scholarly journals Case Report: Double Micro-Guidewire Technique for Emergent Rescue of Proximal Stent Collapse During Recanalization of Nonacute Occlusion of Vertebral Artery

2021 ◽  
Vol 12 ◽  
Author(s):  
Kun Zhang ◽  
Jin-Chao Xia ◽  
Hui-Li Gao ◽  
Bu-Lang Gao ◽  
Yong-Feng Wang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Case Report ◽  
Vertebral Artery ◽  
Cerebral Arteries ◽  
Cerebrovascular Diseases ◽  
Stent Occlusion ◽  
Stent Lumen ◽  
The Right ◽  
Ischemic Events

Cerebral arteries are usually tortuous, and in the treatment of cerebrovascular diseases with stenting, a stent deployed may be collapsed at one end, leading to reduced blood flow and subsequent stent occlusion. Immediate rescuing measures should be implemented to prevent severe ischemic events. In this case report, we present a case with V4 segment occlusion of the right vertebral artery treated with endovascular stent angioplasty. An Enterprise stent deployed at the occlusion segment was collapsed at the proximal end after withdrawal of the delivery system. Immediate rescuing measures were taken by navigating a micro-guidewire through the lateral stent mesh at the proximal end into the stent lumen followed by advancing a second micro-guidewire right through the reopened proximal stent end into the stent lumen for deployment of a supporting balloon-expandable Apollo stent to prevent stent collapse. Follow-up digital subtraction angiography 6 months later demonstrated patent stents and unobstructed blood flow.

scholarly journals Tortuous vertebral artery triggering vertebral foramen expansion and radiculopathy in a 19-year-old patient: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Ibrahim F. Naldemir ◽  
Elif Nisa Unlu ◽  
Omer Onbas
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Vertebral Artery ◽  
Cerebral Arteries ◽  
Cervical Radiculopathy ◽  
The Elderly ◽  
Loop Formation ◽  
Arterial Tortuosity ◽  
Turkish Patient ◽  
The Right

Abstract Background Arterial tortuosity is a widespread condition commonly occurring in cerebral arteries and often associated with the elderly. Moderate arterial tortuosity is often not symptomatic, but if there is severe tortuosity, various symptoms may occur, depending on the localization. In the literature, many factors have been reported as causing tortuosity in the vertebral arteries. In this case report, considering the age of our patient, we propose that, in addition to these previously reported reasons, congenital factors may also contribute to this situation. Case presentation We present a case of a 19-year-old Turkish patient with a tortuous vertebral artery causing pain and tingling in the right shoulder and neck. Magnetic resonance imaging revealed vertebral foramen enlargement thought to be secondary to a loop formation in the vertebral artery. The diagnosis was confirmed by magnetic resonance angiography. Conclusions There are many causes of cervical radiculopathy. Arterial tortuosity, a rare cause of radiculopathy, should be considered as a differential diagnosis. Consideration of the existence of this variation is of great importance in preventing possible dangerous complications during surgery.

scholarly journals Lateral syndrome of the medulla oblongata (Wallenberg's syndrome) as a complication of a vertebral angiography: a case report

1972 ◽  
Vol 30 (1) ◽  
pp. 78-83 ◽  
Author(s):  
Roberto Melaragno
Keyword(s):  
Case Report ◽  
Contrast Medium ◽  
Vertebral Artery ◽  
Medulla Oblongata ◽  
Cerebral Arteries ◽  
Lateral Part ◽  
Direct Puncture ◽  
Wallenberg’S Syndrome ◽  
Wallenberg's Syndrome ◽  
The Right

Case report of a female patient, 58 years old, who, due to a right homonymous hemianopsia, was submitted under general anesthesia successively to angiographies through the right carotid and vertebral arteries. At the first examination no abnormalities were evidenced, but the contrast medium did not reach the posterior cerebral artery; angiography by the right vertebral artery, with extravasation of the contrast medium into the vessel wall, visualized both posterior cerebral arteries. Immediately after the angiographic study, the patient presented the characteristic picture of the Wallenberg's syndrome caused by involvement of the right lateral part of the medulla oblongata. The evolution of the case was good, despite the residual right hemifacial neuralgic pain. An involvement of the vertebral artery, through an intramural injection of Hypaque is assumed to be the most probable pathogenic mechanism. The reported complication is considered as one more warning to prevent angiographies of the vertebral artery through direct puncture of this vessel, due to its recognized anatomical variations.

scholarly journals COVID-19-associated rhino-orbital mucormycosis (CAROM)—a case report

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Humsheer Singh Sethi ◽  
Kamal Kumar Sen ◽  
Sudhansu Sekhar Mohanty ◽  
Sangram Panda ◽  
Kolluru Radha Krishna ◽  
...  
Keyword(s):  
Case Report ◽  
Health Care Professionals ◽  
Opportunistic Infections ◽  
Fungal Spores ◽  
Nasal Discharge ◽  
Contributing Factors ◽  
Post Discharge ◽  
Pulmonary Mucormycosis ◽  
The Right

Abstract Background There has been a rapid rise in the number of COVID-19-associated rhino-orbital mucormycosis (CAROM) cases especially in South Asian countries, to an extent that it has been considered an epidemic among the COVID-19 patients in India. As of May 13, 2021, 101 CAROM cases have been reported, of which 82 cases were from India and 19 from the rest of the world. On the other hand, pulmonary mucormycosis associated with COVID-19 has a much lesser reported incidence of only 7% of the total COVID-19-associated mucormycosis cases (Singh AK, Singh R, Joshi SR, Misra A, Diab Metab Syndr: Clin Res Rev, 2021). This case report attempts to familiarize the health care professionals and radiologists with the imaging findings that should alarm for follow-up and treatment in the lines of CAROM. Case presentation Rhino-orbital mucormycosis (ROM) is a manifestation of mucormycosis that is thought to be acquired by inhalation of fungal spores into the paranasal sinuses. Here, we describe a 55-year-old male, post COVID-19 status with long standing diabetes who received steroids and ventilator therapy for the management of the viral infection. Post discharge from the COVID-19 isolation ICU, the patient complained of grayish discharge from the right nostril and was readmitted to the hospital for the nasal discharge. After thorough radiological and pathological investigation, the patient was diagnosed with CAROM and managed. Conclusion Uncontrolled diabetes and imprudent use of steroids are both contributing factors in the increased number of CAROM cases. Our report emphasizes on the radiological aspect of CAROM and reinforces the importance of follow-up imaging in post COVID-19 infection cases with a strong suspicion of opportunistic infections.

scholarly journals Urrets-Zavalia Syndrome Following Cataract Surgery

2021 ◽  
pp. 659-663
Author(s):  
Shimon Kurtz ◽  
Maayan Fradkin
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Inflammatory Reaction ◽  
Intraocular Lens Implantation ◽  
Postoperative Course ◽  
Lens Implantation ◽  
The Right

We describe a case of Urrets-Zavalia syndrome (UZS) in a healthy 56-year-old woman who underwent femtosecond-assisted phacoemulsification with intraocular lens implantation in both eyes. One month after an uneventful postoperative course in the left eye, the right eye was operated. Dilated pupil which was nonreactive to light appeared on day 21 postoperatively. This was discovered upon examination following anterior chamber inflammatory reaction which occurred 2 weeks following her surgery. Our case report emphasizes the importance and danger in developing UZS even if the reaction in the anterior chamber does not occur immediately after surgery. In addition, the importance of intraocular pressure follow-up in the period after UZS is acknowledged.

Regional cerebral blood flow patterns of change following the own body image exposure in eating disorders: A longitudinal study

2009 ◽  
Vol 24 (5) ◽  
pp. 275-281 ◽  
Author(s):  
Teresa Rodriguez-Cano ◽  
Luis Beato-Fernandez ◽  
Inmaculada Garcia-Vilches ◽  
Ana Garcia-Vicente ◽  
Victor Poblete-Garcia ◽  
...  
Keyword(s):  
Body Image ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Body Dissatisfaction ◽  
Regional Cerebral Blood Flow ◽  
Whole Body ◽  
Regional Cerebral Blood ◽  
Temporal Area ◽  
The Right

AbstractObjectiveThe aim of the present study is to see if the changes in the regional cerebral blood flow (rCBF) experienced by restrictive anorexia nervosa (AR) and bulimia nervosa (BN) patients, following the exposure to their own body image, persist at follow-up.MethodsThree single photon emission computed tomography (SPECT) were performed on nine patients with a DSM-IV diagnosis of AR, 13 with BP, and 12 controls: at rest, following a neutral stimulus, and after exposure to their previously filmed whole body image. Body dissatisfaction was measured by means of the Body Dissatisfaction Questionnaire (BSQ). One year later the same assessment was repeated.ResultsFollowing the exposure to their own body image, BN showed an increase in body dissatisfaction, which was associated with the increase in the rCBF of the Right Temporal Area. Those changes persisted at follow-up.DiscussionMore specific long term therapies are needed for the treatment of the averse response showed by ED patients to their own body image exposure that is associated with the hyperactivation of the right temporal area when they are confronted with their whole body image.

AVASCULAR NECROSIS OF THE TRIQUETRUM: A CASE REPORT

Hand Surgery ◽  
2005 ◽  
Vol 10 (01) ◽  
pp. 91-94 ◽  
Author(s):  
Y. C. POR ◽  
W. Y. CHEW ◽  
I. Y. Y. TSOU
Keyword(s):  
Case Report ◽  
Avascular Necrosis ◽  
Total Ischemia ◽  
One Year ◽  
The Right

A case of total ischemia of the triquetrum after a crushing injury to the right wrist by a dumbbell is reported. He was treated conservatively with splinting and analgesia. There was complete clinical and radiological recovery after a follow-up of one year.

scholarly journals Benign tumors of the heart: Myxoma of the right atrium - a case report

2018 ◽  
Vol 75 (5) ◽  
pp. 512-515 ◽  
Author(s):  
Sasa Hinic ◽  
Jelena Saric ◽  
Predrag Milojevic ◽  
Jelena Gavrilovic ◽  
Tijana Durmic ◽  
...  
Keyword(s):  
Case Report ◽  
Body Position ◽  
Atrial Myxoma ◽  
Right Atrial ◽  
Benign Tumors ◽  
Non Invasive ◽  
Right Atrial Myxoma ◽  
The Right

Introduction. Myxoma is the most common primary benign heart tumor. The most frequent location is the left atrium, the chamber of the heart that receives oxygen- rich blood from the lungs. Myxomas usually develop in women, typically between the ages of 40 and 60. Symptoms may occur at any time, but most often they are asymptomatic or oligosymptomatic for a long period of time. Symptoms usually go along with body position, and are related to compression of the heart cavities, embolization and the appearance of general symptoms. The diagnosis of benign tumors of the heart is based on anamnesis, clinical features and findings of the tumor masses by use of non-invasive and invasive imaging methods. Extensive surgical resection of the myxoma is curative with minimal mortality. Long term clinical and echocardiographic follow-up is mandatory. Case report. We reported a case of a 62-year-old male, presented with 15 days of intermittent shortness of breath, dizziness and feeling of heart palpitations and subsequently diagnosed with right atrial myxoma based on transthoracic echocardiography . The patient was emergently operated in our hospital. Long-term followup did not reveal recurrence. Conclusion. Our case was an atypical localisation of right atrial myxoma. Whether the intracardiac mass is benign or malignant, early surgery is obligatory in order to prevent complications.

scholarly journals Digital intravascular pressure wave recording during endovascular treatment reveals abnormal shunting flow in vertebral venous fistula of the vertebral artery: illustrative case

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Yoshiteru Shimoda ◽  
Shinya Sonobe ◽  
Kuniyasu Niizuma ◽  
Toshiki Endo ◽  
Hidenori Endo ◽  
...  
Keyword(s):  
Blood Flow ◽  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Resistance Index ◽  
Illustrative Case ◽  
Limb Weakness ◽  
Dicrotic Notch ◽  
The Central Nervous System ◽  
Venous Fistula ◽  
The Right

BACKGROUND An arteriovenous fistula is an abnormal arteriovenous shunt between an artery and a vein, which often leads to venous congestion in the central nervous system. The blood flow near the fistula is different from normal artery flow. A novel method to detect the abnormal shunting flow or pressure near the fistula is needed. OBSERVATIONS A 76-year-old woman presented to the authors’ institute with progressive right upper limb weakness. Right vertebral angiography showed a fistula between the right extracranial vertebral artery (VA) and the right vertebral venous plexus at the C7 level. The patient underwent endovascular treatment for shunt flow reduction. Before the procedure, blood pressures were measured at the proximal VA, distal VA near the fistula, and just at the fistula and drainer using a microcatheter. The blood pressure waveforms were characteristically different in terms of resistance index, half-decay time, and appearance of dicrotic notch. The fistula was embolized with coils and N-butyl cyanoacrylate solution. LESSONS During endovascular treatment, the authors were able to digitally record the vascular pressure waveform from the tip of the microcatheter and succeeded in calculating several parameters that characterize the shunting flow. Furthermore, these parameters could help recognize the abnormal blood flow, allowing a safer endovascular surgery.

scholarly journals MANAGEMENT OF THROMBOANGIITIS OBLITERANS - A CASE REPORT

2021 ◽  
Vol 9 (7) ◽  
pp. 1560-1563
Author(s):  
Vishal Chougule ◽  
Shailesh Shetty
Keyword(s):  
Case Report ◽  
Strong Association ◽  
Complete Healing ◽  
Lower Limbs ◽  
Thromboangiitis Obliterans ◽  
Foul Smell ◽  
Treatment Principle ◽  
The Right ◽  
Time Of Admission

Thromboangitis obliterans (TAOs) is a rare disease affecting arteries and veins of the upper and lower limbs. The condition has a strong association with the use of tobacco. Thromboangitis obliterans also known as Buerger's disease is found in the age group between 40 to 45 years, and men are most prone to get affected. The present case is a male aged 65 years complaining of a wound on the heel on the right foot, associated with pain, discharge, slough, foul smell, edema and discolouration of the skin for which he visited our hospital, the patient was previ- ously diagnosed as TAO, considering his clinical features at the time of admission, an intervention was planned based on the treatment principle of Dusta Vrana like Virechana, Basti and Raktamokshana. There was complete healing of the wound at the end of the treatment with no signs of recurrence during the follow-up suggesting the need for Shodhana in the effective management of TAO. Keywords: Dushta Vrana, Thromboangiitis Obliterans, Ayurveda, Panchakarma, Shodhana, Case report

Abstract 09: Ultra-Fast Hypothermia Inhibit Early Cerebral Consumption of Lactate After Experimental Cardiac Arrest in Rabbits : A Microdialysis Study

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Matthias Kohlhauer ◽  
Alexandra Demelos ◽  
Emilie Boissady ◽  
Bijan Ghaleh ◽  
Renaud Tissier
Keyword(s):  
Blood Flow ◽  
Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Therapeutic Window ◽  
Ultra Fast Cooling ◽  
Extracellular Lactate ◽  
Microdialysis Study ◽  
The Right ◽  
And Control

Introduction: Ultra-fast hypothermia through total liquid ventilation (TLV) has been shown to be neuroprotective after cardiac arrest. Hypothesis: The mechanism could involve a modification in brain metabolic substrat. Method: Anesthetized rabbits were instrumented with a carotid flow probe as well as arterial and jugular venous catheters. A microdialysis catether was implanted in the right brain cortex. Animals were then submitted to 10 min of ventricular fibrillation and cardiopulmonary resuscitation. After resumption of spontaneous circulation (ROSC), they were randomly submitted to ultra-fast cooling to 32°C by TLV (TLV group) or normothermic follow-up (Control) during 4h. Cerebral consumption of lactate, glucose and O 2 was calculated using arteriovenous differences in their content times mean carotid blood flow. Results: In Control, cerebral blood flow was significantly and sustainly decreased after ROSC (61±6 vs 101±6 ml/min after 240 min vs baseline), with a further decrease with hypothermia in TLV group (23±2 ml/min after 240 min, p<0.05). As compared to Control, TLV reduced the cerebral consumption of glucose (-69% at 240 min) and O 2 (-73% at 240 min). Importantly, Control animals showed a dramatic but transient cerebral consumption of lactate during the first 120 min after cardiac arrest (e.g. 124±31 mmol/min at 60 min). Concomitantly, this was associated with an increase in pyruvate extracellular stocks in brain (e.g. 57±10 μmol/L at 30 min). In TLV group, hypothermia blunted this initial burst of lactate consumption (e.g. 41±12 mmol/min at 60 min, p<0,05) and led to an accumulation in extracellular lactate ( e.g. 2053±68 vs 1246±278 μmol/L at 60 min, in TLV and Control respectively). This early build-up of lactate was then progressively consumed after 120 min in TLV group, allowing a delayed accumulation in pyruvate extracellular stocks from 120 min until the end of follow-up (103±19 and 17±4 μmol/L of pyruvate at 240 min in TLV vs Control respectively). Conclusion: Ultra-fast hypothermia reduces the cerebral consumption of lactate during the first 120 min after ROSC, allowing a delayed renewal in pyruvate stocks. This could explain the potent benefit of hypothermia during this early therapeutic window of 120 min.

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