Spontaneous retrograde dissection of the right common iliac artery: a case report

Spontaneous retrograde dissection of the right common iliac artery incidentally imaged by intra-arterial digital subtraction angiography (IADSA) and confirmed by contrast infusion computed tomography (CT) is reported. This is the first case report of this extremely rare condition, but histologic verification could not be obtained. The usefulness of IADSA in mapping during catheterization complicated by marked resistance is underscored.

Gliomas with dural invasion: computed tomography and angiography

This report is a review of the findings of computed tomography and angiography of eight supratentorial gliomas with dural invasion. Computed tomography revealed localized increases in the thickness of ring enhancements at the sites of dural invasion in four cases, which was attributed to increased blood supplies by the meningeal vessels. Angiographically, feeders from the meningeal vessels entered the tumors mostly through relatively broad areas of tumor-dura attachment. A sunburst type of neovascularity from a meningeal artery was seen in only one case. In most such cases the differential diagnosis from meningioma was possible by the computed tomographic and angiographic findings. Selective external carotid angiography was the most important examination for diagnosing dural invasion by gliomas.

Angiographic observations in idiopathic trigeminal neuralgia

Twenty-four patients with idiopathic trigeminal neuralgia were treated by neurovascular decompression surgery. All patients underwent preoperative vertebral angiography. After surgery, the vertebral angiograms of these patients were retrospectively reviewed. In 23 of the 24 patients, the superior cerebellar artery (SCA) and/or the anterior inferior cerebellar artery (AICA) compressed the trigeminal nerve. In the remaining case, no such compression by vessels was observed. On review of the angiograms, most of the compressing arteries, and the sites and numbers of compression points could be identified. Most of the caudal points of the SCAs which did not compress the trigeminal nerve were located higher than the compression points of the SCAs. It was therefore concluded that vertebral angiography is useful in the preoperative evaluation of compressing arteries. Since superimposition of arteries could be avoided, the straight AP projection was the most valuable of the three projections employed.

Therapeutic embolization for renal angiomyolipoma: case report and review of the literature

A 47-year-old woman experienced sudden onset of severe left flank pain. By computed tomography (CT) and arteriography, her condition was diagnosed as a ruptured angiomyolipoma of the left kidney. She did not have tuberous sclerosis. Using polyvinyl alcohol foam (Ivalon) particles, immediate embolization of a main artery feeding the tumor--the posterior branch of the left renal artery--was performed. Three months after embolization, intravenous digital subtraction angiography (IVDSA) showed this main feeder was still occluded. This case and others encountered in our review of the literature underscore the usefulness of therapeutic embolization for renal angiomyolipoma.

Oligodendrogliomas of the lateral ventricle: computed tomography and angiography

Computed tomographic (CT) and angiographic findings in four cases of oligodendroglioma of the lateral ventricle are reported. CT showed a midline nodular intraventricular mass containing punctate calcifications and cysts. The tumors were slightly to markedly enhanced after the infusion of contrast media. Angiography showed slightly increased vascularity in the mass, and displacement of subependymal veins near the tumor. Oligodendrogliomas of the lateral ventricle are rare but should be included in the differential diagnosis of intraventricular tumors near the foramen of Monro.

Computed tomography and angiography in MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes); report of 3 cases

Among mitochondrial encephalomyopathies, MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes, Pavlakis et al. 1983) is recognized as a distinct syndrome characterized by generalized convulsions and recurrent stroke-like episodes. The neuroradiological findings of three patients with MELAS are reported here. Retrospective review shows that MELAS should be included in the differential diagnosis of infarct-like lesions of the cerebrum.

Solitary pontine metastasis from hepatocellular carcinoma: a case report

This is the first report of a case of solitary pontine metastasis from hepatocellular carcinoma.

Bilateral venous infarctions of the thalamus: a case report

This is a mini-report of a case of bilateral nonhemorrhagic venous infarctions of the thalamus, complicated by a dural arteriovenous malformation.

[A case of dural arteriovenous malformation with bilateral thalamic infarction]

A 59-year-old man was admitted because of frequent vomiting and obtundation in February 1982. Neurological examination on admission revealed only slight impairment of consciousness. Papilledema, meningeal irritation sign and paralysis were not elicited. The plain CT scan was normal, but the CT scan with contrast material showed patchy enhancement in the left temporal lobe and around the third ventricle. Cerebral angiography showed a dural arteriovenous malformation (dural AVM) in the left transverse sinus fed by the left occipital artery, and the retrograde flow into the straight sinus. By the third day following admission, the level of consciousness became alert. The patient did not complain of headache, bruit and visual disturbance. He showed mild disorientation and memory disturbance. But his ordinary daily-living was independent. In August 1982, the patient gradually became inactive and apathetic. At times he lay in bed with moving his eyes, swallowing foods. At other times, he lay in bed with closing his eyes, immobile, and unresponsive except to strong painful stimuli. The patient was incontinent and required nursing care. During three month periods, the patient progressively became somnolent, speechless and immobile. Eventually, he was in a state of akinetic mutism. The patient became unresponsive. The state of consciousness fluctuated within a narrow range. The pupils were isocoric and did not react to light. He sometimes moved his eyes horizontally, but the vertical eye movement was limited. Deep tendon reflexes were hyperactive with Babinski reflex bilaterally. Passive mobilization of extremities revealed hypertonic. The CT scan disclosed the bilateral symmetrical infarction of the thalamus.(ABSTRACT TRUNCATED AT 250 WORDS)

Radiological analysis of hemifacial spasm with special reference to angiographic manifestations

Fifty-one patients with hemifacial spasm secondary to facial nerve compression by normal appearing, elongated, tortuous and/or dilated arteries, were treated by microsurgical neurovascular decompression. Post-operatively, 91% of 44 of these patients with one to six year postoperative follow-ups were satisfactory. The angiographic findings showed significant increase in the number of common trunk anomalies. Variations of the anterior and posterior inferior cerebellar and vertebral arteries are discussed in relation to nerve compression.

Moya moya disease: use of digital subtraction angiography in its diagnosis

Fourteen patients suspected of having Moya Moya disease underwent intravenous digital subtraction angiography (DSA), and the findings from nine of these patients were reviewed and analyzed. Obstruction or stenosis of the supraclinoid portion of the internal carotid artery and the proximal portions of the anterior and middle cerebral arteries was observed in all cases. Arteriography, however, was better than intravenous DSA in demonstrating Moya Moya vessels, differentiating complete occlusion from severe stenosis, and demonstrating important transdural collaterals. The disadvantages of intravenous DSA included inferior spatial resolution, the need for large amounts of contrast media, and relatively high radiation doses. Since the summation of vessels cannot be avoided using DSA, arteriography is necessary for the precise evaluation of cerebral hemodynamics before bypass surgery. Intravenous DSA is a safe, reliable method for diagnosing Moya Moya disease and is suitable for the screening and follow-up examinations of patients with the disease.

Posttranscatheter embolization computed tomography in hepatocellular carcinoma. Evaluation of embolization effects

The postcontrast CT scans and angiography of 26 lesions in 23 patients with hepatomas who underwent transcatheter arterial embolization therapy were reviewed. Newly developed low density and high density areas and gas were noted on CT scans of the tumors after embolization in 100, 8 and 58% of the lesions, respectively. The CT findings of residual tumors correlated well with those of follow-up angiography. When discrete smooth round low density zones were observed on CT, there was no residual neovascularity on follow-up arteriography. When there were nodular or thick septum-like structures in low density lesions, arteriography revealed residual tumor vascularity in the lesions. CT proved useful not only in evaluating the effects of embolization, but also in providing important information about residual tumors.