1/15. Traumatic arteriovenous fistula of the posterior inferior cerebellar artery treated with endovascular coil embolization: case report.BACKGROUND: High-flow intracranial arteriovenous (AV) fistulas associated with giant varices are rare lesions. These varices can present with symptoms from mass effect, spontaneous hemorrhage, and seizures to cardiac failure. Direct AV fistulas of the posterior inferior cerebellar artery (pica) are extremely rare lesions, with only two cases reported in the literature. CASE DESCRIPTION: The authors present an unusual case of a 25-year-old male with a direct AV fistula of the pica that resulted from a fracture of the occipital condyle. This high-flow AV fistula drained into a giant varix of the vein of the lateral recess that compressed the brainstem, resulting in a Wallenberg syndrome. The patient underwent embolization of the proximal pica feeding the fistula with a Guglielmi detachable coil (GDC), which resulted in thrombosis of the varix. A postembolization angiogram showed occlusion of the pica AV fistula and draining varix. A computed tomography (CT) scan performed at a 10-month follow-up visit showed dramatic decompression of the brainstem. Although the patient continued to have some sensory changes secondary to Wallenberg syndrome, he was otherwise doing well neurologically. CONCLUSION: The treatment of this lesion is difficult because of its location near the brainstem. Postocclusion edema or hemorrhage can result in mass effect and life-threatening brainstem compression. Our patient, whose AV fistula was caused by trauma, was treated effectively with GDC embolization.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/15. Rendu-Osler-Weber disease with a giant intracerebral varix secondary to a high-flow pial AVF: case report.BACKGROUND: Intracranial varices are rare and most are associated with vein of Galen arteriovenous malformations (AVM) or fistulas (AVF). DESCRIPTION: A 43-year-old left-handed man presented with right hemihypesthesia and spastic gait. Neuroradiological examination revealed a spinal AVF and a giant intracerebral varix associated with a high-flow pial AVF. He had recurrent episodes of nasal bleeding, which were also confirmed in his mother's medical history, and telangiectases in the tip of his tongue and fingers. He was diagnosed with Rendu-Osler-Weber disease. After resection of the spinal AVF that produced his symptoms, we surgically exposed and obliterated the giant varix and AVF under intra- and postoperative hypotension and mild barbiturate therapy. The arteriovenous shunt was completely obliterated without hyperperfusion of the surrounding brain. CONCLUSION: This is an extremely rare case of Rendu-Osler-Weber disease with a giant intracerebral varix secondary to a high-flow pial AVF that did not involve the vein of Galen.- - - - - - - - - - ranking = 3.5keywords = giant (Clic here for more details about this article) |
3/15. azygos vein varix mimicking mediastinal mass in a patient with liver cirrhosis: a case report.A giant venous varix of the azygos arch is a very rare cause of a mediastinal mass. The usual diagnosis of a mediastinal mass by mediastinoscopy or percutaneous fine-needle aspiration or biopsy is very hazardous if there is a venous varix. Noninvasive thoracic CT scanning is a safe and better choice for diagnosis. We describe the case of a woman with a posterior mediastinal mass caused by a giant azygos vein varix. Thoracic CT documented the diagnosis. The etiology of the azygos varix was portal hypertension secondary to liver cirrhosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/15. Intracerebral hemorrhage from a middle meningeal arteriovenous fistula with a giant venous varix.A patient with a congenital arteriovenous fistula between the middle meningeal artery and a cortical vein with a giant venous varix is described. The patient presented with an intracerebral hemorrhage that had been evacuated. Permanent cure of the fistula was achieved without morbidity by embolization with Ivalon particles.- - - - - - - - - - ranking = 2.5keywords = giant (Clic here for more details about this article) |
5/15. Surgical management of a pial arteriovenous fistula with giant varix in an infant.A seven-month-old infant presented with a generalized seizure. The radiological evaluation revealed a large arteriovenous fistula in the left sylvian region. The fistula connected the left middle cerebral artery and the vein of Trolard. A giant varix was present at the venous end. The child underwent craniotomy, complete disconnection of the fistula and excision of the varix. Except for recurrent seizures, which were eventually controlled on anticonvulsants, the child's neurological development has been good on long-term follow-up of three years. Pial arteriovenous fistulae are rare intracranial vascular malformations. Though significant operative risks exist, they can be successfully managed surgically with good long-term prognosis.- - - - - - - - - - ranking = 2.5keywords = giant (Clic here for more details about this article) |
6/15. Varix of the heart causing outflow tract obstruction.We report a case about a neonate who died of severe subaortic stenosis due to a giant vascular dilation of the left ventricular outflow tract. We emphasize the fatal result of this benign lesion and make differential diagnosis with haemangiomas and valvular blood cysts.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
7/15. Giant suprasellar varix: an unusual cause of chiasmal compression.A 63-year-old woman developed visual field defects consistent with lateral compression of the optic chiasm. The cause of the compression was found to be a giant venous varix formed by the dilatation of the outflow vein from a dural arteriovenous fistula located in the superior petrosal sinus. After embolization and surgical obliteration of the fistula, the patient's visual function improved markedly.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
8/15. Giant varices in portal hypertension: CT findings.Two cases of giant varices in portal hypertension are presented. Dynamic computed tomography (CT) was useful in establishing that the masses were in fact dilated veins.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
9/15. Isolated growth hormone deficiency associated with a giant arteriovenous varix.A 6.5-year-old girl with short stature (height age, 3 years; bone age, 1.75 years) had isolated growth hormone deficiency. Preoperative computed tomography and magnetic resonance imaging demonstrated a large, well-demarcated, homogeneous mass above the dorsum sellae with a density consistent with flowing blood. Vertebral angiography showed a giant intracranial varix caused by an arteriovenous fistula that originated at the apex of the basilar artery. At operation, an aneurysm clip was placed at the origin of the fistula, and occlusion of the fistula was confirmed by intraoperative digital subtraction angiography. There were no permanent neurological sequelae. Despite shrinkage of the varix, demonstrated by follow-up computed tomography, growth hormone deficiency persisted postoperatively. Biosynthetic growth hormone therapy was initiated 6.5 months after surgery and resulted in a height increment of 8.2 cm after 9 months of treatment.- - - - - - - - - - ranking = 2.5keywords = giant (Clic here for more details about this article) |
10/15. Giant intracranial varix associated with venous angioma and intracerebral hemorrhage.A rare case of giant cerebral varix with venous angioma and intracerebral hemorrhage, surgically treated with good outcome, is reported. Varices and venous angiomas are infrequent in the clinical practice and are usually asymptomatic. Giant venous varices are less rarely associated with vein of Galen aneurysms or high flow arteriovenous shunts, whereas isolated giant varices are exceptional. association of varix and venous angioma has been reported only in three instances. The radiological diagnosis of the cerebral venous malformation is briefly discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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