Cerebral Infarction Caused by a Tortuous Subclavian Artery: a Case Report / 신경중재치료의학

Tortuous arteries are common clinical observation. Although mild tortuosity is asymptomatic, severe tortuosity can lead to ischemic attack in several organs. With advances in imaging technology, an increasing number of tortuous vessels have been detected. The purpose of this report is to describe a case of acute cerebral infarction due to tortuous subclavian artery and to review the literature.

Mycotic Pulmonary Artery Aneurysm as an Unusual Complication of Thoracic Actinomycosis

Although pulmonary artery aneurysms are a rare vascular anomaly, they are seen in a wide variety of conditions, such as congenital heart disease, infection, trauma, pulmonary hypertension, cystic medial necrosis and generalized vasculitis. To our knowledge, mycotic aneurysms caused by pulmonary actinomycosis have not been reported in the radiologic literature. Herein, a case of pulmonary actinomycosis complicated by mycotic aneurysm is presented. On CT scans, this case showed focal aneurysmal dilatation of a peripheral pulmonary artery within necrotizing pneumonia of the right lower lobe, which was successfully treated with transcatheter embolization using wire coils.

Infraoptic Course of the Anterior Cerebral Artery: Case Report

An infraoptic anterior cerebral artery (ACA) arising at a low bifurcation of the internal carotid artery is a rare anomaly, of which about 33 cases have been reported to date, often in association with cerebral aneurysms. We describe a case involving an infraoptic ACA in which a ruptured middle cerebral artery aneurysm was also present. Angiography revealed the presence of an abnormal solitary ACA, arising from the intracranial proximal internal carotid artery near the origin of the ophthalmic artery, and a contralateral middle cerebral artery aneurysm. Magnetic resonance imaging showed that the ACA passed below the ipsilateral optic nerve, anterior to the optic chiasm, to join the normally positioned anterior communicating artery above the optic chiasm.

Congenital Absence or Hypoplasia of the Internal Carotid Artery: Angiography and HRCT Evaluation at the Skull Base

PURPOSE: To evaluate the findings of angiography and high-resolution CT of the skull base in the patients with congenital absence or hypoplasia of the unilateral internal carotid artery. MATERIALS AND METHODS: Eight patients with congenital unilateral absence (n=6) or hypoplasia (n=2) of the internal carotid artery were included in this study. None showed symptoms related to the absence of the artery. All underwent selective arteriography and six underwent high-resolution CT of the skull base. The angio-graphic findings of the carotid artery and collateral pathways to the absent side, as well as the high-resolution CT findings of the bony carotid canal at the skull base, were evaluated. RESULTS: In all cases, intracranial collaterals were of the adult type. The anterior cerebral arteries were supplied via the anterior communicating artery in all patients, and the middle cerebral arteries via the posterior communicating artery in five. In two, collateral flows were supplied by both the anterior and posterior communicating arteries, and in four, high-resolution CT of the skull base showed remnants or sclerosis of the carotid canal. One patient showed a hypoplastic bony carotid canal, and in one, this canal was absent. Intracranial aneurysms were found in four patients; in three, thses were located at the anterior communicating artery, and in the other, at the posterior cerebral artery. In four of six patients with no internal carotid artery, the ophthalmic arteries were opacified via the middle meningeal artery. CONCLUSION: In cases involving congenital absence or hypoplasia of the internal carotid artery, differentiation between agenesis and aplasia may be based on the pattern of collateral circulation. High-resolution CT find-ings may suggest that this change has a congenital origin.

Aberrant Internal Carotid Artery in the Middle Ear: A Case Report

Aberrant internal carotid artery in the middle ear is a rare disease which, if unrecognized on radiological studies, can lead to serious complications during tissue biopsy. We report the imaging features of a case with aberrant internal carotid artery in the middle ear. A 60-year-old woman visited our hospital because of hearing difficulty on the right side. Temporal bone CT showed a well-defined mass of the right middle ear and lateral bony defect in the carotid canal adjacent to the mass. After arterial phase temporal bone CT with spiral CT andangiography, the mass could be diagnosed as aberrant internal carotid artery in the middle ear.