ABSTRACT
We report two cases in which the vertebral artery (VA) entered the spinal canal via the intervertebral foramen at the C2-C3 disc level, an extremely rare variation regarded as a C3 segmental type of VA, that we diagnosed by magnetic resonance angiography. The C2 segmental type of VA, in which the VA enters the spinal canal via the C1-C2 intervertebral space, is relatively common. It is important to identify these variations before surgery of the craniovertebral junction or interventional procedures to prevent complications.
Subject(s)
Anatomic Variation , Vertebral Artery/anatomy & histology , Aged, 80 and over , Female , Humans , Magnetic Resonance Angiography , Male , Middle Aged , Vertebral Artery/diagnostic imagingABSTRACT
A 45-year-old man was admitted to our hospital because of progressive inactivity and mild disturbance of consciousness which appeared two weeks ago. Brain CT revealed symmetric hypointensity of bilateral thalamus, and the lesion appeared hyperintensity on T2 weighted MRI image. He was first considered as immune-mediated cerebritis, and steroid pulse therapy was applied, but the clinical features were not improved. The diagnosis of cerebral venous thrombosis was established, when MR venography (MRV) showed severe stenosis in straight sinus. Consciousness was improved after the start of anticoagulation therapy, but mild dementia was remained as a sequela. MRV was useful to distinguish straight sinus thrombosis from cerebritis in this case.
Subject(s)
Cerebral Veins , Confusion/etiology , Depression/etiology , Sinus Thrombosis, Intracranial/complications , Thalamic Diseases/complications , Venous Thrombosis/complications , Acute Disease , Consciousness Disorders/etiology , Diagnosis, Differential , Humans , Magnetic Resonance Angiography , Male , Middle Aged , Sinus Thrombosis, Intracranial/diagnosis , Sinus Thrombosis, Intracranial/therapy , Thalamic Diseases/diagnosis , Thalamic Diseases/therapy , Venous Thrombosis/diagnosis , Venous Thrombosis/therapyABSTRACT
A 33-year-old male with acute pancreatitis induced by hypertriglyceridemia had problems during treatment with plasma exchange. The hypercoagulable state was prevented by introducing innovative methods for cleaning and warming of the circuit and dialyzer. This enabled successful therapy, and the patient fully recovered from life-threatening acute pancreatitis.