RESUMO
Thrombosis of the straight and transverse sinuses associated with a large hemorrhagic venous infarct developed in an infant with large chronic subdural fluid collections after drainage of the subdurals. CT and MR studies obtained before and after the onset of venous sinus thrombosis showed interval widening of a segment of the posterior falx between the vein of Galen and the superior sagittal sinus. MR angiography confirmed a recanalized falcine sinus.
Assuntos
Síndrome da Criança Espancada , Cavidades Cranianas/patologia , Doenças em Gêmeos , Hematoma Subdural/diagnóstico , Doenças do Prematuro/diagnóstico , Trombose dos Seios Intracranianos/diagnóstico , Infarto Cerebral/diagnóstico , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Angiografia por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
The imaging and pathologic features of three cases of nonlaryngeal neuroendocrine carcinoma of the head and neck are described. Neuroendocrine carcinomas represent malignant epithelial neuroendocrine neoplasms and are classified as three types: typical carcinoid (well differentiated), atypical carcinoid (moderately differentiated), and small cell neuroendocrine (poorly differentiated) carcinomas. The CT and MR imaging features of these tumors are nonspecific. Paranasal sinus neuroendocrine carcinomas showed expansion and destruction of the sinus, whereas metastatic neuroendocrine carcinomas to an intraparotid lymph node presented as a circumscribed parotid mass on CT scans.
Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Tumores Neuroendócrinos/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: To determine the effect of proximal flow arrest on the frequency and timing of distal embolic events during occlusion of the common femoral artery with detachable coils. METHODS: Twenty-three complex fibered platinum coils were delivered into 10 common femoral arteries without proximal flow arrest. The arteries were continuously monitored for flow and embolic events by Doppler sonography during delivery and for at least 10 minutes after delivery of each coil. Thirty-four coils were delivered into 6 arteries after proximal flow arrest by inflation of a nondetachable balloon. After balloon deflation, each artery was monitored by Doppler sonography for 10 minutes. RESULTS: In the 10 arteries occluded without flow arrest, 87 events (8.7 per artery) occurred, of which 47 were embolic and 40 were indeterminate. In the 6 arteries with flow arrest, the number of emboli detected was 3 (0.5 per artery). Embolic events occurred only if there was residual flow. In those arteries that were occluded when the flow-arrest balloon was deflated, no emboli were detected. CONCLUSIONS: Proximal flow arrest virtually eliminates the risk of distal emboli during arterial occlusion with detachable fibered coils. The use of fibered coils, in conjunction with proximal flow arrest, allows for safe arterial occlusion when detachable balloons are not available or their use is not feasible.
Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Embolia/diagnóstico por imagem , Embolização Terapêutica/instrumentação , Processamento de Imagem Assistida por Computador , Ultrassonografia Doppler em Cores , Animais , Cães , Artéria Femoral/diagnóstico por imagem , Fatores de RiscoRESUMO
PURPOSE: To determine the clinical effectiveness of parent artery occlusion of the carotid or vertebral artery by means of temporary proximal flow arrest and microcoils. METHODS: Nineteen parent artery occlusions (15 carotid, four vertebral) were performed in 19 patients who successfully passed a balloon test occlusion. In these patients, endovascular occlusion of the carotid or vertebral artery was accomplished with the use of temporary proximal flow arrest and microcoils. RESULTS: All 19 parent arteries were occluded. Eighteen patients (95%) had good outcomes and one (5%) had a poor outcome. Fourteen patients (74%) had no complications and five (26%) had complications, of whom only one was left with a permanent neurologic deficit. Three (60%) of the complications were the result of delayed ischemic events after parent artery occlusion and were not predicted by balloon test occlusion. CONCLUSION: Endovascular occlusion with temporary proximal flow arrest and microcoils can be done effectively and successfully. The predictive value of the balloon test occlusion is the major complicating factor, as it is with balloon occlusion. This technique offers an additional tool that can be used for endovascular occlusion of the carotid or vertebral artery and seems to be less difficult technically. It is our primary technique for parent artery occlusion.
Assuntos
Falso Aneurisma/terapia , Fístula Arteriovenosa/terapia , Artéria Carótida Interna , Seio Cavernoso , Embolização Terapêutica/instrumentação , Neoplasias de Cabeça e Pescoço/terapia , Aneurisma Intracraniano/terapia , Artéria Vertebral , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Falso Aneurisma/diagnóstico por imagem , Fístula Arteriovenosa/diagnóstico por imagem , Encéfalo/irrigação sanguínea , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/etiologia , Artéria Carótida Interna/diagnóstico por imagem , Seio Cavernoso/diagnóstico por imagem , Angiografia Cerebral , Infarto Cerebral/diagnóstico por imagem , Infarto Cerebral/etiologia , Criança , Pré-Escolar , Circulação Colateral/fisiologia , Desenho de Equipamento , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/irrigação sanguínea , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Artéria Vertebral/diagnóstico por imagemRESUMO
OBJECT: The goal of this study was to evaluate gene delivery to a benign brain tumor. METHODS: A recombinant adenovirus vector bearing the Escherichia coli beta-galactosidase reporter gene was selectively injected into the vascular supply of a spontaneously occurring canine olfactory groove meningioma. The tumor and a small amount of peritumoral brain tissue were removed 5 days after viral injection and stained with X-Gal to assess gene delivery. The authors noted significant beta-galactosidase gene expression by the tumor, but not by surrounding brain tissue. No obvious viral-related cytotoxicity was noted. CONCLUSIONS: The authors found that meningiomas can be successfully transduced by adenovirus vectors by using endovascular techniques.
Assuntos
Terapia Genética , Neoplasias Meníngeas/veterinária , Meningioma/veterinária , Adenoviridae/genética , Animais , Corantes , DNA Recombinante/genética , Cães , Escherichia coli/genética , Osso Etmoide/patologia , Feminino , Galactosídeos , Regulação Enzimológica da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Genes Reporter/genética , Vetores Genéticos , Indóis , Injeções Intra-Arteriais , Neoplasias Meníngeas/irrigação sanguínea , Neoplasias Meníngeas/patologia , Neoplasias Meníngeas/cirurgia , Neoplasias Meníngeas/terapia , Meningioma/irrigação sanguínea , Meningioma/patologia , Meningioma/cirurgia , Meningioma/terapia , Transdução Genética , beta-Galactosidase/genéticaRESUMO
Magnetic resonance angiography (MRA) plays an important role in the evaluation of cerebrovascular disease. This is especially true in the diagnosis and management of cerebral vascular malformations. Both time-of-flight and phase contrast MRA techniques have proved useful for the imaging of all types of cerebral vascular malformations including AVMs, dural fistulas, cavernous malformations, and venous angiomas. The role of MRA in the evaluation of these lesions is discussed.
Assuntos
Malformações Arteriovenosas Intracranianas/diagnóstico , Angiografia por Ressonância Magnética , Encéfalo/patologia , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/diagnóstico por imagem , Angiografia Cerebral , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/diagnóstico por imagem , Humanos , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Angiografia por Ressonância Magnética/métodosRESUMO
BACKGROUND: Arachnoid cysts are intra-arachnoidal cerebrospinal fluid collections that are usually asymptomatic, however, they may become acutely symptomatic due to enlargement of the cyst or the presence of hemorrhage. MATERIALS AND METHODS: We report a case of a child presenting with a 3-week history of headaches, nausea, and vision problems. There was no history of trauma. MRI clearly demonstrated a left middle cranial fossa arachnoid cyst with associated subacute intracystic and subdural hematoma that was causing mass effect and required surgery. RESULTS: This lesion was isodense to the brain on CT. CONCLUSION: We focus on the importance of MR imaging in the differentiation of these subacute/early chronic hemorrhagic collections that may be overlooked with CT.