◽

Vol 102 (3) ◽

pp. 558-564 ◽

Cited By ~ 32

Author(s):

Tomoaki Terada ◽

Hiroo Yamaga ◽

Tomoyuki Tsumoto ◽

Osamu Masuo ◽

Toru Itakura

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Single Photon ◽

Photon Emission ◽

Protection System ◽

Chronic Stage ◽

Embolic Protection ◽

Hemodynamic Compromise ◽

Endovascular Recanalization

✓ A symptomatic internal carotid artery (ICA) occlusion with hemodynamic compromise was treated at its chronic stage by using an endovascular technique. An embolic protection system was used during the recanalization procedure to prevent stroke by reversing the flow from the distal ICA to the common carotid artery. The totally occluded ICA was completely recanalized through percutaneous transluminal angioplasty and stent placement. The patient's symptom (transient ischemic attack) disappeared completely after treatment with no new neurological deficit. Single-photon emission computerized tomography findings confirmed improvement of the hemodynamic compromise, and no new high-intensity spots appeared on diffusion-weighted magnetic resonance imaging after treatment. This case shows that endovascular recanalization by using an embolic protection device can be considered as an alternative treatment for symptomatic ICA occlusion with hemodynamic compromise and refractoriness to antiplatelet therapy, even in the chronic stage of the illness.

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Endovascular recanalization of the completely occluded internal carotid artery using a flow reversal system at the subacute to chronic stage

Journal of Neurosurgery ◽

10.3171/2009.6.jns09125 ◽

2010 ◽

Vol 112 (3) ◽

pp. 563-571 ◽

Cited By ~ 21

Author(s):

Tomoaki Terada ◽

Hideo Okada ◽

Masataka Nanto ◽

Aki Shintani ◽

Ryo Yoshimura ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Single Photon ◽

Photon Emission ◽

Emission Computed Tomography ◽

Chronic Stage ◽

Embolic Protection ◽

Hemodynamic Compromise ◽

Endovascular Recanalization

Object The efficacy and pitfalls of endovascular recanalization were evaluated in cases of internal carotid artery (ICA) occlusion in the subacute to chronic stage. Methods Fourteen cases (15 lesions) of symptomatic ICA occlusion with hemodynamic compromise or recurrent symptoms were treated at the subacute to chronic stage using an endovascular technique. The Parodi embolic protection system was used during the recanalization procedure to prevent embolic stroke by reversing the flow from the distal ICA to the common carotid artery. Results Recanalization of the occluded ICA was possible in 14 of 15 lesions. The occlusion points were 10 cervical ICAs and 4 petrous/cavernous ICAs in successfully recanalized cases. Ischemic symptoms disappeared completely after the treatment, and new ischemic symptoms did not appear related to the treated lesion. Single photon emission computed tomography findings demonstrated the improvement of hemodynamic compromise in all cases. One case showed right middle cerebral artery branch occlusion during the procedure, but this patient's neurological symptoms were stable due to preexisting hemiparesis. Endovascular recanalization was possible and effective in improving hemodynamic compromise. However, there are still several problems with this technique, such as hyperperfusion syndrome after recanalization, cerebral embolism during treatment, durability after treatment, and identification of the occlusion point before treatment. Conclusions Endovascular recanalization using an embolic protection device can be considered as an alternative treatment for symptomatic ICA occlusion with hemodynamic compromise or refractoriness to antiplatelet therapy, even in the subacute to chronic stage of the illness.

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Reversal of severe SPECT asymmetry after venous extra-intracranial high flow bypass in a patient submitted to therapeutic internal carotid occlusion: case report

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2001000500027 ◽

2001 ◽

Vol 59 (3B) ◽

pp. 797-801 ◽

Cited By ~ 1

Author(s):

Jorge Marcondes ◽

Antônio Aversa ◽

Marcio Peçanha ◽

Flávio Domingues ◽

Fernanda Nascimento ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Single Photon ◽

Photon Emission ◽

High Flow ◽

Carotid Occlusion ◽

Balloon Test Occlusion ◽

Vein Bypass ◽

Therapeutic Occlusion

Therapeutic occlusion of the internal carotid artery is the main option for the treatment of the symptomatic intracavernous internal carotid artery aneurysms, but the issue of the best way of doing the balloon test occlusion (BTO) regarding prediction of future ischemic events remains debatable. Single photon emission computerized tomography (SPECT) has been offered as one of the best option of monitoring regional cerebral blood flow (rCBF) during the BTO, where severe asymmetry is predictive of delayed ischemia. We describe a case of important SPECT asymmetry during BTO clinically negative and its complete reversal with carotid occlusion after extra-intracranial bypass with high flow safenous vein bypass between the cervical carotid artery and the middle cerebral artery.

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