Concordancia diagnóstica de la angiorresonancia y la angiografía carotídea en los aneurismas cerebrales / Diagnostic agreement of the angiographic resonance and the carotid angiography in the cerebral aneurysms

Se describen 3 casos clínicos de pacientes ingresados en el Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba por sospecharse la presencia de aneurismas cerebrales, teniendo en cuenta las manifestaciones neurológicas que presentaban. Mediante los estudios de resonancia magnética y angiorresonancia realizados, se observaron las imágenes de la lesión vascular, las cuales fueron confirmadas por angiografía carotídea

Three clinical cases of patients admitted in Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba due to the suspicious presence of cerebral aneurysms are described, keeping in mind the neurological manifestations they presented. By means of the studies of magnetic resonance and angiographic resonance carried out, the images of the vascular lesion were observed, which were confirmed by carotid angiography

A Bilateral Internal Carotid Angiography-Based Neck Remodelling Technique for Anterior Communicating Artery Aneurysms: Technical Notes / 대한뇌혈관외과학회지

We report three cases of a novel balloon remodelling technique across the anterior communicating artery (ACoA) through simultaneous bilateral internal carotid angiography. In all three cases, simultaneous bilateral carotid angiography for balloon-assisted coil embolisation of anterior communicating artery aneurysms (ACoAA) provided improved anatomical detail and resulted in effective and safe procedures compared to typical unilateral angiography.

The Efficacy of Simultaneous Bilateral Internal Carotid Angiography during Coil Embolization for Anterior Communicating Artery Aneurysms

OBJECTIVE: Successful coil embolization of anterior communicating (A-com) artery aneurysms requires good visualization and understanding of the entire H complex. Bilateral carotid angiography may optimize anatomical understanding and visualization of the H complex. We therefore assessed the efficacy of simultaneous bilateral internal carotid angiography during coil embolization for A-com artery aneurysms. METHODS: Of the 153 patients with intracranial saccular aneurysms who underwent embolization between July 2008 and December 2009, 12 had A-com artery aneurysms and were embolized under bilateral carotid angiography. Patients were evaluated angiographically, immediately and 6 months (n=11) after embolization, using a 3-point scale (complete, residual neck, residual aneurysm). The safety, performance and efficacy of this approach were retrospectively evaluated. RESULTS: In all patients, bilateral internal carotid artery angiography provided more detailed anatomical information and understanding around the A-com artery, and, in complex situations, it allowed for more effective coil embolization through bilateral routes to the A-com artery. Angiography immediately after embolization showed occlusion of 11 of the 12 (92%) aneurysms, with none of these 11 showing evidence of recanalization at 6 months. CONCLUSION: These findings indicate that simultaneous bilateral carotid angiography during coil embolization of selected complex A-com artery aneurysms provided improved anatomical understanding, and resulted in more effective and safer procedures than typical unilateral angiography.

Cerebral Infarction after Transfemoral Carotid Angiography : Report of 2 Cases / 대한뇌혈관외과학회지

Computerized tomography angiography (CTA) and magnetic resonance angiography (MRA) have been frequently used as non-invasive methods for the evaluation of cerebral vessels. The use of an invasive therapeutic method, transfemoral carotid angiography (TFCA), has also recently increased. The complication rate after TFCA is reported to be 0.9 % to 4%, and it is continuously decreasing. We experienced 2 patients who underwent TFCA as a diagnostic tool. The embolic type of cerebral infarction, which occurred within 30 hours, was diagnosed with performing diffusion weighted MRI (DW-MRI). One patient developed temporary dysphasia and motor weakness, but the patient improved after 2 days. The other patient presented with an altered mentality and motor weakness with some permanent deficits. TFCA is a less invasive method for treating cerebral vessels, and because this is a popular therapeutic modality, the frequency of complications will increase. Clinicians should bear in mind that complications may occur when performing TFCA and so they should be prepared to deal with them.

Relationship between coronary atherosclerotic stenosis and cerebral atherosclerotic stenosis / 老年心脏病学杂志（英文版）

To investigate the relationship between severity of cerebrovascular atherosclerosis stenosis and that of coronary atherosclerosis stenosis.Methods Cerebral angiography and coronary angiography were performed in 34 patients who had coronary disease with cerebral ischemia.Patients were divided into 3 subgroups according to the degree ofstenosis on angiography,concomitant diseases,risk factors and biochemical data.Results The follow-up study showed that the incidence of cardiac and cerebrovascular death increased significantly in patients with moderate to severe stenosis of coronary and cerebral arteries;the severity of stenosis in the coronary artery parallels that in the solitary carotid artery,or dual carotid and vertebral arteries.Conclusions Patients with coronary and cerebral artery stenosis,especially those with multi-risk factors,such as hypertension,diabetes and cigarette smoking,should receive intensive treatment to reduce cardiac and cerebrovascular events.(J Geriatr Cardiol 2008;5:227-229)

Optimization of scanning parameters in dual-source computer tomography angiography on carotid / 医学研究生学报

Objective:Rudimental contrast media in the subclavian vein often influence the display of carotid on dual-source computer tomography angiography.This article aimed to investigate this influence,and find a best solution.Methods:One hundred patients were randomly divided into Groups A(n=52) and B(n=48).The former received traditional imaging,with 65 ml contrast media,4.0 ml/s injection flow and caudocranial scanning direction,while the latter kept all the parameters unchanged except the scanning direction,from caudocranial to craniocaudal.Each group was graded by original axial images,maximum intensity projection(MIP),silhouette images and VR images for vascular delineation of the carotid.Results: The carotid artery was clearly displayed in Group B,while the subclavian vein was unsatisfactorily revealed in Group A,with statistically significant differences in extent scores between the two groups(P

Spontaneous Dural Carotid-C avernous Sinus Fistula: A Case Report

The case reported here, concerns a spontaneous low-flow fistula between the carotid arterial network and the cavernous sinus, with ophthalmological symptoms such as conjunctival congestion and diplopia in a 41-year-old woman. The patient has suffered from diabetes without trauma history. Patient's ocular symptoms and signs were only present in the left eye with best-corrected visual acuity 0.04 at the time of presentation. Other ophthalmic findings were exophthalmos, elevated intraocular pressure, and visual field defects. Enlarged extraocular muscles and proptosis were found on orbital computed tomography leading to the misdiagnosis of orbial pseudotumor or thyroid rbitopathy. Carotid angiography showed dural carotid-cavernous sinus fistula, which involved left-side internal and external carotid arterial network and right-side internal carotid arterial network. Orbital color Doppler imaging showed a flow reversal with a systolic component in the enlarged superior ophthalmic vein. We were able to diagnose dural carotid-cavernous sinus fistula. Dural carotid-cavernous sinus fistula was closed successfully by embolization via the vein without omplication. The visual acuity, proptosis, and dilated and tortuous vessels of the conjunctiva improved.

A Case of Ocular Ischemic Syndrome Associated with Right Internal Carotid Artery Obstruction

Ocular ischemic syndrome(OIS) occurs secondary to severe carotid artery obstruction and includes various ocular signs and symptoms such as conreal edema, rubeosis iridis, neovascular glaucoma, hypoperfusion retinopathy, and choroidal perfusion disturbance. It is often missed or misdiagnosed in the early stage because of its very diverse and sometimes subtle initial presentations. Furthermore it is more difficult to differentiate the ocular ischemic syndrome from diabetic retinopathy or central retinal vein oclusion in early presentations. The early diagnosis is crucial for the care of this patient because OIS usually has a poor visual prognosis in the late stage and may be the presenting sign of serious cerebrovascular and ischemic heart disease. We have experienced a case of ocular ischemic syndrome in a 45 year old man with diabetic retinopathy and hypertensive retinopathy who presented with a neovascular glaucoma associated with ipsilateral internal carotid artery obstruction.

A Case of Dural Arterio-venous Malformation Involving the Cavernous Sinus

Dural arterio-venous malformations are vascular communications in which blood flows through small meningeal branches of the carotid arteries to enter the venous circulation near the cavernous sinus. Dural arterio-venous malformations are distinct neuroophthalmological syndrome which consisisted of symptoms such as exphthalmos, increased intraocular pressure, ipsilateral headache, and dilatation of episcleral vessels, but they are difficult to diagnose clinically. Moreover it is difficult to differentiate them from the more common carotid-cavernous fistulas which represent similar symptoms of dural arteio-venous malformations. We report a case of dural arteriovenous malformation, involving the cavernous sinus and confimed with selective carotid arteriography, in a patient who presented with symptoms of unilateral tinnitus, conjunctival injection, and raised intraocular pressure, along with the review of literatures.

A traumatic Giant Intracavernous Aneurysm Associated with Fatal Epistaxis: A Case Report

The autors reported a giant aneurysm in the cavernous portion of the internal carotid artery which occurred after head trauma. The patient was a 24 year old man who had suffered massive epistaxis with hyoptension about 25 days after a traffic accident. On plain skull X-ray, there was evidence of a basal skull fracture and a linear fracture at the right frontotemporal area. The computed tomographic scan revealed round, well enhanced density in the sellar region. During a reattack of massive epistaxis, emergency carotid angiography showed a right cavernous-internal carotid artery aneurysm with a small extravasation of dye into the sphenoid sinus.

Two Cases of Traumatic Pericallosal Artery Aneurysm: A Case Report

Two patients with traumatic aneurysm were children below 10 years and the aneurysmal sac located at the peripheral branch o f the anterior cerebral artey. One of the traumatic aneurysm had been found by rupture of aneurysmal sac during medical treatment under the impression of traumatic cerebral hemorrhage. The other had been found during disabiliy evaluation with unruptured status. In the latter case, traumatic aneurysm was suspected by the small sized enhancing lesion below the falx cerebri in Brain CT scan and confirmed by transfemoral carotid angiography. We clipped neck of these traumatic aneurysm successfully. So. we report these two cases of traumatic aneurysms with review of the literatures.

Carotid-Cavernous Fistula

Carotid-cavernous fistula(CCF) is the most common arteria-venous fistula in the head and neck region which has characteristic ophthalmic findings and threat of visual loss. An analysis of clinical records was done of 21 CCF patients who visited the Department of Ophthalmology, Seoul National University Hospital from August 1, 1986 to July 31, 1990. Seventeen cases(81.0%) were of the direct type, and four cases(19.0%) were of the indirect or spontaneous type. Fifteen patients(88.2%) of the direct type had a definite history of recent head trauma. Clinical symptoms on the first visit included exophthalmos(76.2%), conjunctival injection(76.2%), noise in cranial cavity(76.2%), visual disturbance(61.9%), diplopia(42.9%), and ocular pain(28.6%). In general ocular examination, exophthalmometry revealed proptosis in all cases. In seventeen cases(81.0%) vascular bruit was heard with auscultation on the eyelid. Eleven cases(52.4%) showed a limitation of ocular movement and sixth nerve palsy was the most common type(45.5%). On funduscopic examination, nine patients(42.9%) showed engorged retinal vessels. Increased intraocular pressure(Ta>21 mmHg) was recorded in 9 patients(42.9%). Computerized tomography(CT) of orbit or brain, and percutaneous transarterial carotid angiography were used as a diagnostic procedure in all patients. In thirteen of 17 direct type patients detachable balloon embolization was done at the time of angiography, and in 12 cases(92.3%) fistulas were successfully embolized.

A Case of Traumatic Giant Aneurysm

The authors are reporting traumatic giant aneurysm arising from supraclinoid portion of internal carotid artery. The patients was a 22-years old man who had suffered a major head injury in a traffic accident. On admission he was comatous and there were multiple abrasion over the body and severe hemorrhage comming from the left ear with open fracture in left parietal. 4 weeks later, computed tomographic scan demonstrated large well enhanced mass in the suprasellar region. Carotid angiography showed giant aneurysm fed by supraclinoid portion of internal carotid artery. After frontotemporal craniectomy, direct approach was performed using surgical microscope.

Selective External Carotid Angiography by Retrocatheterism via Superficial Temporal Artery / 昆明医科大学学报

This paper deals with a preliminary experience of the selective external carotid angiography by retrocatheterism via the superficial temporal artery in 6 cases.The method and technique were completely described.The external carotid angiography in different ways was discusse.Authors believe that the external carotid angiography by retrocatherism via the superficial temporal artery is a simple and reliable method, the image being very clear and complicatins rare.The method is worth using in oral maxillofacial surgery.

A Case of Moyamoya Disease in Child

A childhood case of moyamoya disease with subarachnoid hemorrhage is reported. This patient exhibited left hemiparesis, dysarthria, convulsion and mental retardation. He also had characteristic angiographic picture: occlusion of supraclinoid segment of both internal carotid arteries, combined with collateral networks in the base of brain.

Cirsoid Aneurysm of the Scalp: Case Report

The authors report a case of cirsoid aneurysm in which diagnosis is reached by carotid angiography. To clarify the confusion regarding this rare lesion, the definition, origin and pathogenesis of the lesion are discussed.