Isolated anomalous origin of the vertebral artery from the common carotid artery.

Anomalous origins of the vertebral arteries are uncommon and typically associated with other abnormalities of the great vessels. We present a case of an isolated origin of the right vertebral artery from the ipsilateral common carotid artery detected using magnetic resonance angiography. Such variants can significantly affect endovascular and surgical planning.

Hemorrhage in the Wall of Pyogenic Brain Abscess on Susceptibility Weighted MR Sequence: A Report of 3 Cases.

Background and Purpose. In pyogenic brain abscess, hemorrhage in the walls is considered exceptional. Recently, hemorrhagic changes in the walls of pyogenic abscess have been demonstrated on susceptibility weighted imaging with 3T MRI. Here, we report hemorrhagic changes in the walls of pyogenic brain abscess on susceptibility weighted imaging with 1.5T MRI. Method. MRI of brain was done using 1.5T MRI with diffusion weighted sequence, susceptibility weighted sequence, and other standard sequences in 3 consecutive cases of pyogenic brain abscess. Stereotactic biopsy and cultures were obtained in 2 cases. One case was treated empirically with antibiotics. Results. Susceptibility sequence demonstrated hemorrhage in the wall of brain abscess in all three cases. All three cases also demonstrated restricted diffusion on diffusion weighted imaging. Conclusion. Susceptibility weighted imaging can demonstrate hemorrhagic changes in the walls of pyogenic brain abscess on 1.5T MRI. Presence of hemorrhage in the walls of ring enhancing lesions should not automatically lead to a diagnosis of tumor.

Tuberous sclerosis with multiple intracranial aneurysms: atypical tuberous sclerosis diagnosed in adult due to third nerve palsy.

Association between tuberous sclerosis and intracranial aneurysms is not well established and is at best suspicious. Sporadic cases of incidentally detected unruptured single, anterior circulation aneurysms have been reported in the literature in cases of typical tuberous sclerosis. We herein describe an unrecognised case of atypical tuberous sclerosis with bilateral PCom aneurysms which was diagnosed retrospectively while evaluating an unexplained intracranial hemorrhage with third nerve palsy. We intend this case would again strengthen a possible association between TS and intracranial aneurysms and lead to a systematic larger prospective/retrospective analysis.