Giant congenital malformation of the perirectal plexus in computed tomography imaging - case report.

BACKGROUND: Congenital arteriovenous malformation (AVM) in the pelvic area is uncommon in males. CASE REPORT: The described case is of a giant lesion of this type that caused recurrent hemorrhaging in the lower part of the gastrointestinal tract. Preliminary diagnosis of vascular pathology was made on the basis of an endoscopic examination that revealed numerous pulsating protuberances of the rectal wall, in which blood flow was identified by means of transrectal ultrasonography. Complementing the diagnostics with a CT revealed a considerable extent of malformation, as well as its morphology and anatomical relations with the surrounding tissues. RESULTS: Following a two-year follow-up period, the malformation did not progress or demonstrate any intensification of clinical symptoms, therefore the patient continues to undergo conservative treatment.

Cranial dural arteriovenous fistula as a rare cause of tinnitus - case report.

BACKGROUND: Tinnitus, occurring at least once in a lifetime in about 10-20% of the population, is an important clinical problem with complex etiology. Rare causes of tinnitus include cranial dural arteriovenous fistulas (DAVFs), which are usually small lesions consisting of abnormal connections between branches of dural arteries and venous sinuses or veins. CASE REPORT: Authors present a case of a 44-year-old woman with persistent, unilateral, treatment-resistant pulsatile tinnitus caused by a small dural arteriovenous fistula revealed in computed tomography angiography. CONCLUSIONS: Computed tomography angiography is a useful diagnostic method that in some cases allows for establishing the cause of unilateral, pulsatile tinnitus.

Multiple fusiform cerebral aneurysms - case report.

BACKGROUND: A true aneurysym is a dilation of arterial lumen as a consequence of congenital or acquired abnormalities leading to a reduction of mechanical resistance of vascular wall, most commonly caused by its defected structure in the form of absence or weakening of the muscular and/or elastic layer. From the pathophysiological point of view, cerebral aneurysms can be classified as 'saccular' - most commonly occurring, and 'other types', including fusiform/dolichoectatic, dissecting, serpentine, posttraumatic, mycotic and giant aneurysms with or without intra-aneurysmal thrombosis. CASE REPORT: We present a rare case of a patient with multiple fusiform dilations of cerebral vessels and giant fusiform aneurysm in supraclinoid segment of the internal carotid artery. The patient presented to hospital because of sudden, severe vertigo with nausea, impaired balance and disturbed vision. Vascular anomalies were detected on CT scanning without contrast. The diagnostic work-up was complemented by CT angiography, MRI and cerebral angiography. CONCLUSIONS: Aneurysm located within the intracranial arteries is one of the most common vascular defects of the brain. The number, size and location of aneurysms are highly variable. Aneurysms can have either supra- or infratentorial location, affecting a single or multiple arteries within one or both brain hemispheres. There is often a correlation between the location of the aneurysm and its etiology, as in case of so-called mirror-image aneurysms. Symmetrically located aneurysms may indicate a defect in vascular structure. Asymmetric location, as in the patient described above, is more likely due to acquired causes, mainly atherosclerosis, but also septic emboli or blood disorders.

A case of a spontaneous splenorenal shunt associated with the nutcracker syndrome.

BACKGROUND: Hypertension in the portal vein system stimulates the vascular system to develop a porto-caval collateral system, which occurs by adaptation of the already existing junctions between the porto-caval and the systemic circulation to changed conditions or by angiogenesis. CASE REPORT: We present a case of a 42-year-old man with alcoholic cirrhosis of the liver and exacerbation of chronic pancreatitis, whose computed tomography of the abdominal cavity revealed a massive varicoid dilatation of a vein of the spleen with a splenorenal shunt and tortuous dilated venous vessels in the retroperitoneal space and mesentery. CONCLUSIONS: The unusual image of the mesenteric and retroperitoneal venous vessels in our patient resulted from the coexistence of collateral porto-systemic circulation and compression of the left renal vein.