1/22. Superior and inferior limb ischaemia in giant cell arteritis: angiography follow-up.giant cell arteritis most often affects the superficial temporal artery. Arterial territories such as the facial, carotid, myometrial and upper and lower limb arteries may be affected. In this paper we describe the case of a 52-year-old patient with upper and lower limb ischaemia who presented with grade III ischaemia in the left lower limb. giant cell arteritis was diagnosed as responsible for the symptoms. After treatment with corticoids, an angiographic improvement was evidence after 2-year period. The low number of reported cases, the diverse symptoms and varied course make diagnosis of GCA difficult. Therefore, GCA must be taken into consideration in the ischaemia of inferior and superior limbs whether isolated or simultaneous.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/22. pulmonary artery compression by a giant aortocoronary vein graft aneurysm.Late failure of saphenous vein aortocoronary bypass grafts is predominantly due to vein graft atherosclerotic disease. Rarely, saphenous vein aortocoronary bypass grafts undergo aneurysmal degeneration. We report a case of a giant true aneurysm of a saphenous vein aortocoronary bypass graft producing right heart failure from main pulmonary artery compression.- - - - - - - - - - ranking = 1.25keywords = giant (Clic here for more details about this article) |
3/22. Treatment of kasabach-merritt syndrome by embolisation of a giant liver hemangioma.We report the case of a 14-month-old child with kasabach-merritt syndrome, due to a giant liver hemangioma. The therapeutic approach consisted of peripheral transcatheter embolisation of the right hepatic artery with Ivalon microspheres without the addition of thrombogenic material. This procedure brought to a sensible permanent reduction of the size of the liver hemangioma with normalisation of the previous altered coagulation parameters after 6 years of follow-up.- - - - - - - - - - ranking = 1.25keywords = giant (Clic here for more details about this article) |
4/22. Siegrist streaks in giant cell arteritis.A patient who presented with symptoms of giant cell arteritis was found to have a right ophthalmic artery occlusion. One month after initial evaluation, the peripheral retina demonstrated multiple linear bands of chorioretinal atrophy known as Siegrist streaks. Although most commonly described in the setting of acute hypertension, Siegrist streaks also occur in patients with giant cell arteritis.- - - - - - - - - - ranking = 1.5keywords = giant (Clic here for more details about this article) |
5/22. Giant vegetation of the mitral valve simulating primary cardiac tumor.A case of a giant vegetation of the mitral valve causing sudden death of the patient is reported. The case underlines that urgent removal of a big mass must always be considered because of the risk of sudden death or catastrophic embolism. Echocardiographic differential diagnosis of a mass is discussed and is crucial for the choice of the strategy.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
6/22. An occult case of giant cell arteritis presenting with combined anterior ischemic optic neuropathy and cilioretinal artery occlusion.A 61-year-old female presented with a moderate decrease in vision in the left eye. The patient denied any other ocular or systemic symptoms related to giant cell arteritis. visual acuity was 20/50 in the left eye with a 2 relative afferent pupillary defect and markedly abnormal color vision. Dilated fundus examination and flourescein angiography revealed optic disc edema as well as a cilioretinal artery occlusion. Erythrocyte sedimentation rate was only slightly elevated. Subsequent biopsy of the superficial temporal artery confirmed the diagnosis of giant cell arteritis. Cilioretinal arteries are anatomical variants derived from the short posterior ciliary arteries. Arteritic anterior ischemic optic neuropathy typically results from thrombotic occlusion of the short posterior ciliary arteries. Consequently, arteritic occlusion of the short posterior ciliary arteries can result in concomitant occlusion of the cilioretinal artery. This case highlights the situation where clinical symptoms were not suspicious for giant cell arteritis but the presence of an anterior ischemic optic neuropathy and a cilioretinal artery occlusion was virtually pathognomonic for giant cell arteritis.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
7/22. Severe, unstable migraine: a risk factor for postoperative ophthalmic artery spasm?Acute ophthalmic artery occlusion (AOAO) is rare. We describe a patient with severe unstable migraine who developed AOAO with a giant retinal fold following the removal of a cavernous haemangioma. We discuss prophylatic measures that may be taken in such patients.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
8/22. Giant middle cerebral artery aneurysm with parent artery occlusion--case report.A 54-year-old female was admitted with consciousness disturbance and right hemiparesis. Computed tomographic (CT) scans and angiograms revealed diffuse subarachnoid hemorrhage, a partially thrombosed, giant middle cerebral artery aneurysm (5 x 5 x 4 cm), and occlusion of the parent artery at the aneurysm site. Despite conservative treatment, a generalized convulsion occurred. Emergency CT scans revealed irregular enlargement of the left temporal high-density mass and severe mass effect due to cerebral infarction. Barbiturate coma therapy was administered, but she did not recover and died 9 days after admission. Only two cases of ruptured aneurysm with simultaneous occlusion of the major cerebral vessels have been reported, both with poor outcome. In this case, the mechanism of parent artery occlusion is unclear, but thrombus protrusion from the giant aneurysm into the parent artery may have been involved.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
9/22. Two cases of spontaneous internal carotid artery occlusion due to giant intracranial carotid artery aneurysm.Although spontaneous thrombosis of a giant intracranial aneurysm is relatively common, occlusion of its parent artery is rare. We describe two recent patients in whom the parent artery spontaneously occluded. One patient had severe stenosis of the left internal carotid artery, with delayed appearance of a faint shadow of vascular widening near the posterior clinoid process. One month later, complete occlusion of the left internal carotid artery was shown angiographically. The second patient had dysarthria and left hemiparesis, resulting in the diagnosis of a left internal carotid artery giant aneurysm. He had suffered an episode of visual disturbance of the right eye 5 years before. angiography showed the right cervical internal carotid artery to be occluded. We believe the mechanism of parent artery occlusion in our two patients to be due first to stretching of the internal carotid artery by the enlarged aneurysm, followed by compression of the internal carotid artery by the aneurysm itself. Next, the anterior clinoid process and the optic nerve are involved, and, finally, thrombosis of the aneurysmal cavity extends into the internal carotid artery itself.- - - - - - - - - - ranking = 1.5keywords = giant (Clic here for more details about this article) |
10/22. Asymptomatic occlusion of the internal carotid artery at the skull base.Three cases are presented of asymptomatic occlusion of the internal carotid artery at level of the skull base due to external compression. In 2 patients the compression was caused by a meningioma infiltrating the skull-base whereas in the third case a giant aneurysm of the i.c.a. caused the compression in the cavernous sinus. Although the patients suffered from eye-movement palsies caused by local compression of the tumour itself it is quite remarkable that this total occlusion of the internal carotid artery was tolerated without neurological deficit at all. It can be concluded that in these patients the collateral circulation through the arterial circle of willis and the watershed area supplied enough flow to compensate the main arterial occlusion.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
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