ABSTRACT
A case is reported of a 53-year-old woman who was hit by a bullet which penetrated the skull base and caused a left carotid-cavernous fistula of the direct type and a pseudoaneurysmal dilation of the high cervical portion of the left internal carotid artery. The fistula was successfully embolized by positioning a balloon into the fistula itself by means of the Debrun technique: unexpectedly the size of the pseudoaneurysm decreased after the embolization; the possible explanations for this event are discussed.
Subject(s)
Arteriovenous Fistula/therapy , Carotid Artery Diseases/therapy , Cavernous Sinus , Embolization, Therapeutic , Intracranial Aneurysm/diagnostic imaging , Wounds, Gunshot/complications , Arteriovenous Fistula/etiology , Carotid Artery Diseases/etiology , Carotid Artery, Internal , Cerebral Angiography , Female , Humans , Middle AgedSubject(s)
Basilar Artery , Embolization, Therapeutic/methods , Intracranial Aneurysm/therapy , Vertebral Artery , Adult , Female , HumansABSTRACT
The authors report a case of an arteriovenous fistula between the ascending pharyngeal artery and the internal jugular vein. The importance of an exact diagnosis and some precautions to be taken during therapeutic embolization are emphasized, as well as the need for superselective cannulation of the feeding artery. The problem of differential diagnosis with glomus tumors is discussed, and a brief mention is made of the anatomy of the jugular foramen and embryology of these tumors. Only one similar case treated by embolization with solid particles was found in the literature. To date, embolization using solid particles rather than liquid agents appears to be the best treatment of fistulas of this type.
Subject(s)
Arteriovenous Fistula/therapy , Embolization, Therapeutic , Jugular Veins , Pharynx/blood supply , Angiography , Arteries , Female , Humans , Middle AgedSubject(s)
Hepatolenticular Degeneration/diagnostic imaging , Adolescent , Adult , Child , Female , Humans , Male , Tomography, X-Ray ComputedABSTRACT
Minimosymptomatic occlusion of the MCA before the origin of the perforating branches is an exceedingly rare occurrence. We report two cases of MCA occlusion at its origin, the second case proven by the CT scan in vivo. Published work rules out the possibility of a functionally effective deep collateral circulation in the distribution of the capsular rami of the MCA. In view of this we argue that there may be cases - admittedly very rare - in which, given the individual variability of the vascular supply, the MCA may be of negligible functional importance to the circulation of the internal capsule. In such cases occlusion of the MCA would be relatively well tolerated.
Subject(s)
Arterial Occlusive Diseases/diagnostic imaging , Carotid Arteries/diagnostic imaging , Adult , Angiography , Cerebral Angiography , Humans , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
Three cases with germinoma in the region of the pineal body diagnosed by means of computer tomography are described. The diagnosis was verified in all of them during operation. Computer tomography demonstrated three-dimensional structures with irregular contours in the posterior parts of the third ventricle which was seen more clearly after injection of the contrast medium. Petrifaction was found in the center of the pathological structure in all cases. The diagnostic value of computer tomography from the standpoint of the localization of the tumor is emphasized.
