• Title/Summary/Keyword: internal carotid artery

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Augmentation of the Patency of an Extracranial-Intracranial Bypass Accompanied by the Occlusion of an Intracranial Stenotic Lesion

  • Lee, Jae-Hyun;Joo, Sung-Pil;Lee, Jung-Kil;Kim, Tae-Sun
    • Journal of Korean Neurosurgical Society
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    • v.41 no.3
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    • pp.200-203
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    • 2007
  • We describe a case that showed augmention of the superficial temporal artery [STA] pedicle's patency 15 months after extracranial to intracranial [EC-IC] bypass surgery for a carotid artery occlusion with contralateral intracranial internal carotid artery stenosis. It is rare that meager patency of the STA pedicle in the early postoperative angiogram can be become well augmented with time where most branches of the middle cerebral artery [MCA] are robustly filled with blood from the STA. A 28-year-old woman with a history of a previous left hemispheric stroke presented with slurred speech after several bouts of seizure. Magnetic resonance imaging showed a new infarct on the right hemisphere in addition to an old infarct on the left hemisphere. Carotid angiography revealed stenosis of the right carotid siphon and occlusion of the left carotid artery. The patient underwent EC-IC bypass on the right side. Even though the early postoperative angiogram showed meager filling of MCA with no significant stenotic lesion change, a subsequent angiogram taken 15 months later, demonstrated a widely patent STA pedicle with occlusion of the previous intracranial stenotic lesion. Selected cases with an inaccessible intracranial stenotic lesion can benefit from EC-IC bypass surgery; however, its clear indication should first be established.

Nontraumatic Extracranial Carotid Artery Aneurysm (비외상성 경동맥류)

  • Kim Bum-Joon;Choi Jong-Ouck;Chung Keun;Kim Yong-Whoan;Choi Geon
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.90-93
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    • 1997
  • Aneurysm of extracranial carotid artery which usually originated from trauma, but it can be developed by atheroscrelosis, infection and congenital vascular disease, is defined as abnormal dilatation of intimal wall of carotid artery. The proper management should not be delayed due to occurrence of high neulorogic complication. Recently the authors experienced a case of nontraumatic extracranial internal carotid artery aneurysm, which was successfully resected using intraoperative EEG monitoring for the prevention of ischemic attack and was reconstructed with end to end anastomosis using nylon 9 - 0. On postoperative day #13, we could confirm well healed aneurysmal site and normal blood flow in the view of arteriography.

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Occlusion of the Internal Carotid Artery due to Intracranial Fungal Infection

  • Kim, Joo-Pyung;Park, Bong-Jin;Lee, Mi-Suk;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.49 no.3
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    • pp.186-189
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    • 2011
  • In recent years the immunocompromised population has increased rapidly to include people with acquired immune deficiency syndrome (AIDS), drug abusers, and transplant patients. Accordingly, the incidence of intracranial fungal infection has increased. Our institution experienced 2 cases of internal carotid artery (ICA) occlusion due to invasion of the cavernous sinus by an intracranial fungal infection. The first case was a 60-year-old man who presented with headache, eye pain, conjunctival injection, right-sided diplopia, and blurred vision. Infected tissues within the frontal and ethmoid sinuses were removed via bifrontal craniotomy and endoscopic sinus surgery through the Caldwell Luc approach. The second case was a 63-year-old woman who developed right-sided facial pain after a tooth extraction. The infection was not controlled despite continuous use of antifungal agents, resulting in death from sepsis. We believe that when intracranial fungal infection is suspected in a patient with orbital symptoms and a focal neurologic deficit, immediate angiographic investigation of possible ICA occlusion is warranted. Aggressive treatment with antifungal agents is the only way to improve prognosis.

A Study on High-Resolution Technique in MRI Scan for Cerebral Aneurysm Disease -Comparison between High-Resolution Technique and Standard Technique- (뇌 동맥류 질환 자기공명검사에서 고분해능(High-Resolution) 기법의 관한 연구 - 고분해능기법과 표준기법 비교 -)

  • Choi, Sung-Hyun;Goo, Eun-Hoe;Hwang, Sun-Kwang;Lee, Gang-Won;Lee, Jong-Woong
    • Korean Journal of Digital Imaging in Medicine
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    • v.14 no.1
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    • pp.7-12
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    • 2012
  • The purpose of this study was to examine usefulness of 3T equipment-based time-of-flight magnetic resonance angiography (3T-TOF MRA) by comparing standard technique (ST) with high resolution technique (HRT) in evaluation of cerebral blood vessel. The 3T-TOF MRA was performed for 31 patients who were suspected of having cerebrovascular disease from March to July 2010. For evaluation of cerebral blood vessel, classification was conducted randomly: group I that included vertebral artery and basilar artery, group II that ranged from 2.5cm before basin part of common carotid artery to basin part of internal and external carotid arteries and to genu part of internal carotid artery, group III that ranged from vertebral part of internal carotid artery to the first basin art of anterior and middle cerebral through education recognizes the importance of dose reduction and examine if their efforts and further reduce patient dose could achieve optimization of the medical exposure is considered.

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Posterior Cerebral Artery Territorial Hemorrhage Including Thalamus After Carotid Artery Stenting : A Case Report (목동맥 스텐트 삽입술 후 시상을 포함한 후대뇌동맥 영역에 발생한 뇌출혈 : 증례보고)

  • Yi, SangHak;Hwang, Yong;Lee, Hak Seung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.456-461
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    • 2018
  • Carotid artery stenting (CAS) has emerged as an alternative treatment for carotid stenosis in patients poorly suited for endarterectomy. Intracerebral hemorrhage following carotid revascularization (endarterectomy, angioplasty, artery stenting) is rare and thought to be related to reperfusion injury in most cases. Early experience suggests an increased incidence of hemorrhage following CAS as compared to endarterectomy. In this study, data were obtained through a case report on an 80-year-old male patient with cerebral infarction. The 80-year-old hypertensive man developed sudden monoparesis in the left arm. He underwent CAS for 90% stenosis of the left proximal internal carotid artery. Brain CT after procedure showed acute hematoma with left posterior cerebral artery territorial hemorrhage, including the upper thalamus with extended intraventricular hemorrhage (IVH). Since this hemorrhage occurred in vascular territory unlikely to have been supplied by the treated artery, this case suggests that the mechanism of intracerebral hemorrhage following CAS may in some cases be different from hyperperfusion hemorrhage classically described following endarterectomy.

Clinical study on the estimation of blood flow velocity using doppler ultrasound of the cerebral artery in stroke patients (도플러 초음파를 이용한 중풍환자(中風患者)의 뇌혈관(腦血管) 혈류측정(血流測定)에 관한 임상적(臨床的) 연구(硏究) (경동맥(頸動脈), 추골동맥(椎骨動脈) 및 기저동맥(基底動脈)을 중심으로))

  • Chang, In-Su;Sun, Jungn-Ki
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.345-360
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    • 1996
  • Background and Purpose: To evaluate the blood flow velocity using doppler ultrasound of the carotid artery, vertebral artery, and basilar artery in stroke patients Material and Methods: To evaluate the blood flow, I measured the peak systolic velocity and mean velocity of the common carotid artery(CCA), internal carotid artery(ICA), external carotid artery (ECA). vertebral artery(VA), and basilar artery(BA) in 44 stroke patients and 15 healthy adults. To investigate the difference between ischemic stroke patients and normal healthy adults, I selected 44 ischemic stroke patients diagnosed by brain CT and brain MRI, and 15 healthy adults who did not have any symptoms of stroke, hypertension, heart disease, and diabetes melitus. Results: Peak velocity in normal adults was 50.6${\pm}$1.6cm/sec in the CCA, 67.2${\pm}$1.7cm/sec in the ICA, 62.5${\pm}$2.4cm/see in the ECA, 45.5${\pm}$1.9cm/sec VA. and 50.5${\pm}$3.5cm/sec in the BA. Mean velocity in normal adults was 26.9${\pm}$1.1cm/sec in the CCA, 43.7${\pm}$1.4cm/sec in the ICA, 26.7${\pm}$1.3cm/sec in the ECA. 31.6${\pm}$1.9cm/sec in the VA and 33.0${\pm}$2.6cm/sec in the BA. In this study, there was a significant increase in the velocity of ICA, ECA, and VA of ischemic stroke patients in comparison with normal healthy adults. And the blood flow velocity of this study in the CCA and ECA was different from other reported foreign values and the other known values in my country. Conclusion: There was a significant difference in the blood flow velocity between ischemic stroke patients and normal healthy adults. And the blood flow velocity of this study was different from other reported foreign values and the other known values in my country. Therefore, it needs more detailed studies about old aged Korean and ischemic stroke patients than previous studies.

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The Evaluation of Carotid Artery Stenosis Using Spiral CT. (Spiral CT를 이용한 경동맥 질환의 평가)

  • Yoon, Hee-Suk;Hwang, Yun-Chean;Shin, Hyun-Kil;Beak, Cheon-Ki;Yoon, Suck-Min
    • Journal of radiological science and technology
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    • v.19 no.2
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    • pp.45-49
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    • 1996
  • To determine the utility of spiral computed tomography(CT) in the evaluation of carotid artery stenosis, spiral CT images of 10 patients were compared with both ones of conventional angiography and magnetic resonance(MR) angiography. The severeness of stenosis was determined for each Internal carotid artery on the basis of arterial narrowness : mild stenosis : 40 % or less, moderate stenosis = $40{\sim}70%$, severe stenosis = greater than 70 % of arterial narrowness. The short examination and clear depiction of the arterial lumen In areas of complex or low flow make CT angiography attractive alternative to MR angiography. Spiral CT angiography shows normal and abnormal carotid anatomy well when compared with conventional anglography.

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Both Carotid Endarterectomy in Obstrution of Carotid Arteries and Bypass Graft with Kidney Preservation in Obstrution of Abdominal AoRta -A Report of Case (양측 경동맥협착의 혈관내막절제수술 및 신장보호액 주입을 이용한 복부대동백 폐색 수술 치험 -1례 보고-)

  • 김병철;편승환
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.625-630
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    • 1997
  • A 56 years old male patient adklitted to our neurology department because of repeated tingling sensation in right 3, 4, 5th. (infers and weakness on grasping, which were progressively developed re ently. At this time, he had also suffered from claudication in both lower extremities. Carotid angiogram showed that right internal carotid artery was obstructed completely, and both common, both external and left internal carotid arteries had significant stenosis, Concommitantly, aortogram suggested complete obstruction just below the renal arteries. We plamled staged operation for two separated arterial lesions. Both carotid endarterectomy was performed. and we used carotid shunt for left side during operation. Abdominal aortic lesion was operated 2 weeks later We obligately clamped aorta just below the celiac artery and infuse4 kidney perservation solution to pertect kidney during ischemia. Reversed Y bypass graft and kidney perservation was successful despite of 40 minute ischemia. Postoperative courts was uneventful and patient was discharged without any specific problem.

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Development of 'De novo' Aneurysm after Therapeutic Carotid Occlusion

  • Jin, Sung-Chul;Choi, Choong-Gon;Kwon, Do-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.236-239
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    • 2009
  • Carotid occlusion is an inevitable therapeutic modality for the treatment of complex aneurysms such as giant, traumatic, and intracavernous aneurysms. Late complications of carotid occlusion include 'de novo' aneurysm formation at a distant site because of hemodynamic changes in the circle of Willis. We report a case of de novo aneurysm in a vessel that appeared to be normal on initial angiography. The patient developed an anterior communicating artery aneurysm and marked growth of a basilar bifurcation aneurysm 9 years after trapping of the left internal carotid artery for the treatment of a ruptured large saccular aneurysm involving ophthalmic and cavernous segments. We propose that patients who undergo therapeutic carotid occlusion should be periodically followed by magnetic resonance angiography or computed tomographic angiography to evaluate the possibility of de novo aneurysm formation; this advice is in line with previous reports.

Optimal Region of Interest Location of Test Bolus Technique in Extra Cranial Carotid Contrast Enhanced Magnetic Resonance Angiography

  • Choi, Kwan-Woo;Na, Sa-Ra;Son, Soon-Yong;Jeong, Mi-Ae
    • Journal of Magnetics
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    • v.22 no.2
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    • pp.234-237
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    • 2017
  • This study is aimed to optimize a location of region of interest (ROI) in test bolus carotid contrast enhanced magnetic resonance angiography (CE-MRA) at 3.0T. A total of consecutive 270 patients with no cardiovascular and vessel diseases were selected. Patients underwent elliptical centric 3D CE-MRA with the test bolus technique to identify the individual arterial arrival time. Quantitative measurements were performed by drawing ROIs of $25mm^2$ and signal intensities (SI) were measured in the center of common carotid artery (CCA), internal carotid artery (ICA) and aortic arch (AA). As a result, ROIs located within AA showed a significantly clarified arterial peak and over three times increased SI, while no significant arterial peak time differences were observed compared to ROIs located within CCA. In conclusion, it was demonstrated that the aortic arch is the optimal position to locate ROI in test bolus images of the carotid CE-MRA.