ABSTRACT
A 17-year-old girl affected by Seckel syndrome and multiple intracranial aneurysms is reported. Cerebral hemorrhage was the reason for the diagnostic work-up. The aneurysms were surgically treated. The main features of the syndrome, technical problems encountered during surgery and the prognosis of this condition are discussed.
Subject(s)
Abnormalities, Multiple/genetics , Craniofacial Abnormalities/genetics , Intracranial Aneurysm/genetics , Abnormalities, Multiple/diagnostic imaging , Abnormalities, Multiple/surgery , Adolescent , Brain/abnormalities , Brain/surgery , Cerebral Angiography , Cerebral Hemorrhage/diagnostic imaging , Cerebral Hemorrhage/genetics , Cerebral Hemorrhage/surgery , Chromosome Aberrations/genetics , Chromosome Disorders , Craniofacial Abnormalities/diagnostic imaging , Craniofacial Abnormalities/surgery , Female , Genes, Recessive/genetics , Humans , Intracranial Aneurysm/diagnostic imaging , Intracranial Aneurysm/surgery , Postoperative Complications/diagnostic imaging , Reoperation , SyndromeABSTRACT
There are numerous clinical situations in which interventional angiography fully reveals its two-fold diagnostic and therapeutic value. The present review focuses attention on the use of such procedures in certain thoracic emergencies. Indications, diagnostic results and therapeutic advantages are examined together with possible complications. Pulmonary embolism is a serious circulatory condition that is often difficult to diagnose because of the lack of specificity of its accompanying symptoms. In these cases the role of the angiographic radiologist is often three-fold: diagnosis, therapy (possibility of carrying out locoregional thrombolysis), and prophylaxis (positioning of caval filters that prevent the migration of thrombi). Haemoptysis may arise from both the pulmonary and bronchial vessels and may be caused by various pathologies (cancer, angiodysplasia, vasculitis, aspergillosis). Angiographic study in such cases is indispensable for identifying the source of bleeding and for arresting, using embolising material, haemorrhage that it is no longer possible to control with other therapeutic modalities. Foreign bodies held in the vascular tree are in the main fragments of catheters detached accidentally or as a result of incorrect manoeuvres or for defects of construction of the material. Their removal is possible today by using, percutaneously, angiographic techniques (snare loop, basket, hook system, balloon catheters) which make it possible to hook up the fragment and remove it.
Subject(s)
Blood Vessels , Foreign Bodies/diagnostic imaging , Hemoptysis/diagnostic imaging , Pulmonary Embolism/diagnostic imaging , Radiology, Interventional , Algorithms , Emergencies , Humans , RadiographyABSTRACT
Schwannoma is the most common intraspinal tumor, which at times goes out of spinal canal and spreads into the paraspinal tissue to produce a dumbbell configuration. A 58-year-old woman is reported, in whom a plain thorax X-rays accidentally disclosed a mass located in the posterior mediastinum. Computerized tomography (CT) revealed a dumbbell lesion, 4.5 cm in diameter, in the right rib-vertebral groove at the T9 level. Spinal angiography showed localization of Adamkievicz artery at the T10 level on the left side. The lesion appeared hypervascular and was embolized by particulate agents (Contour Emboli 150-250 mu) with reduction of its blush. A combined two-team (thoracic and neurosurgeon) approach permitted an uneventful removal of a schwannoma.
