Intracranial carotid calcification on CT images as an indicator of atheromatous plaque: analysis of high-resolution CTA images using a 64-multidetector scanner.

PURPOSE: Intracranial arterial wall calcifications are frequently observed on routine head computed tomography (CT) images. The purpose of this study was to evaluate whether calcification of the intracranial carotid artery on CT images could predict atheromatous plaque and luminal stenosis. MATERIALS AND METHODS: A total of 259 patients were examined using three-dimensional CT angiography using high-resolution 64 detector scanners. We examined patients from the petrous portion to the top of the internal carotid arteries. We evaluated the existence of calcification and atheromatous plaque based on our criteria retrospectively. The thickness of calcification was measured in each vessel, and the shape of calcification was classified into three types. RESULTS: There was low correlation between the thickness of the calcification and luminal stenosis, but the shape of the calcification corresponded well to the stenosis. The population of patients with >50% stenosis of the intracranial carotid artery differed statistically significantly for each calcification shape. There was a high negative predictive value (97.7%) in the correlation between the existence of calcification and atheromatous plaque on the multidetector CT images. CONCLUSION: Calcification of the intracranial carotid artery on CT images shows a high negative predictive value for the existence of atheromatous plaque in the same artery. The thickness of the calcification did not correlate well with luminal stenosis, but its shape seemed to predict luminal stenosis.

High-flow Paraspinal Osseous Epidural Arteriovenous Fistula. A Case Report.

We report the clinical and neuroradiological imaging findings of a 26-year-old man who presented with lumbago related to high flow paraspinal osseous epidural arteriovenous fistulas in the thoracic spine. This case was of particular interest because of his exclusive epidural and paraspinal venous drainage and the presence of a prominent dilated venous pouch in the spinal canal. Angiography demonstrated multiple high flow arteriovenous fistulas with an osseous nidus. Transarterial glue embolization was performed by multistage sessions. Clinical symptoms improved dramatically. The unusual features of this case have important implications for therapeutic management.

Endovascular remodeling technique for vein of Galen aneurysmal malformations--angiographic confirmation of a connection between the median prosencephalic vein and the deep venous system.

It is commonly believed that in vein of Galen aneurysmal malformations (VGAMs) venous structures normally constituting the deep or Galenic venous system, such as the internal cerebral vein (ICV) and the basal vein of Rosenthal, are not connected to the vein of Galen. In this report, the authors describe 2 cases of successfully treated VGAM in which drainage of an ICV into the vein of Galen was confirmed by follow-up angiography. Two mural types of VGAM were treated using transarterial glue embolization when 1 child was 5 months and the other was 6 months old. The postoperative outcomes for these babies were complete cures. Follow-up digital subtraction angiography obtained after 12 months (Case 1) and 6 months (Case 2) confirmed that the shrunken median prosencephalic vein connects with the deep venous system. The possibility of normal deep Galenic venous drainage must be considered in endovascular management of VGAM. The goal of endovascular intervention is to close only the ventral component of the dilated median prosencephalic vein.