1/213. Surgical treatment of internal carotid artery anterior wall aneurysm with extravasation during angiography--case report.A 54-year-old female presented subarachnoid hemorrhage from an aneurysm arising from the anterior (dorsal) wall of the internal carotid artery (ICA). During four-vessel angiography, an extravasated saccular pooling of contrast medium emerged in the suprasellar area unrelated to any arterial branch. The saccular pooling was visualized in the arterial phase and cleared in the venophase during every contrast medium injection. We suspected that the extravasated pooling was surrounded by hard clot but communicated with the artery. Direct surgery was performed but major premature bleeding occurred during the microsurgical procedure. After temporary clipping, an opening of the anterior (dorsal) wall of the ICA was found without apparent aneurysm wall. The vessel wall was sutured with nylon thread. The total occlusion time of the ICA was about 50 minutes. Follow-up angiography demonstrated good patency of the ICA. About 2 years after the operation, the patient was able to walk with a stick and to communicate freely through speech, although left hemiparesis and left homonymous hemianopsia persisted. The outcome suggests our treatment strategy was not optimal, but suture of the ICA wall is one of the therapeutic choices when premature rupture occurs in the operation.- - - - - - - - - - ranking = 1keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
2/213. Localized scleroderma associated with progressing ischemic stroke.We present a 73 year-old Japanese woman with localized scleroderma involving the right side of the scalp accompanied by continuous tingling pain, who developed insidiously progressive left hemiparesis. In magnetic resonance imaging of the brain, an infarct first appeared in the watershed region of the right middle cerebral artery territory and subsequently extended to deep white matter accompanied by scattered hemorrhages. Focal stenosis in the M2 portion of the right middle cerebral artery was revealed on magnetic resonance angiography, and the distal vessels were only shown faintly. A biopsy specimen from the sclerotic scalp lesion showed obvious thickening of vessel walls and mild mononuclear cell infiltration. We believe that the progressing ischemic stroke was caused by hemodynamic disturbances from localized sclerotic obstruction of the middle cerebral artery, with an autoimmune pathogenesis.- - - - - - - - - - ranking = 0.024134351559823keywords = artery (Clic here for more details about this article) |
3/213. Moyamoya syndrome in a patient with congenital human immunodeficiency virus infection.A 10-year-old boy with congenital human immunodeficiency virus (hiv) infection developed recurrent episodes of left hemiparesis at age 7 years. The progression of his disease was followed by computed tomography, magnetic resonance imaging, magnetic resonance angiography, and cerebral angiography. The series of images showed progressive stenosis of both carotid arteries at the suprasellar origin with involvement of his anterior and middle cerebral arteries, while prominent collateral vessels developed from his external carotid supply through ophthalmic and middle meningeal arteries. The pattern of cerebrovascular disease is consistent with moyamoya syndrome. We suggest that further studies on the pathophysiology of cerebrovascular disease in patients with hiv could be helpful in understanding the cause of moyamoya disease as well. Also, with the various advances in treatment of hiv, neurovascular complications could be seen more frequently as the long-term survival in these patients improves.- - - - - - - - - - ranking = 0.18043905596327keywords = carotid (Clic here for more details about this article) |
4/213. moyamoya disease showing atypical angiographic findings--two case reports.A 7-year-old boy and a 10-year-old girl presented with moyamoya disease showing atypical angiographic findings. In these cases, the internal carotid artery (ICA) had a tapering occlusion just distal to the origin of the ophthalmic artery, whereas the top of the ICA was not occluded and was retrogradely supplied through the posterior communicating artery from the posterior circulation. Surgical treatment resolved the symptoms in both patients. moyamoya disease may include a number of variant types not showing all the characteristic angiographic findings of moyamoya disease.- - - - - - - - - - ranking = 0.21448061093589keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
5/213. Aggravation of brainstem symptoms caused by a large superior cerebellar artery aneurysm after embolization by Guglielmi detachable coils--case report.An 81-year-old male presented with right oculomotor nerve paresis and left hemiparesis caused by a mass effect of a large superior cerebellar artery aneurysm. Endovascular treatment was performed using Guglielmi detachable coils. The patient subsequently suffered aggravation of the mass effect 3 weeks after the embolization. Bilateral vertebral artery occlusion was performed, which decreased the cerebral edema surrounding the aneurysm, but his neurological symptoms did not improve. Parent artery occlusion is recommended as the first choice of treatment for an unclippable large or giant aneurysm causing a mass effect on the brainstem.- - - - - - - - - - ranking = 0.056313486972921keywords = artery (Clic here for more details about this article) |
6/213. 'Fou rire prodromique' as the heralding symptom of lenticular infarction, caused by dissection of the internal carotid artery in a 12-year-old boy.A 12-year-old, right-handed boy experienced a pathological fit of laughter before a sudden right hemiplegia. magnetic resonance imaging showed a left basal ganglia infarction, induced by a left internal carotid dissection. Arteriography revealed an underlying fibromuscular dysplasia. This case study demonstrates that cerebral artery dissection can occur in children and that a basal ganglia infarction may be preceded by pathological laughter called 'fou rire prodromique'. The clinical and anatomical relationship of this paroxysmal event are discussed.- - - - - - - - - - ranking = 0.89182848475229keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
7/213. Bilateral chronic subdural hematomas resulting in unilateral oculomotor nerve paresis and brain stem symptoms after operation--case report.An 85-year-old male presented with bilateral chronic subdural hematomas (CSDHs) resulting in unilateral oculomotor nerve paresis and brainstem symptoms immediately after removal of both hematomas in a single operation. Initial computed tomography on admission demonstrated marked thick bilateral hematomas buckling the brain parenchyma with a minimal midline shift. Almost simultaneous removal of the hematomas was performed with the left side was decompressed first with a time difference of at most 2 minutes. However, the patient developed right oculomotor nerve paresis, left hemiparesis, and consciousness disturbance after the operation. The relatively marked increase in pressure on the right side may have caused transient unilateral brain stem compression and herniation of unilateral medial temporal lobe during the short time between the right and left procedures. Another factor was the vulnerability of the oculomotor nerve resulting from posterior replacement of the brain stem and stretching of the oculomotor nerves as seen on sagittal magnetic resonance (MR) images. Axial MR images obtained at the same time demonstrated medial deflection of the distal oculomotor nerve after crossing the posterior cerebral artery, which indicates previous transient compression of the nerve and the brain stem. Gradual and symmetrical decompression without time lag is recommended for the treatment of huge bilateral CSDHs.- - - - - - - - - - ranking = 0.0080447838532744keywords = artery (Clic here for more details about this article) |
8/213. dissection of the middle cerebral artery caused by invasion of malignant glioma presenting as acute onset of hemiplegia.A 57-year-old, previously healthy man who developed acute onset of hemiplegia is presented. Neuro-imaging studies on admission suggested dissection of the middle cerebral artery producing infarction in the frontotemporal region. In contrast to his stable clinical course, serial neuro-imaging studies disclosed rapid growth of malignant glioma, which was confirmed at surgery. Microscopic examination of the surgical specimen demonstrated invasion of glioma cells into the arterial wall associated with intramural haematoma formation of the middle cerebral artery. This case is the first to document dissection of an intracranial artery caused by invasion of tumour cells.- - - - - - - - - - ranking = 0.056313486972921keywords = artery (Clic here for more details about this article) |
9/213. subclavian artery stenosis caused by non-specific arteritis (Takayasu disease): treatment with Palmaz stent.A 32-year old woman was admitted to the hospital with a sudden onset of right-sided hemiplegia and aphasia. Immediate angiographic examination revealed a severe form of type I takayasu arteritis with occlusion of all supra-aortic vessels, with the exception of the left subclavian artery which was, however, almost completely occluded 1 cm proximal to the origin of the left vertebral artery. Since the latter provided the entire blood supply to the brain tissues, an immediate attempt was undertaken to dilate the left subclavian artery; when this was unrewarding, stenting of the lesion was successfully accomplished with excellent primary and 6-month follow-up results.- - - - - - - - - - ranking = 0.056313486972921keywords = artery (Clic here for more details about this article) |
10/213. Management of penetrating injury to the petrous internal carotid artery: case report.We report the management of a penetrating foreign body injury to the neck with a length of fencing wire traversing the internal carotid artery within the petrous temporal bone and entering the middle cranial fossa. Discussion points include methods of haemorrhage control, as well as ligation versus repair or bypass as the definitive treatment.- - - - - - - - - - ranking = 0.99195521614673keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
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