• Title/Summary/Keyword: Angiography, follow up

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Giant Serpentine Aneurysm of the Middle Cerebral Artery

  • Lee, Seung-Joo;Ahn, Jae-Sung;Kwun, Byung-Duk;Kim, Chang-Jin
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.177-180
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    • 2010
  • Giant serpentine aneurysms are rare and have distinct angiographic findings. The rarity, large size, complex anatomy and hemodynamic characteristics of giant serpentine aneurysms make treatment difficult. We report a case of a giant serpentine aneurysm of the right middle cerebral artery (MCA) that presented as headache. Treatment involved a superficial temporal artery (STA)-MCA bypass followed by aneurysm resection. The patient was discharged without neurological deficits, and early and late follow-up angiography disclosed successful removal of the aneurysm and a patent bypass graft. We conclude that STA-MCA bypass and aneurysm excision is a successful treatment method for a giant serpentine aneurysm.

Angiographically Occult Vascular Malformation of the Cauda Equina Presenting Massive Spinal Subdural and Subarachnoid Hematoma

  • Kim, Ji-Hyun;Lee, Sun-Ho;Kim, Eun-Sang;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.373-376
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    • 2011
  • We report a case of a non traumatic spinal subdural hematoma or subarachnoid hematoma manifesting as lumbago, leg pain and bladder dysfunction that showed angiographically occult vascular malformation (AOVM). Although the spinal angiogram did not reveal any vascular abnormality, the follow-up magnetic resonance image showed AOVM. Complete surgical removal was performed due to the aggravated bladder dysfunction. This case highlights the need to consider bleeding due to spinal AOVM, even when angiography is negative.

Amaurosis Fugax Associated with Stenosis of the Intracranial Internal Carotid Artery : Successful Restoration of Ophthalmic Artery Flow by Stent Placement

  • Lee, Chang-Young
    • Journal of Korean Neurosurgical Society
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    • v.40 no.1
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    • pp.28-30
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    • 2006
  • Two patients presented with amaurosis fugax[AMF]. despite treatment with antiplatelet drugs and anticoagulants due to previous transient ischemic attacks. Angiography demonstrated severe stenosis in the cavernous and petrous internal carotid artery[ICA] respectively, with reduced flow in the ophthalmic artery[OA]. Endovascular stent placement in both patients resulted in normalization of the vessel lumen of the stenotic vessel segments. In addition, complete restoration of OA flow was noted immediately after stenting. Both patients showed no further episode of AMF over a follow-up period of 38 and 23 months respectively. Our clinical and angiographic findings suggest that hemodynamic Insufficiency in retinal vasculature caused by a stenosis of the cavernous or petrous ICA can be treated successfully by endovascular stent.

Infantile Dural Arteriovenous Fistula of the Transverse Sinus Presenting with Ocular Symptoms, Case Reports and Review of Literature

  • Sultan, Ahmed Elsayed;Hassan, Tamer
    • Journal of Korean Neurosurgical Society
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    • v.59 no.3
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    • pp.296-301
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    • 2016
  • Dural arteriovenous fistula (DAVF) of the transverse sinus with ophthalmic manifestations in young children are rare. We reviewed two cases of direct AVF of the transverse sinus with ocular manifestations managed at our institution. The first, a 2.5 years old male child presented with left exophthalmos. Angiography revealed AVF between the occipital artery and the transverse sinus. The second, a 2 years old female child, complained of left exophthalmos. Imaging studies showed bilateral direct AVFs of the transverse sinus with bilateral dysmaturation of the sigmoid sinus. Transarterial embolization was done in both cases. Clinical and radiological follow up revealed complete cure. This report suggests that DAVF of the transverse sinus supplied by the external carotid branches can present with ophthalmic manifestations especially if there is distal venous stenosis or obliteration involving sigmoid sinus. Transarterial embolization using coils and liquid embolic agents could be safe and feasible to obliterate the fistula.

Stent-assisted Angioplasty for Symptomatic Radiation-induced Carotid Stenosis

  • Kwon, Yoon-Kwang;Kim, Eal-Maan;Lee, Chang-Young
    • Journal of Korean Neurosurgical Society
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    • v.41 no.5
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    • pp.327-329
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    • 2007
  • A 44-year-old woman presented with recurrent, transient episodes of left-side hemiparesis. She had received a radiation dose of 6120 cGy to her cervical region for parotid gland carcinoma 13 years previously. Cerebral angiography revealed a long, irregular tight stenosis involving the right extracranial internal carotid artery [ICA] and common carotid artery [CCA], measuring approximately 90% at the most severe narrowing according to North American Symptomatic Carotid Endarterectomy Trial criteria. Endovascular stent placement resulted in restoration of the carotid lumen to about 80% of its original diameter. She showed no further ischemic events during the follow-up period of 48 months. Our clinical and angiographic findings suggest that carotid stenting is considered a safe and effective treatment option in patients with radiation-induced carotid stenosis.

Malignant Fibrous Histiocytoma of the Pulmonary Artery A Case Report (폐동맥에서 발생한 악성 섬유성 조직구종 1례 보)

  • 이재원
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.358-366
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    • 1987
  • A case of malignant fibrous histiocytoma [MFH] of left pulmonary artery was reported in the 27 year-old male. He was admitted because of hemoptysis for several times. Chest x-ray revealed nodular lesions in left hilar area and left upper lobe. A left thoracotomy was performed followed left upper lobectomy. The main tumor was originated from the pulmonary arterial bifurcation and proximal portion of the left pulmonary artery. By light microscopy, there were many pleomorphic giant cells, which displayed the storiform pattern. And in those area, dilated or compressed vascular channels were involved by tumor cells, suggesting origin of This tumor. Pulmonary artery angiography and chest CT revealed this tumor was originated from pulmonary artery. It would be the first reported primary malignant fibrous histiocytoma of the pulmonary artery in our country. Postoperative prognosis was uneventful, but recently he was suffered from dyspnea, that was noticed by OVD follow-up for 1 month, probably the heart failure sign due to pulmonary arterial flow obstruction.

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Surgical Treatment of Intracardiac Myxoma (심장 점액종의 외과적 치료)

  • 이선희
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1158-1167
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    • 1990
  • Since November 1979, 20 patients have undergone excision of an intracardiac myxoma, which was located in the left atrium in 18[90%], in the right atrium in 1[5%], and in the right ventricle in 1[5%], There were 17 female and 3 male patients with a mean age of 43.5 years [range 23 to 68 years]. Only one patient was asymptomatic, the others were seen mostly exertional dyspnea, palpitation, sings of systemic illness. Diagnosis was confirmed by echocardiography in all cases and angiography in two cases, preoperatively, The myxomas were successfully removed in all patients, either by shaving them from the atrial septum or by excising a portion of normal atrial septum with tumor. All heart chambers were carefully explored for presence of multi-centric myxoma or tumor debris. We conclude that excision of intracardiac myxoma is curative and long term survival is excellent and long term clinical and echocardiographic follow-up are recommended since late recurrence, although rare, has been reported.

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Contralateral Hemifacial Spasm Occurred Simultaneously in Acute Bell's Palsy (급성 벨마비와 동시에 발생한 반대측 반얼굴연축)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.7 no.2
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    • pp.117-120
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    • 2005
  • Hemifacial spasm (HFS) may develop after Bell's palsy (BP). But it was not reported that contralateral HFS occurred simultaneously in acute BP. A 25-year-old woman admitted with left HFS occurred simultaneously in acute right BP for 6 days. Past, family, and social history were unremarkable. Nerve conduction studies (NCS) and blink reflex (BR) test showed bilateral facial neuropathies. Brain MRI and cerebral angiography were normal. The symptoms and signs of HFS and BP were improved slowly after acyclovir and prednisolone therapy. Follow-up serial NCS and BR also showed a rapid improvement.

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Endovascular Treatment of a Large Partially Thrombosed Basilar Tip Aneurysm

  • Kim, Young-Joon;Ko, Jung-Ho
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.62-65
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    • 2012
  • Despite the remarkable developments in neurosurgical and neuro-interventional procedures, the optimal treatment for large or giant partially thrombosed aneurysms with a mass effect remains controversial. The authors report a case of a partially thrombosed aneurysm with a mass effect, which was successfully treated by stent-assisted coil embolization. A 41-year-old man presented with headache. Brain computed tomography depicted an $18{\times}18$ mm sized thrombosed aneurysm in the interpeducular cistern. More than 80% of the aneurysm volume was filled with thrombus and the canalized portion beyond its neck measured $6.8{\times}5.6$ mm by diagnostic cerebral angiography. Stent-assisted endovascular coiling was performed on the canalized sac and the aneurysm was completely obliterated. Furthermore, most of the thrombosed aneurysm disappeared in the interpeduncular cistern was clearly visualized follow-up brain magnetic resonance imaging conducted at 21 months. The authors report a case of selective coiling of a large, partially thrombosed basilar tip aneurysm.

Supraceliac Aorta Bypass Surgery For Juxtarenal Aortic Occlussive Disease -2 Cases - (신장근접 대동맥 폐색증의 상복강대동맥 우회술)

  • 오중환
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.105-111
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    • 1992
  • Total atherosclerotic obstruction of the juxtarenal abdominal aorta is a relatively rarely encountered form of atherosclerotic vascsular disease, accounting for less than 5% of all arterial obstrutive disease. We have encountered two patients with such lesions, both of whom were admitted for intermittent claudication of the lower extremities and symptoms of vascular ischemia. Digital subtraction angiography[DSA] was performed on both patients, the results of which revealed total obstruction of the aorta just inferior to the renal arteries without involving the latter. Operative technique involved the use of the sup-raceliac aorta as the site of proximal anastomosis of aortofemoral bypass followed by a fem-orofemoral bypass graft with Smm sized Woven Dacron[Vascutek] through a subcutaneous tunnel within the retroperitoneal space. Both patients experienced restoration of blood flow distal to the obstruction postoperatively without any complications, and OPD follow-up one month postoperatively and postoperative DSA showed evidence of continued graft patency with persistent symptomatic improvement.

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