1/55. Spontaneous bilateral internal carotid artery dissection with hypoglossal nerve palsy.Spontaneous dissection of the extracranial internal carotid artery (ICA) is increasingly being recognized as a common vascular disease. We report on a 52-year-old-male presented with bilateral extracranial internal artery dissection and twelfth nerve palsy and review the previous literature.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/55. renal artery stenosis and aneurysmatic dilatation of arteria carotis interna in tuberous sclerosis complex.hypertension in children with neurocutaneous disorders (phacomatoses) is a well-recognized complication of these diseases and the cause of hypertension is fairly specific within each group. In patients with neurofibromatosis, hypertension is mainly caused by renovascular disease, whereas in tuberous sclerosis (TSC) reasons for hypertension are renoparenchymal lesions, such as angiomyolipoma or cysts. We report on a girl with TSC and hypertension due to unilateral renal artery stenosis associated with aneurysmatic changes of internal carotid artery. This unusual combination of symptoms in our patient supports the importance of thorough and complete investigation of hypertension in children with phacomatoses.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
3/55. Delayed recognition of a vascular complication, carotid artery aneurysm, 60 years after operation for muscular torticollis. A case report.An extremely rare vascular complication, carotid artery aneurysm, developed 60 years after a torticollis operation. The patient's internal jugular vein was completely obstructed proximal to the subclavian vein. There was an associated incomplete obstruction of the ipsilateral common carotid artery on the right aspect of the neck--the site where resection of the whole sternocleidomastoid muscle had been performed when she was one year old. The patient had audible bruits over the right common carotid at the base of her neck but no signs of occlusive cerebrovascular disease. The diagnosis was made mainly with use of technetium radionuclide angiography. To the authors' knowledge, this is the first such report in the English or German literature.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
4/55. Intracerebral abscess formation following embolisation of an internal carotid artery aneurysm using Guglielmi detachable coils.infection following endovascular therapy for cerebrovascular disease is a potential but rare complication. A 70-year-old lady in whom an intracranial abscess formed secondary to GDC embolisation of a giant right internal carotid artery aneurysm is reported. Computed tomography (CT) showed the abscess and staphylococcus aureus was cultured from the cerebrospinal fluid and blood. The abscess was successfully treated by antibiotic therapy. Infected Guglielmi detachable coils (GDC) may result in abscess formation in the presence of underlying cerebral ischaemia.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
5/55. Neurological complications of Werner's syndrome.patients with Werner's syndrome have the appearance of premature ageing. Neurological complications are usually regarded as uncommon. The neurological manifestations in three patients with cardinal features of Werner's syndrome, including short stature, premature greying and baldness, thin arms and legs, cataracts and scleroderma-like skin changes, are presented. The neurological features included transient ischaemic attacks secondary to atherosclerosis in the common carotid arteries (one patient), sensory peripheral neuropathy (one patient) and peripheral neuropathy with a possible myelopathy (one patient). In one of these patients the diagnosis of Werner's syndrome was not recognised prior to neurological referral. Although neurological disease in patients with Werner's syndrome is uncommon, it may be under-recognised. Some of the neurological complications are secondary to premature cerebrovascular disease, but the pathogenesis of peripheral neuropathy and myelopathy in patients with Werner's syndrome is uncertain.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
6/55. Isolated extra-cranial internal carotid artery aneurysm in a young adult with Eale's disease.A young male patient, a known case of Eale's disease presented with a large isolated aneurysm of the extra-cranial part of internal carotid artery. Detailed investigation failed to establish the etiology of the aneurysm, and it is possible that the underlying pathology may be the same as that of Eale's disease. Eale's disease is an idiopathic vascular disease of the peripheral retina and we hypothesize that aneurysm in this patient may be associated with Eale's disease of the eye.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
7/55. Intracranial atypical fibromuscular dysplasia with ruptured aneurysm--case report.A 53-year-old woman was admitted with severe subarachnoid hemorrhage due to rupture of an aneurysm associated with atypical intracranial fibromuscular dysplasia (FMD). Angiography demonstrated the aneurysm and very irregular form of the left internal carotid artery (ICA), the right ICA, and right proximal middle cerebral artery (MCA). Other arteries showed signs of atherosclerosis. The aneurysm was treated by embolization, but she subsequently died of shock of unknown cause. Detailed examination of serial angiograms detected enlargement of the aneurysm and progression of the irregular appearance of the ICA. FMD is a non-inflammatory and non-atheromatous arteriopathy that commonly affects the cervical ICA and sometimes the intracranial ICA. The association with saccular aneurysm is widely known and the prevalence of incidental aneurysms is higher than that in the general population. The common "string of beads" finding is easily distinguished from other vascular diseases, but non-specific findings such as "tubular stenosis" and "diverticular-like outpouching" are harder to differentiate. FMD is associated with various complications and appropriate periodic follow-up examination is required. Detailed analysis of serial angiograms may facilitate diagnosis of this condition.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
8/55. Double microcatheter technique for endovascular coiling of wide-neck aneurysms using a new guiding device for the transcarotid approach: technical note.In the endovascular treatment of cerebrovascular diseases, positioning the guiding catheter is of great importance. In cases where vessel tortuosity prohibits positioning the guiding catheter in the carotid artery via the femoral approach, we use a direct carotid approach via common carotid artery puncture. For direct puncture of the common carotid artery we devised a 6-Fr sheath with double insertion points. This new device facilitates the use of double microcatheters and provides safe and effective vascular access.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
9/55. Extracranial-intracranial bypass for symptomatic occlusive cerebrovascular disease not amenable to carotid endarterectomy.OBJECT: The role of cerebral revascularization remains unclear in symptomatic occlusive cerebrovascular disease refractory to medical therapy. Despite the disappointing findings of the Cooperative Study on Extracranial-Intracranial Bypass, a subpopulation of patients with ischemic cerebrovascular disease and poor hemodynamic reserve may benefit from extracranial-intracranial (EC-IC) bypass. The authors reviewed the records of 65 patients who underwent 71 EC-IC bypass procedures at their institution over the past 6 years. methods: All patients except one presented with repeated transient ischemic attacks (TIAs) that were referable to the involved vascular region. Eight patients underwent EC-IC bypass urgently for "crescendo" TIAs refractory to antiplatelet and anticoagulation therapy. Indications for surgery included cervical internal carotid artery (ICA) occlusion in 28, supraclinoid ICA stenosis in two, middle cerebral artery stenosis or occlusion in 14, moyamoya disease in 18, and ICA dissection in three. cerebral angiography demonstrated poor collateral flow to the involved region in each case. There were no postoperative strokes or deaths in this series. Following EC-IC bypass, the vast majority (95.4%) of patients experienced cessation of their ischemic events and stabilization of preexisting neurological dysfunction. Of the eight patients who underwent EC-IC bypass urgently for crescendo TIAs, two awoke with increased neurological deficits that improved rapidly within 24 hours of surgery. CONCLUSIONS: Although the Cooperative Study failed to show benefit from this treatment modality, the authors have continued to perform EC-IC bypass in certain cases. Carefully selected individuals with occlusive cerebrovascular disease and persistent ischemic symptoms refractory to maximal medical therapy appear to benefit from cerebral revascularization.- - - - - - - - - - ranking = 7keywords = vascular disease (Clic here for more details about this article) |
10/55. Critical carotid and vertebral arterial occlusive disease and cough syncope.BACKGROUND AND PURPOSE: cough syncope typically occurs in patients with known chronic lung disease. The mechanism usually involves a combination of decreased venous return, increased cerebrospinal fluid pressure, and secondary hypocapnia, all resulting in cerebral arterial vasoconstriction. cough syncope has not in the past been associated with occlusive cerebrovascular disease. CASE DESCRIPTION: We describe a 50-year-old man with a 6-month history of episodes of loss of consciousness during paroxysms of coughing. physical examination showed asymmetrical upper extremity blood pressures and carotid and subclavian artery bruits. Pulmonary function studies were normal. Ultrasound and angiography showed total occlusion of the left common carotid artery, right internal carotid artery, and right vertebral artery; tight stenosis of the right subclavian artery; and a hypoplastic left vertebral artery. The patient had a left subclavian-to-left common carotid artery bypass and has had no syncope since that time. CONCLUSIONS: To our knowledge, this is the first reported case of cough syncope and severe cerebrovascular disease in which surgery led to amelioration of symptoms. Cerebrovascular occlusive disease may contribute to cough syncope.- - - - - - - - - - ranking = 2keywords = vascular disease (Clic here for more details about this article) |
| | Next -> |