Pediatric Cervical Aneurysmal Bone Cyst Treated by Endovascular Approach.

INTRODUCTION: Aneurysmal bone cyst (ABC) is a rare, benign, and expansible bone lesion, occurring mainly in childhood. Although most lesions are located at the metaphysis of long bones, they can also be found in flat bones and spine. CASE PRESENTATION: We report a case of a 16-year-old boy with cervical ABC treated by endovascular embolization. The afferents were occluded as a preoperative preparation for surgery; however, as the patient became asymptomatic after the procedure, the family refused surgery. Image at 1-year follow-up showed reduction and ossification of the lesion. CONCLUSION: Endovascular treatment decreases surgical morbidity by reducing blood loss, which is particularly important in the pediatric population. This therapeutic option may also halt ABC growth in selected cases.

Prenatal Diagnosis of Vein of Galen Aneurysmal Malformation Allows Early Transumbilical Endovascular Treatment

Neonates with vein of Galen aneurysmal malformation (VGAM) presenting with severe cardiac failure and pulmonary hypertension represent a challenge for endovascular therapy.When early treatment is required, the small femoral arteries in this population are usually difficult to cannulate. Alternatively, the umbilical vessels offer a natural pathway to reach the lesion. Therefore, prenatal diagnosis of VGAM allows for delivery planning, perinatal management, and embolization through umbilical approach, thus leading to better outcomes.

Dural Arteriovenous Fistula Associated with Dental Implant.

BACKGROUND: Dural arteriovenous fistulas (DAVFs) are characterized by pathologic shunts between meningeal arteries and venous sinuses, without nidus. Although many lesions are considered idiopathic, there may be an association with inflammatory processes, including sinus thrombosis, venous hypertension, craniotomy, trauma, and infections. CASE DESCRIPTION: A 50-year-old woman with an infectious complication of a dental implant evolved with an occipital DAVF. To our knowledge, this is the first case of a dental implant-related DAVF reported in the medical literature. CONCLUSIONS: Physicians should be aware of the possibility of DAVF formation after craniofacial infections. Better understanding of the etiopathogenesis of this type of lesion is required to avoid and treat potential complications.

Cerebellar mutism after embolization of vermian arteriovenous malformation.

BACKGROUND: Cerebellar mutism is usually associated with posterior fossa tumor surgery. CASE REPORT: We report a case of a 17-year-old female, presented with headache and tremor after hemorrhage from a vermian arteriovenous malformation. She was successfully treated by embolization; however, on immediate postoperative, she developed persistent mutism. To the best authors' knowledge, this is the first case of cerebellar mutism after endovascular treatment reported in the medical literature. CONCLUSION: The endovascular approach may have the same potential of complication of conventional surgery; therefore, more study is necessary to clarify the role and limits of this technique to treat cerebellar arteriovenous malformation.

Atypical Presentation of PHACE Syndrome: Hidden Facial Hemangioma.

PHACE(S) syndrome is a neurocutaneous syndrome with a wide array of presentations. The most known and present trait is facial hemangioma > 5 cm. The name is an acronym for Posterior fossa malformations, infantile Hemangiomas, Arterial anomalies, aortic Coarctation, Eye abnormalities, and middle-line malformations of the Sternum. The exact etiopathogenic mechanism of this syndrome is not fully understood, and its treatment depends on detailed and individualized assessment. The aim of this paper is to describe a child with a throat hemangioma, vascular malformations, cognitive delay, and other anomalies to illustrate the neuroimaging found in this syndrome.

Carotid artery occlusion in Kabuki syndrome: Case report and literature review.

BACKGROUND: Kabuki syndrome is a rare multiple congenital anomaly syndrome whose main diagnostic findings are craniofacial phenotypic changes and mental retardation. Organic structural lesions in the central nervous system are rare, although have been described already. Systemic vascular changes have also been reported rarely. CASE DESCRIPTION: We report the case of a young patient with Kabuki syndrome who had a transient ischemic attack due to dissection of the internal carotid artery and a likely gliosis area on the white matter. CONCLUSION: Association of cervical arterial disease with this syndrome has never been described, and its pathophysiology is not yet established; however, it can direct future research and maybe treatment.

Carotid cavernous fistula after percutaneous balloon compression for trigeminal neuralgia: Endovascular treatment with coils.

BACKGROUND: Percutaneous ganglyolysis treatment of trigeminal neuralgia is rarely associated with vascular complications, such as hematoma, subarachnoid hemorrhage, and stroke. Internal carotid artery injury may also occur after misguided needle placement, particularly far posteriorly or medially, resulting in carotid cavernous fistula. Anatomical variations of the foramen ovale can predispose those complications. CASE DESCRIPTION: A young woman diagnosed with trigeminal neuralgia during 11 years was submitted to a balloon rhizotomy by percutaneous approach to the trigeminal ganglion, with severe intraoperative bleeding. Cavernous syndrome developed few hours later. Magnetic resonance imaging and digital subtraction angiography confirmed an indirect carotid cavernous sinus fistula, which was treated by one session of endovascular procedure using coils, achieving total occlusion of the fistula and total recovery of the symptoms. CONCLUSIONS: Embolization with coils is a minimally invasive, safe, and effective procedure for the treatment of carotid cavernous fistulas, including those related to iatrogenic causes.