1/89. Clinically aggressive diffuse capillary telangiectasia of the brain stem: a clinical radiologic-pathologic case study.Capillary malformations or telangiectasias of the brain usually exhibit a benign clinical course, although occassionally they may be associated with mild to moderate symptomatology of uncertain origin. We report a case of an exceptionally aggressive capillary telangiectasia in a child, which was associated with progressive neurologic deterioration resulting in death.- - - - - - - - - - ranking = 1keywords = malformation (Clic here for more details about this article) |
2/89. Spontaneous thrombosis of vein of Galen aneurysmal malformation.Two cases of aneurysmal malformations of the vein of Galen (AVG) with spontaneous thrombosis are reported. Angiogram and MRI before thrombosis demonstrated AVGs with slow arteriovenous shunts and associated stagnation of contrast in the venous sac secondary to severe outflow restriction. Based on these findings, one patient was managed conservatively, and the other underwent placement of a ventriculoperitoneal shunt. Surveillance of the lesions with subsequent MRIs revealed spontaneous thrombosis of the AVGs with excellent clinical outcomes. Proposed mechanisms of spontaneous thrombosis include slow flow shunts, obstruction of the venous outflow or obstruction of the feeding artery. Similar cases in the literature are reviewed with special emphasis on diagnostic tests, symptomatology, mechanisms of thrombosis and therapeutic options.- - - - - - - - - - ranking = 5.1218321109235keywords = malformation, vein (Clic here for more details about this article) |
3/89. Management of vein of galen malformations. A review based on five neurosurgically treated cases and literature reports.The high morbidity and mortality associated with the management of vein of Galen aneurysmal malformations (VGAM) continues to pose a tremendous challenge to the neurosurgeon as well as to the attending interventional radiologist. Since 1985, five patients with VGAM have been referred to the neurosurgical unit of the University of Cologne, two neonates, one infant and two adults. Four patients underwent direct operation and two patients received a shunt. The treatment was performed without mortality. A review of the literature reflects no substantial difference between neurosurgical treatment during the last 15 years (mortality 10%) and endovascular treatment (best series mortality 6%).- - - - - - - - - - ranking = 5.1218321109235keywords = malformation, vein (Clic here for more details about this article) |
4/89. Presumed capillary telangiectasia of the pons: MRI and follow-up.Capillary telangiectasia is a vascular abnormality primarily of the brainstem. The clinical relevance is unclear as is the association with clearly pathologic findings such as cavernous haemangioma. We report on four cases with capillary telangiectasia proven by follow-up and describe the imaging characteristics. T2 abnormality was only observed in half of the patients as was the presence of a discernable collecting vein. Whereas two cases were incidental findings in neurologically normal persons and one had symptoms clearly attributable to lacunar stroke, one patient may have had symptoms due to the vascular abnormality in the pons.- - - - - - - - - - ranking = 0.024366422184706keywords = vein (Clic here for more details about this article) |
5/89. Colour Doppler flow imaging of the superior ophthalmic vein in dural arteriovenous fistulas before and after surgery.The aim of this study was to examine the clinical significance of the colour Doppler flow imaging (CDFI) findings of the superior ophthalmic vein (SOV) in intracranial dural arteriovenous fistulas (DAVF). The SOV was examined by CDFI in 12 cases of DAVF before and after surgery. Before surgery, the average SOV diameter was 3.57 /-1.18 mm (mean /- standard deviation, which was significantly wide (P<0.05) compared with the control value. One case showed reversed flow. Four cases showed an abnormal waveform. The cases with the more severe clinical symptoms showed wider SOV diameters and more abnormal waveforms than those with mild clinical symptoms. Postoperatively, the mean SOV diameter and mean resistance index improved significantly (P< 0.05); the flow direction and waveform became normal in each. The SOV CDFI findings were found to be useful as screening and follow-up techniques for the intracranial DAVFs.- - - - - - - - - - ranking = 0.12183211092353keywords = vein (Clic here for more details about this article) |
6/89. Surgery for dural arteriovenous fistula in superior sagittal sinus and transverse sigmoid sinus.The aim of this study was to evaluate the outcome of surgically treated dural arteriovenous fistula (DAVF). The authors performed surgical removal of DAVF in 12 patients. The locations of DAVF were the transverse sigmoid sinus in seven patients and superior sagittal sinus in five patients. These 12 patients had undergone endovascular embolisation prior to removal. Among them, six patients were completely cured, according to angiography immediately after embolisation, but these six patients showed the recurrence of DAVF within 1 year. The other six patients showed a decrease of feeding vessels. Therefore, all 12 patients underwent surgical removal of DAVF. The surgical strategies were as follows. The feeding vessels and the cortical veins with retrograde filling were occluded and cut. The affected sinus was skeletonised, and if it was occluded or almost occluded, the sinus was removed. Postoperatively, transient aphasia was seen in one patient. There was no surgical morbidity or mortality. During the follow-up period (mean 2.9 years), no recurrence of DAVF was seen. Surgical treatment is a safe and effective treatment manoeuvre for DAVF around the transverse sigmoid sinus and superior sagittal sinus.- - - - - - - - - - ranking = 0.024366422184706keywords = vein (Clic here for more details about this article) |
7/89. Spinal intradural perimedullary arteriovenous fistula with varix in infant.A rare occurrence of type IV spinal arteriovenous malformation (intradural perimedullary arteriovenous fistula) is described in an 18-month-old boy initially misdiagnosed with guillain-barre syndrome. An intramedullary mixed-intensity mass lesion at Th1 was demonstrated by magnetic resonance imaging together with flow voids over the dorsal aspect of the swollen spinal cord. angiography demonstrated an intradural perimedullary arteriovenous fistula including an intraparenchymal vascular pocket. After partial embolisation of the posterior spinal arteries through the left intercostal-radicular artery, the arteriovenous fistula was removed completely together with an organised haematoma. The fistula directly opened into a vascular pocket, which was confirmed pathologically to be a varix. The postoperative course was uneventful, and the patient resumed ambulation within 4 months. The case, subclassifiable as a type IVb spinal perimedullary AVF, was unique given its location and the patient's age at presentation.- - - - - - - - - - ranking = 1keywords = malformation (Clic here for more details about this article) |
8/89. Intracranial dural arteriovenous fistula with spinal medullary venous drainage.We report on a 46-year-old patient in whom an intracranial dural arteriovenous (AV) fistula, supplied by a branch of the ascending pharyngeal artery, drained into spinal veins and produced rapidly progressive symptoms of myelopathy and brainstem dysfunction including respiratory insufficiency. magnetic resonance imaging studies demonstrated brainstem oedema and dilated veins of the brainstem and spinal cord. Endovascular embolization of the fistula led to good neurological recovery, although the patient had been paraplegic for 24 h prior to embolization. This case demonstrates the MRI characteristics of an intracranial dural AV fistula with spinal drainage and illustrates the importance of early diagnosis and treatment. Even paraplegia may be reversible, if angiography is performed and the fistula treated before ischaemic and gliotic changes become irreversible.- - - - - - - - - - ranking = 0.048732844369411keywords = vein (Clic here for more details about this article) |
9/89. MRI of intraosseous dural arteriovenous malformation: findings in two cases.Intraosseous dural arteriovenous malformation (DAVM) is rare. The intraosseous component of this DAVM has usually been neglected on conventional angiography and found during operation after the bone drilling has been completed. Considerable bleeding usually occurs during operation because of the unexpected hypervascular bone marrow. We report the use of MRI to help in the diagnosis and therapeutic plan for this rare type of DAVM.- - - - - - - - - - ranking = 5keywords = malformation (Clic here for more details about this article) |
10/89. Cerebellar hemorrhage caused by dural arteriovenous fistula: a review of five cases.OBJECT: In this study the authors performed a retrospective analysis of five cases in which the patients (three women and two men) were treated for intracranial dural arteriovenous fistulas (AVFs) associated with cerebellar hemorrhage. On the basis of their findings, the authors evaluated the characteristics of this unusual symptom. methods: The dural AVFs were located in the right cavernous sinus in one patient, the left transverse-sigmoid sinus in three patients, and the right superior petrosal sinus (SPS) in one patient. All patients presented with severe headache and/or loss of consciousness. Computerized tomography scans revealed a small cerebellar hemorrhage near the fourth ventricle and hydrocephalus in four cases, and a massive hemispheric cerebellar hemorrhage in the remaining case. The four patients with small hemorrhages underwent ventriculostomy and endovascular treatment; all recovered. The patient suffering from a massive hemorrhage because of a dural AVF in the SPS was treated by suboccipital craniectomy, hematoma evacuation, and removal of the vascular anomaly. This patient remains in a persistent vegetative state. In four cases, results of angiography demonstrated retrograde leptomeningeal venous drainage through the SPS to the anastomotic lateral mesencephalic vein (ALMV) and/or to the vein of the lateral recess of the fourth ventricle (VLR4V). Retrograde leptomeningeal venous drainage to the ALMV and/or VLR4V was responsible for cerebellar hemorrhage in these cases. CONCLUSIONS: Thus, it is important to consider dural AVF in cases in which there is even a small hemorrhage near the fourth ventricle accompanied by intraventricular perforation and a decreased level of consciousness.- - - - - - - - - - ranking = 0.048732844369411keywords = vein (Clic here for more details about this article) |
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