A case of a type II proatlantal artery with arteriovenous malformation.

We describe a 64-year-old woman evaluated with angiography a case of persistence of a proatlantal artery (type II) with an arteriovenous malformation associated to the posterior cerebral artery. This association has been reported once in the literature consulted. The proatlantal artery arises from external carotid artery, cranial to the origin of facial artery at the level of C4 vertebra, anteromedial to the internal carotid artery, laying on it during its course cranial, lateral and posterior. After making a loop at the level of the transverse process of C3 vertebra, it enters into the transverse foramen of C3 vertebra and continuing its course, through the transverse foramen of C2 and C1 vertebra, as vertebral artery. Winds behind the superior articular process of the atlas enters the skull through the foramen magnum and, at the lower border of the pons, joins with the vessel of the opposite side to form the basilar artery. The internal carotid artery is normal. This variation is associated with congenital arteriovenous malformations that represent the persistence of an embryonic pattern of congenital vessels.

[Neurovascular intervention in the acute phase of cerebral infarction]. / Intervencionismo neurovascular en la fase aguda del infarto cerebral.

BACKGROUND AND PURPOSE: Endovascular therapies in acute ischaemic stroke may offer benefits to patients that are not eligible for standard use of intravenous tissue activator plasminogen (iv t-PA) or when this is not effective. Our aim is to present the initial experience in with endovascular techniques in the Community of Madrid. METHODS: We present data from our registry of acute ischaemic strokes treated with endovascular re-perfusion therapies in five University Hospitals in Madrid (Spain) during the period 2005-2009. We recorded demographic data, vascular risk factors, risk severity with the NIHSS (National Institute of Health Stroke Scale), endovascular techniques, complications and mortality rates. Functional outcome and neurological disability at 90 days was defined by the modified Rankin scale (mRs). RESULTS: A total of 41 patients were treated with endovascular therapies. Mean age was 58.6 ± 19.9, and 56.1% were males. Of those 22 patients had an anterior circulation stroke and 19 had a posterior circulation stroke. Baseline NIHSS score was: median, 17 [range, 2-34]; 7 patients had previously received iv t-PA. The following endovascular techniques were performed: mechanical disruption (26 patients), intra-arterial infusion of t-PA (26 patients), angioplasty and stenting (5 patients), mechanical use of MERCI device (3 patients). Partial or total re-canalization was achieved in 32 patients (78%). Only one patient had a symptomatic cerebral haemorrhage. Three months after stroke, 53.6% of the patients were independent (mRs ≤ 2) and overall mortality rate was 19.5%. CONCLUSIONS: Acute ischaemic stroke is a potentially treatable medical emergency within the first hours after the onset of symptoms. Stroke endovascular procedures constitute an alternative for patients with iv t-PA exclusion criteria or when this is not effective.

Angiofibroma nasofaringeo juvenil. Situación actual / Juvenile nasopharyngeal angiofibroma

El angiofibroma nasofaríngeo juvenil (AJN) es un infrecuente tumor benigno y altamente vascularizado. En esteartículo se presenta un caso tratado en nuestro servicio. Se describe la forma de presentación, pruebas diagnósticas, preparación previo al tratamiento mediante embolización de arterias nutricias por parte de los neurorradiólogos vasculares, y la vía de abordaje LeFort para el tratamiento.Debido a la complejidad del abordaje por su localización, alta recurrencia, e histopatología; la cirugía siempre ha tenido un cierto grado de morbilidad. La embolización preoperatoria ha contribuido a disminuirla.Se presenta una revisión bibliográfica de las últimastendencias sobre la situación actual sobre este tumor

Juvenile Juvenile nasopharyngeal angiofibroma (JNA) is a benign and highly vascular tumor. In this article we present a case treated in our institution. We present form of presentation, exploration and intra-arterial pre-operative embolization by neuroradiology, and the treatment with the Le Fort technique. JNA has a complex anatomy, high recurrence and special histopathology, therefore the surgery is very complex and as an with high morbidity. The pre-operative embolization has decrease the hemorragic complications. We review the literature the of the JNA nowadays

[Clinical applications of in vivo proton magnetic resonance spectroscopy in the study of astrocytomas: state of the art]. / Aplicaciones clínicas de la espectroscopía de protón por resonancia magnética in vivo en el estudio de los astrocitomas: estado actual.

We review the current state in literature of the use of magnetic resonance spectroscopy in the assessment and characterization of cerebral astrocytomas. Special attention will be paid to the presurgical grading of astrocytomas and to the role of spectroscopy in differentiating these tumors from other neoplastic and nonneoplastic brain lesions.

Aplicaciones clínicas de la espectroscopía de protón por resonancia magnética in vivo en el estudio de los astrocitomas: estado actual / Clinical applications of in vivo proton magnetic resonance spectroscopy in the study of astrocytomas: state of the art

Se realiza una revisión de la literatura sobre el estado actual de las aplicaciones de la espectroscopía por resonancia magnética en el diagnóstico y caracterización de los astrocitomas cerebrales, haciendo especial hincapié en su utilidad en la determinación prequirúrgica del grado tumoral de las lesiones y en el diagnóstico diferencial con otros tumores y procesos pseudotumorales. (AU)

Imágenes de resonancia magnética en encefalopatía de Wernicke de un paciente hemodializado / Magnetic resonance imaging in Wernicke´s encephalopathy of a hemodialyzed patient

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Fístula broncobiliar entre un quiste hidatídico hepático y el lóbulo medio del pulmón derecho / Bronchobiliary fistulous tract between a liver hyda tid cyst and the middle lobe of the right lung

Presentamos el caso de una fístula broncobiliar entre un quiste hidatídico localizado en el lóbulo derecho hepático y el lóbulo medio del pulmón derecho, localización poco frecuente de estos trayectos fistulosos. Dado lo poco habitual de esta patología revisamos su etiopatogenia, sintomatología, diagnóstico y tratamiento. (AU)

[Bronchobiliary fistulae between a liver hydatid cyst and the middle lobe of the right lung]. / Fístula broncobiliar entre un quiste hidatídico hepático y el lóbulo medio del pulmón derecho.

We report a case of bronchobiliary fistula between a liver hydatid cyst and the middle lobe of the right lung. It is also reviewed the etiology, pathogenesis, clinical features, diagnosis and treatment of bronchobiliary fistulas.