• Title/Summary/Keyword: Brain Angiography

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Detection of Cerebrovascular Disease in a Child with Hutchinson-Gilford Progeria Syndrome Using MR Angiography: A Case Report (Hutchison-Gilford 조로증 증후군 환아에서의 뇌 자기공명 혈관조영술 소견: 증례 보고)

  • Jae Ho Lee;Ha Young Lee;Myung Kwan Lim;Young Hye Kang
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1360-1365
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    • 2022
  • Hutchinson-Gilford progeria syndrome (HGPS) is a rare, progressive, premature aging syndrome with early morbidity due to cardiovascular and cerebrovascular diseases. Clinical symptoms are very diverse, including non-specific symptoms such as growth retardation, scleroderma, alopecia, and osteoporosis, as well as hypertension and cardiovascular diseases that occur in childhood and adolescence due to accelerated vascular aging. In patients with HGPS, MR angiography is recommended for early diagnosis of asymptomatic stroke or vascular changes and to assess increased risk of cerebrovascular disease. We report the second domestic case of HGPS confirmed by genetic analysis in a 5-year-old child with typical clinical features, and the first English case report in Korea to present brain MR angiography findings.

Serious Blood-Brain Barrier Disruption after Coil Embolization of Unruptured Intracranial Aneurysm : Report of Two Cases and Role of Immediate Postembolization CT Scan

  • Lee, Kyung-Kyu;Kang, Dong-Hun;Kim, Yong-Sun;Park, Jae-Chan
    • Journal of Korean Neurosurgical Society
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    • v.50 no.1
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    • pp.45-47
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    • 2011
  • Abnormal contrast enhancement on brain computed tomography (CT) scan after diagnostic or interventional angiography is not rare, and has known to be induced by temporary blood-brain barrier (BBB) disruption from contrast media. Furthermore, it has been regarded as clinically subtle, but reported to have no symptom or mild transient symptoms. However, we recently experienced two cases of serious BBB disruption during the acute period after coiling of an unruptured intracranial aneurysm. One patient presented with an unruptured paraclinoid internal carotid artery (ICA) aneurysm on the right and the other with an unruptured right supraclinoid ICA aneurysm. Both patients showed similar findings on immediate postembolization CT scan and clinical courses after coiling. Typical radiological, clinical characteristics of BBB disruption were described. In addition, the role of immediate postembolization CT scan are also discussed.

Contralateral Cerebral Infarction after Stent Placement in Carotid Artery : An Unexpected Complication

  • Park, Seong-Ho;Lee, Chang-Young
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.159-162
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    • 2008
  • Stenting is a useful alternative treatment modality in carotid artery stenosis patients who are too high-risk to undergo carotid endarterectomy (CEA). We report a case of contralateral cerebral infarction after stenting for extracranial carotid stenosis. A 78-year-old woman was admitted to the hospital with left-sided weakness. Based on magnetic resonance imaging (MRI) of the brain and conventional angiography, she was diagnosed with an acute watershed infarct of the right hemisphere secondary to severe carotid stenosis. Stenting was performed for treatment of the right carotid artery stenosis after a one-week cerebral angiogram was completed. Thirty minutes after stent placement, the patient exhibited a generalized seizure. Four hours later, brain MRI revealed left hemispheric cerebral infarction. Complex aorta-like arch elongation, tortuosity, calcification, and acute angulation at the origin of the supra-aortic arteries may increase the risk of procedural complications. In our case, we suggest that difficult carotid artery catheterization, with aggressive maneuvering during stenting, likely injured the tortuous, atherosclerotic aortic arch, and led to infarction of the contralateral cerebral hemisphere by thromboemboli formed on the wall of the atherosclerotic aorta.

Visualization of Brain Vessel for MRA Image (MRA영상에서 뇌혈관의 가시화)

  • 김영철;김령주;남상희;문치웅;최흥국
    • Proceedings of the Korea Multimedia Society Conference
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    • 2002.05c
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    • pp.286-289
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    • 2002
  • 뇌 혈관 영상은 2D로 되어있어 임상에서 뇌의 이상 유무와 질병의 진행 정도를 판별하는데 어려움이 있다. Volume Rendering은 2차원 데이터를 3차원 영상으로 재구성하여 오브젝트의 내부 모습을 3차원으로 볼 수 있게 해주는 장점이 있어 진단에 도움을 줄 수가 있다. MRA(Magnetic Resonance Angiography) 는 MRI(Magnetic Resonance Imaging)을 이용하여 Vascular Imaging 하는 기법이다. MRA 혈관 영상을 가시화하는 방법으로 MIP(Maximum Intensity Projection)를 이용하였다. 본 논문에서는 256×256 크기의 MRA영상 48장을 MIP 로 볼륨 랜더링하여 뇌 혈관 영상을 3차원으로 가시화 하였다.

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Dynamic Computed Tomography based on Spatio-temporal Analysis in Acute Stroke: Preliminary Study (급성 뇌졸중 환자의 시공간 분석 기법을 이용한 동적 전산화 단층 검사: 예비 연구)

  • Park, Ha-Young;Pyeon, Do-Yeong;Kim, Da-Hye;Jung, Young-jin
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.543-547
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    • 2016
  • Acute stroke is a one of common disease that require fast diagnosis and treatment to save patients life. however, the acute stroke may cause lifelong disability due to brain damage with no prompt surgical procedure. In order to diagnose the Stroke, brain perfusion CT examination and possible rapid implementation of 3D angiography has been widely used. However, a low-dose technique should be applied for the examination since a lot of radiation exposure to the patient may cause secondary damage for the patients. Therefore, the degradation of the measured CT images may interferes with a clinical check in that blood vessel shapes on the CT image are significantly affected by gaussian noise. In this study, we employed the spatio-temporal technique to analyze dynamic (brain perfusion) CT data to improve an image quality for successful clinical diagnosis. As a results, proposed technique could remove gaussian noise successfully, demonstrated a possibility of new image segmentation technique for CT angiography. Qualitative evaluation was conducted by skilled radiological technologists, indicated significant quality improvement of dynamic CT images. the proposed technique will be useful tools as a clinical application for brain perfusion CT examination.

The Role of Postoperative Magnetic Resonance Imaging of Microvascular Decompression of the Facial Nerve in Patients with Hemifacial Spasm (반측성 안면경련증 환자에서 안면신경의 미세혈관감압술 후에 시행한 자기공명영상의 역할)

  • Han, In Bo;Chang, Jong Hee;Chang, Jin Woo;Park, Yong Gou;Kim, Dong Ik;Chung, Sang Sup
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.44-50
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    • 2001
  • Objectives : The objective of this study was to investigate the role of postoperative three dimensional short-range magnetic resonance angiography(3D-TOF MRA) in predicting the clinical outcomes following microvascular decompression(MVD) for the treatment of a hemifacial spasm(HFS). Material and Method : Postoperative magnetic resonance(MR) imaging was performed on 123 patients with a HFS between March 1999 and May 2000. All patients who had postoperative MR imaging were undertaken preoperative MR imaging. Of the 123 patients, 122 patients were included in this retrospective study. The degree of the detachment of vascular contact, and change of the position of offender were determined by pre- and postoperative 3D-TOF MRA. These findings were compared with the surgical findings and clinical outcomes. Results : Of 122 patients who had successful MVD, clear decompression of offenders of the root entry zone(REZ) of facial nerve was found in 106 patients(86.9%), partial decompression in 10 patients(8.2%) and contact of offenders to the REZ of facial nerve in 6 patients(4.9%) by the postoperative 3D-TOF MRA. Our patients demonstrated that the types of offender did not influence with the degree of decompression of REZ of facial nerve and with surgical outcomes(p>0.05). Also, there was no significant relationship between the degree of decompression of the REZ of facial nerve from offenders and an improvement of symptoms(p>0.05). Futhermore, there was no significant relationship between the degree of decompression of the REZ of facial nerve from offenders and an improvement time (p>0.05). Conclusion : Our data suggests that MVD of facial nerve alone may not be sufficient to resolve the symptoms in all patients with hemifacial spasm. Therefore, another unknown factors besides vascular compression may be involved to cause symptoms in certain patients and it may be necessary to remove these factors with MVD simultaneously to obtain the resolution of symptom.

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"Misery Collaterals" as Poor Angiographic Findings - Definition, Classification, and Practical Application -

  • Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.159-163
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    • 2006
  • Objective : Unique Internal carotid artery angiographic findings have been found especially in very poor grade aneurysmal subarachnoid hemorrhage[SAH] patients before and during the endovascular coiling. The author investigates their patterns and classifies them into lour subtypes. Methods : Among Hunt&Hess grade IV, V SAH patients, the author could gather eight patients who showed abnormal intracranial circulation in cerebral catheter-based angiography. Results : The author introduces new term 'misery collaterals' first and has classified them into four types with the case illustrations. Type 1 is the worst condition defined as almost no intracranial circulation. Type 2 is the condition of little intracranial circulation with contrast filling just only at vessels of brain base, type 3 is of no or little cortical circulation with contrast filling at bilateral large vessels of brain base through circle of Willis channel and type 4 is of visible bilateral cortical circulation but delayed intracranial circulation time. The prognosis of these eight patients showed misery collaterals were disappointed. Conclusion : These finding can be used as the supportive information in deciding a management plan in poor grade SAH patients.

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.