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Sample records for cervical artery dissection

  1. Cervical artery dissection following a turbulent flight.

    LENUS (Irish Health Repository)

    Quinn, Colin

    2012-01-31

    BACKGROUND: Cervical artery dissection is a common cause of stroke in young patients without vascular risk factors and may affect the carotid or vertebral arteries. The risk of spontaneous dissection is higher in those with genetic predisposing factors while other cases may be precipitated by an event involving head or neck movement or associated with direct neck trauma. CASE REPORT: We present the case of a previously well young woman with a history of migraine who developed internal carotid artery dissection following a turbulent short-haul commercial flight while restrained using a seatbelt. DISCUSSION: We propose that repetitive flexion-hyperextension neck movements encountered during the flight were the most likely precipitant of carotid artery dissection in this case and review the therapeutic options available.

  2. Spontaneous Cervical Artery Dissection: The Borgess Classification

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    Firas eAl-Ali

    2013-09-01

    Full Text Available ABSTRACTBackground and Purpose: The pathogenesis of spontaneous cervical artery dissections (sCAD and its best medical treatment are debated. This may be due to a lack of clear classification of sCAD. We propose the new Borgess classification of sCAD, based on the presence or absence of intimal tear as depicted on imaging studies and effect on blood flow. Materials and Methods: This is a single-center investigator-initiated registry on consecutive patients treated for sCAD. In the Borgess classification, type I dissections have intact intima and type II dissections have an intimal tear. Results: Forty-four patients and 52 dissected arteries were found. Forty-nine of 52 dissections (93% were treated with dual anti-platelet therapy. Twenty-one of 52 dissections were type I; 31 were type II. Type I dissections were more likely to present with ischemic symptoms (stroke, TIA (p=0.001. More type I dissections occurred in the vertebral artery, while more type II dissections occurred in the internal carotid artery (p

  3. [Medical management of cervical arterial dissections].

    Science.gov (United States)

    Vuillier, F; Tatu, L; Moulin, T

    2002-12-01

    Medical management of cervical arterial dissections is not standardized and has not been the subject of randomized trials. Management is mainly based on the presumed pathophysiology of secondary cerebral infarcts associated with dissections and the individual experience of each treating team. First, a review of the literature regarding medical management of acute and chronic dissections is presented. Then, results from a national study sponsored by the Société Française Neuro-Vasculaire and the Société Française de Neuro-Radiologie evaluating the medical management of this pathology in French neuro-vascular centers will be presented. These data will be useful to generate practical management recommendations and establish guidelines for further studies.

  4. Acute headache and persistent headache attributed to cervical artery dissection

    DEFF Research Database (Denmark)

    Schytz, Henrik W; Ashina, Messoud; Magyari, Melinda

    2014-01-01

    The criteria for headache attributed to cervical artery dissection have been changed in the new third edition of the International Classification of Headache Disorders (ICHD-III beta). We have retrospectively investigated 19 patients diagnosed from 2001 to 2006 with cervical artery dissection...... at onset and followed them up six months after dissection. At dissection onset 17/19 patients were classified as headache probably attributed to vascular disorder at the time of dissection using the ICHD second edition (ICHD-II) criteria. In contrast, 17/19 of patients fulfilled the ICHD-III beta criteria......-III beta criteria for cervical artery dissection are useful for classifying patients at the first encounter. We show for the first time that persistent headache attributed to arterial dissection is frequent....

  5. Dissection of a non-bifurcating cervical carotid artery.

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    Nas, Omer Fatih; Karakullukcuoglu, Zeynel; Hakyemez, Bahattin; Erdogan, Cuneyt

    2016-06-01

    A non-bifurcating cervical carotid artery is a rare anomaly in the population. Radiologic diagnosis of pathologies seen together with this anomaly can be challenging. Despite not being diagnostic all the time, digital subtraction angiography is accepted as the gold standard method for the diagnosis of dissection. We present a case of a non-bifurcating cervical carotid artery and concomitant dissection, which presented to the hospital with trauma and ischemic findings.

  6. CrossFit-related cervical internal carotid artery dissection.

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    Lu, Albert; Shen, Peter; Lee, Paul; Dahlin, Brian; Waldau, Ben; Nidecker, Anna E; Nundkumar, Anoop; Bobinski, Matthew

    2015-08-01

    CrossFit is a high-intensity strength and conditioning program that has gained popularity over the past decade. Potential injuries associated with CrossFit training have been suggested in past reports. We report three cases of cervical carotid dissection that are associated with CrossFit workouts. Patient 1 suffered a distal cervical internal carotid artery (ICA) dissection near the skull base and a small infarct in Wernicke's area. He was placed on anticoagulation and on follow-up has near complete recovery. Patient 2 suffered a proximal cervical ICA dissection that led to arterial occlusion and recurrent middle cerebral artery territory infarcts and significant neurological sequelae. Patient 3 had a skull base ICA dissection that led to a partial Horner's syndrome but no cerebral infarct. While direct causality cannot be proven, intense CrossFit workouts may have led to the ICA dissections in these patients.

  7. Cervical artery dissection: early recognition and stroke prevention.

    Science.gov (United States)

    Cadena, Rhonda

    2016-07-01

    Cervical artery dissections involve the carotid or vertebral arteries. Although the overall incidence is low, they remain a common cause of stroke in children, young adults, and trauma patients. Symptoms such as headache, neck pain, and dizziness are commonly seen in the emergency department, but may not be apparent in the obtunded trauma patient. A missed diagnosis of cervical artery dissection can result in devastating neurological sequelae, so emergency clinicians must act quickly to recognize this event and begin treatment as soon as possible while neurological consultation is obtained. This issue reviews the evidence in applying advanced screening criteria and choosing imaging and antithrombotic treatment strategies for patients with cervical artery dissections to reduce the occurrence of ischemic stroke.

  8. Juvenile Stroke: Cervical Artery Dissection in a Patient after a Polytrauma

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    Nicole Marschner-Preuth

    2013-01-01

    Full Text Available Dissections of the cervical arteries cause about 20% of total juvenile strokes. Approximately 4% of the carotid artery dissections are due to a (polytrauma such as car accidents. Despite improved diagnostic facilities, traumatic dissections are often underdiagnosed or diagnosed too late due to a lack of awareness of potential initial signs and symptoms.We report here a case of a delayed embolic stroke after a car accident caused by a dissection of the carotid artery and subsequent pseudoaneurysm.To reduce the long-term morbidity or mortality of multiple trauma patients, an early detection of cervical carotid and vertebral dissections is strictly necessary.

  9. Cerebrum-cervical arterial dissection in adults during sports and recreation

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    Yara Dadalti Fragoso

    2015-01-01

    Full Text Available Dissection of cervical arteries constitutes a medical emergency. Although relatively rarely, activities classified as sports and recreation may be a cause of arterial dissection independently of neck or head trauma. The purpose of the present paper was to present a series of cases of cerebrum-cervical arterial dissection in individuals during or soon after the practice of these sports activities.Methods Retrospective data on patients with arterial dissection related to sports and recreation.Results Forty-one cases were identified. The most frequently affected vessel was the vertebral artery. A large variety of activities had a temporal relationship to arterial dissection, and jogging was the most frequent of these. This is the largest case series in the literature.Conclusion Arterial dissection may be a complication from practicing sports.

  10. Common variation in PHACTR1 is associated with susceptibility to cervical artery dissection

    NARCIS (Netherlands)

    Debette, S.; Kamatani, Y.; Metso, T.M.; Kloss, M.; Chauhan, G.; Engelter, S.T.; Pezzini, S; Thijs, V.; Markus, H.S.; Dichgans, M.; Wolf, C.; Dittrich, R.; Touze, E.; Southerland, A.M.; Samson, Y.; Abboud, S.; Bejot, Y.; Caso, V.; Bersano, A.; Gschwendtner, A.; Sessa, M.; Cole, J.; Lamy, C.; Medeiros, E.; Beretta, S.; Bonati, L.H.; Grau, A.J.; Michel, P.; Majersik, J.J.; Sharma, P.; Kalashnikova, L.; Nazarova, M.; Dobrynina, L.; Bartels, E.; Guillon, B.; Herik, E.G. van den; Fernandez-Cadenas, I.; Jood, K.; Nalls, M.A.; Leeuw, H.F. de; Jern, C.; Cheng, Y.C.; Werner, I.; Metso, A.J.; Lichy, C.; Lyrer, P.A.; Brandt, T.; Boncoraglio, G.B.; Wichmann, H.E.; Gieger, C.; Johnson, A.D.; Bottcher, T.; Castellano, M.; Arveiler, D.; Ikram, M.A.; Breteler, M.M.; Padovani, A.; Meschia, J.F.; Kuhlenbaumer, G.; Rolfs, A.; Worrall, B.B.; Ringelstein, E.B.; Zelenika, D.; Tatlisumak, T.; Lathrop, M.; Leys, D.; Amouyel, P.; Dallongeville, J.

    2015-01-01

    Cervical artery dissection (CeAD), a mural hematoma in a carotid or vertebral artery, is a major cause of ischemic stroke in young adults although relatively uncommon in the general population (incidence of 2.6/100,000 per year). Minor cervical traumas, infection, migraine and hypertension are putat

  11. Anticoagulants versus antiplatelet drugs for cervical artery dissection: case for anticoagulants.

    Science.gov (United States)

    Norris, John W

    2013-02-01

    There are no reliable data from randomised trials to decide whether anticoagulants or antiplatelet agents are better to prevent further thromboembolic events after cervical arterial dissection. Most neurologists favour anticoagulants based on the underlying pathology and the likely course of acute post-dissection thromboembolism.

  12. Dissections of the cervical brain supplying arteries; Dissektionen der zervikalen hirnversorgenden Gefaesse

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    Jensen-Kondering, U. [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Klinik fuer Radiologie und Neuroradiologie

    2015-12-15

    Dissections of the cervical brain supplying arteries are rare but are an important cause of stroke in young and middle aged patients. Furthermore, recognition of dissections is crucial to prevent recurring embolic events by adequate choice of therapy. In this article the anatomical and pathophysiological basics, diagnostic and treatment options will be discussed with an emphasis on cross sectional imaging and typical imaging findings.

  13. Association of cervical artery dissection with connective tissue abnormalities in skin and arteries.

    Science.gov (United States)

    Brandt, T; Morcher, M; Hausser, I

    2005-01-01

    Spontaneous cervical artery dissections (sCAD) often occur in otherwise healthy individuals without known risk factors for stroke and frequently develop spontaneously without relevant trauma. An underlying arteriopathy leading to a so-called 'weakness of the vessel wall' and predisposing certain individuals to dissection has often been postulated. Therefore, the morphology of connective tissue, a main component of vessel wall and environment, was investigated in carotids and skin. While the overall morphology of dermal connective tissue is normal, about half of patients with sCAD show mild ultrastructural connective tissue alterations. These ultrastructural morphological aberrations can be designated either as 'Ehlers-Danlos syndrome (EDS) III-like', resembling mild findings in patients with the hypermobility type of EDS (EDS III); or coined 'EDS IV-like' with collagen fibers containing fibrils with highly variable diameters resembling mild findings in vascular EDS; or the abnormalities are restricted to the elastic fibers (with fragmentation and minicalcifications) without significant alterations in the morphology of the collagen fibrils. These findings had some similarity with the morphology found in heterozygous carriers of pseudoxanthoma elasticum. A grading scale according to the severity of the findings has been introduced. Similar connective tissue abnormalities were detected in some first-degree relatives of patients with sCAD showing hereditary at least in a subgroup. They can serve as a phenotypic marker for further genetic studies in patients with sCAD and large families to possibly identify the underlying basic molecular defect(s). Very few of patients (connective tissue abnormalities have clinical manifestations of skin, joint, or skeletal abnormalities of a defined heritable connective tissue disorder. In specimens of arterial walls of carotid, aortic, and renal arteries of patients with sCAD, pronounced systemic, histopathological, and

  14. Antiplatelets versus anticoagulants for the treatment of cervical artery dissection: Bayesian meta-analysis.

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    Hakan Sarikaya

    Full Text Available OBJECTIVE: To compare the effects of antiplatelets and anticoagulants on stroke and death in patients with acute cervical artery dissection. DESIGN: Systematic review with Bayesian meta-analysis. DATA SOURCES: The reviewers searched MEDLINE and EMBASE from inception to November 2012, checked reference lists, and contacted authors. STUDY SELECTION: Studies were eligible if they were randomised, quasi-randomised or observational comparisons of antiplatelets and anticoagulants in patients with cervical artery dissection. DATA EXTRACTION: Data were extracted by one reviewer and checked by another. Bayesian techniques were used to appropriately account for studies with scarce event data and imbalances in the size of comparison groups. DATA SYNTHESIS: Thirty-seven studies (1991 patients were included. We found no randomised trial. The primary analysis revealed a large treatment effect in favour of antiplatelets for preventing the primary composite outcome of ischaemic stroke, intracranial haemorrhage or death within the first 3 months after treatment initiation (relative risk 0.32, 95% credibility interval 0.12 to 0.63, while the degree of between-study heterogeneity was moderate (τ(2 = 0.18. In an analysis restricted to studies of higher methodological quality, the possible advantage of antiplatelets over anticoagulants was less obvious than in the main analysis (relative risk 0.73, 95% credibility interval 0.17 to 2.30. CONCLUSION: In view of these results and the safety advantages, easier usage and lower cost of antiplatelets, we conclude that antiplatelets should be given precedence over anticoagulants as a first line treatment in patients with cervical artery dissection unless results of an adequately powered randomised trial suggest the opposite.

  15. [Internal carotid artery dissection after Heimlich maneuver].

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    Rakotoharinandrasana, H; Petit, E; Dumas, P; Vandermarcq, P; Gil, R; Neau, J-Ph

    2003-01-01

    We report a case of cervical artery dissection following a Heimlich maneuver. Cervical artery dissections are at the present time well known and are sometimes associated with trivial traumas. However, to our knowledge, this complication of such maneuver was never reported in the literature. Pathophysiological mechanisms are discussed.

  16. Aberrations of dermal connective tissue in patients with cervical artery dissection (sCAD).

    Science.gov (United States)

    Uhlig, Phillip; Bruckner, Peter; Dittrich, Ralf; Ringelstein, E Bernd; Kuhlenbäumer, Gregor; Hansen, Uwe

    2008-03-01

    Spontaneous cervical artery dissection (sCAD) is a common cause of stroke in patients below 55 years of age. Hereditary connective tissue disorders, including Ehlers-Danlos syndrome type IV, have been associated with sCAD and suprastructural abnormalities of both collagen fibrils and elastic fibers have been found by transmission electron microscopy in the dermis of about 50% of sCAD patients. Here, we investigated dermal connective tissue abnormalities using a novel method. Transmission and immunogold electron microscopy were used to study mechanically generated fragments of dermal matrix suprastructures, in particular collagen fibrils. Analysis of dermal tissue of sCAD patients revealed structurally abnormal collagen fibrils with irregularly contoured surfaces and increased diameters, often associated with a faint or absent banding pattern. Interestingly, only a small number of fibrils displayed short abnormal sections along the length of the fibril. Collagens I and III were present in normal as well as abnormal sections of the fibrils.However, immunogold labeling for the two proteins was strongly increased in abnormal sections.A systematic blinded investigation of skin biopsies of 31 sCAD patients and 17 controls revealed abnormal collagen fibrils in 7 sCAD patients but none of the controls. We conclude that approximately 20% of sCAD patients show collagen fibril alterations, establishing a promising basis for further investigation of connective tissue aberrations in skin biopsies of sCAD patients.

  17. Different types of connective tissue alterations associated with cervical artery dissections.

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    Hausser, Ingrid; Müller, Uta; Engelter, Stefan; Lyrer, Philippe; Pezzini, Alessandro; Padovani, Alessandro; Moormann, Birgit; Busse, Otto; Weber, Ralf; Brandt, Tobias; Grond-Ginsbach, Caspar

    2004-06-01

    This study describes the technical handling and the diagnostic evaluation of skin biopsies in order to standardize the assessment of the delicate morphologic abnormalities that are found in patients with spontaneous cervical artery dissections (sCAD). Skin biopsies from 126 patients with sCAD and from 29 healthy relatives were analyzed. The morphology of the connective tissue was normal in 54 patients with sCAD (43%) and aberrant in 72 patients with sCAD (57%). These latter patients were classified into three groups: in 43 patients, we repeatedly observed composite collagen fibrils and elastic fibers with fragmentation and minicalcifications. In 13 further patients, the dermis was significantly thinner than in healthy subjects. The collagen fibers contained fibrils with highly variable diameters. In a third group of 16 sCAD patients, the abnormalities were restricted to the elastic fibers (with fragmentation and minicalcifications) without significant alterations in the morphology of the collagen fibrils. The finding of different morphologic classes of aberrations among patients suggests that the connective tissue defects are genetically heterogeneous. The segregation of the connective tissue phenotype in three families suggested an autosomal dominant pattern of inheritance.

  18. Spontaneous healing of cervical pseudoaneurysm in vertebral artery dissection under anticoagulant therapy

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    Sommer, A.; Neff, W.; Schwartz, A. [Department of Neurology, Klinikum Mannheim, Medical Faculty, University of Heidelberg, Theodor-Kutzer-Ufer 1, D-68132 Mannheim (Germany)

    1998-04-01

    We report a 41-year-old woman with embolic stroke of the mid-pons attributed to embolism from vertebral artery dissection. Angiography revealed an occluded artery on one side and an incidental pseudoaneurysm of the midcervical portion of the vertebral artery on the other. After 3 months of warfarin therapy control angiography showed complete occlusion of the pseudoaneurysm. We discuss therapeutic choices and review the literature. (orig.) With 4 figs., 8 refs.

  19. Wall stress of the cervical carotid artery in patients with carotid dissection: a case-control study.

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    Callaghan, Fraser M; Luechinger, Roger; Kurtcuoglu, Vartan; Sarikaya, Hakan; Poulikakos, Dimos; Baumgartner, Ralf W

    2011-04-01

    Spontaneous internal carotid artery (ICA) dissection (sICAD) results from an intimal tear located around the distal carotid sinus. The mechanisms causing the tear are unknown. This case-control study tested the hypotheses that head movements increase the wall stress in the cervical ICA and that the stress increase is greater in patients with sICAD than in controls. Five patients with unilateral, recanalized, left sICAD and five matched controls were investigated before and after maximal head rotation to the left and neck hyperextension after 45° head rotation to the left. The anatomy of the extracranial carotid arteries was assessed by magnetic resonance imaging and used to create finite element models of the right ICA. Wall stress increased after head movements. Increases above the 80th and 90th percentile were located at the intimal side of the artery wall from 7.4 mm below to 10 mm above the cranial edge of the carotid sinus, i.e., at the same location as histologically confirmed tears in patients with sICAD. Wall stress increase did not differ between patients and controls. The present findings suggest that wall stress increases at the intimal side of the artery wall surrounding the distal edge of the carotid bulb after head movements may be important for the development of carotid dissection. The lack of wall stress difference between the two groups indicates that the carotid arteries of patients with carotid dissection have either distinct functional or anatomical properties or endured unusually heavy wall stresses to initiate dissection.

  20. Internal carotid artery dissection after anterior cervical disc replacement: first case report and literature review of vascular complications of the approach.

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    Loret, Jean-Edouard; Francois, Patrick; Papagiannaki, Chrysanthi; Cottier, Jean-Philippe; Terrier, Louis-Marie; Zemmoura, Ilyess

    2013-07-01

    We report the case of a 41-year-old woman who underwent cervical total disc replacement at C4C5 and C5C6 levels and fusion at C6C7 level through an anterior right-side approach. After anesthesia recovery, the patient presented left hemiparesia and facial palsy due to large right hemispheric stroke. Diffusion-weighted magnetic resonance imaging was performed as soon as the patient developed neurologic symptoms of stroke and revealed a right internal carotid artery dissection. Digital substraction angiography, endovascular stenting, angioplasty and thrombectomy were performed. Six months after treatment, clinical examination showed mild left-arm spasticity. To the best of our knowledge, only two cases of internal carotid artery stroke without dissection or thrombosis are reported. In conclusion, although vascular complications are rare after anterior cervical spine procedure, internal carotid artery dissection can occur. Suspected risk factors are prolonged retraction of the carotid artery and neck extension.

  1. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.

    2014-01-01

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be

  2. Lower limb compartment syndrome by reperfusion injury after treatment of arterial thrombosis post-laparoscopic radical hysterectomy and pelvic lymph node dissection for cervical cancer

    Science.gov (United States)

    Yeon, Jihee; Jung, Ye Won; Yang, Shin Seok; Kang, Byung Hun; Lee, Mina; Ko, Young Bok; Yang, Jung Bo; Lee, Ki Hwan

    2017-01-01

    Compartment syndrome is a clinical condition associated with decreased blood circulation that can lead to swelling of tissue in limited space. Several factors including lithotomy position, prolonged surgery, intermittent pneumatic compressor, and reperfusion after treatment of arterial thrombosis may contribute to compartment syndrome. However, compartment syndrome rarely occurs after gynecologic surgery. In this case, the patient was diagnosed as compartment syndrome due to reperfusion injury after treatment of arterial thrombosis, which occurred after laparoscopic radical hysterectomy and pelvic lymph node dissection for cervical cancer. Despite its rarity, prevention and identifying the risk factors of complication should be performed perioperatively; furthermore, gynecologist should be aware of the possibility of complications. PMID:28344966

  3. Isolated superior mesenteric artery dissection

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    Lalitha Palle

    2010-01-01

    Full Text Available Isolated superior mesenteric artery (SMA dissection without involvement of the aorta and the SMA origin is unusual. We present a case of an elderly gentleman who had chronic abdominal pain, worse after meals. CT angiography, performed on a 64-slice CT scanner, revealed SMA dissection with a thrombus. A large artery of Drummond was also seen. The patient was managed conservatively.

  4. Spontaneous Coronary Artery Dissection.

    Science.gov (United States)

    Tweet, Marysia S; Gulati, Rajiv; Hayes, Sharonne N

    2016-07-01

    Spontaneous coronary artery dissection is an important etiology of nonatherosclerotic acute coronary syndrome, myocardial infarction, and sudden death. Innovations in the catheterization laboratory including optical coherence tomography and intravascular ultrasound have enhanced the ability to visualize intimal disruption and intramural hematoma associated with SCAD. Formerly considered "rare," these technological advances and heightened awareness suggest that SCAD is more prevalent than prior estimates. SCAD is associated with female sex, young age, extreme emotional stress, or extreme exertion, pregnancy, and fibromuscular dysplasia. The clinical characteristics and management strategies of SCAD patients are different than for atherosclerotic heart disease and deserve specific consideration. This review will highlight recent discoveries about SCAD as well as describe current efforts to elucidate remaining gaps in knowledge.

  5. Age determination of vessel wall hematoma in spontaneous cervical artery dissection: A multi-sequence 3T Cardiovascular Magnetic resonance study

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    Habs Maximilian

    2011-11-01

    Full Text Available Abstract Background Previously proposed classifications for carotid plaque and cerebral parenchymal hemorrhages are used to estimate the age of hematoma according to its signal intensities on T1w and T2w MR images. Using these classifications, we systematically investigated the value of cardiovascular magnetic resonance (CMR in determining the age of vessel wall hematoma (VWH in patients with spontaneous cervical artery dissection (sCAD. Methods 35 consecutive patients (mean age 43.6 ± 9.8 years with sCAD received a cervical multi-sequence 3T CMR with fat-saturated black-blood T1w-, T2w- and TOF images. Age of sCAD was defined as time between onset of symptoms (stroke, TIA or Horner's syndrome and the CMR scan. VWH were categorized into hyperacute, acute, early subacute, late subacute and chronic based on their signal intensities on T1w- and T2w images. Results The mean age of sCAD was 2.0, 5.8, 15.7 and 58.7 days in patients with acute, early subacute, late subacute and chronic VWH as classified by CMR (p Conclusions Signal intensities of VWH in sCAD vary over time and multi-sequence CMR can help to determine the age of an arterial dissection. Furthermore, findings of this study suggest that the time course of carotid hematomas differs from that of cerebral hematomas.

  6. Spontaneous isolated celiac artery dissection

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    Tuba Cimilli Ozturk

    2011-01-01

    Full Text Available Dyspepsia with mild, stabbing epigastric discomfort without history of trauma is a very common symptom that emergency physicians see in their daily practice. Vascular emergencies, mostly the aortic dissection and aneurysm, are always described in the differential diagnosis with persistent symptoms. Isolated celiac artery dissection occurring spontaneously is a very rare diagnosis. The involvement of branch vessels is generally observed and patients show various clinical signs and symptoms according to the involved branch vessel. Here we are presenting a case with spontaneous isolated celiac artery dissection, without any branch vessel involvement or visceral damage, detected by computed tomography scans taken on admission.

  7. Spontaneous internal carotid artery dissection.

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    Khimenko, L P; Esham, H R; Ahmed, W

    2000-10-01

    Once considered uncommon, spontaneous dissection of the carotid artery is an increasingly recognized cause of stroke, headache, cranial nerve palsy, or ophthalmologic events, especially in young adults. Even in the presence of existing signs and symptoms, the diagnosis can be missed by experienced physicians of all specialties. We report a case of spontaneous internal carotid artery dissection in a 38-year-old woman with a cortical stroke and visual disturbances as initial symptoms. The diagnosis was confirmed by magnetic resonance imaging/angiography and by angiography. Prompt anticoagulation was instituted, and the patient had complete resolution of symptoms. Cervicocephalic arterial dissection should be included in the differential diagnosis of the causes of cerebrovascular events.

  8. Dissecção espontânea cervical carotídea e verbal: estudo de 48 pacientes Spontaneous cervical carotid and vertebral arteries dissection: study of 48 patients

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    Cynthia Resende Campos

    2004-06-01

    Full Text Available OBJETIVO: Dada a ausência de estudos de séries brasileiras de pacientes com dissecção arterial cervical espontânea, com o objetivo de descrever os fatores de risco, sintomas precedentes, manifestações clínicas, resultados da investigação, tratamento e evolução. MÉTODO: realizamos a análise retrospectiva dos prontuários e laudos radiológicos [angiografia digital(AD, ressonância magnética(RM e ângio-ressonância(ARM] dos pacientes com esse diagnóstico atendidos no Serviço de Neurologia do HC/USP entre 1997 e 2003. RESULTADOS: 48 pacientes (24 homens, média de idade 37,9 anos; 26 pacientes com dissecção carotídea (DC unilateral, 15 com vertebral (DV unilateral e 7 com multiarterial, todos com déficits neurológicos. Os principais fatores de risco para doença vascular foram hipertensão arterial, tabagismo e dislipidemia. Mais de 80% apresentaram pelo menos um sintoma precedente, na maioria cefaléia têmporo-parietal. Cervicalgia foi referida por 44% dos pacientes com DV e por 3,4% dos com DC. O tempo médio entre o primeiro sintoma e o déficit foi 5,4 dias para as DC e 13,5 para as DV. AD foi o principal método diagnóstico (93%, associado a RM e ARM em 42% dos casos. Em 3 pacientes a RM cervical com supressão de gordura foi isoladamente suficiente. 75% dos pacientes receberam anticoagulação. Dois pacientes fizeram trombólise endovenosa sem complicações. A evolução foi boa, exceto por dois óbitos (DC bilateral. CONCLUSÃO: Os resultados são semelhantes aos da literatura, exceto pela baixa freqüência de cervicalgia nos casos de DC e pelo predomínio de cefaléia têmporo-parietal nas dissecções arteriais cervicais. Fatores de risco para doença vascular isquêmica foram frequentes.OBJETIVE: To report a Brazilian series of spontaneous cervical arterial dissections, risk factors, warning symptoms, clinical manifestations, diagnostic tests, treatment and prognosis. METHOD: We performed the retrospective

  9. Hemodynamic Impact of a Spontaneous Cervical Dissection on an Ipsilateral Saccular Aneurysm

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    See, Alfred P.; Penn, David L.; Du, Rose; Frerichs, Kai U

    2016-01-01

    The dynamic, hemodynamic impact of a cervical dissection on an ipsilateral, intracranial saccular aneurysm has not been well illustrated. This 45-year-old female was found to have a small, supraclinoid aneurysm ipsilateral to a spontaneous cervical internal carotid artery dissection. With healing of the dissection, the aneurysm appeared to have significantly enlarged. Retrospective review of the magnetic resonance imaging (MRI) at the time of the initial dissection demonstrated thrombus, similar in overall morphology to the angiographic appearance of the "enlarged" aneurysm. As the dissection healed far proximal to the intradural portion of the internal carotid artery, this suggested that the aneurysm was likely a typical, saccular posterior communicating artery aneurysm that had thrombosed and then recanalized secondary to flow changes from the dissection. The aneurysm was coiled uneventfully, in distinction from more complex treatment approaches such as flow diversion or proximal occlusion to treat an enlarging, dissecting pseudoaneurysm. This case illustrates that flow changes from cervical dissections may result in thrombosis of downstream saccular aneurysms. With healing, these aneurysms may recanalize and be misidentified as enlarging dissecting pseudoaneurysms. Review of an MRI from the time of the dissection facilitated the conclusion that the aneurysm was a saccular posterior communicating artery aneurysm, influencing treatment approach.

  10. Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature

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    Nadgir, R.N.; Ahmed, T. [University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States); Loevner, L.A.; Moonis, G.; Slawek, K.; Imbesi, S. [Neuroradiology Section, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States); Chalela, J. [Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States)

    2003-05-01

    Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation. (orig.)

  11. Spontaneous Coronary Artery Dissection with Cardiac Tamponade.

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    Goh, Anne C H; Lundstrom, Robert J

    2015-10-01

    Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome. Clinical presentation ranges from chest pain alone to ST-segment-elevation myocardial infarction, ventricular fibrillation, and sudden death. The treatment of patients with spontaneous coronary artery dissection is challenging because the disease pathophysiology is unclear, optimal treatment is unknown, and short- and long-term prognostic data are minimal. We report the case of a 70-year-old woman who presented with an acute ST-segment-elevation myocardial infarction secondary to a spontaneous dissection of the left anterior descending coronary artery. She was treated conservatively. Cardiac tamponade developed 16 hours after presentation. Repeat coronary angiography revealed extension of the dissection. Medical therapy was continued after the hemopericardium was aspirated. The patient remained asymptomatic 3 years after hospital discharge. To our knowledge, this is the first reported case of spontaneous coronary artery dissection in association with cardiac tamponade that was treated conservatively and had a successful outcome.

  12. Renal infarction resulting from traumatic renal artery dissection.

    Science.gov (United States)

    Kang, Kyung Pyo; Lee, Sik; Kim, Won; Jin, Gong Yong; Na, Ki Ryang; Yun, Il Yong; Park, Sung Kwang

    2008-06-01

    Renal artery dissection may be caused by iatrogenic injury, trauma, underlying arterial diseases such as fibromuscular disease, atherosclerotic disease, or connective tissue disease. Radiological imaging may be helpful in detecting renal artery pathology, such as renal artery dissection. For patients with acute, isolated renal artery dissection, surgical treatment, endovascular management, or medical treatment have been considered effective measures to preserve renal function. We report a case of renal infarction that came about as a consequence of renal artery dissection.

  13. Fatal dissection of the pulmonary artery in pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    B. Degano

    2009-09-01

    Full Text Available A 41-yr-old patient with chronic stable idiopathic pulmonary arterial hypertension (PAH presented with sudden chest pain and unusual dyspnoea during physical exertion. The patient had been diagnosed with PAH at the age of 12 yrs and was in New York Heart Association functional class I/II. The patient was being treated with an anticoagulant regimen, low-dose diuretics and continuous intravenous epoprostenol therapy. A computed tomography scan showed ancient massive thrombi in dilated central pulmonary arteries, which were not haemodynamically significant (perfusion lung scans did not demonstrate segmental or larger defects, and extensive dissection of the right pulmonary artery starting from the intermediate branch. Due to the extensiveness of the dissection, the patient was immediately considered for heart–lung transplantation, but died 72 h after the onset of symptoms. Permission for post mortem examination was denied. Pulmonary artery dissection should be suspected in PAH patients presenting with chest pain and worsening dyspnoea. In the current case, the factors possibly associated with increased risk for dissection may include dilatation of the pulmonary artery, local inflammation favoured by in situ thrombosis, and acute increase of pulmonary pressure secondary to physical exertion. Extensive pulmonary artery dissection is a life-threatening complication of PAH, and urgent heart/lung transplantation might be the treatment of choice in eligible patients. In addition, better identification of the risk factors for pulmonary artery dissection may help in considering transplantation for selected patients at risk.

  14. Bilateral vertebral artery dissection possibly precipitated in delayed fashion as a result of roller coaster rides.

    Science.gov (United States)

    Schneck, Michael; Simionescu, Monica; Bijari, Armita

    2008-01-01

    A 34-year-old woman presented with a 5-month history of persistent vertigo after multiple roller coaster rides, followed by neck pain for 1 month and then 2 weeks of blurred vision related to diplopia. She was ultimately found to have bilateral cervical vertebral artery dissection. The images are described and the literature is reviewed regarding late diagnosis of vertebral dissection and prior cases of roller coaster-associated dissection.

  15. "Ostrich sign" indicates bilateral vertebral artery dissection.

    Science.gov (United States)

    Rose, David Z; Husain, M Rizwan

    2012-11-01

    Vertebral artery dissections (VADs) comprise about 2% of ischemic strokes and can be associated with trauma, chiropractic manipulation, motor vehicle collisions, whiplash, amusement park rides, golfing, and other motion-induced injuries to the neck. We present a case of bilateral extracranial VAD as a complication of conducting an orchestra. To our knowledge, this has not been documented in the literature. Conceivably, vigorous neck twisting in an inexperienced, amateur conductor may place excessive rotational forces upon mobile portions of the verterbral arteries, tear the intima, deposit subintimal blood that extends longitudinally, and cause neck pain and/or posterior fossa ischemic symptoms. Magnetic resonance angiography examinations of axially oriented slices of bilateral VADs resemble the face of an ostrich. This observation is similar to the "puppy sign," in which bilateral internal carotid artery dissections resemble the face of a dog. Craniocervical dissections of either the carotid or vertebral arteries have the potential to form an aneurysm, cause artery-to-artery embolism, or completely occlude the parent artery, resulting in an ischemic stroke. Because bilateral VADs in axial magnetic resonance angiographic sections stand out like the eyes of an ostrich, and because the fast identification of VADs is so critical, we eponymize this image the "ostrich sign."

  16. Vertebral artery dissection with compelling evidence on duplex ultrasound presenting only with neck pain

    Directory of Open Access Journals (Sweden)

    Siepmann T

    2016-11-01

    Full Text Available Timo Siepmann, Monique Borchert, Kristian Barlinn Department of Neurology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany Abstract: Vertebral artery dissection (VAD is among the most common identifiable etiologies of stroke in young adults and poses a diagnostic challenge due to nonspecific symptoms and substantial variability of imaging results. Here, we present a case of unspecific neck pain as isolated symptom of VAD with unusually compelling evidence on duplex ultrasound. This observation has clinical relevance as the absence of any neurological symptoms in our patient highlights the necessity of considering cervical artery dissection in patients presenting with unspecific symptoms such as neck pain, even if isolated. Furthermore, our image of intramural hematoma on duplex ultrasound has been captured in an unusual, clear and distinct fashion and might therefore be a useful reference image in the clinical assessment of patients with a suspicion of cervical artery dissection. Keywords: vertebrobasilar, cervical, duplex sonography, magnetic resonance imaging

  17. Spontaneous Coronary Artery Dissection: The Phantom Menace

    Science.gov (United States)

    Spinthakis, Nikolaos; Abdulkareem, Nada; Farag, Mohamed; Gorog, Diana A.

    2016-01-01

    We present a case of a 66-year-old lady with chest pain, without dynamic 12-lead electrocardiographic (ECG) changes and normal serial troponin. Coronary angiography revealed a linear filing defect in the first obtuse marginal branch of the circumflex artery indicating coronary artery dissection, with superadded thrombus. She was managed medically with dual antiplatelet therapy and has responded well. Spontaneous coronary artery dissection (SCAD) is a rare cause of cardiac chest pain, which can be missed without coronary angiography. Unlike most other lesions in patients with unstable symptoms, where coronary intervention with stenting is recommended, patients with SCAD generally fare better with conservative measures than with intervention, unless there is hemodynamic instability. PMID:28197295

  18. Association between internal carotid artery dissection and arterial tortuosity

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Piga, Mario [Azienda Ospedaliero Universitaria (A.O.U.), Department of Radiology, Monserrato, Cagliari (Italy); Argiolas, Giovanni Maria; Siotto, Paolo [Azienda Ospedaliero Brotzu (A.O.B.), Department of Radiology, di Cagliari (Italy); Sumer, Suna; Wintermark, Max [Neuroradiology Division, Neuroradiology, UVA Department of Radiology, Charlottesville, VA (United States); Raz, Eytan [New York University School of Medicine, Department of Radiology, New York, NY (United States); Sapienza University of Rome, Department of Neurology and Psychiatry, Rome (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Department of Vascular Surgery, di Cagliari (Italy)

    2014-10-18

    Carotid artery dissection is an important cause of ischemic stroke in all age groups, particularly in young patients. The purpose of this work was to assess whether there is an association between the presence of an internal carotid artery dissection (ICAD) and the arterial tortuosity. This study considered 124 patients (72 males and 52 females; median age 57 years) with CT/MR diagnosis of ICAD of the internal carotid artery were considered in this multi-centric retrospective study. The arterial tortuosity was evaluated and, when present, was categorized as elongation, kinking, or coiling. For each patient, both the right and left sides were considered for a total number of 248 arteries in order to have the same number of cases and controls. Fisher's exact test was applied to test the association between elongation, kinking, coiling, dissection, and the side affected by CAD. Fisher's exact test showed a statistically significant association between the ICAD and kinking (p = 0.0089) and coiling (p = 0.0251) whereas no statistically significant difference was found with arterial vessel elongation (p = 0.444). ICAD was more often seen on the left side compared to the right (p = 0.0001). These results were confirmed using both carotid arteries of the same patient as dependent parameter with p = 0.0012, 0.0129, and 0.3323 for kinking, coiling, and elongation, respectively. The presence of kinking and coiling is associated with ICAD. (orig.)

  19. Spontaneous healing of spontaneous coronary artery dissection.

    Science.gov (United States)

    Almafragi, Amar; Convens, Carl; Heuvel, Paul Van Den

    2010-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and sudden cardiac death. It should be suspected in every healthy young woman without cardiac risk factors, especially during the peripartum or postpartum periods. It is important to check for a history of drug abuse, collagen vascular disease or blunt trauma of the chest. Coronary angiography is essential for diagnosis and early management. We wonder whether thrombolysis might aggravate coronary dissection. All types of treatment (medical therapy, percutaneous intervention or surgery) improve the prognosis without affecting survival times if used appropriately according to the clinical stability and the angiographic features of the involved coronary arteries. Prompt recognition and targeted treatment improve outcomes. We report a case of SCAD in a young female free of traditional cardiovascular risk factors, who presented six hours after thrombolysis for ST elevation myocardial infarction. Coronary angiography showed a dissection of the left anterior descending and immediate branch. She had successful coronary artery bypass grafting, with complete healing of left anterior descending dissection.

  20. Vertebral artery dissection with compelling evidence on duplex ultrasound presenting only with neck pain

    Science.gov (United States)

    Siepmann, Timo; Borchert, Monique; Barlinn, Kristian

    2016-01-01

    Vertebral artery dissection (VAD) is among the most common identifiable etiologies of stroke in young adults and poses a diagnostic challenge due to nonspecific symptoms and substantial variability of imaging results. Here, we present a case of unspecific neck pain as isolated symptom of VAD with unusually compelling evidence on duplex ultrasound. This observation has clinical relevance as the absence of any neurological symptoms in our patient highlights the necessity of considering cervical artery dissection in patients presenting with unspecific symptoms such as neck pain, even if isolated. Furthermore, our image of intramural hematoma on duplex ultrasound has been captured in an unusual, clear and distinct fashion and might therefore be a useful reference image in the clinical assessment of patients with a suspicion of cervical artery dissection. PMID:27843318

  1. A hitherto unreported disruption of cervical branches of facial artery

    Directory of Open Access Journals (Sweden)

    Sharma P

    2011-03-01

    Full Text Available According to its course, the branches of the facial artery are arranged under two headings; cervical component (branches in the digastric triangle and facial component (branches on the face.Variations in the branches of the facial component of the facial artery have been frequently studied and reported. However, variations in the cervical component are rare. A hitherto unreported variant of the cervical component of the facial artery was observed in a 55-year-old male cadaver during routine undergraduate dissection. The facial artery was arising from the external carotid artery as a common trunk with the lingual artery in the right carotid triangle and its ascending palatine and tonsillar branches were arising from the external carotid artery. It is important for surgeons and radiologists to be aware of the normal anatomy of the facial artery and the external carotid artery. Herein, we describe the detailed anatomical features of the variant branching pattern of the right facial artery and its clinical implications.

  2. Spontaneous Coronary Artery Dissection: Case Report Review of the Literature

    Directory of Open Access Journals (Sweden)

    Kemal Karaağaç

    2013-03-01

    Full Text Available Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome with a high risk of mortality. The clinical presentation is similar to the atherosclerotic coronary artery disease. The diagnosis is usually made by coronary angiography. Spontaneous coronary artery dissection is more common in women than men. Fast and accurate diagnosis and treatment of spontaneous coronary artery dissection patients improves survival. Therapeutic options include surgery, percutaneous coronary intervention and medical therapy.

  3. Pancreaticoduodenectomy with early superior mesenteric artery dissection

    Institute of Scientific and Technical Information of China (English)

    Yu-Fei Xu; Zuo-Jin Liu; Jian-Ping Gong

    2010-01-01

    BACKGROUND: Pancreatic adenocarcinoma remains the fourth leading cause of cancer-related death and is one of the most aggressive human tumors. At present, surgical resection is the only potentially curative treatment. Early neck division is inadequate when invasion of the superior mesenteric artery (SMA) is suspected or in cases of replaced or accessory right hepatic artery. Malignant periampullary tumors often invade retroperitoneal peripancreatic tissues and a positive resection margin is associated with a poor long-term survival. DATA SOURCES: English-language medical databases, PubMed, ELSEVIER and SPRINGERLINK, were searched for articles on"posterior approach pancreaticoduodenectomy","superior mesenteric artery ifrst approach", "retroperitoneal tissue","hanging maneuver", and related topics. RESULTS:The modiifcation allowed the surgeon to early identify the nonresectability of a replaced right hepatic artery if present, enabling complete dissection of the right side of the SMA and portal vein as well as complete excision of the retroportal pancreatic lamina. CONCLUSION: Pancreaticoduodenectomy with early retro-pancreatic dissection is a useful and safe technical variant, which is indicated for the improvement of the safety and curative effect of the procedure.

  4. Postcoital Internal Carotid Artery Dissection Presenting as Isolated Painful Horner Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Eren Gozke

    2013-01-01

    Full Text Available Postcoital artery dissection is a rare condition. Here we report a 40-year-old male patient with painful Horner syndrome related to postcoital internal carotid artery (ICA dissection. In neurologic examination of the patient, semiptosis, enophthalmus, and myosis were observed on the left side. There were no carotid bruits. On T1-weighted and fat-suppressed cranial MRI, hyperintensity consistent with intramural hematoma was observed within cervical and temporal petrous segments of left ICA. On cervical and cranial MRA, marked decrease in the calibration of C1 and C2 segments of the left ICA was remarkable. The patient was diagnosed as left ICA dissection and anticoagulant therapy was initiated. A prominent improvement was noted in clinical findings during two months of followup period.

  5. SMAD2 Mutations Are Associated with Arterial Aneurysms and Dissections

    NARCIS (Netherlands)

    Micha, D.; Guo, D.C.; Hilhorst-Hofstee, Y.; Kooten, F. van; Atmaja, D.; Overwater, E.; Cayami, F.K.; Regalado, E.S.; Uffelen, R. van; Venselaar, H.; Faradz, S.M.H.; Vriend, G.; Weiss, M.M.; Sistermans, E.A.; Maugeri, A.; Milewicz, D.M.; Pals, G.; Dijk, F.S. Van

    2015-01-01

    We report three families with arterial aneurysms and dissections in which variants predicted to be pathogenic were identified in SMAD2. Moreover, one variant occurred de novo in a proband with unaffected parents. SMAD2 is a strong candidate gene for arterial aneurysms and dissections given its role

  6. MRI and MR angiography of vertebral artery dissection

    Energy Technology Data Exchange (ETDEWEB)

    Mascalchi, M. [Cattedra di Radiologia, Universita di Pisa (Italy); Bianchi, M.C. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Mangiafico, S. [Servizio di Neuroradiologia, Ospedale di Careggi, Firenze (Italy); Ferrito, G. [Servizio di Neuroradiologia, Ospedali Riuniti, Livorno (Italy); Puglioli, M. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Marin, E. [Servizio di Radiologia, Ospedale S. M. Nuova, Firenze (Italy); Mugnai, S. [Clinica Neurologica, Universita di Firenze (Italy); Canapicchi, R. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Quilici, N. [Servizio di Neuroradiologia, Ospedali Riuniti, Livorno (Italy); Inzitari, D. [Clinica Neurologica, Universita di Firenze (Italy)

    1997-05-01

    A review of 4,500 angiograms yielded 11 patients with dissection of the vertebral arteries who had MRI and (in 4 patients) MR angiography (MRA) in the acute phase of stroke. One patient with incidental discovery at arteriography of asymptomatic vertebral artery dissection and two patients with acute strokes with MRI and MRA findings consistent with vertebral artery dissection were included. Dissection occurred after neck trauma or chiropractic manipulation in 4 patients and was spontaneous in 10. Dissection involved the extracranial vertebral artery in 9 patients, the extra-intracranial junction in 1, and the intracranial artery in 4. MRI demonstrated infarcts in the brain stem, cerebellum, thalamus or temporo-occipital regions in 7 patients with extra- or extra-intracranial dissections and a solitary lateral medullary infarct in 4 patients (3 with intracranial and 1 with extra-intracranial dissection). In 2 patients no brain abnormality related to vertebral artery dissection was found and in one MRI did not show subarachnoid haemorrhage revealed by CT. Intramural dissecting haematoma appeared as crescentic or rounded high signal on T1-weighted images in 10 patients examined 3-20 days after the onset of symptoms. The abnormal vessel stood out in the low signal cerebrospinal fluid in intracranial dissections, whereas it was more difficult to detect in extracranial dissections because of the intermediate-to-high signal of the normal perivascular structures and slow flow proximal and distal to the dissection. In two patients examined within 36 h of the onset, mural thickening was of intermediate signal intensity on T1-weighted images and high signal on spin-density and T2-weighted images. MRA showed abrupt stenosis in 2 patients and disappearance of flow signal at and distal to the dissection in 5. Follow-up arteriography, MRI or MRA showed findings consistent with occlusion of the dissected vessel in 6 of 8 patients. (orig.). With 7 figs., 3 tabs.

  7. Incidence of cerebral ischemia in patients with suspected cervical artery dissection: first results of a prospective study; Inzidenz zerebraler Ischaemien bei Patienten mit dem Verdacht einer spontanen Dissektion der extrakraniellen Arterien: Erste Ergebnisse einer prospektiven Studie

    Energy Technology Data Exchange (ETDEWEB)

    Nassenstein, I. [Westfaelische Wilhelms-Univ. Muenster (Germany). Leibniz-Inst. fuer Arteriosklerose-Forschung; Kraemer, S.C.; Niederstadt, T.; Stehling, C.; Bachmann, R. [Universitaetsklinikum Muenster (Germany). Inst. fuer Klinische Radiologie; Dittrich, R.; Ringelstein, E.B. [Westfaelische Wilhelms-Univ. Muenster (Germany). Klinik fuer Neurologie; Kuhlenbaeumer, G. [Westfaelische Wilhelms-Univ. Muenster (Germany). Leibniz-Inst. fuer Arteriosklerose-Forschung; Westfaelische Wilhelms-Univ. Muenster (Germany). Klinik fuer Neurologie; Heindel, W. [Westfaelische Wilhelms-Univ. Muenster (Germany). Leibniz-Inst. fuer Arteriosklerose-Forschung; Universitaetsklinikum Muenster (Germany). Inst. fuer Klinische Radiologie

    2005-11-15

    Purpose: Aim of this prospective study was to investigate the incidence of spontaneous cervical artery dissection (sCAD) and cerebral ischemia in patients with suspected sCAD by using a combined head-neck MR-imaging protocol. Materials and Methods: 51 consecutive patients (24 m, 27 f, mean age 39.5 years, range 18 - 55 yrs) admitted to our stroke unit with suspected sCAD according to clinical criteria and age <55 years underwent a combined head and neck MR examination within 24 hours of admission (Gyroscan Intera 1.5 T, Philips). Head MRI included ax FLAIR, ax T{sub 1}, ax DWI and TOF angiography (imaging time 12 min). Neck MRI consisted of ax T1w-TSE, T2w-TSE, contrast enhanced T1w-TSE and CE-MRA (imaging time 17 min). Three radiologists assessed both studies in consensus with regard to the presence of sCAD and acute ischemia. Results: One patient had to be excluded because of motion artefacts. In 17 of 50 patients sCAD was diagnosed, and in 20 of 50 patients cerebral ischemia. In 5 patients cerebral ischemia was caused by sCAD. Conclusion: The proposed combined MR protocol allows imaging work-up of patients with suspected sCAD within approximately 30 min, resulting in conclusive information about the status of the extracranial vasculature and the presence of ischemia. The high incidence of patients with definite sCAD and the low incidence of cerebral ischemia indicates the necessity of an early definite diagnosis in order to start timely anticoagulation to prevent development of stroke. (orig.)

  8. Pulmonary Artery Dissection: A Fatal Complication of Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Chuanchen Zhang

    2016-01-01

    Full Text Available Pulmonary artery dissection is extremely rare but it is a really life-threatening condition when it happens. Most patients die suddenly from major bleeding or tamponade caused by direct rupture into mediastinum or retrograde into the pericardial sac. What we are reporting is a rare case of a 46-year-old female patient whose pulmonary artery dissection involves both the pulmonary valve and right pulmonary artery. The patient had acute chest pain and severe dyspnea, and the diagnosis of pulmonary artery dissection was confirmed by ultrasonography and CT angiography. Moreover, its etiology, clinical manifestations, and management are also discussed in this article.

  9. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

    Directory of Open Access Journals (Sweden)

    Deniz Kamacı Şener

    2012-12-01

    Full Text Available Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  10. Spontaneous renal artery dissection complicating with renal infarction.

    Science.gov (United States)

    Tsai, Tsung-Han; Su, Jung-Tsung; Hu, Sung-Yuan; Chao, Chih-Chung; Tsan, Yu-Tse; Lin, Tzu-Chieh

    2010-12-01

    Spontaneous renal artery dissection (SRAD) is a rare entity. We reported a 30-year-old healthy man presenting with sudden onset of left flank pain. Abdominal plain film and sonography were unremarkable. The contrast-enhanced abdominal computed tomographic (CT) scan demonstrated a dissecting intimal flap of the left distal renal artery (RA) complicating infarction. Selective angiography of the renal artery disclosed a long dissection of left distal RA with a patent true lumen and occlusion of left accessory RA. Conservative treatment with control of blood pressure and antiplatelet agent was prescribed. The patient was discharged with an uneventful condition on day 5.

  11. Severe orthostatic hypotension due to unilateral carotid artery dissection

    Directory of Open Access Journals (Sweden)

    Nobuyuki Ishii

    2014-06-01

    Full Text Available A 46-year-old woman was admitted to our hospital with mild right-sided hemiparesis and orthostatic hypotension. Magnetic resonance angiography of the neck showed stenosis of the left distal carotid sinus surrounded by intraluminal hyperintensities on both T1-weighted and T2-weighted images, representing a periluminal hematoma secondary to carotid artery dissection. The dissection hyperextended the carotid artery wall and stimulated baroreceptors in the carotid sinus. The stimulated baroreceptors induced carotid sinus hypersensitivity, which may have been related to her orthostatic hypotension. Post-stroke orthostatic hypotension should prompt consideration of carotid artery dissection.

  12. Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy

    Directory of Open Access Journals (Sweden)

    Alexander L. Pan

    2012-01-01

    Full Text Available Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year-old female who developed two spontaneous coronary dissections while on topical hormonal replacement therapy. The patient had no other risk factors for coronary dissection. After withdrawal from topical hormonal therapy, our patient has done well and has not had recurrent coronary artery dissections over a one-year follow-up period. The potential contributory role of topical hormonal therapy as a cause of spontaneous coronary dissection should be recognized.

  13. SMAD2 Mutations Are Associated with Arterial Aneurysms and Dissections.

    Science.gov (United States)

    Micha, Dimitra; Guo, Dong-Chuan; Hilhorst-Hofstee, Yvonne; van Kooten, Fop; Atmaja, Dian; Overwater, Eline; Cayami, Ferdy K; Regalado, Ellen S; van Uffelen, René; Venselaar, Hanka; Faradz, Sultana M H; Vriend, Gerrit; Weiss, Marjan M; Sistermans, Erik A; Maugeri, Alessandra; Milewicz, Dianna M; Pals, Gerard; van Dijk, Fleur S

    2015-12-01

    We report three families with arterial aneurysms and dissections in which variants predicted to be pathogenic were identified in SMAD2. Moreover, one variant occurred de novo in a proband with unaffected parents. SMAD2 is a strong candidate gene for arterial aneurysms and dissections given its role in the TGF-β signaling pathway. Furthermore, although SMAD2 and SMAD3 probably have functionally distinct roles in cell signaling, they are structurally very similar. Our findings indicate that SMAD2 mutations are associated with arterial aneurysms and dissections and are in accordance with the observation that patients with pathogenic variants in genes encoding proteins involved in the TGF-β signaling pathway exhibit arterial aneurysms and dissections as key features.

  14. An interesting case report of vertebral artery dissection following polytrauma

    Directory of Open Access Journals (Sweden)

    Vikas Acharya

    2016-01-01

    Conclusion: Our report displays select images related to this case report and emphasizes the consideration of routine imaging in head and neck traumatic injuries to diagnose internal carotid and/or vertebral artery dissections much earlier.

  15. Spontaneous carotid artery dissection causing a juvenile cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Trattnig, S.; Huebsch, P.; Schindler, E.

    1988-11-01

    The case of a 19-year-old patient is presented who was admitted with aphasia and hemiparesis due to basal ganglia infarction as a result of spontaneous dissection of the internal carotid artery. The difficulties in diagnosing this disease with CT and MRI in the acute stage are demonstrated. Angiography is still imperative in order to ascertain that a carotid dissection has occurred.

  16. A Case Report on Spontaneous Coronary Artery Dissection

    Directory of Open Access Journals (Sweden)

    Tunaggina Afrin Khan

    2015-01-01

    Full Text Available Spontaneous coronary artery dissection is an extremely rare cause of acute coronary syndrome. Although it predominantly affects young women in the peripartum period, it can also occur in men. The left coronary artery is most frequently involved. The usual presentation is ST segment elevation myocardial infarction. Although several treatment modalities have been proposed, the optimal treatment options still remain to be established. This current case report focuses on a 40- year-old male presented with acute coronary syndrome and subsequently was found to have coronary artery dissection.

  17. Ten years patency of left internal mammary artery trunk dissection graft after coronary artery bypass procedure

    Institute of Scientific and Technical Information of China (English)

    CHENG Yu-tong; YU Jian-bo; SUN Tao; QUE Bin; WANG Su; LI Zhi-zhong

    2010-01-01

    @@ The left internal mammary artery (LIMA) had become the conduit of choice for myocardial revascularization, since it has been proved that 10 years patency rates of LIMA grafts are more than 90%. 1,2 The arterial graft trunk dissection is a rare event, affecting the procedure effects and related to reoperation.3 According to Kim and coworker's study,4 the arterial graft trunkdelayed dissection manifested by early post-operative angiography only occurred in 6 of 1111 of the off-pump coronary artery bypass grafts. So up to now, the consequence of dissections without severe hemodynamicabnormality is beyond our knowledge.

  18. Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy

    OpenAIRE

    2012-01-01

    Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year...

  19. Individualized management for intracranial vertebral artery dissecting aneurysms

    Directory of Open Access Journals (Sweden)

    SHANG Yan-guo

    2012-02-01

    Full Text Available Objective To discuss the individualized management strategy for intracranial vertebral artery dissecting aneurysms. Methods Eighteen patients with intracranial vertebral artery dissecting aneurysms were treated with different surgical methods. Results Eighteen patients underwent different surgical treatment. Five patients underwent complete occlusion of the aneurysm and parent artery by coiling, 5 were treated by stent -assisted coiling (3 densely packed coiling and 2 non-densely packed coiling, 4 underwent stent-only therapy and 3 of them presented hemodynamic improvement after surgery, 3 were treated by direct surgical clipping, and 1 underwent occipital artery-posterior inferior cerebellar artery bypass. Two aneurysms ruptured immaturely, in which one patient died on the third day after operation and one patient occurred moderate disablity. Only 1 patient who underwent complete occlusion of aneurysm and parent artery presented temporarily ischemic symptoms. No adverse effects were seen in other patients. Seventeen patients were followed up for 1 month to 3 years, and all the aneurysms were stable. Conclusion There are many kinds of therapeutic methods for intracranial vertebral artery dissecting aneurysms. The patients should be treated according to several factors such as the clinical manifestations, aneurysm configuration, and relationship with the posterior inferior cerebellar artery. The treatment should be individualized.

  20. Acute occlusion of the left subclavian artery with artery dissection

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Subclavian steal syndrome is cerebral or brain stem ischemia resulting from diversion of blood flow from the basilar artery to the subclavian artery, which is caused by occlusive disease of either the subclavian artery or the innominate artery before they branch off at the vertebral artery. In the patients with subclavian steal syndrome the subclavian artery is fed by retrograde flow from the vertebral artery via the carotids and the circle of Willis.

  1. External iliac artery dissection secondary to endofibrosis in a cyclist.

    Science.gov (United States)

    Willson, Thomas D; Revesz, Elizabeth; Podbielski, Francis J; Blecha, Matthew J

    2010-07-01

    Endofibrosis of the external iliac artery is an uncommon disease affecting primarily young, otherwise healthy, endurance athletes. Thigh pain during maximal exercise with quick resolution postexercise is characteristic of the so-called cyclist's iliac syndrome. We report an unusual case in which the typical endofibrotic plaque was accompanied by dissection of the external iliac artery. The patient was treated surgically with excision of the affected artery segment and placement of an interposition graft. This case highlights an unusual finding in association with external iliac artery endofibrosis and provides an opportunity to briefly review the literature on the subject.

  2. Spontaneous coronary artery dissection: case report and literature review.

    Science.gov (United States)

    D'Ovidio, Cristian; Sablone, Sara; Carnevale, Aldo

    2015-05-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction and sudden cardiac death. It occurs most commonly in otherwise healthy women during pregnancy or the postpartum period. The true incidence of SCAD is underestimated, as most cases are diagnosed at autopsy. The pathophysiology of SCAD is still not fully understood, and its management can be challenging. This report describes a 35-year-old pregnant female who presented with an acute antero-lateral ST elevation secondary to spontaneous dissection of the left anterior descending artery and the circumflex artery. The diagnosis was established by coronary artery angiography. However, the patient died following cardiac tamponade. The examination of this case represented a starting point for the reviewing of the diagnosis, clinical course, and management of SCAD, and for the placing of this in context with the existing literature. This study highlights the importance of prompt diagnosis and subsequent lifesaving treatment.

  3. Syncope with spontaneous coronary artery dissection in an elderly woman

    Institute of Scientific and Technical Information of China (English)

    CHEN Yu-feng; CHANG Mu-hsin; CHANG Ting-chuan; LAI Chao-hung; JONG Gwo-ping

    2011-01-01

    Diagnosis of spontaneous coronary artery dissection (SCAD) is challenging because of its rarity and uncertain etiology.It frequently occurs in young women during pregnancy and in the postpartum period,and rarely found in elder women with no history of cardiovascular disease or coronary risk factors.In this article we report a case of SCAD in a 75-year-old woman without traditional cardiovascular risk factors who presented with syncope and mild chest discomfort.There were no abnormal electrocardiographic changes and no elevated cardiac enzymes were detected.Computed tomography of brain revealed nothing abnormal.Coronary artery disease was suspected.Coronary angiogram revealed dissection in the middle left circumflex artery.The patient underwent percutaneous transluminal coronary angioplasty and was free of symptoms at 6-month follow-up.Our report suggests that emergency coronary angiography is indicated if syncope caused by coronary artery disease is suspected.

  4. Propagation of dissection in a residually-stressed artery model.

    Science.gov (United States)

    Wang, Lei; Roper, Steven M; Hill, Nicholas A; Luo, Xiaoyu

    2017-02-01

    This paper studies dissection propagation subject to internal pressure in a residually-stressed two-layer arterial model. The artery is assumed to be infinitely long, and the resultant plane strain problem is solved using the extended finite element method. The arterial layers are modelled using the anisotropic hyperelastic Holzapfel-Gasser-Ogden model, and the tissue damage due to tear propagation is described using a linear cohesive traction-separation law. Residual stress in the arterial wall is determined by an opening angle [Formula: see text] in a stress-free configuration. An initial tear is introduced within the artery which is subject to internal pressure. Quasi-static solutions are computed to determine the critical value of the pressure, at which the dissection starts to propagate. Our model shows that the dissection tends to propagate radially outwards. Interestingly, the critical pressure is higher for both very short and very long tears. The simulations also reveal that the inner wall buckles for longer tears, which is supported by clinical CT scans. In all simulated cases, the critical pressure is found to increase with the opening angle. In other words, residual stress acts to protect the artery against tear propagation. The effect of residual stress is more prominent when a tear is of intermediate length ([Formula: see text]90[Formula: see text] arc length). There is an intricate balance between tear length, wall buckling, fibre orientation, and residual stress that determines the tear propagation.

  5. [Spontaneous renal artery dissection with renal infarction: a case report].

    Science.gov (United States)

    Oki, Takashi; Adachi, Hiroyuki; Tahara, Hideo; Kino, Sigeo

    2011-11-01

    A 58-year-old woman visited our hospital with nausea and right flank pain. At first abdominal ultrasonography was performed, suggesting a right renal infarction. Computed tomography (CT) study of the abdomen with intravenous contrast was performed to determine the cause of the symptoms. The scan revealed poor enhancement in the lower half of the right kidney. She was diagnosed with a right renal infarction. She was initially treated with anticoagulant therapy, but 5 days later, she complained of nausea. This time, CT demonstrated exacerbation of a right renal infarction with renal artery dissection. Based on this finding, we performed a right nephrectomy. The result of pathology was segmental arterial mediolysis. She was discharged 12 days after the surgery and is doing well at 6 months after discharge. Spontaneous renal artery dissection is a rare disease. It constitutes approximately 0.05% of arteriographic dissections. In addition, spontaneous renal artery dissection shows nonspecific symptoms. Together, these two factors may cause a delay in diagnosis.

  6. Vertebral artery dissection associated with generalized convulsive seizures

    DEFF Research Database (Denmark)

    Amin, Faisal Mohammad; Larsen, Vibeke Andrée; Tfelt-Hansen, Peer

    2013-01-01

    showed a left-sided pontine infarction, an infarct in the left cerebellar hemisphere and a right vertebral artery dissection (VAD). The patient was treated with heparin and an oral anticoagulant for 6 months. Recovery of neurologic function was excellent. In patients with symptoms of disturbances...

  7. Case report on vertebral artery dissection in mixed martial arts.

    Science.gov (United States)

    Slowey, Michael; Maw, Graeme; Furyk, Jeremy

    2012-04-01

    A 41-year-old man presented to the ED with severe vertigo 2 days after a grappling injury while training in mixed martial arts. Imaging revealed a cerebellar infarct with complete occlusion of the right vertebral artery secondary to dissection. Management options are discussed as is the ongoing controversy regarding the safety of the sport.

  8. Three cases of cervicocephalic artery dissection in an amusement park.

    Science.gov (United States)

    Kurita, Naohide; Ueno, Yuji; Watanabe, Masao; Miyamoto, Nobukazu; Shimura, Hideki; Nonaka, Senshu; Tsutsumi, Satoshi; Yasumoto, Yukimasa; Hattori, Nobutaka; Urabe, Takao

    2014-01-01

    About 20 cases of cerebrovascular accidents in amusement parks have been documented. However, only a few cases of amusement park stroke (APS) after roller coaster rides have been reported. Here, we present triggers of stroke, clinical characteristics, and the angiographic appearance of 3 consecutive patients of APS. Their clinical characteristics included young age, absence of atherosclerotic risk factors, and severe injuries. Serial changes in angiographic appearance led to the diagnosis of cervicocephalic artery dissection (CAD). Patients A and B were diagnosed with isolated middle cerebral artery (MCA) dissection, and patient C was diagnosed with internal carotid artery dissection involving MCA dissection. Running excitedly toward an attraction in patient A, a go-kart ride in patient B, and riding in an enhanced motion vehicle in patient C were considered as the likely triggers for APS. We had specific cases with APS associated with CAD, which can occur under diverse contexts other than roller coaster rides at amusement parks. Our findings suggest that the variable directions of the high gravitational forces induced by vehicle riding or running excitedly might injure the MCA or internal carotid artery, and thereby cause CAD in the amusement park.

  9. Clinical Features and Prognosis of Intracranial Artery Dissection

    NARCIS (Netherlands)

    Sikkema, Tineke; Uyttenboogaart, Maarten; Dijk, van J.M.C.; Groen, Rob J. M.; Metzemaekers, Jan D. M.; Eshghi, Omid; Mazuri, Aryan; Bakker, Nicolaas A.; Luijckx, Gert-Jan

    2015-01-01

    BACKGROUND: Intracranial artery dissections (IADs) are an important cause of stroke or subarachnoid hemorrhage (SAH). Outcome of IAD in the anterior circulation or presentation without SAH is rarely investigated and might be different. OBJECTIVE: To evaluate the clinical features and prognosis of pa

  10. Isolated vagus nerve paralysis associated with internal carotid artery dissection.

    Science.gov (United States)

    Nakagawa, Hideki; Kusuyama, Toshiyuki; Ogawa, Kaoru

    2014-02-01

    Dysphagia and hoarseness caused by laryngopharyngeal paralysis associated with internal carotid artery (ICA) dissection is rare. We reported a case which recovered spontaneously. A 57-year old man visited our hospital complaining of dysphagia and hoarseness lasting for two weeks. Paralysis of right vocal fold and rotational movement of the posterior pharyngeal wall toward the left side during swallowing were observed. Magnetic resonance imaging was performed under diagnosis of isolated right vagus nerve paralysis, and dissection of the right ICA was revealed. He was treated conservatively, and both of laryngopharyngeal movement and the ICA dissection were improved completely. There is a possibility that laryngeal paralysis caused by ICA dissection has been misdiagnosed as an idiopathic paralysis.

  11. Robotic thyroidectomy and cervical neck dissection for thyroid cancer.

    Science.gov (United States)

    Paek, Se Hyun; Kang, Kyung Ho

    2016-06-01

    A robotic approach for thyroid surgery was developed to overcome the limitations of endoscopic thyroidectomy and provide many technical advantages. This approach facilitates the surgeon's control through a magnified three-dimensional view, decreased tremor, and freedom of motion with articulated instruments. Robotic thyroidectomy is safe and technically feasible in patients with well-differentiated, low-risk thyroid cancer. Furthermore, robotic thyroidectomy may become a good surgical alternative option for patients with more advanced thyroid cancer. Our modified bilateral axillo-breast approach (BABA) for central and lateral cervical neck lymph node (LN) dissection has yielded excellent surgical outcomes as an open procedure. The incorporation of robotics in thyroid cancer surgery will continue to evolve, and the surgical indications for robotic thyroidectomy will continue to expand. Further analyses that include long-term outcomes and randomized comparative trials remain important.

  12. Superior Mesenteric Artery Dissection after Extracorporeal Shockwave Lithotripsy

    Directory of Open Access Journals (Sweden)

    Christos Bakoyiannis

    2012-01-01

    Full Text Available The use of shockwave lithotripsy is currently the mainstay of treatment in renal calculosis. Several complications including vessel injuries have been implied to extracorporeal shockwave lithotripsy. We report an isolated dissection of the superior mesenteric artery in a 60-year-old male presenting with abdominal pain which occurred three days after extracorporeal shockwave lithotripsy. The patient was treated conservatively and the abdominal pain subsided 24 hours later. The patient's history, the course of his disease, and the timing may suggest a correlation between the dissection and the ESWL.

  13. Multiparity and Spontaneous Coronary Artery Dissection in the Postpartum Period

    Directory of Open Access Journals (Sweden)

    Müntecep Aşker

    2012-01-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a deadly cause of myocardial infarction (MI that mainly affects otherwise healthy, young females. Forty percent of patients die suddenly or within a few hours of symptom onset. We examine the case of a young female who presented with chest pain. She developed ST elevations in anterolateral leads mimicking ST elevation MI. Cardiac catheterization was done and showed a middle left anterior descending (LAD dissection. The patient underwent primary percutaneous transluminal coronary angioplasty with coronary stent placed in the LAD.

  14. Symptomatic isolated middle cerebral artery dissection: High resolution MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Byon, Jung Hee; Kwak, Hyo Sung; Chung, Gyung Ho; Hwang, Seung Bae [Dept. of Radiology, Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2015-11-15

    To perform high-resolution magnetic resonance imaging (HRMRI) and determine clinical features of patients with acute symptomatic middle cerebral artery (MCA) dissection. Thirteen patients with acute symptomatic MCA dissection underwent HRMRI within 3 days after initial clinical onset. They also underwent routine brain MR imaging. HRMRI examinations included time-of-flight MR angiography (MRA), T2-weighted, T1-weighted, proton-density-weighted, and three-dimensional magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequences. Conventional angiography and MRA were used as reference standard to establish the diagnosis of MCA dissection. The angiographic findings and HRMRI findings such as intimal flap, double lumen, and intramural hematoma were analyzed in this study. All patients presented cerebral ischemia (median National Institutes of Health Stroke Scale score = 4, range = 0-18). String sign was seen on MRA in seven patients. However, double lumen was seen in all patients on HRMRI by intimal flap. High signal lesion on MPRAGE sequences around the dissection lumen due to intramural hematoma was seen in three patients. HRMRI can be used to easily detect the wall structure of MCA such as the intimal flap and double lumen in patients with acute symptomatic MCA dissection. MPRAGE can detect hemorrhage in false lumen of MCA dissection.

  15. Stroke due to a fusiform aneurysm of the cervical vertebral artery: case report

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, S. [Department of Neurosurgery, Kyushu University Hospital, Fukuoka (Japan)]|[Department of Neurosurgery, Kyushu University Hospital 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-82 (Japan); Inoue, T. [Department of Neurosurgery, Clinical Research Institute, National Kyushu Medical Center, Fukuoka (Japan); Haga, S.; Nishio, S.; Fukui, M. [Department of Neurosurgery, Kyushu University Hospital, Fukuoka (Japan); Kono, S. [First Department of Pathology, Kyushu University Hospital, Fukuoka (Japan); Mizushima, A. [Department of Radiology, Kyushu University Hospital, Fukuoka (Japan)

    1998-01-01

    Aneurysms of the cervical vertebral artery (VA) are uncommon; they are often caused by trauma or spontaneous dissection. A fusiform aneurysm without evidence of atherosclerosis or dissection has not been reported previously. A 46-year-old man presented with a pontine infarct. Imaging revealed a fusiform aneurysm of the left VA at the C5-6 level, with occlusion of the basilar artery. Associated minor anomalies included fusion of the vertebral bodies of C5 and C6, cervical rib and platybasia. The left VA arose directly from the aortic arch and entered the transverse foramen at the C4 level. Hyperextension and left lateral flexion of the neck caused kinking of the VA proximal to the aneurysm. Turbulent flow in the aneurysm lumen was noted on angiography. (orig.) With 4 figs., 10 refs.

  16. Preoperative Arterial Interventional Chemotherapy on Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    WANG Hui; LING HU-Hua; TANG Liang-dan; ZHANG Xing-hua

    2008-01-01

    Objective:To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer.Methods:Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with bulky cervical cancer.The patients received bleomycin 45 mg and cisplatin or oxaliplatin 80 mg/m2.Results:25 cases(including 8 cases with stage Ⅰ and 17 cases with stage Ⅱ)received one or two courses of preoperative interventional chemotherapy.The size of the focal lesions was decreased greatly and radical hysterectomy and lymphadenectomy were performed successfully in all the patients.All of the specimens were sent for pathological examination.Lymphocyte infiltration was found more obvious in the cancer tissues as compared with their counterpart before treatment.As a result,relevant vaginal bleeding was stopped completely shortly after the treatment.Conclusion:Arterial interventional chemotherapy was proved to reduce the local size of cervical cancer and thus control the hemorrhage efficiently.The patients with cervical cancer can receive radical hysterectomy therapy after the interventional chemotherapy.

  17. Traumatic vertebral artery dissection presenting with incomplete congruous homonymous quadrantanopia

    Directory of Open Access Journals (Sweden)

    Chen Celia S

    2010-05-01

    Full Text Available Abstract Background To describe a rare presentation of vertebral artery dissection (VAD as a small but congruous incomplete homonymous hemianopia demonstrating use of visual field testing in the diagnosis. Case presentation A 30 year old woman had been unwell for 4 months with difficulty focusing, vertigo, dizziness and a feeling of falling to the right. A small but congruous right inferior homonymous quadrantanopia was found on examination leading to further investigation that uncovered a vertebral artery dissection and multiple posterior circulation infarctions including a left occipital stroke matching the field defect. Conclusions We describe an atypical case of VAD presenting with a small congruous quadrantanopia. This is a rare but significant condition that predisposes to multiple thromboembolic infarction that may be easily misdiagnosed and a high index of suspicion is required to make the diagnosis.

  18. Spontaneous coronary artery dissection in a young man - Case report

    Directory of Open Access Journals (Sweden)

    Auer Johann

    2011-03-01

    Full Text Available Abstract A 31 year old man with a 17-year-history of drug abuse (heroine and cannabis was admitted with recurrent chest pain over a period of about three weeks. Chest discomfort severely worsened during the 5 hours before hospital admission. Electrocardiography revealed poor R-wave progression and non specific repolarization abnormalities. Echocardiography showed extensive left ventricular anterior and apical wall motion abnormalities and a ventricular thrombus located at the apex of the left ventricle was present. Subsequently, a diagnosis of acute coronary syndrome was made. Coronary angiography revealed spontaneous coronary artery dissection of the left anterior descending (LAD artery with Thrombolysis In Myocardial Infarction (TIMI flow 2 to 3. We managed the patient conservatively. The clinical course was uneventful and repeated angiography on day 4 demonstrated spontaneous healing of large parts of the dissection with TIMI 3 flow in the LAD.

  19. Application of a cervical low incision in the functional neck dissection of thyroid papillary carcinoma

    OpenAIRE

    Xu, Jiajie; Chen, Chao; Zheng,ChuanMing; Wang, Kejing; Shang, Jinbiao; FANG, XIANHUA; Ge, Minghua; TAN, ZHUO

    2016-01-01

    The present study aimed to discuss the advantage of the application of a cervical low incision for functional neck dissection in patients with thyroid papillary carcinoma. The study was a retrospective analysis of 87 thyroid papillary carcinoma patients; cervical low incision in the functional neck dissection was applied for 47 cases and the classic ‘L’ incision was applied for 40 cases. The different integrity, surgical time, blood loss and the aesthetic property of the incision were compare...

  20. Spontaneous coronary artery dissection: current insights and therapy

    OpenAIRE

    2008-01-01

    Spontaneous coronary artery dissection (SCAD) is a very rare cause of acute coronary syndromes in young otherwise healthy patients with a striking predilection for the female gender. The pathological mechanism has not been fully clarified yet. However, several diseases and conditions have been associated with SCAD, such as atherosclerosis, connective tissue disorders and the peripartum episode. In this paper we present a review of the literature, discussing the possible mechanisms for SCAD, t...

  1. Spontaneous coronary artery dissection as a cause of myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Aytekin; Aksakal; U?ur; Arslan; Mehmet; Yaman; Mehmet; Urumda?; Ahmet; Hakan; Ate?

    2014-01-01

    Spontaneous coronary artery dissection(SCAD) is a rare disease that is usually seen in young women in left descending coronary artery and result in events like sudden cardiac death and acute myocardial infarction. A 70-year-old man was admitted to the emergency department with chest pain which started 1 h ago during a relative’s funeral. The initial electrocardiography demonstrated 2 mm ST-segment depression in leads V1-V3 and the patient underwent emergent coronary angiography. SCAD simultaneously in two different coronary arteries [left anterior descending(LAD) artery and left circumflex(LCx)] artery was detected and SCAD in LCx artery was causing total occlusion which resulted in acute myocardial infarction. Successful stenting was performed thereafter for both lesions. In addition to the existence of SCAD simultaneously in two different coronary arteries, the presence of muscular bridge and SCAD together at the same site of the LAD artery was another interesting point which made us report this case.

  2. A Vertebral Artery Dissection with Basilar Artery Occlusion in a Child

    Directory of Open Access Journals (Sweden)

    Katleen Devue

    2014-01-01

    Full Text Available This paper presents the case report of an 11-year-old boy with an acute dissection with thrombosis of the left vertebral artery and thrombosis of the basilar artery. The patient was treated with acute systemic thrombolysis, followed by intra-arterial thrombolysis, without any clinical improvement, showing left hemiplegia, bilateral clonus, hyperreflexia, and impaired consciousness. MRI indicated persistent thrombosis of the arteria basilaris with edema and ischemia of the right brainstem. Heparinization for 72 hours, followed by a two-week LMWH treatment and subsequent oral warfarin therapy, resulted in a lasting improvement of the symptoms. Vertebral artery dissection after minor trauma is rare in children. While acute basilar artery occlusion as a complication is even more infrequent, it is potentially fatal, which means that prompt diagnosis and treatment are imperative. The lack of class I recommendation guidelines for children regarding treatment of vertebral artery dissection and basilar artery occlusion means that initial and follow-up management both require a multidisciplinary approach to coordinate emergency, critical care, interventional radiology, and child neurology services.

  3. Two-vessel coronary artery dissection in the peripartum period. Case report and literature review.

    Science.gov (United States)

    Madu, E C; Kosinski, D J; Wilson, W R; Burket, M W; Fraker, T D; Ansel, G M

    1994-09-01

    The authors report a case of early peripartum myocardial infarction resulting from spontaneous dissection of the left anterior descending coronary artery and right coronary artery in a twenty-four-year-old woman. This is the first report of double-vessel coronary dissection involving both the left and right coronary arteries diagnosed antemortem and successfully treated.

  4. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Morton Adam

    2012-12-01

    Full Text Available Abstract A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature.

  5. Fatal subarachnoid hemorrhage associated with internal carotid artery dissection resulting from whiplash trauma.

    Science.gov (United States)

    Uhrenholt, Lars; Freeman, Michael D; Webb, Alexandra L; Pedersen, Michael; Boel, Lene Warner Thorup

    2015-12-01

    Spinal injury following inertial loading of the head and neck (whiplash) is a common sequel of low speed traffic crashes. A variety of non-musculoskeletal injuries have been described in association with injury to the spine following whiplash trauma, including traumatic brain injury, vestibular derangement, and cranial nerve injury, among others. Vascular injuries in the head and neck have, however, only rarely been described. We present the case of a middle-aged male who sustained an ultimately fatal injury that resulted from injury to the internal carotid artery (ICA) and intracerebral vascular structures following a hard braking maneuver, with no direct head- or neck contact with the vehicular interior. Based on this unusual mechanism of injury we reviewed hospital data from the United States nationwide inpatient database (NIS) to assess the frequency of similar injuries reportedly resulting from traffic crashes. The post-mortem examination revealed a left internal carotid artery dissection associated with subarachnoid hemorrhage (SAH). Based on the close temporal association, the absent prior history, and the plausibility of the injury mechanism, the injury was attributed to the braking maneuver. An analysis of NIS data demonstrated that the prevalence of subarachnoid hemorrhage is significantly higher when there is a traumatic etiology, and higher yet when the trauma is a traffic crash (odds ratio 3.3 and 4.3, respectively). The presented case, together with the hospital inpatient data analysis, indicate that although SAH in combination with ICA dissection is relatively rare, it is substantially more probable following a traffic crash. In a clinical or forensic setting the inference that magnitude of a trauma was low should not serve as a basis for either excluding a cervical artery dissection from a differential diagnosis, or for excluding the trauma as a cause of a diagnosed dissection. This case report illustrates a rare fatal outcome of inertial load to

  6. Fatal Vertebral Artery Injury in Penetrating Cervical Spine Trauma

    Directory of Open Access Journals (Sweden)

    Chadi Tannoury

    2015-01-01

    Full Text Available Study Design. This case illustrates complications to a vertebral artery injury (VAI resulting from penetrating cervical spine trauma. Objectives. To discuss the management of both VAI and cervical spine trauma after penetrating gunshot wound to the neck. Summary of Background Data. Vertebral artery injury following cervical spine trauma is infrequent, and a unilateral VAI often occurs without neurologic sequela. Nevertheless, devastating complications of stroke and death do occur. Methods. A gunshot wound to the neck resulted in a C6 vertebral body fracture and C5–C7 transverse foramina fractures. Neck CT angiogram identified a left vertebral artery occlusion. A cerebral angiography confirmed occlusion of the left extracranial vertebral artery and patency of the remaining cerebrovascular system. Following anterior cervical corpectomy and stabilization, brainstem infarction occurred and resulted in death. Results. A fatal outcome resulted from vertebral artery thrombus propagation with occlusion of the basilar artery triggering basilar ischemia and subsequent brainstem and cerebellar infarction. Conclusions. Vertebral artery injury secondary to cervical spine trauma can lead to potentially devastating neurologic sequela. Early surgical stabilization, along with anticoagulation therapy, contributes towards managing the combination of injuries. Unfortunately, despite efforts, a poor outcome is sometimes inevitable when cervical spine trauma is coupled with a VAI.

  7. [The efficacy of superselective intra-arterial chemo-radiotherapy for cervical neck lymph node metastases].

    Science.gov (United States)

    Mada, Yusuke; Koshitsuka, Keiichi; Ihara, Fumie; Ueki, Yuji; Konno, Akiyoshi

    2014-06-01

    We report herein on 32 cases of head and neck carcinoma with cervical lymph node metastases treated by radiotherapy and concomitant intraarterial cisplatin (RADPLAT) from April 2009 to May 2013. N3 cases revealed residual disease of the cervical lymph nodes in 7/9 cases. Among the 22 patients excluding N1 and N3 cases, the pathological CR rate was 63.6%. Among the 13 patients in whom the anticancer drug was directly infused into the cervical lymph nodes, the pathological CR rate was 76.9%, whereas in the 9 patients without direct infusion of the cervical lymph nodes, the pathological CR rate was 44.4%. Therefore, we recommend the direct infusion into cervical lymph node metastases for not only N3 cases but also N2 cases if a feeding artery is identified easily. When clinical examination after RADPLAT leads to suspected residual disease, neck dissection should be adapted. If the clinical examination leads to a diagnosis of CR, we recommend a biopsy of the original cervical lymph nodes because the cases which we diagnosed as CR revealed residual disease of the cervical lymph nodes in 4/16.

  8. Resolution of Internal Carotid Dissection with Middle Cerebral Artery Occlusion in Pregnancy

    Directory of Open Access Journals (Sweden)

    Nicole Ulrich

    2015-01-01

    Full Text Available Introduction. Cervical artery dissection (CAD is a common cause of stroke in younger patients. While the incidence of stroke in pregnancy is increasing, CAD remains a rare cause of ischemic stroke in the pregnant population, with only 30 cases described in the literature, most in the postpartum period. Methods. The case of a pregnant patient at 18 weeks of gestation presenting with CAD and ischemic stroke following intercourse is discussed. Discussion. CAD results from an intimal tear in the carotid artery, allowing accumulation of blood in the vessel wall. Stroke results from embolization of thrombogenic material in the wall. Etiology includes minor trauma, connective tissue disorders, or anatomic variations of the carotid artery. Most patients present with headache and/or neck pain, while ischemic symptoms are seen in at least 50% of patients. In the pregnant population, imaging with MRI or MRA of the head and neck aids in diagnosis. Once the diagnosis is made, patients are treated with either anticoagulation or antiplatelet medications. The optimal treatment in both pregnant and nonpregnant patients has not been well-studied. Conclusion. CAD is an important diagnosis to consider in a pregnant patient with persistent headache, especially if neurological symptoms are present. Imaging should be quickly obtained so treatment can be initiated.

  9. MR manifestations of vertebral artery injuries in cervical spine trauma

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Jeong Sik; Chung, Tae Sub; Kim, Young Soo; Cho, Yong Eun; Kang, Byung Chul; Kim, Dong Ik [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-11-01

    To assess the diagnostic efficacy of magnetic resonance (MR) imaging in the detection of a vertebral artery injury occurring from major cervical spine trauma. Conventional MR findings of 63 patients and 63 control subjects were compared to detect a possible change in the vertebral arteries resulted from trauma. Plain films, CT and clinical records were also reviewed to correlate the degree of cervical spine injury with vascular change. Nine cases of absent flow signals in vessel lumen were observed in eight patients and one was observed in the control group. Patients more frequently demonstrated other abnormalities such as intraluminal linear signals (n=3) or focal luminal narrowing (n=9) but there was no statistical significance. There was a close relationship between degree of cord damage and occlusion of the vertebral artery. Conventional MR imaging is useful in the detection of vertebral artery occlusion resulting from cervical spine trauma.

  10. Postpartal dissection of all coronary arteries in an in vitro-fertilized postmenopausal woman.

    Science.gov (United States)

    Karadag, Bilgehan; Roffi, Marco

    2009-01-01

    Myocardial infarction complicates approximately 1 in 10,000 pregnancies. Although coronary artery dissection is the leading cause of pregnancy-related myocardial infarction during the postpartum period, the pathogenesis of coronary dissection during this period remains uncertain.Herein, we report the case of a 52-year-old black postmenopausal woman with no apparent cardiovascular risk factors who gave birth to twins after in vitro fertilization. Ten days after delivery, she presented with an acute coronary syndrome. Coronary angiography revealed dissection of all 3 coronary arteries. Despite aggressive medical management, the patient experienced recurrent myocardial ischemia. Repeat coronary angiography revealed progression of the dissection process, which required urgent coronary artery bypass surgery. The patient's postoperative course was uneventful. To our knowledge, this report is the 1st description of pregnancy-associated coronary artery dissections in a postmenopausal woman, and the 1st such event in a pregnancy that resulted from in vitro fertilization.

  11. Coronary angiography of pregnancy-associated coronary artery dissection: a high-risk procedure.

    Science.gov (United States)

    Martins, Raphaël Pedro; Leurent, Guillaume; Corbineau, Hervé; Fouquet, Olivier; Seconda, Sébastien; Baruteau, Alban E; Moreau, Olivier; Le Breton, Hervé; Bedossa, Marc

    2010-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome occurring predominantly in young women without any cardiovascular risk factors, especially during the peripartum and early postpartum period. Here, we report a case of a 28-year-old pregnant woman who was found to have an isolated distal SCAD of the left anterior descending artery (LAD). Coronary angiography was complicated by extensive LAD and circumflex arteries dissection, requiring an emergency coronary artery bypass grafting associated with ventricular assist device implantation and underlying the extreme fragility of coronary arteries in pregnant women.

  12. Spontaneous Coronary Artery Dissection in a Male Patient with Takayasu's Arteritis and Antiphospholipid Antibody Syndrome.

    Science.gov (United States)

    Gerede, Demet Menekşe; Yüksel, Bağdagül; Tutar, Eralp; Küçükşahin, Orhan; Uzun, Cağlar; Atasoy, Kayhan Çetin; Düzgün, Nurşen; Bengisun, Uğur

    2013-01-01

    We present a case of a 34-year-old male who presented to the emergency ward with fever and abdominal pain. The diagnosis of Takayasu's arteritis and also antiphospholipid syndrome was made during an imaging workup of deep-vein thrombosis. A spontaneous coronary artery dissection was revealed in coronary CT angiography requested for chest pain and dyspnea. The patient was treated medically and discharged on close followup. The concurrence of spontaneous coronary artery dissection with antiphospholipid syndrome and Takayasu's arteritis has not been reported in the previous literature. The possibility of a spontaneous coronary artery dissection should be considered in patients presenting with both diseases.

  13. Cerebellar hemorrhage after embolization of ruptured vertebral dissecting aneurysm proximal to PICA including parent artery

    Directory of Open Access Journals (Sweden)

    Akira Tamase

    2014-01-01

    Full Text Available Background: Some complications related to vertebral artery occlusion by endovascular technique have been reported. However, cerebellar hemorrhage after vertebral artery occlusion in subacute phase is rare. In this report, we describe a patient who showed cerebellar hemorrhage during hypertensive therapy for vasospasm after embolization of a vertebral dissecting aneurysm. Case Description: A 56-year-old female with a ruptured vertebral dissecting aneurysm proximal to the posterior inferior cerebellar artery developed cerebellar hemorrhage 15 days after embolization of the vertebral artery, including the dissected site. In this patient, the preserved posterior inferior cerebellar artery fed by retrograde blood flow might have been hemodynamically stressed during hypertensive and antiplatelet therapies for subarachnoid hemorrhage, resulting in cerebellar hemorrhage. Conclusion: Although cerebellar hemorrhage is not prone to occur in the nonacute stage of embolization of the vertebral artery, it should be taken into consideration that cerebellar hemorrhage may occur during hypertensive treatment.

  14. Ruptured Dissecting Aneurysm of the Middle Cerebral Artery with Spontaneous Resolution: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Ihn, Yon Kwon; Jung, Won Sang [Dept. of Radiology, St Vincent' s Hospital, The Catholic University of Korea College of Medicine, Suwon (Korea, Republic of)

    2011-11-15

    Dissecting aneurysms of the middle cerebral artery (MCA) are known to cause cerebral infarcts in younger people and can also cause subarachnoid hemorrhage (SAH) or intracranial hemorrhage. Bleeding caused by an isolated dissecting aneurysm of the MCA is relatively rare. We report the case of a young woman with SAH that occurred subsequent to a ruptured dissecting aneurysm of the MCA which resolved spontaneously as demonstrated by angiography.

  15. Catheter-induced dissection of a normal right coronary artery: Reappraisal of the underlying mechanisms

    Directory of Open Access Journals (Sweden)

    Wassam El Din HadadEl Shafey

    2016-06-01

    Full Text Available Iatrogenic coronary artery dissection during diagnostic coronary catheterization is a rare but life-threatening event with a reported incidence of less than 0.1%. The current case report addresses the issue of catheter-induced dissection of an apparently normal right coronary artery (RCA. I tried to explain the factors underlying its occurrence, in view of the current knowledge of the aortic root motion during the cardiac cycle, and the spatial orientation of the RCA ostium.

  16. Renal infarction caused by spontaneous renal artery dissection: treatment with catheter-directed thrombolysis and stenting.

    Science.gov (United States)

    Jeon, Yong Sun; Cho, Soon Gu; Hong, Ki Cheon

    2009-03-01

    Spontaneous renal artery dissection (SRAD) is rare and presents a diagnostic and therapeutic challenge. We report a case of a 36-year-old man who had an SRAD-complicated renal infarction. The patient experienced severe unilateral flank pain. Enhanced abdominal computed axial tomography scan showed renal infarction, and urinalysis showed no hematuria. Selective renal angiography was essential to evaluate the extent of dissection and suitability for repair. The patient was treated with catheter-directed thrombolysis and frenal artery stenting.

  17. Pulmonary artery dissection in a patient with Eisenmenger syndrome treated with heart and lung transplantation

    DEFF Research Database (Denmark)

    Tønder, Niels; Køber, Lars; Hassager, Christian

    2004-01-01

    We report the case of a patient with known Eisenmenger syndrome due to congenital ventricular septal defect, who developed pulmonary artery dissection. The patient was successfully treated with heart and lung transplantation.......We report the case of a patient with known Eisenmenger syndrome due to congenital ventricular septal defect, who developed pulmonary artery dissection. The patient was successfully treated with heart and lung transplantation....

  18. Spontaneous Bilateral Vertebral Artery Dissection During a Basketball Game: A Case Report.

    Science.gov (United States)

    Mas Rodriguez, Manuel F; Berrios, Rafael Arias; Ramos, Edwardo

    2016-01-01

    Spontaneous vertebral artery dissection accounts for 2% of all ischemic strokes and can occur as a consequence of sports events. We present an unusual case of spontaneous bilateral vertebral artery dissection in a 30-year-old male patient during a basketball game. He developed severe dysphagia, right hemiparesis, and balance dysfunction. We also present a review of the pathology, diagnosis, symptomatology, treatment, prognosis, and occurrence of this entity in sports.

  19. Optical coherence tomography assessment of edge dissections after drug-eluting stent implantation in coronary artery

    Institute of Scientific and Technical Information of China (English)

    GUO Jun; HAN Bao-shi; GAI Lu-yue; YANG Ting-shu; CHEN Yun-dai; TIAN Feng; LIU Hong-bin; CHEN Lian; SUN Zhi-jun; REN Yi-hong; JIN Qin-hua; LIU Chang-fu

    2012-01-01

    Background Edge dissections after coronary stent implantation are associated with increased short-term risk of major adverse cardiovascular events.The incidence and outcome of edge dissections after coronary stent implantation were reportedly different using different imaging techniques.We used optical coherence tomography (OCT) to assess the incidence,morphological findings and related factors of edge dissections after drug-eluting stent (DES) implantation.Methods Totally 42 patients with 43 de novo lesions in 43 native arteries undergoing DES implantation with OCT imaging were enrolled in this study.Results Nine edge dissections were detected in 43 arteries after DES implantation.There were four morphological patterns of stent edge dissections indentified in this study:(1) superficial intimal tears (n=3),(2) subintimal dissections (n=4),(3) split of media (n=1),(4) disruption of the fibrotic cap of plaque (n=1).Stent edge expansion and stent expansion were both higher in the group with dissections than those in the group without dissections (1.682±0.425 vs.1.229±0.285,P=0.0290; 1.507±0.445 vs.1.174±0.265,P=0.0072).Conclusions The incidence of stent edge dissections detected by OCT was 21%.Stent edge dissection is related with stent edge expansion and stent expansion.

  20. Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm.

    Science.gov (United States)

    Khatibi, Kasra; Heit, Jeremy J; Telischak, Nicholas A; Elbers, Jorina M; Do, Huy M

    2016-08-01

    A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit.

  1. Direct cervical arterial access for intracranial endovascular treatment

    Energy Technology Data Exchange (ETDEWEB)

    Blanc, R. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); APHP, Hopital Henri Mondor, Service de Neuroradiologie Diagnostique et Therapeutique, Creteil Cedex (France); Piotin, M.; Mounayer, C.; Spelle, L. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Moret, J. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Hopital de la Fondation Ophtalmologique Adolphe de Rothschild, Service de Neuroradiologie Interventionnelle, Paris Cedex 19 (France)

    2006-12-15

    Tortuous vasculature is a cause of failure of endovascular treatment of intracranial vascular lesions. We report our experience of direct cervical accesses in patients in whom the arterial femoral route was not attainable. In this retrospective study, 42 direct punctures of the carotid or the vertebral arteries at the neck were performed in 38 patients. The vessel harboring the intracranial lesion was punctured at the neck above the main tortuosity, a sheath was then positioned under fluoroscopic control to allow a stable access to the intracranial circulation. After the procedure, the sheath was removed and hemostasis was gained either by manual compression or by an arterial closure device (4 of 42, 9%). The cervical route allowed access to all intracranial lesions in all 42 procedures. A complication was encountered in six procedures (14%) related to the direct puncture. In 2 of the 42 procedures (4%), a transient vasospasm was encountered. A cervical hematoma formed in 3 of the 42 procedures (7%) after sheath withdrawal (one patient in whom an 8F sheath had been used, required surgical evacuation of a hematoma compressing the upper airways; the other patients did well without surgical evacuation). In the remaining patient (1 of 42 procedures, 2%), a small asymptomatic aneurysm at the puncture site was seen on the follow-up angiogram. Direct cervical arterial approaches to accessing the intracranial circulation is effective in patients in whom the femoral route does not allow the navigation and stabilization of guiding catheters. (orig.)

  2. Risk factors for vertebral artery injuries in cervical spine trauma

    Directory of Open Access Journals (Sweden)

    Nanjundappa S. Harshavardhana

    2014-10-01

    Full Text Available Blunt cerebrovascular injuries (i.e. involvement of carotid and vertebral arteries are increasingly being recognized in setting of cervical spine trauma/fractures and are associated with high incidence of stroke/morbidity and mortality. The incidence of vertebral artery injuries (VAI is more common than previously thought and regular screening is seldom performed. However there exists no screening criteria and conflicting reports exists between spine and trauma literature. Many clinicians do not routinely screen/evaluate patients presenting with cervical spine trauma for potential VAI. This article provides a brief summary of existing evidence regarding the incidence of VAI in the background of cervical trauma/fractures. The type and fracture pattern that is associated with a high risk of VAI warranting mandatory screening/further work-up is discussed. A brief overview of diagnostic modalities and their respective sensitivity/specificity along with available treatment options is also summarized.

  3. Spontaneous intracranial arterial dissection in the young: diagnosis by CT angiography

    Directory of Open Access Journals (Sweden)

    Given Curtis A

    2006-04-01

    Full Text Available Abstract Background Spontaneous carotid artery dissections have been rarely reported in children. Diagnosis has traditionally been confirmed by catheter arteriography. More recently diagnosis has been made by magnetic resonance imaging and magnetic resonance angiography; however the sensitivity of these techniques has yet to be determined. The authors are unaware of reports of carotid dissection confirmed by dynamic computed tomography (computerized tomographic arteriography in the young. Case presentation We recently evaluated a fourteen year-old male following the development of transient neurologic symptoms. There was no antecedent illness or trauma. Dynamic computed tomography revealed an intracranial dissection involving the supraclinoid segment of the left internal carotid artery (confirmed by catheter arteriography. Studies for vasculitis, pro-thrombotic states, and defects of collagen were negative. Conclusion Spontaneous carotid artery dissection is a potential cause of transient neurological symptoms and ischemic stroke in the pediatric population. Dynamic computed tomography appears to be a reliable diagnostic tool which can lead to early diagnosis.

  4. Vertebral artery dissection due to indirect neck trauma : an underrecognised entity.

    Directory of Open Access Journals (Sweden)

    Prabhakar S

    2001-10-01

    Full Text Available Vertebral artery dissection is an important cause of brain stem stroke, especially in the young. Dissections of carotid and vertebral arteries in neck account for about 20% of strokes in young compared with 2.5% in the elderly. Three patients of vertebral artery dissection related to indirect neck trauma are described. The first patient developed the symptoms while dancing, the second after a trivial fall and the third while he was on a dental chair. None of them had a direct severe neck trauma or concomitant risk factor like hypertension, connective tissue disease or migraine. Clinical symptomatology was similar in all the patients and included occipito-nuchal pain, headache and brain stem dysfunction chiefly in the posterior inferior cerebellar artery (PICA territory. One of the patients also had associated ischaemic myelopathy. MRA and DSA confirmed dissection in all with a predominant steno-occlusive picture. Cases of so called trivial neck movement/torsion related dissection have been described previously but have not received any major importance. Usually classified as ′spontaneous′ or ′traumatic′, there is a possible ambiguity in literature about appropriate terminology. We emphasise that a history of such subtle precipitating events be taken while diagnosing young patients with brain stem strokes, to recognise this clinical entity. Although mechanisms are not absolutely clear, yet there seems to be an important relationship between arterial dissection and neck movements or minor trauma.

  5. Isolated Celiac and Splenic Artery Dissection: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Tania Moussa

    2015-01-01

    Full Text Available An isolated dissection of the celiac artery is an extremely rare condition that requires a high level of suspicion to evoke the diagnosis. Once established, the natural course is unpredictable in view of the discrepancies in its management requiring a case-by-case analysis. In this paper, we report an unusual case of spontaneous abdominal pain that was diagnosed with celiac and splenic artery rupture secondary to physical stress. This paper underlines the necessity to maintain a high level of suspicion for arterial dissections and we also review the management plan in such cases.

  6. Pregnancy-related spontaneous coronary artery dissection: Two case reports and a comprehensive review of literature

    Directory of Open Access Journals (Sweden)

    Azeem S Sheikh

    2012-01-01

    Full Text Available Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome, particularly seen in women during pregnancy or in the puerperium. It has a high acute phase mortality. The etiology is uncertain. Hormonal changes during pregnancy, hemodynamic stress and changes in the autoimmune status have been considered as possible etiological factors. A timely diagnosis and institution of appropriate treatment is important for a successful outcome. There is no consensus of opinion for optimal treatment. Conservative management, coronary artery bypass graft surgery, and percutaneous coronary intervention, all have been described in the literature as possible therapeutic options. Spontaneous coronary artery dissection should be considered as a differential in any young woman presenting with chest pain associated with pregnancy. We report two cases of pregnancy-associated spontaneous coronary artery dissection, both successfully managed, along with a comprehensive review of the previously published literature.

  7. Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    Lyudmila Andreevna Kalashnikova

    2013-01-01

    Full Text Available The paper gives the data available in the literature and the author’s results of an examination of almost 140 patients with dissection of the internal carotid and vertebral arteries (ICA and VA. Dissection is blood penetration through an intimal tear from the lumen of an artery into its wall to develop intramural hematoma (IMH. The cause of dissection is the weakness of the arterial wall presumably due to mitochondrial cytopathy. IMH narrows/occludes the arterial lumen or is a source of arterioarterial embolism, which in turn leads to ischemic stroke. Stroke as a result of dissection generally develops in young patients, who are not prone to traditional vascular risk factors, frequently after the influence of provocative factors (mild head/neck injury, head jerks, physical strain, contraceptives, etc.. The characteristics of stroke are head/neck pain on the side of dissection that appears a few days prior to stroke or simultaneously with the latter; quite often a good recovery of impaired functions; and low recurrence rates. Another major manifestation, isolated cervicocephalic pain, is encountered in PA dissection more frequently (in almost a third of cases and in ICA dissection less frequently (about 5%. Magnetic resonance (MR angiography and fat-saturated T1-weighted MR imaging play a leading role in the verification of dissection. Dissection should be treated with anticoagulants/antiaggregants in its acute phase, as well as with trophic drugs, primarily actovegin, in both acute and chronic phases.

  8. Cervical chordoma with vertebral artery encasement mimicking neurofibroma: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Mortele, B.; Lemmerling, M.; Mortele, K.; Verstraete, K.; Defreyne, L.; Kunnen, M. [Department of Radiology, University Hospital, Gent (Belgium); Vandekerckhove, T. [Department of Neurosurgery, University Hospital, Gent (Belgium)

    2000-06-01

    A case of cervical chordoma in a 36-year-old white man with hypoesthesia in the neck and right shoulder, neck pain, and restricted neck mobility is presented. Plain radiographs of the cervical spine showed radiolucency of the body of C2 on the right side and enlargement of the right intervertebral foramen at C2-C3 level. Tumor encasement of the vertebral artery was demonstrated by MR imaging and confirmed by conventional arteriography. This proved to be particularly important for preoperative assessment. (orig.)

  9. Dissection of internal carotid artery presenting as isolated ischaemic optic neuropathy

    Directory of Open Access Journals (Sweden)

    Serdar Oruc

    2016-08-01

    Full Text Available Carotid artery dissections are one of the important reasons of cerebrovascular events that are observed before the age of 45. Besides the local findings such as head, neck and face pains, Horner syndrome findings, pulsatile tinnitus and cranial nerve involvements, some other symptoms such as ischemic stroke, transient ischemic attacks and amaurosis fugax can also be observed in the approximately three quarters of patients. Ischemic optic neuropathy may be seen as %4 in the carotid artery dissections and it mostly accompanies other ischemic local symptoms. It is rare to observe the ischemic optic neuropathy as the first and unique finding in the carotid artery dissections. In this study, a 55 year old male patient with carotid artery dissection was represented. He did not have any other complaint, except the sudden unilateral visual loss and he was sent to our clinics from the opthalmology clinics in order to search for the etiology of ischemic optic neuropathy. It should be kept in mind that there can be a possibility to have carotid artery dissections in patients with unilateral visual loss.

  10. A case series of 22 patients with internal carotid artery dissection

    Directory of Open Access Journals (Sweden)

    Jovanović Aleksandar

    2011-01-01

    Full Text Available The aim of this study was to analyze the spectrum of clinical presentations of internal carotid artery dissection. Twenty-two patients with internal carotid artery dissection, mean age 39.02, were evaluated over the past ten years. Magnetic resonance imaging and magnetic resonance angiography were used to establish the diagnosis. Facial and neck pain and Horner’s syndrome were the only presenting symptoms in 4 patients (without brain infarction; facial pain, Horner’s syndrome and contralateral sensorimotor deficit in 6; headache and contralateral sensorimotor deficit in 2; contralateral sensorimotor deficit with or without speech impairment in 10. Internal carotid artery dissection was triggered by a trauma in 7, whereas it was spontaneous in 15. Magnetic resonance imaging revealed infarction in 18 patients. A good outcome (modified Rankin score 0-2 was seen in 20 patients. The spectrum of clinical presentations of internal carotid artery dissection is variable. Internal carotid artery dissection is not necessarily accompanied by infarction on magnetic resonance imaging.

  11. A morphological comparison of cervical spondylotic myelopathy: MRI and dissection findings.

    Science.gov (United States)

    Tsurumi, Takamasa; Goto, Noboru; Shibata, Masakazu; Goto, Jun; Kamiyama, Akemi

    2005-03-01

    The number of people with functional disabilities has been increasing with the rapid changes of age structure in the overall population. One of the major causes of disturbances in daily activities is cervical spondylotic myelopathy (CSM). The transverse area and sagittal diameter of the spinal cord measured by MRI is reported to correlate with the clinical manifestations of CSM, the duration of the disease, and the speed of recovery after surgery in patients with CSM. The purpose of this research is to determine the morphological characteristics of CSM as seen in MRI findings including the spinal cord sagittal diameter, transverse diameter, transverse area and flatness ratio. Twenty-eight of several patients with CSM were treated conservatively after carrying out measurements by MRI. In addition, anatomical studies were carried out on the spinal cords after anatomical dissection of the vertebral column in seven cadavers with CSM. These results, when compared with the morphological analysis of the cervical spinal cord, show that there is a correlation between the transverse areas at C4, C5 and C6 levels, as those at every level of the cervical transverse areas of tissue sections in the dissection cadavers were 10-18% smaller than those in the MRI patients. These results should be taken into account for the treatment of CSM patients.

  12. A case of anterior cerebral artery dissection caused by scuba diving.

    Science.gov (United States)

    Fukuoka, Takuya; Kato, Yuji; Ohe, Yasuko; Deguchi, Ichiro; Maruyama, Hajime; Hayashi, Takeshi; Tanahashi, Norio

    2014-08-01

    A 51-year-old man was admitted with right hemiparesis during scuba diving, without headache. Brain magnetic resonance (MR) imaging depicted high-intensity areas in the left superior frontal and cingulate gyri on diffusion-weighted imaging. Dissection of the anterior cerebral artery (ACA) was detected using axial MR angiography and 3-dimensional MR cisternography. Dissection of the ACA during and after scuba diving has not been reported before. Dissection of the arteries should be included in the differential diagnosis when neurologic symptoms occur both during and after scuba diving, even if the patient does not experience headache. Furthermore, the combination of MR cisternography and MR angiography is useful to detect ACA dissection.

  13. Delayed presentation of carotid artery dissection following major orthopaedic trauma resulting in dense hemiparesis.

    LENUS (Irish Health Repository)

    Edmundson, S P

    2012-01-31

    We report a 30-year-old patient who was involved in a high-velocity road traffic accident and developed a left-sided hemiparesis, which was noted in the post-operative period following bilateral femoral intramedullary nailing. CT scanning of the brain revealed infarcts in the right frontal and parietal lobes in the distribution of the right middle cerebral artery. CT angiography showed occlusion of the right internal carotid artery consistent with internal carotid artery dissection. He was anticoagulated and nine months later was able to walk independently. An awareness of this injury is needed to diagnose blunt trauma to the internal carotid artery. Even in the absence of obvious neck trauma, carotid artery dissection should be suspected in patients with a neurological deficit in the peri-operative period.

  14. Acute fatal coronary artery dissection following exercise-related blunt chest trauma.

    Science.gov (United States)

    Barbesier, Marie; Boval, Catherine; Desfeux, Jacques; Lebreton, Catherine; Léonetti, Georges; Piercecchi, Marie-Dominique

    2015-01-01

    Coronary artery injury such as acute coronary dissection is an uncommon and potentially life-threatening complication after blunt chest trauma. The authors report an unusual autopsy case of a 43-year-old healthy man who suddenly collapsed after receiving a punch to the chest during the practice of kung fu. The occurrence of the punch was supported by the presence of one recent contusion on the left lateral chest area at the external examination and by areas of hemorrhage next to the left lateral intercostal spaces at the internal examination. The histological examination revealed the presence of an acute dissection of the proximal segment of the left anterior descending coronary artery. Only few cases of coronary artery dissection have been reported due to trauma during sports activities such as rugby and soccer games, but never during the practice of martial arts, sports usually considered as safe and responsible for only minor trauma.

  15. Endovascular stent graft for treatment of complicated spontaneous dissection of celiac artery: Report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ung Rae; Lee, Young Hwan [Dept. of Diagnostic Radiology, Catholic University of Daegu School of Medicine, Daegu (Korea, Republic of); Kim, Young Hwan [Dept. of Diagnostic Radiology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2013-06-15

    We report 2 cases of complicated spontaneous dissection of the celiac artery, which were successfully treated by a stent graft. The first patient was a 47-year-old man who presented with acute abdominal pain. CT scan showed ruptured saccular aneurysm with surrounding retroperitoneal hematoma. The second patient was a 57-year-old man with progressive dissecting aneurysm. Endovascular stent graft was placed in the celiac trunk to control bleeding, and to prevent rupture in each patient. Follow-up CT scans showed complete obliteration of a dissecting aneurysm.

  16. Angiographic features of unilateral nonbifurcating cervical carotid artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    En, Na Lae [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Seung Koo [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-08-15

    Nonbifurcating cervical carotid artery is a rare anomaly of the common carotid artery (CCA), in which the branches of the external carotid artery (ECA) arise directly from the CCA or proximal internal carotid artery without bifurcation, and therefore there is no proximal main trunk of the ECA. We report a unilateral nonbifurcating cervical carotid artery of a 67-year-old woman, incidentally found during cerebral aneurismal treatment.

  17. Hybrid endovascular treatment of an anomalous right subclavian artery dissection in a patient with Marfan syndrome.

    Science.gov (United States)

    Stanley, Gregory A; Arko, Frank R; Foteh, Mazin I; Jessen, Michael E; DiMaio, J Michael

    2012-08-01

    We report the case of a 26-year-old female patient with Marfan syndrome and an aberrant right subclavian artery (ARSA) with associated Kommerell diverticulum. The patient presented with spontaneous acute dissection of the ARSA that showed fusiform dilation to 4 cm in diameter. Definitive treatment was performed using a two-stage hybrid endovascular technique, including extrathoracic bilateral upper extremity bypass and thoracic endovascular aortic repair with debranching of the right and left subclavian arteries. This was followed by coil and plug embolization to exclude the dissection and prevent subsequent endoleak.

  18. The use of flow diverter stents in the management of traumatic vertebral artery dissections.

    Science.gov (United States)

    Cohen, José E; Gomori, John M; Moscovici, Samuel; Bala, Miklosh; Itshayek, Eyal

    2013-05-01

    Flow diverters constitute a new generation of flexible self-expanding stent-like devices with a high metal-surface area coverage, specifically designed for the endovascular management of complex cerebral aneurysms. Recently, other potential applications for these devices in the field of occlusive cerebrovascular disease have been described. In vertebral artery dissections causing occlusion associated with a burden of extensive clots, we have found that the reduced porosity of the diverter mesh serves as an effective barrier to in-stent clot protrusion and distal embolization. We describe the novel use of a flow diverter for the management of an occlusive traumatic vertebral artery dissection. Diverter implantation allowed subsequent angioplasty.

  19. Precontrol of the pulmonary artery during thoracoscopic left upper lobectomy and systemic lymph node dissection

    Science.gov (United States)

    Ma, Lin; Mei, Jiandong; Liu, Chengwu

    2016-01-01

    The main reasons of emergent conversion during thoracoscopic lobectomy included tumor invasion, hilar lymph node (LN) metastasis, and lymphoid tuberculosis. We presented a video which depicted a three-portal thoracoscopic left upper lobectomy with dissection of large LNs. Severe adhesions between a large LN and the first branch of the left pulmonary artery (PA) were found during surgery. For safety reasons, the left main pulmonary artery (LMPA) was clamped with an endoscopic bulldog clamp prior to lymph nodal dissection. The strategy of precontrolling the LMPA during thoracoscopic lobectomy is useful for these patients with complicated hilum, and may assure the safety of the operation. PMID:27162690

  20. Uterine artery embolization for cervical ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Qiao Zhou, MD

    2015-12-01

    Full Text Available A 36-year-old woman with 3 prior C-sections is diagnosed with a caesarean scar ectopic pregnancy. Despite receiving intramuscular and transvaginal methotrexate injection 2 months before presentation, the beta human chorionic gonadotropin was recorded to be 73 mIU/mL at the time of encounter. The patient complained of vaginal bleeding with a significant drop in hematocrit from 40% to 33%. Transvaginal ultrasound confirmed retroplacental hemorrhage and because of the patient's desire to retain fertility, interventional radiology was consulted to perform an uterine artery embolization. The uterine artery embolization was successful in achieving hemostasis and resulted in a decrease of betaHCG to 46 on postprocedure day 1 to <1 mIU/mL by postoperative week 3.

  1. Spontaneous dissection of the coronary and vertebral arteries post-partum: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Cenkowski Marta

    2012-11-01

    Full Text Available Abstract Background Spontaneous coronary and vertebral artery dissections are rare events occurring most commonly in otherwise healthy women during pregnancy or the post-partum period. Case presentation This report describes a 35-year-old female who presented with an acute inferior ST elevation myocardial infarction 7 months post-partum secondary to spontaneous dissection of the left obtuse marginal coronary artery. Despite appropriate medical therapy with dual anti-platelet therapy, the patient presented four weeks later with a spontaneous dissection of the right vertebral artery. Conclusion We review the presentation, diagnosis, and management of spontaneous dissections of the vasculature in the peri-partum period.

  2. Robotic-Assisted Dissection of Bulky Lymph Nodes in Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Ahmet Göçmen

    2014-01-01

    Full Text Available The resection of bulky lymph node metastases, which may provide a therapeutic benefit, has been proposed in several studies based on laparotomy and laparoscopy. There is no published study in the literature examining the resection of bulky lymph node metastases using a robotic technique. In this report, we presented a patient with cervical cancer who underwent robotic-assisted dissection of bulky lymph nodes. The robotic-assisted operation time was 255 minutes, and the mean console time was 215 minutes. The estimated blood loss was 70 mL. The number of lymph nodes retrieved was 28, and the number of the dissected paraaortic lymph nodes was 13. The number of the lymph node metastases was eight. The bulky lymph nodes which are difficult to be eradicated with standard radiation therapy can be resected with robotic-assisted surgery and successful resection of the lymph nodes can improve the treatment strategy. This minimal invasive technique is safe and feasible for bulky lymph node dissection.

  3. Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller coaster ride - case report and a review.

    Science.gov (United States)

    Ozkan Arat, Yonca; Volpi, John; Arat, Anıl; Klucznik, Richard; Diaz, Orlando

    2011-01-01

    We present the first case of a woman with no significant medical history who developed dissections of bilateral carotid and bilateral vertebral arteries, as well as a retinal artery occlusion, after a roller coaster ride. A 35-year-old woman developed right-sided neck pain followed by a frontal headache immediately after a roller coaster ride. Five days after the incident, she developed complete loss of vision in her right eye for two hours. Subsequently, the vision improved but remained significantly decreased. On presentation, her visual acuity was 20/200 in the right and 20/20 in the left eye. Her fundus exam revealed retinal edema in the superotemporal retinal artery distribution without any visible emboli. Her neurological exam was otherwise normal. The cerebral angiogram showed bilateral internal carotid and vertebral artery dissections. The patient remained stable with conservative therapy without further worsening of vision or any new neurological deficits. Outcomes for cervicocephalic arterial dissection are usually favorable, but early diagnosis is critical for initiation of appropriate treatment of possible complications. Physicians must have a high index of suspicion for arterial dissection when patients note any headache, neck pain or vertigo triggered by violent motion after leisure activities such as roller coaster rides.

  4. Feasibility of high-resolution MR imaging for the diagnosis of intracranial vertebrobasilar artery dissection

    Energy Technology Data Exchange (ETDEWEB)

    Han, Miran; Rim, Nae-Jung; Kim, Sun Yong; Choi, Jin Wook [Ajou University School of Medicine, Ajou University Medical Center, Department of Radiology, Suwon (Korea, Republic of); Lee, Jin Soo [Ajou University School of Medicine, Ajou University Medical Center, Department of Neurology, Suwon (Korea, Republic of)

    2014-12-15

    To evaluate the feasibility of high-resolution MRI (HR-MRI) for diagnosing intracranial vertebrobasilar artery dissection (VBD) and to identify the most useful imaging findings suggesting dissection. We retrospectively reviewed 50 patients with suspected intracranial VBDs who underwent HR-MRI. Two neuroradiologists independently reviewed the HR-MR images. The diagnosis based on HR-MRI was compared with the final diagnosis by consensus among the neuroradiologists, neurointerventionist, and neurologist. Two neuroradiologists also sought signs of dissection (mural hematoma, dissection flap, outer-diameter enlargement on T2WI of steno-occlusive lesions). Inter- and intraobserver agreements were analysed. HR-MRI corroborated the final diagnosis in 47 (94 %; 31 VBD and 16 non-VBD) patients. A mural haematoma was best detected on T1WI and contrast-enhanced (CE)-T1WI (54.3 %). Dissection flaps were observed in almost all cases on CE-T1WI (91.4 %), and then were detected on T2WI (68.6 %). Outer-diameter enlargement of the steno-occlusive lesions on angiography was detected in more than half of the cases (62.9 %). The two reviewers showed almost perfect agreement for the diagnosis of VBD and detecting dissection signs on every sequence. HR-MRI can be a useful and non-invasive diagnostic tool for intracranial VBD, and dissection flaps on CE-T1WI are the signs with the greatest diagnostic value. (orig.)

  5. Spontaneous coronary artery dissection causing acute coronary syndrome in a young patient without risk factors

    Directory of Open Access Journals (Sweden)

    Parag Chevli

    2014-09-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare cause of acute myocardial infarction that is more common in younger patients (under age 50 and in women. Although the etiology is not known, some predisposing conditions to SCAD are well known and include Marfan syndrome, pregnancy and peripartum state, drug abuse, and some anatomical abnormalities of the coronary arteries such as aneurysms and severe kinking. We describe a case of SCAD in a young woman who presented with sudden onset of chest pain and was admitted for the treatment of acute coronary syndrome. The coronary angiography showed dissection of the left anterior descending artery. The patient underwent successful percutaneous transluminal coronary angioplasty and stent placement.

  6. Spontaneous coronary artery dissection. Case report and literature review

    DEFF Research Database (Denmark)

    Elming, H; Køber, L

    1999-01-01

    descending artery (LAD). Her condition stabilized during treatment with intravenous heparin, aspirin, nitrates, beta-blockers, digoxin, ACE inhibitor and anticoagulants. At discharge she had no symptoms of heart failure. One hundred and forty one cases from the literature are reviewed with special reference...

  7. A Rare Case of Pulmonary Artery Dissection Associated With Infective Endocarditis.

    Science.gov (United States)

    Shi, Xiaoqing; Wang, Xiaoqin; Wang, Chuan; Zhou, Kaiyu; Li, Yifei; Hua, Yimin

    2016-05-01

    Pulmonary artery dissection (PAD) is a rare condition with high mortality and has not been reported in patient with infective endocarditis (IE). Here, we report the first case of such patient who experienced PDA and survived after surgical intervention.A 10-year-old female child was diagnosed as IE with a patent ductus arteriosis (PDA) and a vegetation on the left side of pulmonary artery trunk (10 × 5 mm). Following 3-week antibacterial treatment, the body temperature of patient returned to normal, and the size of vegetation reduced (7 × 3 mm). However, the patient had a sudden attack of sustained and crushing right chest pain, orthopnea with increasing respiratory rate (> 60/min), and acute high fever. Echocardiography revealed the detachment of vegetation on the first day and dissection of pulmonary artery on the next day. The patient received immediate surgical intervention. It was found that aneurysm had a size of 28 × 20 mm and its orifice (the dissecting site) located on the opposite side of the PDA opening (right side of the pulmonary artery trunk). The dissected left wall of pulmonary artery trunk was reconstructed followed by the closure of PDA with suture. The patient recovered uneventfully.From this case, we learned that the surgical intervention should be considered at an early time for IE patients who have a vegetation in pulmonary artery and PDA. After the infection is under control, the earlier surgery may prevent severe complications.

  8. Chronic basilar artery dissection with an associated symptomatic aneurysm presenting with massive subarachnoid hemorrhage.

    Science.gov (United States)

    Cohen, José E; Moscovici, Samuel; Rajz, Gustavo; Vargas, Andres; Itshayek, Eyal

    2016-08-01

    Basilar artery dissection (BAD) is a rare condition with a worse prognosis than a dissection limited to the vertebral artery. We report a rare case of chronic BAD with an associated symptomatic aneurysm presenting with massive subarachnoid hemorrhage (SAH) in a 54-year-old woman. The diagnosis of acute BAD could only be made retrospectively, based on clinical and neuroradiological studies from a hospital admission 10months earlier. Angiography performed after her SAH showed unequivocal signs of imperfect healing; she was either post-recanalization of a complete occlusion or post-dissection. Residual multi-channel intraluminal defects led to the development of a small aneurysm, which was responsible for the massive hemorrhage. The occurrence of an associated aneurysm, and wall disease, but not an intraluminal process, reinforces the diagnosis of dissection. The patient was fully recovered at 90day follow-up. This case reinforces the need for long-term neuroradiological surveillance after non-hemorrhagic intracranial dissections to detect the development of de novo aneurysms.

  9. Altered Hemodynamics Associated with Pathogenesis of the Vertebral Artery Dissecting Aneurysms

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    Akira Kurata

    2012-01-01

    Full Text Available The etiology of the vertebral dissecting aneurysms is largely unknown, and they frequently occurs in relatively healthy young men. Objectives and Methods. A series of 57 consecutive cases defined by angiography were evaluated with regard to deviation in the course of the affected and contralateral vertebral arteries. Division was into 3 types: Type I without any deviation, Type II with mild-to-moderate deviation but not over the midline; and Type III with marked deviation over to the contralateral side beyond the midline. Results. The most frequent type of VA running was Type III for the affected and Type I nonaffected side, with this being found in all 17 patients except one. All of the Type III dissections occurred just proximal to a tortuous portion, while in cases with Type-I- and Type-II-affected sides, the majority (33 of 39 occurred near the union of the vertebral artery. In 10 of 57, a non-dominant side was affected, all except one being of Type I or II. With 12 recent patients assessed angiographically in detail for hemodynamics, eleven patients showed contrast material retrograde inflowing into the pseudolumen from the distal portion of the dissection site. Turbulent blood flow was recognized in all of these patients with retrograde inflow. Conclusions. Turbulent blood flow is one etiology of vertebral artery dissection aneurysms, with the sites in the majority of the cases being just proximal to a tortuous portion or union of vessels. In cases with dissection proximal to the tortuous course of the vertebral artery, retrograde inflow will occur more frequently than antegrade, which should be taken into account in designing therapeutic strategies.

  10. A case of carotid artery dissection devoleped after swimming: The role of heterezygote C677T MTHFR gen mutation

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    Alevtina Ersoy

    2013-12-01

    Full Text Available Carotid artery dissection is one of the most important causes of cerebral stroke in young age. Although most cases of carotid artery dissection appear spontaneously, sometimes it may result from a microtrauma which the patient does not take seriously. This article reports a case of extracranial internal carotid artery dissection starting from intense swimming and manifesting itself only as neck swelling and neck pain. Other analyses showed that the patient also suffered from a cronic venous sinus thrombosis and stroke. Moreover, genetic testing revealed a MTHFR gene mutation. This case is presented because of the multiple vascular events are seen in the same patient.

  11. Mural Dissections of Brain-Supplying Arteries in a Chimpanzee (Pan troglodytes).

    Science.gov (United States)

    Baze, Wallace B; Storts, Ralph W; Wilkerson, Gregory K; Buchl, Stephanie J; Magden, Elizabeth R; Chaffee, Beth K

    2015-12-01

    We describe the pathologic features of mural arterial dissection involving brain-supplying arteries in a 31-y-old female chimpanzee (Pan troglodytes). Several hours after examination for a possible respiratory tract infection, the chimpanzee became unresponsive, developed seizures, and died within 18 h. At necropsy, the occipital cortex of the brain had a small area of congestion, and the cerebellar cortex contained a small necrotic area. Histologic evaluation confirmed the cortical lesions and revealed an additional necrotic area in the medulla oblongata characterized by mural dissection of the brain-supplying vertebral and basilar arteries and subsequent branches. Lesions in the cortices and medulla were within areas supplied by the vertebrobasilar system. Dissection of brain-supplying arteries has been described in humans but not previously in chimpanzees (or any other NHP), suggesting that these species might be useful in understanding this condition in humans. In addition, the lesion should be added to the NHP clinician's and pathologist's differential diagnosis list for similar presentations in this species.

  12. Cervical artery tortuosity is associated with intracranial aneurysm.

    Science.gov (United States)

    Labeyrie, Paul-Emile; Braud, Florent; Gakuba, Clément; Gaberel, Thomas; Orset, Cyrille; Goulay, Romain; Emery, Evelyne; Courthéoux, Patrick; Touzé, Emmanuel

    2017-01-01

    Background Intracranial aneurysms may be associated with an underlying arteriopathy, leading to arterial wall fragility. Arterial tortuosity is a major characteristic of some connective tissue disease. Aim To determine whether intracranial aneurysm is associated with an underlying arteriopathy. Methods Using a case-control design, from May 2012 to May 2013, we selected intracranial aneurysm cases and controls from consecutive patients who had conventional cerebral angiography in our center. Cases were patients with newly diagnosed intracranial aneurysm. Controls were patients who had diagnostic cerebral angiography and free of aneurysm. The prevalence of tortuosity, retrospectively assessed according to standard definitions, was compared between cases and controls and, association between tortuosity and some aneurysm characteristics was examined, in cases only. Results About 659 arteries from 233 patients (112 cases and 121 controls) were examined. Tortuosity was found in 57 (51%) cases and 31 (26%) controls (adjusted OR = 2.71; 95%CI, 1.53-4.80). The same trend was found when looking at each tortuosity subtype (simple tortuosity, coil, kink) or at carotid or vertebral territory separately. In contrast, no association between tortuosity and rupture status, aneurysm number or neck size was found. Conclusions Cervical artery tortuosity is significantly associated with intracranial aneurysm, although not related to main aneurysm characteristics. Our results support the presence of an underlying diffuse arteriopathy in intracranial aneurysm patients.

  13. Diffusion measurement of intraplaque hemorrhage and intramural hematoma using diffusion weighted MRI at 3T in cervical artery

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    Yao, Bin [The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi (China); Yang, Li [Fudan University, Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Shanghai (China); Wang, Guangbin; Shi, Honglu; Wang, Shanshan; Li, Huihua [Shandong University, Shandong Medical Imaging Research Institute, Jinan, Shandong (China); Chen, Weibo; Chan, Queenie [Philips Healthcare, Shanghai (China)

    2016-10-15

    To assess the difference between carotid haemorrhagic plaque and non-haemorrhagic plaque by using diffusion-weighted imaging (DWI) and to evaluate carotid intraplaque haemorrhage (IPH) and intramural hematoma (IMH) of cervical artery dissection with apparent diffusion coefficient (ADC) measurement. Fifty-one symptomatic patients underwent 3.0-T carotid MR imaging, including conventional sequences, three-dimensional (3D) magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequence, and DWI. Thirty-nine patients with carotid plaque and eight patients with IMH of cervical artery dissection were finally included. The groups of hemorrhagic plaque, non-hemorrhagic plaque and IMH were divided according to 3D MPRAGE sequence. ADC values of different groups were measured, and t tests were performed. The mean ADC values of hemorrhagic plaques, non-hemorrhagic plaque and IMH were (1.284 ± 0.327) x 10{sup -3}mm{sup 2}/s, (1.766 ± 0.477) x 10{sup -3}mm{sup 2}/s, and (0.563 ± 0.119) x 10{sup -3}mm{sup 2}/s, respectively. The mean ADC values of hemorrhagic and non-hemorrhagic regions in the hemorrhagic plaque group were (0.985 ± 0.376) x 10{sup -3}mm{sup 2}/s and (1.480 ± 0.465) x 10{sup -3}mm{sup 2}/s, respectively. The differences between the hemorrhagic plaque and non-hemorrhagic plaque, hemorrhagic region and non-hemorrhagic region in hemorrhagic plaque, and the hemorrhagic region in the hemorrhagic plaque and IMH of artery dissection were significant (P < 0.05). DWI may be a useful complement to conventional MR imaging for identifying haemorrhage of carotid plaques and differentiate IMHs from IPH. (orig.)

  14. Isolated superior mesenteric artery dissection: case for conservative treatment and endovascular repair

    Institute of Scientific and Technical Information of China (English)

    WU Bin; ZHANG Jian; YIN Ming-di; WANG Lei; SONG Jin-qiu; LI Xuan; YANG Dong; DUAN Zhi-quan; XIN Shi-jie

    2009-01-01

    @@ Dissection of the superior mesenteric artery (SMA) not associated aortic dissection is an uncommon event. The pathogenesis remains unclear. Diagnosis has become more efficient due to recent advances in imaging techniques and increased awareness of mesenteric vessel diseases. Early recognition has led to early interventions. Although there is still no consensus on the best option of management for this disease, an increasing number of patients in recent years have been reported to be treated successfully by non-operative approaches (medical therapy and/or percutaneous endovascular repair) rather than operations. We report the diagnosis and non-operative managements of isolated dissection of SMA in the acute stage in two cases at the First Hospital of China Medical University from October to December in 2006.

  15. Pulmonary arterial dissection in a post-partum patient with patent ductus arteriosus: Case report and review of the literature.

    Science.gov (United States)

    Yaman, Mehmet; Arslan, Uğur; Ateş, Ahmet Hakan; Aksakal, Aytekin

    2015-02-26

    Pulmonary arterial dissection is an uncommon but usually a deadly complication of chronic pulmonary hypertension. A 26-year-old female patient was admitted to our clinics with sudden dyspnea and chest discomfort one hour after giving birth to twins by vaginal delivery. An echocardiography was performed with a pre-diagnosis of pulmonary embolism. However, echocardiographic examination revealed a dilated main pulmonary artery and a dissection flap extending from main pulmonary artery to left pulmonary artery. In summary, in this report, we described a very rare case of pulmonary artery dissection in a pregnant patient with a previously un-diagnosed patent ductus arteriosus without an obvious rise in pulmonary artery pressure and reviewed the relevant literature.

  16. Pulmonary arterial dissection in a post-partum patient with patent ductus arteriosus: Case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Mehmet; Yaman; Ugur; Arslan; Ahmet; Hakan; Ates; Aytekin; Aksakal

    2015-01-01

    Pulmonary arterial dissection is an uncommon but usually a deadly complication of chronic pulmonary hypertension. A 26-year-old female patient was admitted to our clinics with sudden dyspnea and chest discomfort one hour after giving birth to twins by vaginal delivery. An echocardiography was performed with a pre-diagnosis of pulmonary embolism. However, echocardiographic examination revealed a dilated main pulmonary artery and a dissection flap extending from main pulmonary artery to left pulmonary artery. In summary, in this report, we described a very rare case of pulmonary artery dissection in a pregnant patient with a previously un-diagnosed patent ductus arteriosus without an obvious rise in pulmonary artery pressure and reviewed the relevant literature.

  17. Risk factors and clinical presentation of craniocervical arterial dissection: A prospective study

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    Thomas Lucy C

    2012-09-01

    Full Text Available Abstract Background Craniocervical arterial dissection is a major cause of ischaemic stroke in young adults. The pathogenesis is not fully understood but is thought to be related to a combination of an intrinsic weakness in the arterial wall and an external trigger. Intrinsic susceptibility is thought to be a generalised arteriopathy, vascular anomaly or genetic predisposition. Proposed extrinsic factors include recent viral infection and minor mechanical trauma to the neck, including neck manipulation, which has raised concerns amongst manual practitioners in particular as to the appropriate screening of patients and avoidance of more vigorous therapeutic techniques. The presenting features of dissection may mimic a musculoskeletal presentation, creating a diagnostic dilemma for primary care practitioners. Early recognition is critical so that appropriate management can be commenced. The aims of this study are to prospectively investigate young patients ≤55 years admitted to hospital with radiologically diagnosed craniocervical arterial dissection compared to matched controls with stroke but not dissection, to identify risk factors and early presenting clinical features, so these may be more readily identified by primary care practitioners. Methods Patients ≤ 55 years presenting to hospital with craniocervical arterial dissection and controls will have their medical records reviewed and be interviewed and questioned about possible risk factors, preceding events to admission such as recent neck trauma, and presenting clinical features including any preceding transient ischaemic features. Clinical assessment will include a connective tissue screening examination to identify subclinical connective tissue disorders. Radiology and blood screening will be reviewed for typical features and inflammatory markers. Functional outcome will be reviewed to determine the burden of the stroke. Discussion This study will provide descriptive and

  18. Cocaine mediated apoptosis of vascular cells as a mechanism for carotid artery dissection leading to ischemic stroke.

    Science.gov (United States)

    Dabbouseh, Noura M; Ardelt, Agnieszka

    2011-08-01

    In arterial dissection, blood may enter the arterial wall through an intimal tear, splitting the arterial wall and activating the coagulation cascade at the site of endothelial damage. Dissection of extracranial and intracranial vessels may lead to ischemic stroke through thromboembolic or hemodynamic mechanisms. Major blunt trauma or rapid acceleration-deceleration may cause dissection, but in patients with inherent arterial wall weakness, dissection can occur spontaneously or as a result of minor neck movement. Cocaine use has been associated with dissection of the aortic arch and coronary and renal arteries through cocaine-mediated hypertension. Recent preclinical studies have suggested, however, that cocaine may cause apoptosis of cells in the vascular wall. In this article, we postulate that cocaine may cause apoptosis of vascular endothelial and/or smooth muscle cells, thus weakening the vascular wall and resulting in a dissection-prone state. We review the literature and propose a biological basis for vasculopathy, vascular dissection, and ischemic stroke in the setting of cocaine use. Further research studies on vascular cells, as well as focused analysis of human pathological material, will be important in providing evidence for or against our hypotheses.

  19. Extracranial Vertebral Artery Aneurysm Presenting as a Chronic Cervical Mass Lesion

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    Lampis C. Stavrinou

    2010-01-01

    Full Text Available Background. Aneurysms of the extracranial vertebral artery are rare and can provide a diagnostic and therapeutic challenge. Methods. We reviewed the clinical history of a patient presenting with cervical radiculopathy, who harboured an extracranial vertebral artery aneurysm eroding the cervical spine. Results. CT Angiography and MR Angiography set the diagnosis, by revealing a left C5-C6 vertebral artery aneurysm with cervical root impingement. Bony reconstruction depicted enlargement of the C6 transverse foramen and a marked enlargement of the C6-C7 intravertebral foramen. The lesion was treated by intravascular proximal vertebral artery occlusion. Conclusions. Extracranial vertebral artery aneurysms require a high index of clinical suspicion. This is the first report of a vertebral artery pseudoaneurysm presenting with bony erosion, which supports a less minacious portrayal of vertebral artery aneurysms.

  20. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

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    Mitsudo, Kenji, E-mail: mitsudo@yokohama-cu.ac.jp [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Oguri, Senri [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Yamamoto, Noriyuki [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya (Japan); Itoh, Yoshiyuki [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Kioi, Mitomu; Hirota, Makoto; Tohnai, Iwai [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)

    2012-08-01

    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m{sup 2}; CDDP, total 100-150 mg/m{sup 2}) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3

  1. Tortuous Common Carotid Artery: A Report of Four Cases Observed in Cadaveric Dissections

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    Joe Iwanaga

    2016-01-01

    Full Text Available A tortuous common carotid artery poses a high risk of injury during tracheotomy. Preoperative diagnosis is therefore important to avoid serious complications. We found four cases of tortuous common carotid artery during an anatomical dissection course for students. The first case was a 91-year-old woman who had bilateral tortuous common carotid arteries without arteriosclerosis. Case 2 was a 78-year-old woman who had bilateral tortuous common carotid arteries without arteriosclerosis. Case 3 was an 86-year-old woman who died from bladder cancer and who also had a right tortuous common carotid artery without arteriosclerosis. Case 4 was an 89-year-old woman who had bilateral tortuous common carotid arteries and a tortuous brachiocephalic artery with severe arteriosclerosis. Case 4 was also examined using computed tomography to evaluate the arteriosclerosis. Computed tomography revealed severe calcification of the vascular wall, which was confirmed in the aortic arch and origins of its branches. In all four cases, the tortuosity was located below the level of the thyroid gland. Based on prior study results indicating that fusion between the carotid sheath and visceral fascia was often evident at the level of the thyroid gland, we speculated that the major region in which tortuosity occurs is at the same level or inferior to the level of the thyroid gland.

  2. Endovascular Treatment of the Huge Dissecting Aneurysms Involving the Basilar Artery by the Internal Trapping Technique: Technical Note

    Institute of Scientific and Technical Information of China (English)

    Shi-Qing Mu; Xin-Jian Yang; You-Xiang Li; Chu-Han Jiang; Zhong-Xue Wu

    2015-01-01

    Background:The endovascular strategy of the huge dissecting aneurysms involving the basilar artery (BA) is controversial and challenging.This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping (IT) technique.Methods:We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of lnterventional Neuroradiology of Beijing Tiantan Hospital.Clinical and angiographic data were reviewed and evaluated.Results:All patients were treated by the IT technique.That meant the dissecting artery and aneurysm segments were completed occlusion.After the procedure,the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion.Follow-up angiography was performed at 3-6 months or 12-18 months after the endovascular treatment (median 8 months),14 patients had a good recovery.Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA.After the second treatment,the patient died by the ventricular tachycardia.Conclusions:The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms,but it is not necessarily the safest or most definitive treatment modality.The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.

  3. Endovascular Treatment of the Huge Dissecting Aneurysms Involving the Basilar Artery by the Internal Trapping Technique: Technical Note

    Directory of Open Access Journals (Sweden)

    Shi-Qing Mu

    2015-01-01

    Full Text Available Background: The endovascular strategy of the huge dissecting aneurysms involving the basilar artery (BA is controversial and challenging. This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping (IT technique. Methods: We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of Interventional Neuroradiology of Beijing Tiantan Hospital. Clinical and angiographic data were reviewed and evaluated. Results: All patients were treated by the IT technique. That meant the dissecting artery and aneurysm segments were completed occlusion. After the procedure, the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion. Follow-up angiography was performed at 3-6 months or 12-18 months after the endovascular treatment (median 8 months, 14 patients had a good recovery. Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA. After the second treatment, the patient died by the ventricular tachycardia. Conclusions: The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms, but it is not necessarily the safest or most definitive treatment modality. The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.

  4. Axillary Versus Femoral Arterial Cannulation During Repair of Type A Aortic Dissection?

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    Stamou, Sotiris C.; Gartner, Derek; Kouchoukos, Nicholas T.; Lobdell, Kevin W.; Khabbaz, Kamal; Murphy, Edward; Hagberg, Robert C.

    2016-01-01

    Background The goal of this study was to compare early postoperative outcomes and actuarial-free survival between patients who underwent repair of acute Type A aortic dissection with axillary or femoral artery cannulation. Methods A total of 305 patients from five academic medical centers underwent acute Type A aortic dissection repair via axillary (n = 107) or femoral (n = 198) artery cannulation between January 2000 and December 2010. Major morbidity, operative mortality, and 5-year actuarial survival were compared between groups. Multivariate logistic regression was used to determine predictors of operative mortality, and Cox regression hazard ratios were calculated to determine predictors of long-term mortality. Results Operative mortality was not influenced by cannulation site (16% for axillary cannulation vs. 19% for femoral cannulation, p = 0.64). In multivariate logistic regression analysis, hemodynamic instability (p 200 min; p = 0.05) emerged as independent predictors of operative mortality. Stroke rates were comparable between the two techniques (14% for axillary and 17% for femoral cannulation, p = 0.52). Five-year actuarial survival was comparable between the groups (55.1% for axillary and 65.7% for femoral cannulation, p = 0.36). In Cox regression analysis, predictors of long-term mortality were: age (p < 0.001), stroke (p < 0.001), prolonged cardiopulmonary bypass time (p = 0.001), hemodynamic instability (p = 0.002), and renal failure (p = 0.001). Conclusions The outcomes of femoral versus axillary arterial cannulation in patients with acute Type A aortic dissection are comparable. The choice of arterial cannulation site should be individualized based on different patient risk profiles. PMID:28097193

  5. Medical and Interventional Therapy for Spontaneous Vertebral Artery Dissection in the Craniocervical Segment

    Science.gov (United States)

    Zhang, Guiyun

    2017-01-01

    Background and Purpose. Spontaneous vertebral artery dissection (SVAD) is an important reason for posterior-circulation-ischemic stroke in the young and middle-aged population. Although some previous reports reveal a favorable outcome with conservative therapy, it is still controversial in the treatment of SVAD in some specific patients. Herein, we present our 10 years of clinical experience for SVAD at this location. Material and Methods. 20 patients with 20 SVADs in V2 and V3 segments were retrospectively studied. Clinical manifestations and imageology materials were collected and analyzed. All the patients underwent anticoagulation except for one patient because of contraindication. 14 patients underwent Wingspan stents implantation with general anesthesia. Results. In our sample, ischemia (infarction or transient ischemic attack, TIA) was found in all the patients. Angiographic stenosis and dissection aneurysm were the most common findings in the segments mentioned above. 19 of the patients (95%) got the excellent imageological and clinical outcomes. Conclusions. According to our experience in this group, although anticoagulation is effective in vertebral artery dissection, interventional therapy for SVADs in V2 and/or V3 segments is preferred in some specific patients. Stent with higher radial supporting and flexibility, such as Wingspan stent, is suggested.

  6. The pattern and prevalence of vertebral artery injury in patients with cervical spine fractures

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    Farzanah Ismail

    2013-06-01

    Full Text Available Aim: It is not uncommon for vertebral artery injury to occur when there are fractures through the transverse foraminae of the first to the sixth vertebral bodies. Other important risk factors for vertebral artery injury include facet joint dislocations and fractures of the first to the third cervical vertebral bodies. The aim of this study was to determine the pattern and prevalence of vertebral artery injury on CT angiography (CTA in patients with cervical spine fractures.Method: A retrospective review of patients who had undergone CTA of the vertebral arteries was undertaken. Reports were reviewed to determine which patients met the inclusion criteria of having had both cervical spine fractures and CTA of the vertebral arteries. Images of patients who met the inclusion criteria were analysed by a radiologist.Results: The prevalence of vertebral artery injury was 33%. Four out of the 11 patients who had vertebral artery injury, had post-traumatic spasm of the artery, with associated thrombosis or occlusion of the vessel. In terms of blunt carotid vertebral injury (BCVI grading, most of the patients sustained grade IV injuries. Four patients who had vertebral artery injury had fractures of the upper cervical vertebrae, i.e. C1 to C3. Fifteen transverse process fractures were associated with vertebral artery injury. No vertebral artery injury was detected in patients who had facet joint subluxations.Conclusion: Patients with transverse process fractures of the cervical spine and upper cervical vertebral body fractures should undergo CTA to exclude vertebral artery injury.

  7. Coronary artery aneurysm and type-A aortic dissection demonstrated by retrospectively ECG-gated multislice spiral CT

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    Fallenberg, Eva Maria; Juergens, Kai Uwe; Fischbach, Roman [Department of Clinical Radiology, University Hospital Muenster (Germany); Wichter, Thomas [Department of Cardiology and Angiology, University Hospital Muenster (Germany); Scheld, Hans H. [Department of Thoracic and Cardiovascular Surgery, University Hospital Muenster (Germany)

    2002-01-01

    The case of a 40-year-old male patient with a coronary aneurysm of the proximal left descending artery (LAD) combined with circumferential type-A dissection of the ascending aorta is reported. Computed tomography angiography of the coronary arteries was performed using multislice spiral computed tomography (MSCT) with retrospective ECG gating. Anatomical relations of the LAD aneurysm as well as the origin of the left coronary artery from the false lumen of the dissection were well depicted for planning of the surgical intervention using this new noninvasive imaging modality. (orig.)

  8. TREATMENT OF VERTEBRAL-ARTERY TYPE CERVICAL SPONDYLOPATHY WITH NEEDLE-KNIFE THERAPY

    Institute of Scientific and Technical Information of China (English)

    LI Dianning; YE Ping

    2002-01-01

    In the present paper, 62 cases of vertebral-artery type cervical spondylopathy were treated with needie-knife therapy (acupotomy). After 2- 6 sessions of treatment, 23 cases (37. 1%) were cured, 19 (30. 7%)showed marked improvement, 15 (24.2%) had some improvement and 5 (8.1 % ) failed in the treatment. The total effective rate was 91.9 %. It indicates that acupotomy therapy is a highly effective remedy for treating vertebral-artery type cervical spndylopathy.

  9. A Case of Isolated Celiac Artery Dissection Accompanied by Splenic Infarction Detected by Ultrasonography in the Emergency Department

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    Kazumasa Emori

    2016-01-01

    Full Text Available A 46-year-old male with a history of hypertension visited the emergency department (ED by ambulance complaining of sudden pain in the left side of his back. Ultrasonography (USG performed at ED revealed splenic infarction along with occlusion and dissection of the celiac and splenic arteries without abdominal artery dissection. Contrast enhanced computed tomography (CT revealed the same result. Consequently, spontaneous isolated celiac artery dissection (SICAD was diagnosed. Because his blood pressure was high (159/70 mmHg, antihypertensive medicine was administered (nicardipine and carvedilol. After his blood reached optimal levels (130/80 mmHg, symptoms disappeared. Follow-up USG and contrast enhanced CT performed 8 days and 4 months after onset revealed amelioration of splenic infarction and improvement of the narrowed artery. Here, we report a case of SICAD with splenic infarction presenting with severe left-sided back pain and discuss the relevance of USG in an emergency setting.

  10. Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography.

    Science.gov (United States)

    Rahman, Shahid; Abdul-Waheed, Mohammed; Helmy, Tarek; Huffman, Lynn C; Koshal, Vipin; Guitron, Julian; Merrill, Walter H; Lewis, David F; Dunlap, Stephanie; Shizukuda, Yukitaka; Weintraub, Neal L; Meyer, Christopher; Cilingiroglu, Mehmet

    2009-04-01

    We report a case of a 26-year-old female, who presented at 34 weeks of an uncomplicated pregnancy with an acute ST elevation anterior wall myocardial infarction. Cardiac catheterization suggested a left main coronary artery dissection with pseudoaneurysm formation. The patient's course was complicated by congestive heart failure. She was initially managed conservatively by a multidisciplinary team including heart failure specialists, obstetricians, and cardiovascular surgeons. 4 days after admission, her LMC was imaged by dual-source 64 slice Cardiac computed tomography, coronary dissection was identified extending to the lumen, and the presence of pseudoaneurysm was confirmed. She underwent subsequently a staged procedure, which included placement of an intra-aortic balloon pump, cesarean section, and coronary artery bypass grafting. This case illustrates the utility of coronary artery CT imaging to assess the complexity and stability of coronary artery dissections, thereby helping to determine the need for, and timing of revascularization procedures.

  11. Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography

    Directory of Open Access Journals (Sweden)

    Weintraub Nealw F

    2009-04-01

    Full Text Available Abstract We report a case of a 26-year-old female, who presented at 34 weeks of an uncomplicated pregnancy with an acute ST elevation anterior wall myocardial infarction. Cardiac catheterization suggested a left main coronary artery dissection with pseudoaneurysm formation. The patient's course was complicated by congestive heart failure. She was initially managed conservatively by a multidisciplinary team including heart failure specialists, obstetricians, and cardiovascular surgeons. 4 days after admission, her LMC was imaged by dual-source 64 slice Cardiac computed tomography, coronary dissection was identified extending to the lumen, and the presence of pseudoaneurysm was confirmed. She underwent subsequently a staged procedure, which included placement of an intra-aortic balloon pump, cesarean section, and coronary artery bypass grafting. This case illustrates the utility of coronary artery CT imaging to assess the complexity and stability of coronary artery dissections, thereby helping to determine the need for, and timing of revascularization procedures.

  12. Pulmonary artery dissection causing haemothorax in a cat: potential role of Dirofilaria immitis infection and literature review.

    Science.gov (United States)

    Biasato, I; Tursi, M; Zanet, S; Longato, E; Capucchio, M T

    2017-02-01

    A 7-year-old male castrated domestic short-haired cat suddenly died. Gross examination revealed severe right-sided haemothorax with blood clots, four adult filarial nematodes in the blood clots and the caudal vena cava and haemorrhage dissecting into the tunica media of the right pulmonary artery. Histopathological investigation showed fibrosis of the tunica intima and disorganization/fragmentation of the elastic fibres accompanied by fibrous tissue deposition in the tunica media of both branches of pulmonary artery. Degenerative vasculopathy (intimal fibromuscular hyperplasia and medial hypertrophy/hyperplasia) involving pulmonary arteries was also observed. The polymerase chain reaction amplification and sequencing confirmed the identification of the parasite as Dirofilaria immitis. A diagnosis of pulmonary artery dissection with haemothorax and concomitant heartworm disease was formulated. Degenerative processes of the tunica media have been reported to cause pulmonary artery dissection in both humans and animals. Pulmonary artery remodelling induced by heartworms may be considered the underlying cause in the first case of feline pulmonary artery dissection, herein described.

  13. Vertebral Artery Dissection Associated with Generalized Convulsive Seizures: A Case Report

    Directory of Open Access Journals (Sweden)

    Faisal Mohammad Amin

    2013-07-01

    Full Text Available A 46-year-old male with juvenile myoclonic epilepsy was admitted to the neurological department for convulsive seizures just after lamotrigine was discontinued. On admission he was awake but had a right-sided hemiparesis with Babinski sign and ataxic finger-nose test on the left side. An MR scan showed a left-sided pontine infarction, an infarct in the left cerebellar hemisphere and a right vertebral artery dissection (VAD. The patient was treated with heparin and an oral anticoagulant for 6 months. Recovery of neurologic function was excellent. In patients with symptoms of disturbances of posterior circulation after epileptic seizures, VAD should be considered.

  14. Spontaneous Renal Artery Dissection in a Patient with Neurofibromatosis Type I

    Directory of Open Access Journals (Sweden)

    Nicolas W. Shammas

    2016-01-01

    Full Text Available We present a case of spontaneous renal artery dissection (SRAD in a 28-year-old female with history of neurofibromatosis type I (NF-1 treated successfully with endovascular stenting. The clinical presentation, diagnostic testing, and treatment options are discussed. An endovascular approach with stenting was successfully performed after failure of medical treatment with subcutaneous low molecular weight heparin. Patient’s blood pressure and symptoms improved significantly. This may be the first reported case of SRAD in a patient with NF-1 successfully treated with endovascular stenting.

  15. Operative treatment for cervical fracture and dislocation with blunt unilateral vertebral artery injury

    Institute of Scientific and Technical Information of China (English)

    JIANG Tao; REN Xian-jun; WANG Wei-dong; ZHANG Xia; LI Chang-qing; HAO Yong

    2010-01-01

    Objective: To investigate risks and clinical effects of operative treatment for cervical vertebral fracture and dislocation associated with unilateral vertebral artery injury.Methods: This group consisted of 76 cases of closed cervical spine trauma combined with unilateral vertebral artery injury (23 cases of bilateral facet dislocation, 28 unilateral facet dislocation and 25 fracture). All patients underwent prospective examination of cervical spine MRI and vertebral artery two-dimensional time-of-flight (2D TOF)magnetic resonance angiography (MRA), and anterior cervical decompression. The healthy vertebral artery paths were evaluated before the surgery, and were protected during the surgery according to the anatomical signs.Results: There were no acute or chronic clinical damage symptoms in 76 cases after surgery. No neural damage symptoms were observed in patients with normal neural functions. The neural functions of incomplete paralyzed patients were improved in different grades.Conclusions: Reliable anterior operation can produce good results for cervical fracture and dislocation with unilateral vertebral artery injury. Detecting the course of uninjured vertebral artery before operation and locating the anatomical site during operation are effective to avoid damaging vertebral artery of uninjured side.

  16. Spontaneous Dissection of the Renal Artery in Vascular Ehlers-Danlos Syndrome

    Science.gov (United States)

    Pereira, Filipa; Cardoso, Teresa; Sá, Paula

    2015-01-01

    Ehlers-Danlos syndrome (EDS) is a rare heterogeneous group of connective tissue disorders. The vascular type (vEDS) is an autosomal dominant disorder caused by heterozygous mutations in the COL3A1 gene predisposing to premature arterial, intestinal, or uterine rupture. We report a case of a 38-year-old woman with a recent diagnosis of vEDS admitted in the Emergency Department with a suspicion of a pyelonephritis that evolved to a cardiopulmonary arrest. A fatal retroperitoneal hematoma related with a haemorrhagic dissection of the right renal artery was found after emergency surgery. This case highlights the need to be aware of the particular characteristics of vEDS, such as a severe vascular complication that can lead to a fatal outcome. PMID:26175915

  17. Titanium plate artefact mimicking popliteal artery dissection on digital subtraction CT angiography.

    Science.gov (United States)

    Woodacre, Timothy; Wienand-Barnett, Sophie

    2013-04-05

    Titanium plates used for the internal fixation of long bone fractures cause significant artefact on CT scans but have not been reported to affect digital subtraction CT angiography. We present a patient with clinical suspicion of popliteal artery injury following a high tibial osteotomy. The osteotomy was stabilised with a titanium locking plate. During the digital subtraction process used to produce reconstruction CT angiography, removal of artefact caused by the titanium plate produced CT images mimicking the appearance of a popliteal artery dissection. The imaging inaccuracy was realised prior to the patient undergoing further intervention. We highlight the potential error caused by titanium plates on digital subtraction CT angiography and recommend careful analysis of such images prior to further treatment.

  18. Iatrogenic Bidirectional Dissection of the Right Coronary Artery and the Ascending Aorta: The Worst Nightmare for an Interventional Cardiologist

    OpenAIRE

    Dahdouh, Ziad; Roule, Vincent; Lognoné, Thérèse; Sabatier, Rémi; Bignon, Mathieu; Malcor, Guillaume; Lemaitre, Adrien; Blanchart, Katrien; Wain-Hobson, Julien; Saplacan, Vladimir; Cutone, Fabio; Buklas, Dimitrios; Ivascau, Calin; Massetti, Massimo; Grollier, Gilles

    2012-01-01

    Although rare, iatrogenic aortocoronary dissection is one of the complications most dreaded by the interventional cardiologist. If not managed promptly, it can have redoubted and serious consequences. Herein, we present the case of a 70 year-old woman who was treated by stenting of the second segment of the right coronary artery (RCA) for recurrent angina but, unfortunately, the procedure was complicated by anterograde dissection of the RCA with a simultaneous retrograde propagation to the pr...

  19. Spontaneous Coronary Artery Dissection in a Male Patient with Takayasu’s Arteritis and Antiphospholipid Antibody Syndrome

    Directory of Open Access Journals (Sweden)

    Demet Menekşe Gerede

    2013-01-01

    Full Text Available We present a case of a 34-year-old male who presented to the emergency ward with fever and abdominal pain. The diagnosis of Takayasu’s arteritis and also antiphospholipid syndrome was made during an imaging workup of deep-vein thrombosis. A spontaneous coronary artery dissection was revealed in coronary CT angiography requested for chest pain and dyspnea. The patient was treated medically and discharged on close followup. The concurrence of spontaneous coronary artery dissection with antiphospholipid syndrome and Takayasu’s arteritis has not been reported in the previous literature. The possibility of a spontaneous coronary artery dissection should be considered in patients presenting with both diseases.

  20. Transient ischemic jejunitis due to symptomatic isolated superior mesenteric artery dissection: case report and review of literature

    Science.gov (United States)

    MOCAN, MIHAELA; JEICAN, IONUŢ ISAIA; MOALE, MIHAI; CHIRA, ROMEO

    2017-01-01

    Acute abdominal pain is one of the most common conditions encountered in the emergency department. The differential diagnosis of acute abdominal pain is extensive and identifying the underlying etiology can be challenging. We report a case of acute transient ischemic jejunitis due to symptomatic isolated superior mesenteric artery dissection in a patient with no cardiovascular risk factors or autoimmune diseases. Symptomatic isolated superior mesenteric artery dissection is a rare cause of acute abdominal pain usually treated in the surgical department. The patient had criteria for conservative treatment and rapidly recovered. We highlight a rare condition which should be taken into account for the differential diagnosis of acute abdominal pain.

  1. Acquired infantile Horner syndrome and spontaneous internal carotid artery dissection: a case report and review of literature.

    Science.gov (United States)

    Pirouzian, Amir; Holz, Huck A; Ip, Kenneth C; Sudesh, Rattehalli

    2010-04-01

    Horner syndrome, a triad of ptosis, anisocoria, and anhidrosis, results from interruption in the oculosympathetic pathway. It is classically described as either congenital or acquired to depict its underlying pathophysiology and requisite work-up. We report a case of a 10-month-old infant presenting with an acute onset of left Horner syndrome secondary to a spontaneous extracranial internal carotid artery dissection. To the best of our knowledge, this is the first case report in the literature of acute onset of acquired infantile Horner syndrome in association with spontaneous carotid artery dissection confirmed with magnetic resonance angiogram.

  2. Postoperative peri-axillary seroma following axillary artery cannulation for surgical treatment of acute type A aortic dissection

    Directory of Open Access Journals (Sweden)

    Katsanos Konstantinos

    2010-05-01

    Full Text Available Abstract The arterial cannulation site for optimal tissue perfusion and cerebral protection during cardiopulmonary bypass (CPB for surgical treatment of acute type A aortic dissection remains controversial. Right axillary artery cannulation confers significant advantages, because it provides antegrade arterial perfusion during cardiopulmonary bypass, and allows continuous antegrade cerebral perfusion during hypothermic circulatory arrest, thereby minimizing global cerebral ischemia. However, right axillary artery cannulation has been associated with serious complications, including problems with systemic perfusion during cardiopulmonary bypass, problems with postoperative patency of the artery due to stenosis, thrombosis or dissection, and brachial plexus injury. We herein present the case of a 36-year-old Caucasian man with known Marfan syndrome and acute type A aortic dissection, who had direct right axillary artery cannulation for surgery of the ascending aorta. Postoperatively, the patient developed an axillary perigraft seroma. As this complication has, not, to our knowledge, been reported before in cardiothoracic surgery, we describe this unusual complication and discuss conservative and surgical treatment options.

  3. Effect of neoadjuvant chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion

    Institute of Scientific and Technical Information of China (English)

    Chen; Aiping; Ding; Zhaoxia; Xu; Bing; Zhao; Shuping; Dai; Shuzhen

    2007-01-01

    Objective:To evaluate the effect of preoperative chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion.Methods:Sixty two patients with bulky or locally advanced cervical cancer from 1999 to 2004 were underwent internal iliac arterial infusion chemotherapy by using Seldinger technique.Combined regimens were applied including cisplatin as the major drug.Two weeks later,all patients received radical hysterectomy.Results:The local tumor regression rate was 93.55%.Postoperative pathologic examination showed that no cervical tumor residue in stumps were found in 61 of 62 patients who underwent radical hysterectomy.Large quantity of necrotic tissue appeared on primary tumor.In 16 patients with positive lymph nodes,15 demonstrated necrotic lymph nodes.Conclusion:Internal iliac arterial infusion chemotherapy could effectively reduce tumor volume,increase surgical success rate and decrease lymph nodes and subclinical metastasis rates.

  4. Spontaneous healing and complete disappearance of a ruptured posterior inferior cerebellar artery dissecting aneurysm.

    Science.gov (United States)

    Su, Tsung-Ming; Cheng, Ching-Hsiao; Chen, Wu-Fu; Hsu, Shih-Wei

    2014-05-01

    A 7-month-old baby presented with a 4-day history of drowsiness and vomiting after a falling accident. Magnetic resonance imaging demonstrated diffuse subarachnoid hemorrhage, intraventricular hemorrhage, and variable stages of subdural hematoma in bilateral occipital and left temporal subdural spaces. A partially thrombosed aneurysm was noted in the right craniocervical junction. Ophthalmological examination revealed bilateral retinal petechial hemorrhages. Conventional cerebral angiography revealed a dissecting aneurysm in the right posterior inferior cerebellar artery (PICA). Endovascular embolization was suggested, but the family refused. After conservative treatment, follow-up MRI revealed that the PICA aneurysm had remodeled and ultimately disappeared completely at the 10th month. This case illustrates the relatively plastic nature of intracranial aneurysms in pediatric patients. More studies are necessary to clarify the natural history of spontaneously thrombosed aneurysms to assist in their overall management.

  5. Treatment of Ruptured Vertebral Artery Dissecting Aneurysms Distal to the Posterior Inferior Cerebellar Artery: Stenting or Trapping?

    Energy Technology Data Exchange (ETDEWEB)

    Fang, Yi-Bin, E-mail: fangyibin@163.com; Zhao, Kai-Jun, E-mail: zkjwcfzwh@163.com; Wu, Yi-Na, E-mail: wuyina0923@163.com; Zhou, Yu, E-mail: yzhou-2011@126.com; Li, Qiang, E-mail: lqeimm@126.com; Yang, Peng-Fei, E-mail: 15921196312@163.com; Huang, Qing-Hai, E-mail: ocinhqh@163.com; Zhao, Wen-Yuan, E-mail: doczhaowy@163.com; Xu, Yi, E-mail: xuyichyy@163.com; Liu, Jian-Min, E-mail: chstroke@163.com [Second Military Medical University, Department of Neurosurgery, Changhai Hospital (China)

    2015-06-15

    PurposeThe treatment of ruptured vertebral artery dissecting aneurysms (VADAs) continues to be controversial. Our goal was to evaluate the safety, efficacy, and long-term outcomes of internal trapping and stent-assisted coiling (SAC) for ruptured VADAs distal to the posterior inferior cerebellar artery (supra-PICA VADAs), which is the most common subset.MethodsA retrospective review was conducted of 39 consecutive ruptured supra-PICA VADAs treated with internal trapping (n = 20) or with SAC (n = 19) at our institution. The clinical and angiographic data were retrospectively compared.ResultsThe immediate total occlusion rate of the VADAs was 80 % in the trapping group, which improved to 88.9 % at the follow-ups (45 months on average). Unwanted occlusions of the posterior inferior cerebellar artery (PICA) were detected in three trapped cases. Incomplete obliteration of the VADA or unwanted occlusions of the PICA were detected primarily in the VADAs closest to the PICA. In the stenting group, the immediate total occlusion rate was 47.4 %, which improved to 100 % at the follow-ups (39 months on average). The immediate total occlusion rate of the VADAs was higher in the trapping group (p < 0.05), but the later total occlusion was slightly higher in the stenting group (p > 0.05).ConclusionsOur preliminary results showed that internal trapping and stent-assisted coiling are both technically feasible for treating ruptured supra-PICA VADAs. Although not statistically significant, procedural related complications occurred more frequently in the trapping group. When the VADAs are close to the PICA, we suggest that the lesions should be treated using SAC.

  6. Evaluation of the efficacy of a novel radical neck dissection preserving the external jugular vein, greater auricular nerve, and deep branches of the cervical nerve

    Directory of Open Access Journals (Sweden)

    Li Y

    2013-04-01

    Full Text Available Yadong Li, Jinsong Zhang, Kai Yang Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China Background: Conventional radical neck dissection often causes a variety of complications. Although the dissection method has been improved by retaining some tissues to reduce complications, the incomplete dissection may cause recurrence of disease. In the present study, we developed a novel radical neck dissection, which preserves the external jugular vein, the greater auricular nerve, and the deep branches of the cervical nerve, to effectively reduce complications and subsequently, to promote the postoperative survival quality. Methods: A total of 100 cases of radical neck dissection were retrospectively analyzed to evaluate the efficacy, rate of complication, and postoperative dysfunction of patients treated with the novel radical neck dissection. Data analysis was performed using the Chi-square test. Results: Compared with conventional radical neck dissection, the novel radical neck dissection could significantly reduce complications and promote postoperative survival quality. Particularly, the preservation of the external jugular vein reduced the surgical risk (ie, intracranial hypertension and complications (eg, facial edema, dizziness, headache. Preservation of the deep branches of the cervical nerve and greater auricular nerve resulted in relatively ideal postoperative functions of the shoulders and ear skin sensory function (P 0.05. Conclusion: Our novel radical neck dissection procedure could effectively reduce the complications of intracranial hypertension, shoulder dysfunction, and ear sensory disturbances. It can be used as a regular surgical approach for oral carcinoma radical neck dissection. Keywords: oral cancer, head and neck cancer, squamous cell carcinoma, survival quality, neck dissection, recurrence

  7. Dr. Zhang's Experience in Massotherapy for Treatment of Vertebral-Artery-Type Cervical Spondylopathy

    Institute of Scientific and Technical Information of China (English)

    谢利民; 张涛

    2002-01-01

    @@ Thirty cases of vertebral-artery-type cervical spondylopathy were treated by Dr. Zhang Tao's technique. The cure rate was 50%, and the total effective rate was 100%.The vertebral-artery-type cervical spondylopathy is a commonly-seen condition in the aged people, often accompanied with arteriosclerosis. Based on the techniques performed by Dr. Du Ziming (the late famous TCM physician of our hospital), Dr. Zhang Tao has developed a set of therapeutic techniques for this condition. From June 1997 to April 1998, the author had treated 30 cases of the disease, with satisfactory results reported in the following.

  8. TREATMENT OF VERTEBRAL-ARTERY TYPE CERVICAL SPONDYLOPATHY WITH NEEDLE-KNIFE THERAPY

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    In the present paper,62 cases of vertebral-artery type cervical spondyiopathy were treated with needle-knife therapy (acupotomy).After 2-6 sessions of treatment,23 cases (37.1%) were cured,19(30.7%) showed marked improvement,15(24.2%) had some improvement and 5(8.1%) failed in the treatment.The total effective rate was 91.9%.It indicates that acupotomy therapy is a highly effective remedy for treating vertabral-artery type cervical spndylopathy.

  9. Inadvertent Complication of a Pipeline Embolization Device for Treatment with Vertebral Artery Dissecting Aneurysm : Distal Tip Fracture of Delivery Wire.

    Science.gov (United States)

    Park, Jung Soo; Kwak, Hyo Sung; Lee, Jong Myong

    2016-09-01

    Use of the Pipeline embolization device (PED) has increased based on studies about its safety and effectiveness, and new reports that describe peri- or postprocedural complications are now emerging. We report a rare periprocedural device-related complication that occurred during endovascular treatment with the pipeline embolization device for a dissecting aneurysm on the vertebral artery. A 55-year old woman was admitted due to left medullary infarction, and angiography showed a fusiform dilatation in the left vertebral artery that was suspicious for dissecting aneurysm. Endovascular treatment with PED was planned. Under general anesthesia, the procedure was performed without significant problems and a PED was deployed in an appropriate position. However, in the final step of the procedure, the distal tip of the PED delivery wire became engaged within a small branch of the posterior cerebral artery and fractured. Fortunately, imaging studies after the procedure revealed neither hemorrhagic nor ischemic stroke, and the patient recovered without neurological morbidities except initial symptoms.

  10. Internal carotid artery dissection in a patient with Ehlers-Danlos syndrome type IV: diagnosis and management

    Directory of Open Access Journals (Sweden)

    Michel Nasser

    2013-06-01

    Full Text Available Ehlers-Danlos syndrome (EDS type IV, also known as vascular EDS, is an inherited connective tissue disorder with an estimated prevalence of 1/100,000 to 1/250,000. In EDS type IV, vascular complications may affect all anatomical areas, with a preference for large- and medium-sized arteries. Dissections of the vertebral and carotid arteries in their extra- and intra-cranial segments are typical. The authors report the case of a patient with EDS type IV for whom the diagnosis was established based on clinical signs and who developed internal carotid artery dissection at the age of 44 years. In the absence of a specific treatment for EDS type IV, medical interventions should focus on symptomatic relief, prophylactic measures, and genetic counseling. Invasive imaging techniques are contraindicated, and a conservative approach to vascular complications is usually recommended.

  11. Iatrogenic dissection of the celiac artery and its branches during TAE for HCC: results of follow-up in 30 cases

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Dae Young; Park, Jae Hyung; Chung, Jin Wook; Han, Joon Koo; Han, Man Chung [College of Medicine, Seoul National Univrsity, Seoul (Korea, Republic of); Suh, Chang Hae [College of Medicine, Inha University, Incheon (Korea, Republic of)

    1993-01-15

    The authors analyzed 30 patients whose celiac artery or its branches were dissected during the procedure of transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) and were followed up angiographically. The incidence of arterial dissection was 1.25%. The dissection occurred most frequently in the celiac artery (40% 12/30) and the proper hepatic artery (28% 7/30). The frequency of arterial dissection was affected by the status of the vessel and the experience of the operator. The follow-up angiography revealed complete recanalization in 40% (12/30), irregularity and narrowing of the lumen in 23% (7/30), pseudoaneurysm formation in 23% (7/30), and complete obstruction in 13% (4/30) of the cases. The rate of recanalization in the celiac artery was lower than that of any other arteries in our series. Recanalization to a certain degree without therapeutic intervention was observed in 72% of the dissected arteries enabling and contributing to subsequent successful TAE within 2 months in 78% of the patients with the dissection.

  12. Complicated type B aortic dissection causing ischemia in the celiac and inferior mesenteric artery distribution despite patent superior mesenteric artery bypass.

    Science.gov (United States)

    Afifi, Rana O; Zhu, Youwei; Leake, Samuel S; Kott, Amy; Azizzadeh, Ali; Estrera, Anthony L; Safi, Hazim J; Charlton-Ouw, Kristofer M

    2015-08-01

    Mortality rates associated with acute type B aortic dissection (ABAD) complicated by malperfusion remains significant. Optimal management of patients with ABAD is still debatable. We present a case report of a 50-year-old man who was admitted due to ABAD. He was treated medically with his pain resolved and he was discharged on oral antihypertensive medications. One month after initial diagnosis, he was readmitted with abdominal pain, nausea, vomiting, and diarrhea. On imaging, an extension of the aortic dissection into the visceral arteries with occlusion of the celiac and superior mesenteric arteries (SMA) was noted. He underwent thoracic endovascular aortic repair (TEVAR) and bypass grafting to the SMA. Despite the intervention, the patient developed large bowel, liver, and gastric ischemia and underwent bowel resection. He died from multi-organ failure. In selected cases of uncomplicated ABAD, TEVAR should be considered and when TEVAR fails and visceral malperfusion develops, an aggressive revascularization of multiple visceral arteries should be attempted.

  13. Carotid artery dissection on non-contrast CT: Does color improve the diagnostic confidence?

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca, E-mail: lucasaba@tiscali.it [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Argiolas, Giovanni Maria [Department of Radiology, Azienda Ospedaliero Brotzu (A.O.B.), di Cagliari, Cagliari 09100 (Italy); Raz, Eytan [Department of Radiology, New York University School of Medicine, New York (United States); Department of Neurology and Psychiatry, Sapienza University of Rome (Italy); Sannia, Stefano [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Suri, Jasjit S. [Diagnostic and Monitoring Division, AtheroPointTM LLC, Roseville, CA (United States); Electrical Engineering Department (Aff.), Idaho State University, ID (United States); Siotto, Paolo [Department of Radiology, Azienda Ospedaliero Brotzu (A.O.B.), di Cagliari, Cagliari 09100 (Italy); Sanfilippo, Roberto; Montisci, Roberto [Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Piga, Mario [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Wintermark, Max [Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, Charlottesville, VA, 22908 (United States)

    2014-12-15

    Highlights: • The use of a color scale to display the non-contrast CT images in lieu of the classic grayscale improves the diagnostic confidence of the readers. • Radiologists should consider the use of a color scale, rather than the conventional grayscale, to assess non-contrast CT studies for possible carotid artery dissection. - Abstract: Purpose: The purpose of this work was to evaluate if the use of color maps, instead of conventional grayscale images, would improve the observer's diagnostic confidence in the non-contrast CT evaluation of internal carotid artery dissection (ICAD). Materials and methods: One hundred patients (61 men, 39 women; mean age, 51 years; range, 25–78 years), 40 with and 60 without ICAD, underwent non-contrast CT and were included in this the retrospective study. In this study, three groups of patients were considered: patients with MR confirmation of ICAD, n = 40; patients with MR confirmation of ICAD absence, n = 20; patients who underwent CT of the carotid arteries because of atherosclerotic disease, n = 40. Four blinded observers with different levels of expertise (expert, intermediate A, intermediate B and trainee) analyzed the non-contrast CT datasets using a cross model (one case grayscale and the following case using the color scale). The presence of ICAD was scored on a 5-point scale in order to assess the observer's diagnostic confidence. After 3 months the four observers evaluated the same datasets by using the same cross-model for the alternate readings (one case color scale and the following case using the grayscale). Statistical analysis included receiver operating characteristics (ROC) curve analysis, the Cohen weighted test and sensitivity, specificity, PPV, NPV, accuracy, LR+ and LR−. Results: The ROC curve analysis showed that, for all observers, the use of color scale resulted in an improved diagnostic confidence with AUC values increasing from 0.896 to 0.936, 0.823 to 0.849, 0.84 to 0.909 and 0

  14. IV-DSA of vertigo patients. Asymmetry of cervical vertebral arteries

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Hiromi; Ito, Masatoshi; Takita, Kimio; Matsuzawa, Taiju.

    1988-04-01

    With IV-DSA(Intra-Venous Digital Subtraction Angiography), we examined the relations between vertigo or dizziness and asymmetries of cervical vertebral arteries. In this time, as the asymmetries we chose next three; hemi-stenosis, hemi-occulusion and hemi-strong tortuosity. In the appearance of the asymmetries, there was no differance between those who complain vertigo or dizziness and others.

  15. Aortic dissection

    Science.gov (United States)

    ... linked to aortic dissection include: Bicuspid aortic valve Coarctation (narrowing) of the aorta Connective tissue disorders (such ... failure Aneurysm Aortic insufficiency Blood clots Cardiac tamponade Coarctation of the aorta Hardening of the arteries High ...

  16. [Myocardial infarction by spontaneous dissection of coronary arteries in a subject with type IV Ehlers-Danlos syndrome].

    Science.gov (United States)

    Catanese, V; Venot, P; Lemesle, F; Delille, F; Runge, I; Kuchly, B

    1995-10-07

    Acute myocardial infarction with spontaneous coronary dissection was fatal in a 33-years-old man. Autopsy and family history revealed type IV Ehlers-Danlos syndrome. In this disease, conjunctive tissue is fragilized due to a deficit in type III collagen which leads to spontaneous ruptures in large and medium sized arteries. The present case is the first with a proven rupture of the coronary arteries. This disease should be entertained in young people with no atherogenous risk factor and an acute coronary disorder since peripheral skin and joint syndromes may be discreet or missing. Treatment is difficult in case of spontaneous coronary dissection. Thrombolysis is not possible and diagnosis may require angiography which is in itself dangerous due to the fragility of the coronary vessels.

  17. Fibromuscular Dysplasia Leading to Spontaneous Coronary Artery Dissection with Sudden Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Ata Bajwa

    2015-01-01

    Full Text Available A 30-year-old previously healthy female, who was six-week postpartum, experienced sudden collapse and tonic-clonic seizure. Emergency medicine services arrived at the scene and the patient was found to be in ventricular fibrillation. Advanced cardiovascular life support (ACLS was initiated with return of spontaneous circulation. Afterwards, her initial EKG showed atrial fibrillation with rapid ventricular rate, ST elevation in leads II, III, and aVF, and ST depression in V2–V4. She was transferred to a tertiary care hospital where emergent angiogram was performed revealing obstruction of blood flow in the proximal and mid right coronary artery (RCA. A hazy and irregularly contoured appearance of the RCA was consistent with diagnosis of fibromuscular dysplasia. Subsequently, intravascular ultrasonogram (IVUS was performed which confirmed the diagnosis of RCA dissection. Successful revascularization of the RCA was performed using two bare mental stents. After a complicated course in hospital, she was discharged in stable condition and did very well overall.

  18. The MDCT and MRI Findings of a Pancreatic Arteriovenous Malformation Combined with Isolated Dissection of the Superior Mesenteric Artery: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Soo; Jeong, Woo Kyoung [Hanyang University Guri Hospital, Seoul (Korea, Republic of); Kim, Jin Oo [Naval Pohang Hospital, Pohang (Korea, Republic of); Oh, Ji Young; Song, Soon Young [Hanyang University Medical College, Seoul (Korea, Republic of)

    2010-03-15

    Pancreatic arteriovenous malformation and isolated spontaneous dissection of the superior mesenteric artery are both rare maladies, and now they can be easily diagnosed due to the development of such noninvasive modalities as multi-detector computed tomography and magnetic resonance imaging. We report here on the multi-detector computed tomography and magnetic resonance imaging findings of a rare case of pancreatic arteriovenous malformation combined with isolated dissection of the superior mesenteric artery.

  19. A major pain in the … Back and epigastrium: an unusual case of spontaneous celiac artery dissection

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    Kumkum Sarkar Patel

    2014-11-01

    Full Text Available A 60-year-old woman with mitral valve prolapse, chronic low back pain, and a 30-pack year smoking history presented for a second admission of poorly controlled mid-back pain 10 days after her first admission. She had concomitant epigastric pain, sharp/burning in quality, radiating to the right side and to the mid-back, not associated with food nor improving with pain medications. She denied nausea, vomiting, diarrhea, constipation, dark stools, or blood per rectum. Our purpose was to determine the cause of the patient's epigastric pain. Physical examination revealed epigastric and mid-back tenderness on palpation. Labs were normal except for a hemoglobin drop from 14 to 12.1 g/dL over 2 days. Abdominal ultrasound and subsequent esophagogastroduodenoscopy were normal. Contrast-enhanced abdominal computed tomographic (CT scan revealed the development of a spontaneous celiac artery dissection as the cause of the epigastric pain. The patient was observed without stenting and subsequent CT angiography 4 days later did not reveal worsening of the dissection. She was discharged on aspirin and clopidogrel with outpatient follow-up. Thus far, less than 100 cases of isolated spontaneous celiac artery dissections have been reported. The advent of CT scans and magnetic resonance imaging has increasingly enabled its detection. Risk factors may include hypertension, arteriosclerosis, smoking, and cystic medial necrosis. There is a 5:1 male to female ratio with an average presenting age of 55. Management of dissections may include surgical repair, endovascular stenting, and selective embolization. Limited dissections can be managed conservatively with anti-platelet and/or anticoagulation agents and strict blood pressure control, as done in our patient.

  20. Low arterial pressure on admission as a predictor of mortality in operated patients with type A aortic dissection

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    Pavlović Katica

    2011-01-01

    Full Text Available Background/Aim. Hypertension is a known predictor of proximal aortic dissection, but it is not commonly present in these patients on presentation. The associations between ascending aorta with left ventricular hypertrophy, cardiovascular risk factors and coronary atherosclerosis, and outcome of these patients are not fully elucidated. Methods. This retrospective study included 55 consecutive patients with acute type A aortic dissection treated surgically in our institution during the last 2 years. The diagnosis was based on imaging studies. Diameter of ascending aorta was measured with echocardiography. Results. The mean age of the patients was 55.4 ± 12.19 years, and 72.7% were men. A history of arterial hypertension was present in 76.4% of the patients. Maximal ascending aorta diameter was 4.09 ± 0.59 cm, while patients with frank aneurysm accounted for 5.5%. Systolic blood pressure on admission was < 150 mmHg in 58.2% of the patients. Diastolic blood pressure on admission was < 90 mmHg in 54.5% of the patients. Mean arterial pressure on admission was 104.9 ± 24.6 mmHg. No correlations were demonstrated between maximal ascending aorta diameter and diameter of the left ventricular wall, any obtained risk factor and with coronary artery atherosclerosis (p > 0.05. After six months 11 (20% patients died, while intrahospital mortality was 72%. According to logistic regression analysis which included traditional risk factors, echo parameters, coronary artery disease and logistic euro scor, mean arterial blood pressure was the independent predictor of a six-month mortality [RR 0.956; CI (0.918-0.994 ; p = 0.024]. Conclusion. In our population the acute type A aortic dissection occurred rarely in the setting of frank ascending aortic aneurysms > 5.0 cm. The majority of patients had a history of arterial hypertension. A history of arterial hypertension was not associated with maximal ascending aorta diameter. Mean arterial blood pressure was the

  1. Spontaneous Renal Artery Dissection as a Cause of Acute Renal Infarction: Clinical and MDCT Findings.

    Science.gov (United States)

    Yoon, Kibo; Song, Soon Young; Lee, Chang Hwa; Ko, Byung Hee; Lee, Seunghun; Kang, Bo Kyeong; Kim, Mi Mi

    2017-04-01

    The purpose of this study was to assess the incidence of spontaneous renal artery dissection (SRAD) as a cause of acute renal infarction, and to evaluate the clinical and multidetector computed tomography (MDCT) findings of SRAD. From November 2011 to January 2014, 35 patients who were diagnosed with acute renal infarction by MDCT were included. We analyzed the 35 MDCT data sets and medical records retrospectively, and compared clinical and imaging features of SRAD with an embolism, using Fisher's exact test and the Mann-Whitney test. The most common cause of acute renal infarction was an embolism, and SRAD was the second most common cause. SRAD patients had new-onset hypertension more frequently than embolic patients. Embolic patients were found to have increased C-reactive protein (CRP) more often than SRAD patients. Laboratory results, including tests for lactate dehydrogenase (LDH) and blood urea nitrogen (BUN), and the BUN/creatinine ratio (BCR) were significantly higher in embolic patients than SRAD patients. Bilateral renal involvement was detected in embolic patients more often than in SRAD patients. MDCT images of SRAD patients showed the stenosis of the true lumen, due to compression by a thrombosed false lumen. None of SRAD patients progressed to an estimated glomerular filtration rate renal disease during the follow-up period. SRAD is not a rare cause of acute renal infarction, and it has a benign clinical course. It should be considered in a differential diagnosis of acute renal infarction, particularly in patients with new-onset hypertension, unilateral renal involvement, and normal ranges of CRP, LDH, BUN, and BCR.

  2. Medevac from a cruise ship of a patient with spontaneous coronary artery dissection who presented with epigastralgia.

    Science.gov (United States)

    Garcia-Castaneda, Jenny; Harb-De la Rosa, Alfredo

    2014-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome that has been associated with peripartum and postpartum periods. It results from the separation of the layers of the arterial wall of the coronary artery with the subsequent formation of a false lumen. We report a case of a 54-year-old female who presented to the cruise ship's medical facility complaining of epigastralgia and dizziness. Work up including an electrocardiography and cardiac profile was ordered. Results yielded a diagnosis of non-ST segment elevation myocardial infarction (NSTEMI). Treatment following American Heart Association recommendations including nitrates, clopidogrel and enoxaparin was given. After debarkation at sea and referral to a reference hospital, the patient was diagnosed with SCAD. Patient's outcome was favorable and she was discharged home a few days after, despite being managed as a NSTEMI.

  3. Cervical internal carotid artery pseudoaneurysm complicating malignant otitis externa: first case report.

    Science.gov (United States)

    Baker, Andrew; Rizk, Habib; Carroll, William; Lambert, Paul

    2015-03-01

    Pseudoaneurysm of the internal carotid artery (ICA) is a rare complication of head and neck infections. To date, three cases of petrous ICA pseudoaneurysm have been described as a complication of otogenic infection, including only one secondary to malignant otitis externa. We present here the first case of cervical ICA pseudoaneurysm as a complication of malignant otitis externa, and stress the importance of timely diagnosis to avoid fatal outcomes.

  4. Double Bolus Application in TWIST-MR-Angiography of the Cervical Arteries

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    Andreas Korn

    2012-01-01

    Full Text Available Purpose. The aim of the present work was to test the feasibility of the time-resolved MR-angiography (TWIST-MRA of cervical arteries using double bolus injection. Material and Methods. TWIST-MRA with a temporal resolution of 8.4 seconds for each frame and a spatial resolution with a voxel size of   was performed in 24 patients. A biphasic bolus injection protocol was used with the second injection being started 21 seconds after the first contrast dye bolus. Diagnostic image quality was rated according to a 4-point scale. Results. In 12 patients (50% no clear separation between the cervical venous and arterial vessels was evident after the first bolus injection. Using TWIST-MRA data acquired after the second bolus a sufficient diagnostic image quality (rating , mean 3.5 could be obtained in 22 of 24 patients (92%. Discussion. The double bolus injection protocol using TWIST-MRA allows for very good separation of the cervical arteries.

  5. Bilateral dissection of the internal carotid artery at the base of the skull due to blunt trauma: incidence and severity.

    Science.gov (United States)

    Alimi, Y; Di Mauro, P; Tomachot, L; Albanese, J; Martin, C; Alliez, B; Juhan, C

    1998-11-01

    Between January 1, 1992 and December 31, 1996, a total of 1095 head trauma vicims were admitted in our intensive care unit. If CT scans demonstrated ischemic brain lesions, arteriography to visualize supraaortic vessels was performed. Carotid artery dissection was observed in ten patients (0.91%) and was bilateral in eight patients (0.73%). In the bilateral carotid artery dissection (BCAD) group, there were five women and three men, with a mean age of 35.2 years (range: 17 to 54 years). Injuries resulted from traffic accidents in seven patients and a fall in one patient. Upon admission, six patients presented with alteration of consciousness and three with hemiplegia or hemiparesia, associated with aphasia in two cases. In two other cases, hemiplegia occurred 24 hr and 13 days after the accident. All patients had brain infarction, which was unilateral in five cases and bilateral in three cases. The severity of lesions was graded on the basis of arteriographic findings as follows: Type I, wall involvement without significant stenosis or dilation; Type II, arterial dissection with stenosis >70% (Type IIA) or dilatation >50% (Type IIB) and the normal diameter of the proximal or distal internal carotid artery; and Type III, thrombosis of the internal carotid artery. Lesions were asymmetrical in six patients, including two with Type II and III lesions and four with Type I and II lesions, and symmetrical in two patients, including one with bilateral Type III lesions and one with bilateral Type II lesions. Surgery was performed in two patients with Type II lesions, including one case associated with contralateral carotid thrombosis. The intrapetrous carotid artery was exposed by an ear-nose-throat (ENT) surgeon and repaired by interposition grafting. Follow-up in these two surgical cases was 28 and 31 months. In the remaining six cases, medical treatment was performed. Outcome in nonsurgical cases was variable: death in two cases at 31 and 43 days after the accident

  6. Arterial supply of the cervical thymus lobes in swine fetuses (Sus scrofa domesticus of the Camborough 25 lineage

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    Eduardo Maurício Mendes de Lima

    2009-09-01

    Full Text Available This study aims to discover more about the arterial supply of cervical lobes of the thymus, in relation to its origins, distribution and ordination in swine (Sus scrofa domesticus of Camborough 25 lineage. Thus, 29 swine (17 males and 12 females were studied. The arterial system of the models was colored with aqueous solution of Neoprene Latex “450” (50% and after the models were fixed in 10% formaldehyde aqueous solution. Great individual variations in the length and size of the thymus vessel supply, and also in the layout, size and thickness of the cervical lobes of the thymus, were observed. The superficial cervical artery (96.55%, common carotid artery (54.54% and occipital artery (55.17% contribute to the blood supply of the cervical lobes on both sides. In addition, branches from the lingual artery (3.45% and internal carotid artery (3.45% on both sides, as well as the subclavian artery (6.90% on the left side, were observed. No significant differences in vascularization of lobes in relation to antimerals or sexes were evidenced. Considering the findings, it was conclued that each animal had its own characteristics and peculiarities, thus enabling the establishment of a particular arrangement of the swine strain.

  7. Spontaneous Coronary Artery Dissection and Hemodynamic Instability: Can Emergent PCI Be Life Saving? Report of Two Cases and Literature Review.

    Science.gov (United States)

    Al Emam, Abdel Rahman A; Almomani, Ahmed; Gilani, Syed A

    2014-12-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome. It occurs predominantly among younger females and typically in the absence of atherosclerotic coronary artery disease. It is associated with peripartum period, connective tissue disorders, vasculitides, and extreme exertion. Presentations vary greatly, and this condition can be fatal. Given its rarity, there are no guidelines for management of SCAD. We present the cases of two female patients, with no coronary artery disease risk factors or recent pregnancy, who were presented with non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI), respectively, secondary to SCAD. Both had excellent outcome after emergent percutaneous intervention. Our first patient was presented with NSTEMI with ongoing chest pain and dynamic electrocardiogram (ECG). Emergent left heart catheterization was significant for first obtuse marginal (OM1) dissection, confirmed by optical coherence tomography. Percutaneous coronary intervention (PCI) with two bare metal stents was performed with resolution of symptoms and ECG changes. The second patient is known to have syndrome, presented with STEMI and emergent coronary angiography showed left anterior descending dissection with intramural hematoma confirmed by intravascular ultrasound and treated with a drug-eluting stent with resolution of symptoms and ST changes. Her hospital course was complicated by post-myocardial infarction pericarditis that was improved with colchicine. Both the patients were observed in the coronary care unit for 24 hours. Both remained asymptomatic at 6-month follow-up. SCAD is a rare cause of acute coronary syndrome. In patients with early presentation, limited disease, and ongoing symptoms, emergent cardiac catheterization with percutaneous intervention has excellent outcome. More studies are needed to establish evidence-based management guidelines.

  8. Renal infarction due to spontaneous dissection of the renal artery: an unusual cause of non-visceral type abdominal pain.

    Science.gov (United States)

    Kang, James H-E; Kang, Jin-Yong; Morgan, Robert

    2013-09-18

    A 44-year-old man presented with very severe right upper quadrant pain of sudden onset. This was exacerbated by movement but unaffected by food or defaecation. It was continuous-day and night -but resolved over a 1-week period. The physical examination was normal at presentation, by which time the pain had resolved. His white cell count, alanine transaminase and C reactive protein were elevated but normalised after 10 days. An abdominal CT showed low density lesions in the right kidney consistent with segmental infarcts. CT angiogram showed a dissection of the right renal artery. The patient remained asymptomatic and normotensive when reviewed 1 month later.

  9. Spontaneous coronary artery dissection in the context of positive anticardiolipin antibodies and clinically undiagnosed systemic lupus erythematosus.

    Science.gov (United States)

    Nisar, M K; Mya, T

    2011-11-01

    Spontaneous coronary artery dissection (SCAD) is an extremely uncommon condition that can lead to fatal acute myocardial infarction. There have been very few case reports of SCAD in patients with systemic lupus erythematosus (SLE) and even fewer in association with antiphospholipid antibodies - mainly postpartum. This is the first reported case of SCAD in a patient who was confirmed to have SLE and tested positive for anticardiolipin antibody and lupus anticoagulant. This case demonstrates the importance of carefully considering the differential diagnoses of SCAD at presentation. It also highlights the need for further research to explore the link between SLE, antiphospholipid antibodies and SCAD.

  10. Open triple-branched stent graft applied to patient of acute type a aortic dissection with Aberrant Right Subclavian Artery

    OpenAIRE

    Guo, Changfa; Zhu, Kai; Xu, Demin; Wang, Chunsheng

    2013-01-01

    A 57-year-old Chinese male patient presented with Standford type A aortic dissection with an aberrant right subclavian artery (ARSA). At operation, the ascending aorta was replaced by a mono–branch vascular prosthesis with the branch bypassing to the ARSA; the triple-branched stent graft was inserted into the true lumen of the arch and proximal descending aorta (covering the origin of the ARSA) with each sidearm graft being positioned into the aortic branches; and then its proximal end was su...

  11. [Spontaneous intracranial internal carotid artery dissection: 6 case reports and a review of 39 cases in the literature].

    Science.gov (United States)

    Nagumo, Kiyomi; Nakamori, Akitoshi; Kojima, Shigeyuki

    2003-06-01

    Angiographic, CT and MR findings, precipitating factors, and clinical features of spontaneous intracranial internal carotid artery dissection, in particular the terminal segment of the ICA, are described. Patients who had a possible posttraumatic dissection were excluded from the study. Six patients, 3 men and 3 women, mean age 25.8 years, were studied. Spontaneous ICA dissection accounted for 0.63 percent of 797 patients with ischemic stroke and 14 percent of 36 patients with ischemic stroke who were 45 years of age or younger. Headache was absent in two but clearly preceded the onset of cerebral stroke in four patients, the interval ranging from less than a few minutes to 6 hours. Focal cerebral ischemic symptoms were present in all six patients. Four presented with loss of consciousness. Only one patient had a subarachnoid hemorrhage (SAH). Dissection occurred at the level of the carotid knee portion just beyond the origin of the ophthalmic artery in all the patients. Moreover, there was additional involvement of the ipsilateral MCA in four and ipsilateral ACA in three. Angiographic features of the six ICAs that involved dissection were a smooth tapered luminal narrowing or occlusion in two patients, irregular narrowing in three, a pearl and string sign in one, and retention of the contrast media in three. Follow up angiography or magnetic resonance (MR) angiography was performed on all the patients. The interval from the initial to follow-up angiography was one to six months. Stenosis persisted in one artery but was resolved in the other five arteries. MR angiography showed segmental narrowing of the right supraclinoid internal carotid artery in one patient. MR angiographic source images showed a narrow lumen in the right intracavernous portion of the ICA and a crescent-shaped filling defect. Follow-up MR imaging and MR angiography, 6 months after the initial study, showed amelioration of the luminal narrowing and no filling defect. The filling defect is

  12. Clinical impact of cervical lymph node involvement and central neck dissection in patients with papillary thyroid carcinoma: a retrospective analysis of 368 cases.

    Science.gov (United States)

    Bozec, Alexandre; Dassonville, Olivier; Chamorey, Emmanuel; Poissonnet, Gilles; Sudaka, Anne; Peyrottes, Isabelle; Ettore, Francette; Haudebourg, Juliette; Bussière, Françoise; Benisvy, Danielle; Marcy, Pierre-Yves; Sadoul, Jean Louis; Hofman, Paul; Lassale, Sandra; Vallicioni, Jacques; Demard, François; Santini, José

    2011-08-01

    The impact of cervical lymph node metastases and the optimal surgical management of the neck in patients with papillary thyroid carcinoma (PTC) remain controversial. The objectives of this retrospective study were to determine, in patients with PTC, the predictive factors and the impact on tumor recurrence rate of cervical lymph node involvement, and to evaluate the oncologic results and the morbidity of central neck dissection (CND). We reviewed the records of patients who had undergone surgical treatment for PTC at our institution between 1990 and 2000. A total of 368 patients (86 men and 282 women) were included in this study. Young age (p = 0.02), tumor size (p = 0.001) and extrathyroidal tumor extension (p = 0.003) were significant predictive factors of cervical lymph node metastatic involvement (multivariate analysis). Initial metastatic cervical lymph node involvement was identified as an independent risk factor of tumor recurrence (multivariate analysis, p = 0.01). Metastatic lymph node(s) were found in prophylactic CND specimens in 31% of the patients. CND increased the risk of postoperative hypocalcemia (p = 0.008) and of permanent hypoparathyroidism (p = 0.002). In conclusion, cervical lymph node metastatic involvement at the time of initial surgery is an independent risk factor of tumor recurrence. CND provided an up-staging of more than 30% of patients with a clinically N0 neck, but was associated with significant morbidity regarding parathyroid function.

  13. Spontaneous dissections of the anterior cerebral artery: a meta-analysis of the literature and three recent cases

    Energy Technology Data Exchange (ETDEWEB)

    Hensler, Johannes; Jensen-Kondering, Ulf; Jansen, Olav [University Hospital Schleswig-Holstein (UKSH), Department of Radiology and Neuroradiology, Kiel (Germany); Ulmer, Stephan [Medical Radiological Institute, Neuroradiology, Zurich (Switzerland)

    2016-10-15

    Spontaneous dissections of intracranial arteries are rare, but important causes of stroke, especially in younger patients. Dissections of the anterior cerebral artery (ACA) have been reported only very rarely in the European and North American populations but might be more prevalent than previously thought. This paper describes the presenting pattern of the disease, the clinical and imaging findings, as well as endovascular therapeutical options with respect to a meta-analysis of cases reported in the literature. Additionally, own observations in three recent representative cases are discussed. Overall, 80 cases from recent literature were included to the meta-analysis. The median age was 51 (35-82) years. Ischemia alone was described in 58 cases (73 %), subarachnoid hemorrhage (SAH) in 8 cases (10 %), and a combination of both in 14 cases (17 %). Radiological diagnosis including use of thin-layered 3T-MRI vessel wall imaging with black blood technique was verified by double lumen, by a string sign or string and pearl sign, or by a vessel wall hematoma in 23 (32 %), 62 (89 %), and 14 (20 %) cases, respectively. Interventional or surgical treatment was performed in 7 cases. A good clinical recovery was achieved in 77 % of cases. Dissections of the ACA mostly cause ischemia, but can cause SAH or a combination of both in a relatively young population. Detailed neuroradiological diagnosis including 3T-MRI vessel wall imaging is required as a double lumen, isolated stenosis due to vessel wall hematoma, or the secondary development of a pseudoaneurysm might occur. Interventional therapy is the primary therapy for these vascular complications. (orig.)

  14. Clinical evaluation of intra-arterial infusion chemoradiotherapy for advanced or recurrent cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kaneyasu, Yuko; Fukuhara, Noboru; Karasawa, Kumiko; Isobe, Madoka; Himei, Kengo; Kojima, Nahoko; Toda, Jo; Okawa, Tomohiko [Tokyo Women`s Medical Coll. (Japan); Kita, Midori

    1999-01-01

    Fifty two patients with advanced or recurrent cervical cancer were treated by intraarterial infusion chemotherapy (IAIC) with or without radiotherapy. IAIC regimen was separated into two groups: group I consisted of 5-FU+MMC{+-}ADR (30 patients) and group II consisted of CDDP+MMC{+-}5-FU (22 patients). The tip of the catheter was placed in the bifurcation of abdominal aorta or the bilateral internal iliac arteries (7 patients). Overall response rate (CR+PR) was 71% for all patients, 87% in patients who received radiotherapy, 50% in those not receiving radiotherapy, and 100% in primary patients. Five-year survival rate was 20% in primary patients, 14% in recurrent patients, 3% in group I and 38% in group II (p=0.00182) by chemotherapy regimen, 30% in CR patients, and 13% in non-CR patients (p=0.00436), respectively. Acute hematological side effects of grade III-IV was 48% for all patients, but recovered from by interruption of drugs. Among the 7 patients which the tip of the catheter was placed in internal iliac arteries, there were severe skin ulcers in 2 cases, and severe leg or gluteal region pain, for which narcotics were needed in 2 patients. These data suggest that IAIC mainly with cisplatin with or without radiotherapy was not particularly effective treatment for advanced cervical cancer, but it might be one of the effective treatment for residual cervical cancer after surgery and recurrent cervical cancer once the patient has obtained CR. One should check the blood flow distribution periodically, and control the concentration of drugs. In order to improve prognosis of these patients, one should furthermore consider a combination of IAIC and systemic chemotherapy. (author)

  15. Mechanism and patterns of cervical spine fractures-dislocations in vertebral artery injury

    Directory of Open Access Journals (Sweden)

    Pankaj Gupta

    2012-01-01

    Full Text Available Purpose: To identify the fracture patterns and mechanism of injury, based on subaxial cervical spine injury classification system (SLIC, on non-contrast computed tomography (NCCT of cervical spine predictive of vertebral artery injury (VAI. Patients and Methods: We retrospectively analyzed cervical spine magnetic resonance imaging (MRI of 320 patients who were admitted with cervical spine injury in our level I regional trauma center over a period of two years (April 2010 to April 2012. Diagnosis of VAI was based on hyperintensity replacing the flow void on a T2-weighted axial image. NCCT images of the selected 43 patients with MRI diagnosis of VAI were then assessed for the pattern of injury. The cervical spinal injuries were classified into those involving the C1 and C2 and subaxial spine. For the latter, SLIC was used. Results: A total of 47 VAI were analyzed in 43 patients. Only one patient with VAI on MRI had no detectable abnormality on NCCT. C1 and C2 injuries were found in one and six patients respectively. In subaxial injuries, the most common mechanism of injury was distraction (37.5% with facet dislocation with or without fracture representing the most common pattern of injury (55%. C5 was the single most common affected vertebral level. Extension to foramen transversarium was present in 20 (42.5% cases. Conclusion: CT represents a robust screening tool for patients with VAI. VAI should be suspected in patients with facet dislocation with or without fractures, foramina transversarium fractures and C1-C3 fractures, especially type III odontoid fractures and distraction mechanism of injury.

  16. Thrombolysis in patients with acute ischemic stroke due to arterial extracranial dissection

    NARCIS (Netherlands)

    M.D.I. Vergouwen; P.A.C.A. Beentjes; P.J. Nederkoorn

    2009-01-01

    No data of randomized controlled trials investigating the effect of thrombolysis in patients with ischemic stroke caused by an extracranial dissection are available. Previous case series suggested that thrombolysis in this group of patients is safe and improves outcome, however publication bias may

  17. Arterial Abnormalities Leading to Tinnitus.

    Science.gov (United States)

    Miller, Timothy R; Serulle, Yafell; Gandhi, Dheeraj

    2016-05-01

    Tinnitus is a common symptom that usually originates in the middle ear. Vascular causes of pulsatile tinnitus are categorized by the location of the source of the noise within the cerebral-cervical vasculature: arterial, arteriovenous, and venous. Arterial stenosis secondary to atherosclerotic disease or dissection, arterial anatomic variants at the skull base, and vascular skull base tumors are some of the more common causes of arterial and arteriovenous pulsatile tinnitus. Noninvasive imaging is indicated to evaluate for possible causes of pulsatile tinnitus, and should be followed by catheter angiography if there is a strong clinical suspicion for a dural arteriovenous fistula.

  18. Retreatment and outcomes of recurrent intracranial vertebral artery dissecting aneurysms after stent assisted coiling: a single center experience.

    Directory of Open Access Journals (Sweden)

    Ying Song

    Full Text Available The retreatment of recurrent intracranial vertebral artery dissecting aneurysms (VADAs after stent assisted coiling (SAC has not yet been studied. The purpose of this study was to evaluate the strategies and outcomes for retreatment of recurrent VADAs after SAC.Between September 2009 and November 2013, six consecutive patients presenting with recurrent intracranial VADAs after SAC were enrolled in this study. They were all male with age ranging from 29 to 54 years (mean age, 46.2 years. The procedures of treatments and angiographic and clinical follow-up were reviewed retrospectively. Retreatment modalities were selected individually according to the characteristics of recurrence. The outcomes of retreatment were evaluated by angiographic and clinical follow-up.Six patients with recurrent intracranial VADAs after SAC were retreated, with second SAC in three patients, coil embolization, double overlapping stents placement and endovascular occlusion with aneurysm trapping in one patient, respectively. Immediate angiographic outcomes of retreatment were: complete occlusion in three patients, nearly complete occlusion in two patients, and contrast medium retention in dissecting aneurysm in one patient. All cases were technically successful. No complications related to endovascular procedures occurred. Angiographic follow-up was available in all five patients treated with second SAC or double overlapping stents, which was complete occlusion in four patients, obliteration of parent artery in one patient, showing no recurrence at 4-11 months (mean: 8.6 months. Clinical follow-up was performed in all six patients at 11-51 months after initial endovascular treatment and at 9-43 months after retreatment. The mRS of last clinical follow-up was excellent in five patients and mild disability in only one patient.Endovascular retreatment is feasible and effective for recurrent intracranial VADAs after SAC. Individualized strategies of retreatment should be

  19. Usefulness of R2* maps generated by iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation sequence for cerebral artery dissection

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Ayumi; Shinohara, Yuki; Fujii, Shinya; Miyoshi, Fuminori; Kuya, Keita; Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological, and Therapeutic Science, Faculty of Medicine, Yonago (Japan); Yamashita, Eijiro [Tottori University Hospital, Division of Clinical Radiology, Yonago (Japan)

    2015-09-15

    Acute intramural hematoma resulting from cerebral artery dissection is usually visualized as a region of intermediate signal intensity on T1-weighted images (WI). This often causes problems with distinguishing acute atheromatous lesions from surrounding parenchyma and dissection. The present study aimed to determine whether or not R2* maps generated by the iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation sequence (IDEAL IQ) can distinguish cerebral artery dissection more effectively than three-dimensional variable refocusing flip angle TSE T1WI (T1-CUBE) and T2*WI. We reviewed data from nine patients with arterial dissection who were assessed by MR images including R2* maps, T2*WI, T1-CUBE, and 3D time-of-flight (TOF)-MRA. We visually assessed intramural hematomas in each patient as positive (clearly visible susceptibility effect reflecting intramural hematoma as hyperintensity on R2* map and hypointensity on T2*WI), negative (absent intramural hematoma), equivocal (difficult to distinguish between intramural hematoma and other paramagnetic substances such as veins, vessel wall calcification, or hemorrhage) and not evaluable (difficult to determine intramural hematoma due to susceptibility artifacts arising from skull base). Eight of nine patients were assessed during the acute phase. Lesions in all eight patients were positive for intramural hematoma corresponding to dissection sites on R2* maps, while two lesions were positive on T2*WI and three lesions showed high-intensity on T1-CUBE reflected intramural hematoma during the acute phase. R2* maps generated using IDEAL IQ can detect acute intramural hematoma associated with cerebral artery dissection more effectively than T2*WI and earlier than T1-CUBE. (orig.)

  20. Estudo anatômico do trajeto da artéria vertebral na coluna cervical inferior humana Anatomical study of the vertebral artery path in human lower cervical spine

    Directory of Open Access Journals (Sweden)

    Ben Hur Junitiro Kajimoto

    2007-01-01

    Full Text Available O aumento da utilização de novas técnicas e materiais de síntese para o tratamento cirúrgico de afecções da coluna cervical baixa foi acompanhado da crescente preocupação em relação às complicações que podem ocorrer. A técnica de fixação transpedicular, amplamente utilizada para os outros níveis da coluna vertebral, quando realizada na coluna cervical, apesar de conferir maior estabilidade quando comparada a outras técnicas, pode cursar com complicações graves como lesão da artéria vertebral, lesão de raiz nervosa, além de lesão da articulação facetária. A vértebra C7, no entanto, é considerada mais segura para a realização de tal procedimento, já que, na grande maioria das pessoas, segundo os estudos anatômicos disponíveis, esta não possui a artéria vertebral dentro de seu forame transverso, pois este vaso irá penetrar tal estrutura apenas na vértebra C6. Como hoje existem apenas estudos de imagem para avaliação do trajeto desta artéria e suas variações anatômicas, realizamos este estudo anatômico dissecando 40 artérias vertebrais de cadáveres para avaliar a incidência das variações anatômicas. Encontramos 3 casos onde a artéria vertebral penetrou o forame transverso já em C7 (7,5%, o que aumentaria o risco de uma técnica transpedicular neste nível. O restante das peças anatômicas possuíam anatomia habitual.The increasing use of new techniques and materials for surgical treatment of lower cervical spine conditions has come along with an increasing concern regarding potential complications that might occur. The transpedicular fixation technique, frequently used in other spine levels, is used on the cervical spine, while providing more stability than other techniques, it may cause serious complications such as vertebral artery injury, nervous root injury, or facet joint injuries. However, the C7 vertebra is considered safer for performing this procedure, since, in the vast majority of

  1. 脑动脉夹层的研究现状%Status of cervicocerebral artery dissection

    Institute of Scientific and Technical Information of China (English)

    张栩; 潘旭东

    2008-01-01

    动脉夹层是指动脉壁层内的撕裂而导致血液成分通过破损的血管内膜进入血管壁,使血管壁分层,造成血管狭窄、闭塞或形成假性动脉瘤。当血流聚积在内膜及中层之间时造成管腔狭窄;当血肿主要累及中膜与外膜时则形成动脉瘤样扩张。脑动脉夹层(cervicocerebral artery dissection,CAD)是青年卒中的常见病因。在CAD患者中,颈内动脉夹层(internal carotid artery dissection,ICD)较椎动脉夹层(vetebral artery dissection,VAD)更常见。CAD的病因并不是很清楚,病前的颈部外伤史常见,但不普遍。遗传因素,如Ehlers—Danlos综合征、Marfan综合征等可以促进CAD的发病。

  2. Cervical Spondylopathy Involving the Vertebral Arteries Treated by Body-Acupuncture Combined with Scalp-Acupuncture in 72 Cases

    Institute of Scientific and Technical Information of China (English)

    李保民; 柴富明; 高洪明

    2002-01-01

    @@ Among various types of cervical spondylopathy, the one involving the vertebral arteries is frequently encountered in the middle-aged and the old people. It is often accompanied with arteriosclerosis and high blood viscosity, and clinically it is difficult to be treated. From March 1996 to December 2000, the authors hadtreated 72 cases of cervical spondylopathy of this type and achieved satisfactory therapeutic effects shown by clinical symptoms and indicated by the trans-cranial Doppler ultrasonic examination (TCD). This is reported as follows.

  3. Cervicitis

    Science.gov (United States)

    ... much growth of normal bacteria in the vagina (bacterial vaginosis) can also cause cervicitis. ... under a microscope (may show candidiasis , trichomoniasis , or bacterial vaginosis) Pap test Tests for gonorrhea or chlamydia Rarely, ...

  4. Spontaneous coronary artery dissection presenting as an ischaemic stroke in a middle-aged man with anti-cardiolipin antibodies: a case report

    Directory of Open Access Journals (Sweden)

    Lim F

    2010-03-01

    Full Text Available Abstract Introduction Cerebrovascular disease is a major cause of mortality and morbidity worldwide. Ischemic stroke is the most common manifestation, encompassing a wide variety of causative mechanisms. We present the case of a middle-aged male patient with spontaneous coronary artery dissection in the presence of anti-cardiolipin antibodies, leading to left ventricular thrombus and presenting with stroke. Case presentation A 56-year-old Caucasian man presented with dysarthria and right-sided weakness. There was a history of chest pain with autonomic symptoms four days earlier. Examination revealed right-sided hemiparesis. Electrocardiogram showed sinus rhythm with anterior Q waves. Magnetic resonance imaging of the brain showed large left parietal and smaller multiple cerebral infarcts. Echocardiogram showed anterior wall and apical akinesis with a large mural thrombus. Anti-cardiolipin antibodies immunoglobulin G and immunoglobulin M were strongly positive. Coronary angiography showed dissection of the mid left anterior descending artery with normal flow down the distal vessel. He was treated conservatively with anticoagulation and secondary prevention. He was in good health when seen in clinic four months later. Conclusion We highlight the importance of a comprehensive approach at obtaining the correct diagnosis, input of different specialities and the fact that the presence of anti-cardiolipin antibodies is associated with coronary artery dissection in a middle-aged male patient whose presentation was stroke.

  5. Esvaziamento cervical no carcinoma epidermoide de laringe: indicação de esvaziamento eletivo contralateral Neck dissection in squamous cell carcinoma of the larynx: indication of elective contralateral neck dissection

    Directory of Open Access Journals (Sweden)

    Ali Amar

    2012-04-01

    Full Text Available O planejamento terapêutico dos tumores da laringe inclui a possibilidade de esvaziamento cervical uni ou bilateral. OBJETIVO: Avaliar a prevalência e localização de metástases linfonodais bilaterais ou contralaterais nos tumores de laringe. CASUÍSTICA E MÉTODO: Estudo longitudinal retrospectivo de 272 prontuários de pacientes com carcinoma epidermoide de laringe tratados entre 1996 e 2004, selecionados 104 submetidos à cirurgia com esvaziamento cervical. Avaliada a incidência de metástases bilaterais ou contralaterais, de acordo com a localização e extensão do tumor primário, considerando os subsítios anatômicos e a linha mediana. RESULTADOS: A prevalência de metástases contralaterais nos tumores lateralizados foi de 3,5% nas lesões glóticas e 26% nas lesões supraglóticas. As metástases contralaterais foram infrequentes nos casos N0. Tanto no esvaziamento eletivo como no terapêutico, os níveis linfonodais IIa e III foram os mais acometidos. CONCLUSÃO: Nas lesões glóticas lateralizadas, mesmo nos tumores transglóticos, não há necessidade de esvaziamento contralateral eletivo. Nas lesões da supraglote sem metástases ipsilaterais, a incidência de metástases ocultas não justifica o esvaziamento eletivo contralateral. A linha mediana não é um indicador fidedigno do risco de metástases contralaterais nos tumores da laringe.Unilateral or bilateral neck dissection must be considered in the treatment of laryngeal cancer AIM: To evaluate the prevalence of contralateral metastases in larynx cancer and distribution of these metastases according to lymph node levels in the neck. METHOD: Retrospective longitudinal study of 272 charts from patients with squamous cell cancer of the larynx treated between 1996 and 2004; and we selected 104 surgical cases submitted to neck dissection. We evaluated the incidence of bilateral or contralateral metastases, according to the location and extension of the primary tumor

  6. Novel use of a supraclavicular transverse cervical artery customised perforator flap: a paediatric emergency.

    LENUS (Irish Health Repository)

    Dolan, R T

    2013-08-01

    Perforation of the piriform fossa is a rare, potentially life-threatening paediatric emergency. Prompt diagnosis and early operative intervention is key to patient survival, yet restoring aerodigestive continuity can pose a significant reconstructive challenge. A seven-month old baby girl presented to an emergency department acutely unwell with a twenty-four-hour history of haemoptysis, cough and worsening respiratory distress. A contrast swallow demonstrated extension of contrast into the retropharyngeal region necessitating immediate surgical intervention. A 3.0 cm×1.0 cm perforation within the left posterolateral piriform fossa was identified. The defect was repaired with a supraclavicular transverse cervical artery customised perforator flap. This was inset into the piriform fossa luminal defect as a life-saving procedure. Following a stormy post-operative course, the child was discharged home on day 28 of admission and admitted electively 6 weeks later for division of flap pedicle. This case highlights the novel use of this fasciocutaneous island flap to reconstruct an extensive, potentially fatal, piriform fossa defect in an acute paediatric setting. This simple flap design offers timely mobilisation, reliable blood supply, adequate tenuity and surface area, to reconstruct this extensive defect as a life-saving intervention in a profoundly septic child.

  7. Isolated oculomotor nerve palsy inspontaneous internal carotid artery dissection: case report Paralisia isolada do nervo oculomotor na dissecção de artéria carótida interna: relato de caso

    Directory of Open Access Journals (Sweden)

    Cynthia Resende Campos

    2003-09-01

    Full Text Available Partial oculosympathetic palsy followed by ischemic manifestations in brain or retina are the main symptoms of extracranial internal carotid artery (ICA dissection. Unusually, cranial nerves may be affected. Isolated oculomotor nerve palsy is found only rarely. CASE: We present a 50-year-old nondiabetic man who experienced acute onset of right occipital headache which spread to the right retro-orbital region. Five days later he noticed diplopia and right blurred vision sensation. Neurologic examination disclosed only impaired adduction and upward gaze of right eye, slight ipsilateral pupillary dilatation, without ptosis. Brain MRI was normal. Angiography showed right internal carotid artery dissection with forward occlusion to the base of the skull. Intravenous heparin followed by warfarin was prescribed. The headache and the oculomotor nerve deficit gradually resolved in the next three weeks. DISCUSSION: Isolated oculomotor nerve palsy is underrecognized as a clinical presentation of extracranial ICA dissection. If the angiographic evaluation is incomplete without careful study of extracranial arteries, misdiagnosis may lead to failure to initiate early treatment to prevent thromboembolic complications. For this reason we draw attention to the need for careful evaluation of cervical arteries in patients with oculomotor nerve palsy. Mechanical compression or stretching of the third nerve are possible mechanisms, but the direct impairment of the blood supply to the third nerve seems to be the most plausible explanation.A paralisia oculosimpática parcial (síndrome de Horner seguida por manifestações isquêmicas cerebrais ou retinianas são os principais sintomas da dissecção da artéria carótida interna (ACI extracraniana. O acometimento de nervos cranianos é incomum. Apenas raramente a paralisia isolada do nervo oculomotor pode ser encontrada. CASO: homem de 50 anos, sem diabetes, apresentou cefaléia occipital de início s

  8. Should we abandon cervical spine manipulation for mechanical neck pain? : yes

    OpenAIRE

    2012-01-01

    Cervical spine manipulation (a high velocity, low amplitude, end range thrust manoeuvre) is a common\\ud treatment option for mechanical neck pain yet may carry the potential for serious neurovascular\\ud complications, specifically vertebral artery dissection and subsequent vertebrobasilar stroke. The nonsuperiority\\ud of manipulation to alternative treatments, coupled with concerns regarding safety, renders\\ud cervical spine manipulation unnecessary and inadvisable.

  9. [Morphological signs of mitochondrial cytopathy in skeletal muscles and micro-vessel walls in a patient with cerebral artery dissection associated with MELAS syndrome].

    Science.gov (United States)

    Sakharova, A V; Kalashnikova, L A; Chaĭkovskaia, R P; Mir-Kasimov, M F; Nazarova, M A; Pykhtina, T N; Dobrynina, L A; Patrusheva, N L; Patrushev, L I; Protskiĭ, S V

    2012-01-01

    Skin and muscles biopsy specimens of a patient harboring A3243G mutation in mitochondrial DNA, with dissection of internal carotid and vertebral arteries, associated with MELAS were studied using histochemical and electron-microscopy techniques. Ragged red fibers, regional variability of SDH histochemical reaction, two types of morphologically atypical mitochondria and their aggregation were found in muscle. There was correlation between SDH histochemical staining and number of mitochondria revealed by electron microscopy in muscle tissue. Similar mitochondrial abnormality, their distribution and cell lesions followed by extra-cellular matrix mineralization were found in the blood vessel walls. In line with generalization of cytopathy process caused by gene mutation it can be supposed that changes found in skin and muscle microvessels also exist in large cerebral vessels causing the vessel wall "weakness", predisposing them to dissection.

  10. Use of the frozen elephant trunk technique in complicated chronic dissection with porcelain aorta and visceral arteries originating from different lumens.

    Science.gov (United States)

    Zembala, Michal O; Irimie, Vadim; Urbanski, Paul P

    2016-04-01

    A rare case of aortic arch aneurysm combined with chronic aortic dissection is reported. Because the visceral arteries originated from different, equivalently perfused lumens and the descending aorta was circumferentially calcified (porcelain aorta) limiting the possibilities of anastomosing, careful planning of the surgical strategy was of utmost importance. The complex surgery consisted of ascending and total arch replacement using the 'frozen elephant trunk' technique with Thoraflex™ Hybrid Prosthesis (Vascutek, Terumo, Inchinnan, Scotland); however, before insertion of the stent graft, an angioscopic resection of the dissection membrane in the proximal part of the descending aorta was carried out to ensure a complete expansion of the distal edge of the stent within the entire common lumen of the aorta and unimpaired distal flow in both lumens below the stent graft. The surgery and the postoperative course were uneventful.

  11. Percutaneous cervical carotid artery access with stenting of the left internal carotid artery in an elderly patient

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To describe the successful endovascular treatment in a nonagenarian with symptomatic internal carotid artery stenosis using direct carotid artery access. An independent 98 year-old man was admitted to our hospital for symptoms of progressive weakness with disorientation and dysphasia. Carotid Duplex ultrasonography was performed which revealed a totally occluded right internal carotid artery and high grade stenosis of the left internal carotid artery by velocities of 608/240 cm/sec. The patient refused surgical endarterectomy and thus he was referred for carotid artery stenting. Using the femoral artery approach and multiple catheter techniques, access to the common carotid artery could not be accomplished safely. The procedure was aborted and he was therefore brought back to the catheterization laboratory the following day for direct carotid access. Carotid artery stenting was accomplished by using of a 6F sheath percutaneously in the left common carotid, cerebral protection device (CPD) and a Nitinol stent. The patient was discharged the following day without complications. At 14 months follow-up the patient is functional and independent without recurrence of symptoms. Carotid artery stenting via direct access can be accomplished in patients when the femoral artery approach is anatomically prohibitive. In this case of advanced age and the patient's refusal for surgery, direct carotid access was his only option.

  12. Cervical Rotatory Manipulation Decreases Uniaxial Tensile Properties of Rabbit Atherosclerotic Internal Carotid Artery

    Science.gov (United States)

    Qi, Ji; Zhang, Lei; Chen, Chao; Mondal, Shubhro; Ping, Kaike; Chen, Yili

    2017-01-01

    Objective. To investigate the effects of one of the Chinese massage therapies, cervical rotatory manipulation (CRM), on uniaxial tensile properties of rabbit atherosclerotic internal carotid artery (ICA). Methods. 40 male purebred New Zealand white rabbits were randomly divided into CRM-Model group, Non-CRM-Model group, CRM-Normal group, and Non-CRM-Normal group. After modeling (atherosclerotic model) and intervention (CRM or Non-CRM), uniaxial tensile tests were performed on the ICAs to assess the differences in tensile mechanical properties between the four groups. Results. Both CRM and modeling were the main effects affecting physiological elastic modulus (PEM) of ICA. PEM in CRM-Model group was 1.81 times as much as Non-CRM-Model group, while the value in CRM-Model group was 1.34 times as much as CRM-Normal group. Maximum elastic modulus in CRM-Model group was 1.80 times as much as CRM-Normal group. Max strains in CRM-Model group and Non-CRM-Model group were 30.98% and 28.71% lower than CRM-Normal group and Non-CRM-Normal group, respectively. However, whether treated with CRM or not, the uniaxial tensile properties of healthy ICAs were not statistically different. Conclusion. CRM may decrease the uniaxial tensile properties of rabbit arteriosclerotic ICA, but with no effect on normal group. The study will aid in the meaningful explanation of the controversy about the harmfulness of CRM and the suitable population of CRM. PMID:28303160

  13. Effect of systemic vein chemotherapy and internal iliac arterial embolization infusion chemotherapy on angiogenesis and malignant degree of cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Gang Chen

    2016-01-01

    Objective:To analyze the effect of systemic vein chemotherapy and internal iliac arterial chemoembolization on angiogenesis and malignant degree of cervical cancer.Methods: A total of 108 cases of patients with middle and advanced cervical cancer were included in the research, and the time range of the research was from February 2014 to December 2015. According to different means of chemotherapy, included patients were divided into observation group 54 cases and control group 54 cases, control group received systemic vein chemotherapy, observation group received internal iliac arterial infusion chemotherapy and embolization treatment, and then differences in the levels of angiogenesis-related indicators, blood flow parameters within tumor, serum illness-related indicators, cervical tumor tissue proliferation-related indicators,etc. were compared between two groups after treatment.Results:Serum VEGFR-2, HIF-1α, vWF and Lam values of observation group after chemotherapy were lower than those of control group; PI, VI, FI, VFI and Vmax values of observation group after treatment were lower than those of control group while RI value was higher than that of control group; serum SCC-Ag, TK1, HE4, CYFRA21-1, IGF-Ⅱ and Gal-9 values of observation group after chemotherapy were lower than those of control group; miR-26b, SCD-1, Cyclin D1 and TLR4 protein expression levels in tumor tissue of observation group after treatment were lower than those of control group while miR-99b protein expression level was higher than that of control group.Conclusions: Internal iliac arterial infusion chemotherapy and embolization can significantly decrease tumor angiogenesis and inhibit tumor cell proliferation, and it is a perfect means of interventional chemotherapy.

  14. Endovascular treatment of vertebral artery dissecting aneurysm involving posterior inferior cerebellar artery%累及小脑后下动脉椎动脉夹层动脉瘤的血管内介入治疗效果

    Institute of Scientific and Technical Information of China (English)

    何川; 张鹏; 张鸿祺

    2015-01-01

    Objective To analyze stenting and dual catheter technique in protection of posterior inferior cerebellar artery and its imaging and clinical follow-up results in the endovascular treatment of vertebral artery dissecting aneurysms. Methods From January 2012 to December 2014,the clinical data of 4 patients with vertebral artery dissecting aneurysm involving posterior inferior cerebellar artery treated with endovascular method and admitted to the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were enrolled retrospectively. The whole brain DSA examinations were performed at 6 months after procedure. The clinical follow-up period ranged from 12 to 24 months. Results Three of the 4 patients were treated with posterior inferior cerebellar artery-vertebral artery stenting,one patient was treated by using bidirectional dual catheter technique to protect posterior inferior cerebellar artery. The interventional therapy of 4 patients were all successful. Immediately after procedure,angiography revealed that the posterior inferior cerebellar arteries were patent,no ischemic symptoms were observed. The angiography at 6 months after procedure revealed no recurrence of aneurysms;the posterior inferior cerebellar arteries were patent without in-stent stenosis. No new symptoms of neurological deficit were observed during 12 to 24-month follow-up. Conclusion In the interventional treatment of vertebral artery dissecting aneurysms of posterior inferior cerebellar artery,using the posterior inferior cerebellar artery-vertebral artery stenting technique and bidirectional dual catheter technique may safely and effectively protect the posterior inferior cerebellar artery.%目的:分析椎动脉夹层动脉瘤的血管内介入治疗中支架置入和双导管技术保护小脑后下动脉(PICA)的方法及其影像和临床随访结果。方法回顾性纳入首都医科大学宣武医院神经外科2012年1月至2014年12月收治的4例累及PICA的椎动

  15. Early-onset osteoarthritis, Charcot-Marie-Tooth like neuropathy, autoimmune features, multiple arterial aneurysms and dissections: an unrecognized and life threatening condition.

    Directory of Open Access Journals (Sweden)

    Mélodie Aubart

    Full Text Available BACKGROUND: Severe osteoarthritis and thoracic aortic aneurysms have recently been associated with mutations in the SMAD3 gene, but the full clinical spectrum is incompletely defined. METHODS: All SMAD3 gene mutation carriers coming to our centre and their families were investigated prospectively with a structured panel including standardized clinical workup, blood tests, total body computed tomography, joint X-rays. Electroneuromyography was performed in selected cases. RESULTS: Thirty-four SMAD3 gene mutation carriers coming to our centre were identified and 16 relatives were considered affected because of aortic surgery or sudden death (total 50 subjects. Aortic disease was present in 72%, complicated with aortic dissection, surgery or sudden death in 56% at a mean age of 45 years. Aneurysm or tortuosity of the neck arteries was present in 78%, other arteries were affected in 44%, including dissection of coronary artery. Overall, 95% of mutation carriers displayed either aortic or extra-aortic arterial disease. Acrocyanosis was also present in the majority of patients. Osteoarticular manifestations were recorded in all patients. Joint involvement could be severe requiring surgery in young patients, of unusual localization such as tarsus or shoulder, or mimicking crystalline arthropathy with fibrocartilage calcifications. Sixty eight percent of patients displayed neurological symptoms, and 9 suffered peripheral neuropathy. Electroneuromyography revealed an axonal motor and sensory neuropathy in 3 different families, very evocative of type II Charcot-Marie-Tooth (CMT2 disease, although none had mutations in the known CMT2 genes. Autoimmune features including Sjogren's disease, rheumatoid arthritis, Hashimoto's disease, or isolated autoantibodies- were found in 36% of patients. INTERPRETATION: SMAD3 gene mutations are associated with aortic dilatation and osteoarthritis, but also autoimmunity and peripheral neuropathy which mimics type II

  16. Screening and detection of blunt vertebral artery injury in patients with upper cervical fractures: The role of cervical CT and CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Payabvash, Seyedmehdi, E-mail: spayab@gmail.com [Department of Radiology, University of Minnesota Medical Center, Minneapolis, MN (United States); McKinney, Alexander M., E-mail: mckinrad@umn.edu [Department of Radiology, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN (United States); McKinney, Zeke J., E-mail: zeke.mckinney@hcmed.org [Department of Radiology, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN (United States); Palmer, Christopher S., E-mail: palme018@umn.edu [Department of Radiology, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN (United States); Truwit, Charles L., E-mail: truwit@umn.edu [Department of Radiology, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN (United States)

    2014-03-15

    Objective: To evaluate the clinical utility of nonenhanced CT (NECT)-based screening criteria and CTA in detection of blunt vertebral artery injury (BVAI) in trauma patients with C1 and/or C2 fractures. Methods: We retrospectively reviewed the clinical records of all blunt trauma patients with C1 and/or C2 fractures between 8/2006 and 9/2011. Cervical CTA was prompted by cervical fractures involving/adjacent to a transverse foramen, and/or subluxation on NECT. Two neuroradiologists independently reviewed the CTA studies, and graded the BVAI. Results: 210 patients were included; of these, 124 underwent CTA (21/124 with digital subtraction angiography, DSA), and 2 underwent DSA only. Overall, 30/126 suffered BVAI. Among 21 patients who underwent both CTA and DSA, there was 1 false negative and 1 false positive (both grade 1). There was strong interobserver agreement regarding CTA-based BVAI detection (kappa = 0.93, p < 0.001) and grading (kappa = 0.90, p < 0001). Only 3/30 BVAI patients suffered a posterior circulation stroke; none of the patients who had a negative CTA or were not selected for CTA, based on NECT screening criteria, suffered symptomatic stroke. While C1/C2 comminuted fracture was more common in patients with high grade BVAI (p = 0.039), simultaneous C3–C7 comminuted fracture increased the overall BVAI risk (p = 0.011). Conclusion: CTA reliably detects symptomatic BVAI in patients with upper cervical fractures. Utilization of NECT-based screening criteria such as transverse foraminal involvement or subluxation may be adequate in deciding whether to perform CTA, as no patients who were not selected for CTA suffered a symptomatic stroke. However, CTA may miss lower grade, asymptomatic BVAI.

  17. 自发性腹腔干夹层的 MSCT 血管成像表现%Imaging manifestations of spontaneous celiac artery trunk dissection with multi-detector CT angiography

    Institute of Scientific and Technical Information of China (English)

    宁辉; 张龙江

    2015-01-01

    Objective:To summarize the multi-detector CT angiography (MDCTA)manifestations of spontaneous ce-liac artery trunk dissection.Methods:The clinical and MDCTA manifestations of 14 patients with spontaneous celiac artery trunk dissection were retrospectively analyzed.Results:Of the 14 patients,10 patients (71.4%,10/14)had spontaneous ce-liac artery trunk dissection,4 patients (28.6%,4/14)had both celiac artery trunk and superior mesenteric artery dissec-tion.Intimal plaque,orifice of dissection,true and false lumen were displayed in all involved 14 celiac artery trunk and 4 su-perior mesenteric artery dissections.Three dissected arteries were associated with thrombosis,2 dissected arteries with mu-ral calcification,2 dissected arteries with adjacent hematoma,and 1 with splenic infarct.Of the 14 celiac artery trunk dissec-tion,6 associated with aneurymal protrusion,and all 4 superior mesenteric artery dissection had aneurysmal protrusion asso-ciated.Two patients had celiac artery Digital Subtraction Angiography performed,the manifestations were similar to that of MSCT angiography.Intra-stent thrombosis was found in one patient underwent stent implantation.Conclusion:MDCT angi-ography can detect the pathology of celiac artery trunk dissection sensitively,which might used as the first choice modality for the diagnosis and follow up of this disease entity.%目的:总结自发性腹腔干夹层的 MSCT 血管成像表现。方法:回顾性分析14例自发性腹腔干夹层患者的临床及 MSCT 血管成像表现。结果:14例患者中自发性腹腔干夹层10例(71.4%,10/14),腹腔干和肠系膜上动脉夹层4例(28.6%,4/14)。14条腹腔干血管和4条肠系膜上动脉夹层均显示了内膜片、破口及真假腔,3条血管夹层合并血栓,2条夹层血管合并钙化,2例患者合并周围血肿,1例合并脾梗死。14条腹腔干夹层中6条血管夹层伴有动脉瘤样突起,4条肠系膜上动脉夹层

  18. Dissecção da artéria pulmonar e hipertensão pulmonar Pulmonary hypertension and pulmonary artery dissection

    Directory of Open Access Journals (Sweden)

    Ricardo de Amorim Corrêa

    2013-04-01

    Full Text Available A dissecção da artéria pulmonar é uma complicação fatal da hipertensão pulmonar de longa duração que se manifesta como dor torácica aguda e lancinante, dispneia progressiva, choque cardiogênico ou morte súbita. Sua incidência é subestimada, e as opções terapêuticas são ainda limitadas. O aparecimento de uma dor torácica aguda ou nova, choque cardiogênico ou morte súbita em pacientes portadores de hipertensão pulmonar deve alertar para o diagnóstico de dissecção da artéria pulmonar.Pulmonary artery dissection is a fatal complication of long-standing pulmonary hypertension, manifesting as acute, stabbing chest pain, progressive dyspnea, cardiogenic shock, or sudden death. Its incidence has been underestimated, and therapeutic options are still scarce. In patients with pulmonary hypertension, new chest pain, acute chest pain, or cardiogenic shock should raise the suspicion of pulmonary artery dissection, which can result in sudden death.

  19. Dissecção e rotura da artéria pulmonar associada a persistência do canal arterial: relato de um caso Dissection and rupture of pulmonary artery associated to patent ductus arteriosus: case report

    Directory of Open Access Journals (Sweden)

    Mabel de Moura Barros Zamorano

    1987-08-01

    Full Text Available É descrito um caso de dissecção da artéria pulmonar, com rotura intrapericárdica e tamponamento cardíaco, em menina de 13 anos de idade, portadora de canal arterial grande e valva pulmonar bicúspide. Havia hipertensão pulmonar com arteriopatia plexogênica grave; nas grandes artérias elásticas, a camada média tinha alterações necróticas e reparadoras profundas. Discute-se o papel da medionecrose, condição que é exacerbada pela hipertensão e por características individuais, na patogenia do aneurisma dissecante e no caso em questão. A análise da literatura mostra que, na artéria pulmonar, a dissecção é sempre um acidente fatal, por rotura ou obstrução arterial. O tratamento desta intercorrência, eminentemente cirúrgico, raramente é possível, devido ao caráter fulminante da evolução e à ausência de sinais definidos para o diagnóstico em tempo hábil.The author presents a case of a 13-year old girl with pulmonary trunk dissection and rupture with a cardiac tamponade. There was a ductus arteriosus persistent and a non stenotic bicuspid pulmonary valve. A plexogenic pulmonary arteriopathy and severe process of injury and repair in the elastic vessels are present. The significance of medionecrosis in the pathogenesis ot pulmonary dissection is discussed. An analysis of reports in dissecting pulmonary aneurysm reveals a fatal outcome in the vast majority of them, due either to arterial rupture or obstruction.

  20. Urgent endarterectomy using pretreatment with free radical scavenger, edaravone, and early clamping of the parent arteries for cervical carotid artery stenosis with crescendo transient ischemic attacks caused by mobile thrombus and hemodynamic cerebral ischemia. Case report.

    Science.gov (United States)

    Kobayashi, Masakazu; Ogasawara, Kuniaki; Inoue, Takashi; Saito, Hideo; Komoribayashi, Nobukazu; Suga, Yasunori; Ogawa, Akira

    2007-03-01

    A 68-year-old man with left cervical internal carotid artery stenosis suffered crescendo transient ischemic attacks caused by mobile thrombus detected by carotid echography and secondary impairment of cerebral hemodynamic reserve demonstrated by positron emission tomography. Urgent carotid endarterectomy (CEA) was performed following pretreatment with edaravone and early clamping of the carotid arteries without intraluminal shunting. The postoperative course was uneventful, and postoperative magnetic resonance imaging and single-photon emission computed tomography revealed no new cerebral ischemic lesions and no findings of cerebral hyperperfusion, respectively. The risks associated with CEA are higher for patients with evolving stroke or crescendo transient ischemic attacks than that for patients with stable disease. This case demonstrates that urgent endarterectomy for cervical carotid artery stenosis with crescendo transient ischemic attacks caused by mobile thrombi and hemodynamic cerebral ischemia can be successfully performed following pretreatment with edaravone and early clamping of the carotid arteries.

  1. A case of traumatic intracranial vertebral artery injury presenting with life-threatening symptoms

    Directory of Open Access Journals (Sweden)

    Kishi S

    2012-04-01

    Full Text Available Seiji Kishi1, Kenji Kanaji2, Toshio Doi1, Tadashi Matsumura21Department of Nephrology, Tokushima University Hospital, Kuramoto-cho Tokushima, 2Department of General Internal Medicine, Rakuwakai Otowa Hospital, Otowachinji-cho Yamashina-ku Kyoto, JapanAbstract: Traumatic intracranial vertebral artery injury is a relatively rare but potentially fatal disease. We present a case of a 63-year-old man who presented with sudden onset of loss of consciousness after hitting his head. After immediate resuscitation, he showed quadriplegia and absence of spontaneous breathing. Brain and cervical spine magnetic resonance imaging revealed an atlantoaxial subluxation, fractured C2 odontoid process, left vertebral artery occlusion, and bilateral extensive ischemia in the medulla oblongata and high cervical spinal cord. Digital subtraction angiography demonstrated left vertebral artery dissection just below the level of vertebral body C2.Keywords: vertebral artery dissection, brainstem infarction, bilateral spinal cord infarction, neck trauma

  2. Endovascular treatment for dissecting aneurysms in vertebral artery%椎动脉夹层动脉瘤的血管内治疗

    Institute of Scientific and Technical Information of China (English)

    穆士卿; 李佑祥; 杨新健; 姜除寒; 吕明; 吴中学

    2011-01-01

    目的 总结不同部位椎动脉夹层动脉瘤的诊疗经验.方法 回顾性分析82例椎动脉夹层动脉瘤的临床资料,并根据小脑后下动脉(PICA)与瘤体的关系进行分类,Ⅰ类:PICA起始部远离瘤体;Ⅱ类:PICA起始部发自瘤体上下缘;Ⅲ类:PICA 起始部发自瘤体.所有病人均采用血管内治疗.结果 随访82例,时间3~18个月.Ⅰ类动脉瘤40例,其中行动脉瘤及载瘤动脉闭塞术23例,术后随访未见动脉瘤复发;行支架结合微弹簧圈治疗术17例,术后动脉瘤完全及近全栓塞12例,随访动脉瘸保持稳定13例.Ⅱ类动脉瘤27例均行支架结合微弹簧圈治疗,术后动脉瘤完全及近全栓塞17例,随访动脉瘤保持稳定18例.Ⅲ类动脉瘤15例,行支架结合微弹簧圈治疗7例,术中均行部分栓塞,随访动脉瘤保持稳定4例;行单纯支架植入术8例,术后随访仅3例动脉瘤保持稳定.结论根据PICA和动脉瘤体的关系进行分类,充分考虑PICA的位置关系,可指导椎动脉夹层动脉瘤的血管内治疗.%Objective To summarize the experiences of diagnosis and treatment of dissecting aneurysms in vertebral artery. Methods Clinical data of 82 patients with dissecting aneurysms in vertebral artery were analyzed retrospectively. According to the relationship between posterior inferior cerebellar artery (PICA) and the aneurysms, all the aneurysms were classified into 3 types: PICA origin is far away from aneurysms as Type I , PICA origin is in the margin of the aneurysms as type II and PICA origin is in the middle of the aneurysms as type Ⅲ. All the aneurysms were treated by endovascular technique. Results All the patients were followed up for 3 to 18 months. Type I : The occlusion of parent artery and aneurysms was performed in 23 patients and no aneurysms recurred during follow-up period. Stent combined with micro-coils was performed in 17 patients. The complete and subtotal embolization were achieved in 12 patients after

  3. Risk factors for cervical carotid and intracranial cerebrovascular lesions in patients undergoing coronary artery bypass grafting. Preoperative evaluation using magnetic resonance imaging and angiography

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    Makino, Masahiro [Kyoto Prefectural Univ. of Medicine (Japan). Research Inst. for Neurological Diseases and Geriatrics

    2001-12-01

    Recently neurologic complications after coronary artery bypass grafting (CABG) have received increasing attention. There is no detailed report about the risk factors for these complications, although stenosis in the cervical and intracranial arteries, especially in Japanese patients, latent ischemic brain lesions and preoperative neurological conditions are related to these events. In this prospective study, we evaluated occlusive lesions in the cervical carotid and intracranial arteries, silent brain infarction and cerebral deep white matter lesion with MRA and MRI in patients scheduled to undergo CABG to determine the prevalence of occlusive diseases in cervical carotid and intracranial arteries, latent ischemic change in the brain in this population and to identify preoperative risk factors for these patients. The subjects were 144 consecutive patients (103 men and 41 women, mean age 65.9{+-}9.2 years old) who were scheduled for CABG under elective conditions and who were examined by the same MRI apparatus using the same protocol between November 1998 and March 2001. After routine neurological examination and Mini-Mental State Examination (MMSE) were completed, MRI and MRA were obtained, then the prevalence of abnormalities on MRI and MRA studies and risk factors were evaluated. Cervical carotid artery stenosis with {>=}50% luminal narrowing was detected in 29.2% of the subjects, and that with {>=}75% luminal narrowing was detected in 16.0% of the subjects. Intracranial arterial stenosis showing {>=}50% luminal narrowing was detected in 38.2% of subjects, and that showing {>=}75% luminal narrowing was detected in 19.4% of subjects. Brain infarction was observed in 74.3% of subjects, cerebral deep white matter lesion showing grade 2 or higher on Fazekas classification was observed in 17.4% of the subjects. The characteristics, including possible risk factors of subjects with and without these abnormal findings, were compared. Patients with cervical carotid

  4. Aneurysmatic dissection of an aberrant right subclavian artery; Disseziierendes Aneurysma einer aberranten Arteria subclavia dextra: Diagnose mittels Ultrafast-CT

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    Reittner, P. [Universitaetsklinik fuer Radiologie, Graz (Austria). Abt. fuer Allgemeine Radiologie; Stacher, R. [Universitaetsklinik fuer Radiologie, Graz (Austria). Abt. fuer Allgemeine Radiologie

    1996-01-01

    Diagnosis with Ultrafast-CT: An aneurysm of an aberrant right subclavian artery is a very rare cause for dysphagia. We describe such a case in a 67-year-old patient, diagnosed with Ultrafast-CT and discuss it together in concert with the embryology and the radiological findings. (orig.) [Deutsch] Eine aberrierende Arteria subclavia dextra ist eine seltene Ursache fuer Dysphagie. Anhand eines 67jaehrigen Patienten werden Embryologie und radiologische Charakteristika, diagnostiziert mittels Ultrafast-CT, diskutiert. (orig.)

  5. The outcome analysis on shoulder function after neck dissection with preservation of the deep branch of the cervical plexus%保留颈丛神经深支的颈清扫术后肩功能评估

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      目的探讨颈清扫术中颈丛神经深支保留对术后肩功能的影响。方法37例头颈部恶性肿瘤患者接受不同颈清扫术式,17例保留副神经及颈丛C2-C4深支(A组),11例切除副神经、保留颈丛C2-C4深支(B组),9例切除副神经及颈丛C2-C4深支(C组)。术后6个月就肩关节功能障碍指数(SPADI)、肩关节活动度进行比较,术后6周及6个月就斜方肌肌电图进行比较。结果 SPADI及肩关节活动度A组恢复最好,B组次之,C组最差,三组间两两比较均有统计学差异。术后6周A组斜方肌三部分肌电活动均较强,B组上部活动较强,与A组比较无明显差异,中、下部较A组差;术后6月A组斜方肌三部分肌电均优于B组,C组术后6周及6月均未引出肌电活动。结论颈清扫术中酌情保留颈丛神经深支,可以减少传统手术后肩功能障碍发生的机率和程度,提高患者术后生活质量。%Objective To investigate the relation during preservation of the deep branch of the cervical plexus and shoulder function after neck dissection. Methods Thirty seven patients who had undergone different neck dissections were enrolled and divided into 3 groups. Seventeen patients preserved both accessory nerve and the cervical branches, 11 preserved cervical branches, and 9 sacrificed both of them. Shoulder pain and disability scores (SPADI) and Goniometric measurements were detected at the sixth postoperative month. The distal motor latency of the nerve with sEMG to detect electromyographic activity of the trapezius muscle was conducted at the sixth week and sixth month postoperatively among the three groups. Results The patients in group A whose accessory nerves and cervical branches were preserved had a significant functional rehabilitation of the shoulder, while those who preserved only the cervical branches in group B had a better result than the radical neck dissection in group C after 6 months of

  6. Fatal outcome after brain stem infarction related to bilateral vertebral artery occlusion - case report of a detrimental complication of cervical spine trauma

    Directory of Open Access Journals (Sweden)

    Beauchamp Kathryn M

    2011-07-01

    Full Text Available Abstract Background Vertebral artery injury (VAI after blunt cervical trauma occurs more frequently than historically believed. The symptoms due to vertebral artery (VA occlusion usually manifest within the first 24 hours after trauma. Misdiagnosed VAI or delay in diagnosis has been reported to cause acute deterioration of previously conscious and neurologically intact patients. Case presentation A 67 year-old male was involved in a motor vehicle crash (MVC sustaining multiple injuries. Initial evaluation by the emergency medical response team revealed that he was alert, oriented, and neurologically intact. He was transferred to the local hospital where cervical spine computed tomography (CT revealed several abnormalities. Distraction and subluxation was present at C5-C6 and a comminuted fracture of the left lateral mass of C6 with violation of the transverse foramen was noted. Unavailability of a spine specialist prompted the patient's transfer to an area medical center equipped with spine care capabilities. After arrival, the patient became unresponsive and neurological deficits were noted. His continued deterioration prompted yet another transfer to our Level 1 regional trauma center. A repeat cervical spine CT at our institution revealed significantly worsened subluxation at C5-C6. CT angiogram also revealed complete occlusion of bilateral VA. The following day, a repeat CT of the head revealed brain stem infarction due to bilateral VA occlusion. Shortly following, the patient was diagnosed with brain death and care was withdrawn. Conclusion Brain stem infarction secondary to bilateral VA occlusion following cervical spine trauma resulted in fatal outcome. Prompt imaging evaluation is necessary to assess for VAI in cervical trauma cases with facet joint subluxation/dislocation or transverse foramen fracture so that treatment is not delayed. Additionally, multiple transportation events are risk factors for worsening when unstable cervical

  7. Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: A case report

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    Mimata, Yoshikuni; Sato, Kotaro; Suzuki, Yoshiaki [Iwate Prefectural Chubu Hospital, Department of Orthopaedic Surgery, Kitakami (Japan); Murakami, Hideki [Iwate Medical University, Department of Orthopaedic Surgery, School of Medicine, Morioka (Japan)

    2014-01-15

    Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important. (orig.)

  8. Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: a case report.

    Science.gov (United States)

    Mimata, Yoshikuni; Murakami, Hideki; Sato, Kotaro; Suzuki, Yoshiaki

    2014-01-01

    Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important.

  9. [Spinal accessory nerve and lymphatic neck dissection].

    Science.gov (United States)

    Pinsolle, V; Michelet, V; Majoufre, C; Caix, P; Siberchicot, F; Pinsolle, J

    1997-09-01

    Radical neck dissection was the golden standard of treatment for cervical nodes in head and neck tumors. From the seventies, the preservation of the spinal accessory nerve has become increasingly popular in order to improve the functional result of the neck dissections. The aim of this study was to assess the degree of functional disability associated with each type of neck dissection and the value of anatomical references for dissection of the spinal accessory nerve. One hundred twenty seven patients were evaluated 1 month and 1 year after radical, functional or supraomohyoid neck dissection with a questionnaire and a physical examination. Anatomical measurements of the spinal accessory nerve were performed in 20 patients. We found considerable or severe shoulder dysfunction in 7%, 34% and 51% respectively of patients in whom supraomohyoid, functional and radical neck dissections were performed. Furthermore 49% of patients having undergone a radical neck dissection had little or no symptoms. Sacrifice of the spinal accessory nerve in radical neck dissection may lead to shoulder dysfunction. A functional disability may also be associated, although in a less extent, with any neck dissection in which the spinal accessory nerve is dissected and placed in traction. There is a large variation in the degree of functional disability and pain in patients with similar neck dissections. The course of the spinal accessory nerve in the neck makes it particularly vulnerable to injury during the dissection near the sternocleidomastoid muscle and in the posterior cervical triangle.

  10. Thrombolytic therapy for acute extra-cranial artery dissection: report of two cases Terapia trombolítica em dissecções arteriais cérvico-cefálicas agudas: relato de dois casos

    Directory of Open Access Journals (Sweden)

    Osama O. Zaidat

    2001-12-01

    Full Text Available Extra-cranial arterial dissection accounts for 10% of strokes in young people. Information on safety of thrombolytic administration in this group is limited. The literature, however, does not favor use of thrombolytics for myocardial ischemia when peripheral arterial dissection coexists. Based on the clinical and radiological features, two patients who presented with acute stroke secondary to arterial dissection were considered for thrombolysis. One of them received intra-venous recombinant tissue plasminogen activator (rtPA, and the other patient received intra-arterial rtPA. There were no post thrombolysis complications. This report supports feasibility of administering thrombolytics in acute ischemic strokes resulting from extra-cranial arterial dissection. Future larger studies are necessary to determine the efficacy, safety and long-term outcome in this patient population.Dissecção arterial cérvico-cefálica corresponde a 10 % dos acidentes vasculares cerebrais (AVC em jovens. Informação sobre a segurança da administração de trombolíticos neste grupo é limitada. A literatura médica, entretanto, não favorece o uso de trombolíticos em isquemia miocárdica na coexistência de dissecção arterial periférica. Baseado nas características clínicas e radiológicas, dois pacientes com AVC agudo secundário a dissecção arterial foram considerados para terapia trombolítica. Um deles recebeu rtPA intravenoso e o outro paciente recebeu rtPA intra-arterial. Não houve complicações pós-trombólise. Este relato suporta a possibilidade do tratamento destes pacientes com terapia trombolítica. Estudos maiores são necessários para determinar a eficácia, segurança e resultados a longo prazo nesta população de pacientes.

  11. 胃癌ⅢC期新型腹腔动脉系淋巴结清扫路径%Novel celiac artery lymph node dissection path in gastric cancer of stage Ⅲ C

    Institute of Scientific and Technical Information of China (English)

    杨爱国; 毛顺宝; 陈智勇; 聂凯

    2013-01-01

    Pathological types of gastric cancer in stage Ⅲ C include T4a-SEN3,T4b-SIN2,T4b-SIN3.Celiac artery metastatic lymphadenopathy fused into blocks,usually from bottom to top.Limited operation space revealed anatomical and pathological factors,the dissection of the celiac artery lymph nodes,processing the left gastric artery root difficulty.Application of novel celiac artery lymph nodes dissection path,avoiding the limitation of the celiac artery lymph node dissection space exposure factors,so that the dissection of the celiac artery lymph nodes is more complete,processing the left gastric artery root easily,reduce the amount of bleeding,shorten operation time,increase the average lymph node dissection and the Ⅲ C gastric cancer resection rate.%胃癌临床分期ⅢC期包括T4a-SEN3、T4b-SIN2、T4b-SIN3.由于腹腔动脉系淋巴结肿大、融合,与原发灶粘连成块状,胃周癌性粘连,采用传统路径清扫胃癌ⅢC期腹腔动脉系淋巴结存在显露胃左动脉根部困难,手术空间狭小,严重影响胃癌ⅢC期的切除与根治.运用新型腹腔动脉系淋巴结清扫路径,可使胃癌ⅢC期腹腔动脉系淋巴结清扫彻底,处理胃左动脉容易化,出血较少、手术时间较短,提高了胃癌ⅢC期根治性切除率.该方法应用于胃癌ⅢC期腹腔动脉系淋巴结清扫有独特之处.

  12. A Study of the Relationship between Syncope Attacks and Diminished Carotid and Vertebral Artery Flow Using Doppler Ultrasonography of Cervical Vessels

    Directory of Open Access Journals (Sweden)

    V Shaygan Nejad

    2005-03-01

    Full Text Available Background:Syncope or drop attack is a common and potentially serious condition and prompt evaluation of the affected patients should be evaluated prompting for cardiac disease, seizure, structural lesions of the brain or peripheral nerves, as well as drug induced and metabolic disturbances. This study was conducted to evaluate carotid and vertebral arteries blood flow in patients with syncope in which other etiologies had been ruled out. Methods: This one-year retrospective case-control study involved 33 patients (case group and 33 normal individuals (control group. Carotid and vertebral arteries blood flow was measured in all subjects (ml/min and SPSS was used for data analysis. Results: Mean blood flow in vertebral arteries in the case group was significantly lower than in the control group (P<0.001, however mean carotid artery flow was not significantly different between them (P=0.58. Conclusion: Based on our results and findings of some other studies, we recommend duplex ultrasonography of vertebral and cervical arteries in patients suffering from drop attacks, after ruling out the prominent etiologies, such as seizure, heart disease, etc. Keywords: syncope, ultrasound, carotid artery, vertebral artery

  13. Headache and seizures after cervical epidural injection in a patient undergoing coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Dheeraj Arora

    2012-01-01

    Full Text Available Epidural analgesia is widely used in cardiothoracic surgery. Most of the complications associated with epidural analgesia are related to the insertion techniques of epidural catheter. A 68-year-old obese patient posted for coronary artery bypass grafting surgery developed headache followed by seizures after insertion of the thoracic epidural catheter. Magnetic resonance imaging revealed air in the basal cisterns and in the left frontal region. The patient was managed conservatively and the symptoms subsided after 24 h. Later, the patient underwent coronary angioplasty.

  14. Diagnosis of pulmonary artery dissection by echocardiographic: three case reports and review%超声心动图诊断肺动脉夹层——附3例报告及文献复习

    Institute of Scientific and Technical Information of China (English)

    李嵘娟; 杨娅; 李治安; 赵映; 裴金凤; 张传臣

    2011-01-01

    目的 初步评价超声心动图诊断肺动脉夹层的价值.方法 结合文献,回顾性分析 3 例肺动脉夹层患者的经胸超声心动图表现.结果 3 例肺动脉夹层患者中2例合并左向右分流的先天性心脏病,均为动脉导管未闭;另1例为慢性肺源性心脏病.2例合并重度肺动脉高压.超声心动图均能准确显示夹层发生部位、剥离的内膜及破口情况.结论 肺动脉夹层是一种罕见且病程凶险的疾病,大部分患者合并原发或继发性肺动脉高压,肺动脉显著扩张.超声心动图是肺动脉夹层的首选影像学诊断方法.%Objective To evaluate the value of echocardiography in diagnosis of pulmonary artery dissection. Methods The echocardiographic appearance of 3 patients with pulmonary artery dissection were analyzed retrospectively. Results Two cases had congenital heart diseases with shunt from the left heart to the right, they were both patent arterial ductus. The other 1 cases was chronic pulmonary heart disease. Severe pulmonary hypertension existed in two cases. Site of the dissection, abradant endomembrane and its crevasse could be clearly seen by echocardiography. Conclusion Pulmonary artery dissection is a rare but lite-threatening disease, it often occurs in patients with pulmonary hypertension and dilation of the main pulmonary and/ or branches. Echocardiography should be the first choice in diagnosis of pulmonary artery dissection.

  15. [Contribution to the study of the origin of the phrenic nerve (nervus phrenicus). Apropos of 100 dissections of the cervical plexus].

    Science.gov (United States)

    Caliot, P; Pinsolle, J; Bousquet, V

    1983-12-01

    After recalling the descriptions of classical authors, 100 dissections conducted to the study of the origin of the phrenic nerve (nervus phrenicus). It appears as variable and asymetrical. The presence of an accessory phrenic nerve has been rarely seen. The classical proximal anastomoses of this nerve are inconstant or rare.

  16. MULTI-CENTER RANDOMIZED CONTROLLED TRIALS OF COMBINED TREATMENT OF VERTEBRAL ARTERY TYPE CERVICAL SPONDYLOSIS WITH ACUPUNCTURE AND MASSAGE

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian-wei; WANG Cheng-wei; HU Ling-xiang; LI Ning; ZHANG Fan; LI Chun-yu; ZHAO Jing-jing; LI Ji; HU Yun-guang; ZHANG Yan

    2005-01-01

    Objective:To evaluate the clinical value of synthetical therapy of acupuncture and massage for treating vertebral artery type cervical spondylosis (VACS). Methods: In the present study, triple-center, single-blind, randomized and control methods were adopted. Qualified subjects were randomly assigned to three groups: acupuncture-massage (acu-mas) group, acupuncture group, and massage group (60 subjects in each group). Bilateral Fengchi (风池GB 20), Jiaji (夹脊EX-B 2, C4-7) and Baihui (百会GV 20) were punctured in combination with massage at the neck-shoulder and back region. The treatment was conducted once daily, 14 times altogether. Results: After treatment, of the 60 cases in each of acu-mas, acupuncture and massage groups, 28, 11 and 13 were cured, 13, 20 and 17 markedly effective, 12, 14 and 16 effective, and 7, 15 and 14 ineffective, with the total effective rates being 88.3%, 75.0% and 76.7% respectively. The therapeutic effect of acu-mas group was significantly superior to that of simple acupuncture and massage groups (P0.05). The time for producing therapeutic effects in acu-mas group was significantly shorter than those of acupuncture and massage groups (P<0.01, 0.05), meaning a faster of acu-mas group in producing clinical effect. No adverse events were found in all the 3 groups. Conclusion: Acupuncture and massage are effective and safe in the treatment of VACS, and the therapeutic effect of acupuncture combined with massage is superior to that of simple acupuncture and simple massage therapy.

  17. Aortic dissection: magnetic resonance imaging.

    Science.gov (United States)

    Amparo, E G; Higgins, C B; Hricak, H; Sollitto, R

    1985-05-01

    Fifteen patients with suspected or known aortic dissection were imaged with magnetic resonance (MR). Thirteen of these patients were eventually shown to have dissection. In most instances the diagnosis was established by aortography and/or computed tomography (CT) prior to the MR study. Surgical proof (6/13) and/or aortographic proof (10/13) were available in 11/13 patients with aortic dissection. MR demonstrated the intimal flap and determined whether the dissection was type A or type B. In addition, MR: differentiated between the true and false lumens; determined the origins of the celiac, superior mesenteric, and renal arteries from the true or false lumen in the cases where the dissection extended into the abdominal aorta (8/12); allowed post-surgical surveillance of the dissection; and identified aortoannular ectasia in the three patients who had Marfan syndrome. In addition to the 13 cases with dissection, there were two cases in whom the diagnosis of dissection was excluded by MR. Our early experience suggests that MR can serve as the initial imaging test in clinically suspected cases of aortic dissection and that the information provided by MR is sufficient to manage many cases. Additionally, MR obviates the use of iodinated contrast media.

  18. Ultrasonic study (B mode echography and Doppler) of a case of carotid artery obstruction after cervical irradiation. Comparison with peroperative findings

    Energy Technology Data Exchange (ETDEWEB)

    Berges, O.; Mikol, F.; Monge Straus, M.F.; Vignaud, J. (Fondation A. de Rothschild, 75 - Paris (France))

    1985-01-01

    A case of an obstruction of the carotid artery by a fibrinous clot, that appeared 3 years after a cervical irradiation, for a cancer of a piriform sinus, is presented. The signs, moderate at Doppler examination and arteriography are more impressive with B mode, real time ultrasound. Surgery confirmed the signs observed with B mode ultrasound. Discussion will deal on the value of each method, and on the interest to combine them. The role of rontgentherapy in the genesis of such fibrinous clots will also be discussed.

  19. 定点旋转手法配合中频治疗椎动脉型颈椎病%Vertebral Artery Type Cervical Spondylosis Treated with Cervical Rotatory and Local Manipulation Combined with Modulated Medium Frequency Electrotherapy

    Institute of Scientific and Technical Information of China (English)

    范斌; 冯敬

    2013-01-01

    To explore the curative effect of the combined traditional Chinese medical therapy for vertebral artery type cervical spondylosis.Metheds:238 cases of vertebral artery type cervical spondylosis were randomly divided into treatment group (128 cases) and controlled group (110 cases),the treatment group were treated with cervical rotatory and local manipulation and modulated medium frequency electrotherapy; the controlled group of 110 cases were treated with Tui Na manipulation.Results:After two courses of treatment,the significant effective rate was 68.75% (88 cases) ; the effective rate was27.34% (35 cases) ;the non effective rate was 3.91% (5 eases),the total effectiverate was 96.09% (133 cases) of the treatment group.To compare with the controlled group,there was statistical difference (P<0.001).Conclusion:Local manipulation combined with modulated medium frequency electrotherapy for vertebral artery type cervical spondylosis can alleviate symptoms significantly better and sooner than Tui Na treatment simply.%目的:探讨中医综合治疗推动脉型颈椎病的临床效果.方法:随机将238例患者分为治疗组128例,对照组110例,治疗组采用定点旋转手法配合中频治疗;对照组采用单纯推拿治疗.观察两组的治疗效果.结果:通过两个疗程治疗,治疗组显效88例(68.75%),有效35例(27.34%)无效5例(3.91%)总有效率133例(96.09%),与对照组相比,差异有显著性意义(P< 0.001).结论:定点旋转手法配合中频治疗椎动脉型颈椎病椎动脉型颈椎病起效快且疗效确切,疗效优于单纯推拿治疗.

  20. Dissecting aneurysm of the middle cerebral artery treated with heparin infusion in a 6-year-old child; neurological recovery with delayed spontaneous thrombosis: case illustration and literature review.

    Science.gov (United States)

    Anichini, G; Passacantilli, E; Lenzi, J; Guidetti, G; Santoro, A

    2012-04-01

    Aneurysms in the pediatric population are a rare pathology with specific features which requires a deep knowledge of their pathogenesis for the best therapeutic choice; the authors report their experience with a patient presenting aneurysm of the middle cerebral artery (MCA) associated with proximal stenosis of the vessel. A six-year-old girl came to our observation after sudden onset of headache and left hemiparesis. Angio-MRI and angio-CT scan showed a right MCA dissecting aneurysms associated with proximal stenosis of the vessel. Patient started a therapy with low molecular weight heparin (LMWH), replaced, 15 days later, with acetyl-salicylic acid (ASA). Patient showed a rapid and almost complete neurological recovery, despite several radiological exams confirmed a complete occlusion of the right MCA. As many other authors noted, dissecting aneurysms in the pediatric population are probably due to a defect of the entire arterial wall. Combination of stenosis, turbulence and partial thrombosis of the aneurysm led to a complete occlusion of artery involved, leading to the formation of collateral circles. In our case, complete thrombosis was probably delayed with anticoagulant therapy and the progressive reinforcement of collateral circles lead to the patient's neurological recovery.

  1. Cervical Rib causing Thrombosis of Subclavian Atery

    Directory of Open Access Journals (Sweden)

    P Sharma

    2010-06-01

    Full Text Available We describe here an unusual case of thrombosis of left subclavian artery in a patient with cervical rib. The patient presented with features of ischaemia of left upper limb. X-ray chest revealed bilateral cervical ribs, longer on the left side. Color Doppler studies showed echogenic thrombus within the left subclavian artery. Angiography revealed complete occlusion of left subclavian artery. Embolectomy was done. She was planned for excision of rib. KEYWORDS: cervical rib, thrombosis of subclavian artery.

  2. Reproducibility and differentiation of cervical arteriopathies using in vivo high-resolution black-blood MRI at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, Florian; Strobl, Frederik F.; Cyran, Clemens C.; Helck, Andreas D.; Hartmann, Martin; Schindler, Andreas; Reiser, Maximilian F.; Saam, Tobias [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Nikolaou, Konstantin [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Eberhard-Karls-University Tuebingen, Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2016-06-15

    The aims of the present study are to evaluate the potential of high-resolution black-blood MRI (hr-bb-cMRI) to differentiate common cervical arteriopathies and to evaluate interobserver reproducibility. Forty-three consecutive patients with distinct cervical arteriopathies were examined with cervical hr-bb-cMRI at 3.0 Te with fat-saturated pre- and post-contrast T1w, T2w, and TOF images using dedicated carotid surface coils at our institution. Twenty-three patients had atherosclerotic disease, causing significant stenosis in 12 patients while 11 patients had moderate stenosis. Eight patients presented with cervical vasculitis, and five patients had arterial dissection. Furthermore, seven control subjects with no evidence of carotid disease were included. Two experienced readers blinded to all clinical information reviewed all MR images and classified both carotid and vertebral arteries as affected either by atherosclerosis, dissection, vasculitis, or no disease. Finally, a consensus reading was performed. On a per-vessel level, test performance parameters (sensitivity, specificity, positive predictive value, negative predictive value) were 95, 97.7, 92.9, and 98.5 % for atherosclerotic disease; 91, 100, 100, and 98.7 % for vasculitis; and 100, 100, 100, and 100 % for dissection, respectively. On a per-patient level, performance parameters were 95.7, 85.7, 97.2, and 85.7 % for the diagnosis of atherosclerosis and 100, 100, 100, and 100 % for the diagnosis of dissection and of vasculitis, respectively. Accuracy rates were all above 95 % for all entities. There was a high agreement between observers both in a per-vessel (κ = 0.83) and in a per-patient analysis (κ = 0.82). This study demonstrates that hr-bb-cMRI is able to non-invasively differentiate between the most common cervical arteriopathies with an excellent interreader reproducibility. (orig.)

  3. Effect of Fujian tablet on the expression of Nogo-A mRNA in the cervical spinal cord of middle cerebral artery occlusion model rats

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Inhibiting the expression of Nogo-A in cervical spinal cord by use of interaction of antigen and antibody can help the remodeling of corticospinal projection of focal cerebral ischemia model rats to facilitate neurological recovery, which provides a new possible mechanism for drugs to promote neurological recovery. However, the effects of drugs on the expression of Nogo-A in cervical spinal cord are still unclear.OBJECTIVE: To observe the effect of Fujian tablet on the expression of Nogo-A mRNA in cervical spinal cords of middle cerebral artery occlusion (MCAO) rats, and to investigate the possible regulatory effect of Fujian tablet on the regenerated microenvironment of spinal conduction bundle.DESIGN: A randomized and controlled trial taking Wistar rats as experimental animals.SETTING: Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine.MATERIALS: This experiment was carried out in the laboratory of Shandong Academy of Medical Science between June 2005 and July 2006. A total of 40 healthy male Wistar rats, aged 12 weeks, weighing 250 -300 g, were provided by the Experimental Animal Center of Shandong University. Fujian tablets (main components: Heshouwu, Yinyanghuo, etc) were provided by office of Pharmaceutics of Shandong University of traditional Chinese medicine. Nogo-A detection kit was provided by Wuhan Boster Biotechnology Co.,Ltd.,and batch number was 040309009. This experiment was approved by Local Animal Ethics Committee.METHODS: Forty male rats were randomly divided into 4 groups, with 10 in each: normal group,sham-operation group, model group and administration group. Rats in the administration group and model group were subjected to MCAO. Rats in the sham-operation group underwent the same craniotomy, and their middle cerebral arteries (MCA) were not occluded. Rats in the normal group were untouched. Rats in administration group were intragastrically administrated with the solution of Fujian

  4. OBSERVATION ON THE THERAPEUTIC EFFECT OF ACPUNCTURE COMBINED WITH MASSAGE FOR CERVICAL SPONDYLOSIS OF VERTEBRAL ARTERIAL TYPE BY USING TRANCRANIAL DOPPLYER ULTRASONOGRAPHY

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian-wei; WANG Cheng-wei; HU Ling-xiang; LI Ning; ZHANG Fan; LI Chun-yu; ZHAO Jing-jing; LI Ji; HU Yun-guang; ZHANG Yan

    2006-01-01

    Objective: To observe the effect of acupuncture combined with massage on blood flow velocity of the vertebro-basilar artery in cervical spondylosis of vertebral arterial type (CSVAT) patients. Methods:In the present study, methods of evidence-based medicine, triple-centers, single-blindness, randomization and control were used. A total of 100 cases of CSVAT patients were randomized into acupuncture plus massage (acu-massage) group (n = 38), acupuncture group ( n = 32) and massage group ( n = 30). Acupoints used were Fengchi (风池 GB 20), cervical Jiaji (颈夹脊 EX-B 2), Baihui (百会 GV 20), and the methods of massage used were kneading-rolling, adhesion-separating and acupoint-digital pressing, topical digital pressing and rubbing, traction-extending and mild palm-rubbing. The treatment was conducted once daily, with 7 sessions being a therapeutic course and continuously for 2 courses. Changes of peak velocity (Vp), end-diastolic velocity (Vd), mean velocity (Vm) of blood flow of the vertebral artery (VA) and basilar artery (BA),etc were detected before and after the treatment by using transcranial Doppler (TCD) ultrasonography. Results: After the treatment, the abnormally low Vp of both VA and BA in acu-massage, acupuncture and massage groups, Vm of VA in acu-massage and acupuncture groups, Vm of BA in acu-massage and massage groups, and Vd of VA and BA in the 3 groups all increased significantly in comparison with their own pretreatment ( P < 0.05, 0.01 ), and the therapeutic effects of acu-massage group in the 3 indexes were significantly superior to those of acupuncture group and/or massage group (P < 0.05, 0.01 ). The abnormally increased Vp of VA in acu-massage and acupuncture groups, Vm of VA in the 3 groups, and Vd of VA in acu-massage and massage groups decreased obviously after the treatment in comparison with their own pretreatment (P <0.05, 0.01), and the therapeutic effects of acu-massage group were significantly superior to those of

  5. Effect of Chinese Herbal Fumigation Combined with Tuina on Vertigo and Concentrations of Endothelin and Calcitonin Gene-related Peptide in Patients with Vertebral Artery Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    Zhao Cheng-fei; Liu Xiao-an; Ding Yun

    2014-01-01

    Objective:To observe the effect of Chinese herbal fumigation combined with three-step tuina manipulation on concentration of endothelin (ET) and calcitonin gene-related peptide (CGRP) and vertigo in patients with vertebral artery cervical spondylosis (VACS). Methods:A total of 120 eligible cases were randomly allocated into an observation group and a control group, 60 in each group. Cases in the observation group were treated with Chinese herbal fumigation combined with three-step tuina manipulation, whereas cases in the control group were treated with oral Flunarizine Hydrochloride Capsules. Results: After treatment, vertigo in both groups was alleviated; there were intra-group significant differences in ET decrease and CGRP increase (P Conclusion: Chinese herbal fumigation combined with three-step tuina manipulation can regulate the levels of ET and CGRP and improve vertigo in patients with VACS. Its therapeutic efficacy is superior to oral Flunarizine Hydrochloride Capsules.

  6. Measurement of force to obstruct the cervical arteries and distribution of tension exerted on a ligature in hanging.

    Science.gov (United States)

    Yamasaki, Shigeru; Takase, Izumi; Takada, Naoki; Nishi, Katsuji

    2009-07-01

    We experienced suicidal hanging cases without a ligature in front of the neck. We conducted several anatomical autopsies and the magnetic resonance imaging (MRI), and studied the dynamics behind hanging by applying an apparatus to cadaver and creating a dummy. MRI revealed that the vertebral artery protrudes diagonally upward from the second vertebra to the first one. We also found that this area was not covered with any bony tissue. The average length between the first and second transverse processes was 2 cm. We measured the minimum required force to obstruct the blood stream in both carotid and vertebral arteries exerting 130 mmHg. The required force was 6 kg for the carotid artery and 7 kg for the vertebral artery. Compared to the reported cases, there was not a significant difference in the force to obstruct the carotid artery, however, that of the vertebral artery was lower than the force reported so far. With an experiment of pressure sensitive plastic-sheet, we learned the lateral sides of the neck are compressed more. The results obtained from this study show that the complete and fatal obstruction of the carotid and the vertebral arteries may easily occur when the ligature transects at the lower part of mandible angle.

  7. 孤立性肠系膜上动脉夹层的病例荟萃分析%Cfinical features and therapeutic strategies of isolated superior mesenteric artery dissection:a metaanalysis of 101 cases

    Institute of Scientific and Technical Information of China (English)

    陈跃鑫; 刘昌伟; 刘暴

    2008-01-01

    目的 探讨孤立性肠系膜上动脉夹层的病例特点,治疗方法和措施选择.方法 回顾性分析北京协和医院血管外科中心诊治和文献报道的共101例孤立性肠系膜上动脉夹层病例,分析其临床特点、治疗方案及预后.结果 孤立性肠系膜上动脉夹层病例中男性占84.16%.平均发病年龄53.95岁.保守治疗成功率约70%,36例手术和16例腔内治疗症状缓解率100%,腔内支架治疗再狭窄率12.50%.结论 与保守治疗相比,手术和腔内治疗疗效确切,临床有效率高.治疗策略的制定有赖于临床表现和影像学检查.%Objective To summarize the clinical characters and therapeutic strategies of isolated superior mesenteric artery dissection, a rare disease.Methods The clinical data of 101 patients of isolated superior mesenterie artery dissection, including 2 cases treated in the Peking Union Medical College Hospital and 99 cases collected from the literatures were analyzed.Results 84.16% of the patients were males.The average age of the patients was 53.95.70% conservative treatment was successful in 70% of the patients.The symptoms were alleviated in 52 patients, of which 36 had undergone surgeries and 16 had endovascular therapy.The restenosis rate of endovascular therapy was 12.50%.Conclusion Surgery and endovaseular therapy are more effective than conservative treatments for isolated superior mesenteric artery dissection.The therapeutic strategies depend on the clinical symptoms and imaging examinations.

  8. The role of carotid artery stenting for recent cerebral ischemia.

    Science.gov (United States)

    Bosiers, M; Callaert, J; Deloose, K; Verbist, J; Keirse, K; Peeters, P

    2010-06-01

    Patients with cerebral ischemia as a result of acute cervical internal carotid artery occlusion are generally considered to have a poor prognosis. Despite maximal medical treatment, a better treatment for patients with acute ischemic stroke who present with serious neurologic symptoms on admission or continue to deteriorate neurologically due to a total occlusion, a dissection or a high-grade stenosis of the internal carotid artery is required. An effective intervention to improve their neurologic symptoms and clinical outcome has not yet been established and represents a challenging and complex problem. Treatment of acute symptomatic occlusion of the cervical internal carotid artery includes intravenous administration of thrombolytic agent, carotid endarterectomy and an interventional approach (intra-arterial administration of thrombolytic agent, transluminal angioplasty with or without stenting). The endovascular interventional approach is becoming a part of the stroke therapy armamentarium for intracranial occlusion. It may also now be considered in select patients with acute internal carotid artery occlusion. Stenting and angioplasty for acute internal carotid artery occlusion appears to be feasible, safe and may be associated with early neurological improvement. The encouraging preliminary results await confirmation from prospective, randomized studies.

  9. High-resolution MR imaging of periarterial edema associated with biological inflammation in spontaneous carotid dissection

    Energy Technology Data Exchange (ETDEWEB)

    Naggara, Olivier; Marsico, Rodolpho; Meder, Jean-Francois; Oppenheim, Catherine [Paris-Descartes University, Department of Neuroradiology, Paris (France); Touze, Emmanuel; Mas, Jean-Louis [Paris-Descartes University, Department of Neurology, Paris (France); Leclerc, Xavier; Pruvo, Jean-Pierre [University Hospital Roger Salengro, Department of Neuroradiology, Lille (France); Nguyen, Thanh [Boston University Medical Center, Department of Neurology, Neurosurgery, and Radiology, Boston, MA (United States)

    2009-09-15

    It has been suggested that spontaneous cervical carotid artery dissection (sCAD) may result from arterial inflammation. Periarterial edema (PAE), occasionally described in the vicinity of the mural hematoma in patients with sCAD, may support this hypothesis. Using cervical high-resolution magnetic resonance imaging, three readers, blinded to the mechanism of carotid artery dissection, searched for PAE, defined as periarterial T2-hyperintensity and T1-hypointensity, in 29 consecutive CAD patients categorized as spontaneous CAD (sCAD, n = 18) or traumatic CAD (tCAD, n = 11; i.e., major head or neck trauma within 2 weeks before the clinical onset). The relationships between PAE, inflammatory biological markers, history of infection and CAD mechanism were explored. Multiple CADs (n = 8) were found only in sCAD patients. Compared with tCAD, patients with sCAD were more likely to have a recent history of infection (OR = 12.5 [{sub 95%}CI = 1.3-119], p = 0.03), PAE (83% vs. 27%; OR = 13.3 [{sub 95%}CI = 2.2-82.0], p = 0.005) and to have elevated CRP (OR = 6.1 [{sub 95%}CI = 1.2-32.1], p = 0.0002) or ESR (OR = 8.8 [{sub 95%}CI = 1.5-50.1], p = 0.002) values. Interobserver agreement was 0.84 or higher for PAE identification. sCAD was associated with PAE and biological inflammation. Our results support the hypothesis of an underlying arterial inflammation in sCAD. (orig.)

  10. 甲状腺癌行弧形切口颈部淋巴结清扫术临床分析%Clinical analysis of cervical lymph node dissection by using low-transverse arc collar incision for thyroid carcinoma

    Institute of Scientific and Technical Information of China (English)

    刘晓敏; 赵华栋; 鲁建国

    2016-01-01

    目的:探究低位弧形切口在甲状腺乳头状癌( PTC)功能性颈部淋巴结清扫术中的应用可行性及安全性。方法回顾性分析2012年3月至2014年3月200例PTC伴有颈部淋巴结转移手术患者的临床资料。根据切口形状的不同分为低位组(132例)和传统组(68例),采用SPSS 19.0软件,对两组患者切口长度、淋巴结清扫数目及术后生活质量和外观满意度等连续变量分析使用 t检验;术后并发症及复发情况的比较选用χ2检验, P<0.05认定为有统计学意义。结果低位组在手术用时、切口长度均较传统组短(P<0.05);在其他颈侧区淋巴结清扫数目上两组间没有明显差别(P>0.05),但在Ⅱb区和Ⅴ区淋巴结数目低位组却少于传统组(P<0.05)。在切口瘢痕色泽、厚度、柔软程度、血管分部和患者肩部僵硬感、疼痛、麻木感等方面低位组得分均低于传统组(P<0.05)。淋巴结转移累及Ⅱa区时,Ⅱb区转移风险增高(r=0.183, P<0.001);多区转移时,Ⅱb和Ⅴ区转移风险均增高(r=0.241、0.242, P<0.001)。结论低位弧形切口PTC功能性颈部淋巴结清扫术安全可行,并可以明显改善患者术后生活质量,但对Ⅱb区和Ⅴ区以及多区转移的患者,建议仍采用传统的“L”形切口进行手术。%Objective To explore the feasibility and safety of cervical lymph node function-preserving dissection by using low-transverse arc collar incision for Papillary thyroid carcinomas ( PTC ) . Methods From March 2012 to March 2014, clinical data of 200 patients with PTC and cervical lymph node metastases were analyzed retrospectively .According to the difference of the shape of incision , patients were divided into low-incision group (132 cases) and traditional-incision group (68 cases).Statistical analysis were performed by using SPSS 19.0 software.Continuous variables in

  11. Retinal artery occlusions in children.

    Science.gov (United States)

    Dharmasena, Aruna; Wallis, Simon

    2014-01-01

    The purpose of this study is to present a case of RAO in a 13 year old girl with a preceding history of hyperextension of the neck at her hairdressers for a long duration and use of her mobile phone handset resting it against the side of her neck presumably exerting some pressure on carotids during the same time. Materials and methods of this study was reported as case report and review of literature. A 13 year-old girl presented with the left supero-nasal scotoma due to an inferior temporal branch retinal artery occlusion (BRAO). She underwent extensive investigations and no underlying cause was discovered. She gave a history of cervical extension over a long period of time while having the hair coloured twice in the preceding week. She also mentioned that she was using her mobile phone more or less continuously during both these occasions keeping it against her neck. Given the above history it is possible that the pressure on the ipsilateral carotid arteries or the prolong neck extension may have been responsible for the formation of a platelet embolus resulting in the BRAO. In conclusion, although cerebro-vascular accidents due to 'beauty parlor stroke syndrome' (JAMA 269:2085-2086, 1993) have been reported previously it has not been reported in children to our knowledge. On the other hand, 'beauty parlor stroke syndrome' occurs due to a dissection of the vertebral arteries or due to mechanical compression of the vertebral arteries during the prolonged hyperextension of the neck. The central retinal artery originates from the internal carotid circulation and it is highly unlikely for an embolus to enter the retinal circulation from the vertebral arteries. Therefore, the authors favour the possibility that the compulsive use of a mobile phone exerting pressure on the carotid arteries for a long time may have led to the formation of an embolus and subsequent RAO in this case.

  12. Usefulness of three-dimensional CT angiography (3D-CTA) with a single bolus injection of contrast material for the examination of intracranial and cervical arteries in cerebrovascular disease screening

    Energy Technology Data Exchange (ETDEWEB)

    Takamura, Yukio [Sapporo National Hospital (Japan); Tanooka, Atsushi; Morimoto, Shigefumi

    2001-05-01

    Three-dimensional CT angiography (3D-CTA) has been gaining wide acceptance as a clinically useful tool in the field of neurosurgery. The great diagnostic value of 3D-CTA for cerebral aneurysm or other cerebrovascular diseases has been well established. However, images of the intracranial and cervical arteries have not been obtained simultaneously because of the limitation of the scanning area and the need for contrast material. In order to use 3D-CTA to screen for cerebrovascular disease, we used a helical CT scan with an intravenous single bolus injection of contrast material to perform 3D-CTA of the intracranial and cervical arteries simultaneously. A spiral computed tomographic scan was performed with a Hispeed Advantage RP (General Electric). After injection of 150 ml of nonionized contrast material at a rate of 3 mm/sec in an antecubital vein, an axial computed tomographic scan (120 kV, 200 mA) of the cranial region was performed with a delay of 20-25 seconds after starting the injection. Section thickness was 1 mm with table increments of 1 mm per rotation. The scan volume included 20-30 mm above and below the sella turcica. An axial computed tomographic scan (120 kV, 190 mA) of the cervical region was performed with a delay of 30 seconds after completion of cranial CTA. Section thickness was 3 mm with table increments of 3 mm per rotation. Image reconstruction was carried out through surface rendering and maximum intensity projection processing. From November 1995 to August 1998, we used this technique to screen 218 consecutive outpatients for cerebrovascular disease. Unruptured cerebral aneurysms were found in 20 cases (9.2%). Atherosclerotic diseases of the cervical carotid artery were found in 58 cases (26.6%), as follows: carotid artery occlusion in 2 cases, carotid bifurcation stenosis in 22 cases, and intramural calcification of the internal carotid artery in 50 cases. Atherosclerotic diseases of the intracranial artery were found in 99 cases (45

  13. Anatomical study of blood supply to the cervical spinal cord in the guinea pig.

    Science.gov (United States)

    Mazensky, David; Danko, Jan; Petrovova, Eva; Flesarova, Slavka; Supuka, Peter; Supukova, Anna; Luptakova, Lenka; Purzyc, Halina

    2015-06-01

    The aim of this study was to describe the arterial arrangement of the cervical spinal cord in the guinea pig. The study was carried out on 20 adult English self guinea pigs using corrosion and dissection technique. Batson's corrosion casting kit no. 17(©) was used as a casting medium. The origin of the ventral spinal artery from the left vertebral artery was found on average in 35% of the cases and from the right vertebral artery on average in 40% of the cases. The ventral spinal artery with origin from the anastomosis of two medial branches was found on average in 25% of the cases. The presence of ventral radicular branches of rami spinales entering the ventral spinal artery in the cervical region was observed in 42% of the cases on the right side and in 58% of the cases on the left side. The presence of dorsal radicular branches of rami spinales that reached the spinal cord was observed in 63% of the cases on the left side and in 37% of the cases on the right side. The number of radicular branches supplying the spinal cord is greater in guinea pig than in humans.

  14. Painless aortic dissection presenting as paraplegia.

    Science.gov (United States)

    Colak, Necmettin; Nazli, Yunus; Alpay, Mehmet Fatih; Akkaya, Ismail Olgun; Cakir, Omer

    2012-01-01

    Acute dissection of the aorta can be life-threatening. As a presenting manifestation of aortic dissection, neurologic complications such as paraplegia are rare. Herein, we report the case of a 51-year-old man who presented with sudden-onset paraplegia and ischemia of the legs, with no chest or back pain. His medical history included coronary artery bypass grafting. Physical examination revealed pulseless lower extremities, and computed tomography showed aortic dissection from the ascending aorta to the common iliac arteries bilaterally. A lumbar catheter was inserted for cerebrospinal fluid drainage, and axillary arterial cannulation was established. With the use of cardiopulmonary bypass, the aortic dissection was corrected, and the previous coronary artery grafts were reattached. The surgery restored spinal and lower-extremity perfusion, and the patient walked unaided from the hospital upon his discharge 5 days later. Although acute aortic dissection presenting as paraplegia is rare, it should be considered in patients who have pulseless femoral arteries bilaterally and sudden-onset paraplegia, despite no pain in the chest or back. Prompt diagnosis and intervention can prevent morbidity and death.

  15. 物理综合疗法治疗椎动脉型颈椎病疗效观察%The Effective Observation of Comprehensive Physical Therapy on Cervical Spondylosis of Vertebral Artery Type

    Institute of Scientific and Technical Information of China (English)

    赵素萍

    2013-01-01

    目的:探讨物理综合疗法对椎动脉型颈椎病的疗效。方法将120例椎动脉型颈椎病患者随机分为颈椎牵引、干扰组(对照组)、颈椎牵引加超激光、干扰电综合治疗组(治疗组),治疗20次后,进行比较。结果治疗组总有效率98.3%,对照组为85%。治疗组疗效明显优于对照组(P<0.05)。结论采用颈椎牵引、超激光、干扰电综合疗法治疗椎动脉型颈椎病比颈椎牵引、干扰电疗效更好,值得临床推广。%Objective To discuss the ef icacy of combining physical therapy on cervical spondylosis of vertebral artery type. Methods 120 cases of cervical spondylosis of vertebral artery type were divided randomly into control group (cervical traction with interference current therapy) and treatment group (cervical traction combined with super laser and interference current therapy).They compared the ef icacy after 20 times treatment. Results The total ef ective rate was 98.3%in treatment group,the control group is 85%. But the curative ef ect of treatment group was much bet er than control group (P<0.05). Conclusion The curative ef ect is bet er using combination therapy of cervical traction,super laser and interference current than cervical traction with interference current therapy,and it is worth popularizing.

  16. Theory of"YangJing RouJin," Manual Therapy on VertebralArtery Type Cervical Spondylosis%"养精柔筋"手法治疗椎动脉型颈椎病理论探析

    Institute of Scientific and Technical Information of China (English)

    董万涛; 宋敏; 邓强

    2011-01-01

    There is a close relationship between tendons and the vertebral artery type cervical spondylosis occurrence and development,from the tendons distribution on the neck to explore the etiology and pathogenesis of cervical disease of vertebral artery by the tendons theory, and provide "YangJing RouJin" approach,through modem medical and biomechanical research to support,clarify, its mechanism of promotion and soft tendon,orthopedic soft tendon,YangJing RouJin,to provide new ideas for manual therapy t on vertebral artery type cervical disease,%从颈项部经筋的分布出发,通过经筋理论探讨椎动脉型颈椎病病因病机,提出"养精柔筋"手法,并通过现代医学及生物力学的研究加以佐证,阐明其通经舒筋、正骨柔筋、养精荣筋的机理,为手法治疗椎动脉型颈椎病提供新的思路.

  17. 推拿疗法配合中药湿敷治疗椎动脉型颈椎病30例%Massage Therapy with Traditional Chinese Medicine Wet Compress Treatment of Vertebral Artery Type Cervical Spondylosis 30 Cases

    Institute of Scientific and Technical Information of China (English)

    唐铭

    2013-01-01

    Objective:Observed with massage therapy medicine fumigation treatment of vertebral artery type cervical spondylosis clinical ef icacy. Method:For our hospital 30 cases of vertebral artery type of cervical spondylosis massage therapy with the use of traditional Chinese medicine fumigation treatment. Results:30 patients were cured15 cases,Significant in 10 cases,ef ective in 4 cases,Invalid in 1 cases,the total ef iciency of 97%. Conclusion:Massage therapy with traditional Chinese medicine fumigation treatment of vertebral artery type of cervical spondylosis significant.%目的:观察推拿疗法配合中药熏蒸治疗椎动脉型颈椎病的治疗作用。方法对我院收治的30例椎动脉型颈椎病采用推拿疗法配合中药熏蒸治疗。结果30例患者中,治愈15例,显效10例,有效4例,无效1例,总有效率97%。结论推拿疗法配合中药熏蒸治疗椎动脉型颈椎病疗效显著。

  18. 推拿疗法配合中药熏蒸治疗椎动脉型颈椎病20例%20 Cases Massage Therapy with Traditional Chinese Medicine Fumigation Treatment of Vertebral Artery Type Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    李彬

    2013-01-01

    Objective: Observed with massage therapy medicine fumigation treatment of vertebral artery type cervical spondylosis clinical ef icacy. Method: For our hospital 20 cases of vertebral artery type of cervical spondylosis massage therapy with the use of traditional Chinese medicine fumigation treatment. Results: 20 patients were cured 10 cases, ef ective in 6 cases, ef ective in 3 cases, 1 case, the total ef iciency of 95%. Conclusion: Massage therapy with traditional Chinese medicine fumigation treatment of vertebral artery type of cervical spondylosis significant.%目的:观察推拿疗法配合中药熏蒸治疗椎动脉型颈椎病的治疗作用。方法对我院收治的20例椎动脉型颈椎病采用推拿疗法配合中药熏蒸治疗。结果20例患者中,治愈10例,显效6例,有效3例,无效1例,总有效率95%。结论推拿疗法配合中药熏蒸治疗椎动脉型颈椎病疗效显著。

  19. Clinical evaluation of intra-arterial infusion chemotherapy for advanced or recurrent cervical cancer with or without radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kaneyasu, Yuko; Kita-Okawa, Midori; Kokubo, Nahoko; Karasawa, Kumiko; Fukuhara, Noboru; Toda, Jo; Okawa, Tomohiko [Tokyo Women`s Medical Coll. (Japan)

    1997-09-01

    We analyzed 52 cases of advanced or recurrent cancer of the cervix treated by intra-arterial infusion chemotherapy (IAIC) with or without radiotherapy. IAIC regimen was separated into two groups: Group I consisted of 5-FU + MMC {+-} ADR (30 cases) and Group II of CDDP + MMC {+-} 5-FU (22 cases). The tip of the catheter was placed in the bifurcation of abdominal aorta or the bilateral internal iliac arteries (7 cases). The overall response rate (CR + PR) was 71%, 87% in patients given radiotherapy, 50% in those without radiotherapy, and 100% in primary cases. The five-year survival rate was 20% in primary cases, 14% in recurrent cases, 3% in Group I and 38% in Group II (p=0.00182) by chemotherapy regimen. Severe (more than grade III) hematological acute side effect was 48% for all cases, but recovered by interruption of drugs. In 7 cases in which the tip of the catheter was placed in internal iliac arteries, there were severe skin ulcers in 2 cases and severe pain of leg or gluteal region requiring narcotics in 2 cases. These data suggest that IAIC mainly with cisplatin with or without radiotherapy is one of the effective treatments for advanced or recurrent cervix cancer. But we should check the blood flow distribution periodically, and control the concentration of drugs. (author)

  20. Ileo-right hemi-colonic cervical pull-up on a non-supercharged ileocolic arterial pedicle: A technical and case report.

    Science.gov (United States)

    Weiss, Andreas Rr; Hackl, Christina; Soeder, Yorick; Schlitt, Hans J; Dahlke, Marc-H

    2016-04-14

    Esophageal reconstruction can be challenging when stomach and colon are not anatomically intact and their use as esophageal substitutes is therefore limited. Innovative individual approaches are then necessary to restore the intestinal passage. We describe a technique in which a short stump of the right hemicolon and 25 cm of ileum on a long, non-supercharged, fully mobilized ileocolic arterial pedicle were used for esophageal reconstruction to the neck. In this case, a 65 year-old male patient had accidentally indigested hydrochloric acid which caused necrosis of his upper digestive tract. An emergency esophagectomy, gastrectomy, duodenectomy, pancreatectomy and splenectomy had been performed in an outside hospital. A cervical esophagostomy and a biliodigestive anastomosis had been created and a jejunal catheter for enteral feeding had been placed. After the patient had recovered, a reconstruction of his food passage via the left and transverse colon failed for technical reasons due to an intraoperative necrotic demarcation of the colon. Our team then faced the situation that only a short stump of the right hemi-colon was left in situ when the patient was referred to our center. After intensified nutritional therapy, we reconstructed this patient's food passage with the right hemicolon-approach described herein. After treatment of a postoperative pneumonia, the patient was discharged from hospital on the 26(th) postoperative day in a good clinical condition on an oral-only diet. In conclusion, individual approaches for long-segment reconstruction of the esophagus can be technically feasible in experienced hands. They do not always require arterial supercharging or free intestinal transplantation.

  1. [Balloon occlusion test of the internal carotid artery for evaluating resectability of blood vessel infiltrating cervical metastasis of advanced head and neck cancers--Heidelberg experience].

    Science.gov (United States)

    Dietz, A; von Kummer, R; Adams, H P; Kneip, M; Galito, P; Maier, H

    1993-11-01

    During the last two years 17 patients of the ENT-Department of the University of Heidelberg suffering from squamous-cell carcinomas of the head and neck underwent a balloon occlusion test of the internal carotid artery (ICA). The investigation was performed because of tumorous infiltration of the large cervical vessels. The balloon occlusion of the ICA was accomplished at the Department of Neuroradiology of the University of Heidelberg. While stopping bloodflow in the ICA of one side for 15-20 min, clinical, electrophysiological and Doppler sonographic monitoring was performed, to detect severe cerebral complications. The specific electrophysiological monitoring contained the detection of MSSEP's (median nerve stimulated somatosensorial evoked potentials) and TCMEP's (transcortical motor evoked potentials) during test occlusion. Balloon occlusion was not possible in three patients because of severe arteriosclerosis. Test occlusion had to be discontinued in three patients because of clinical complications (temporary amaurosis, orthostatic complications). Finally, seven patients showed contraindications during test occlusion for permanent occlusion of the ICA. Four patients had a permanent occlusion of the ICA after tumour resection. In two patients the ICA was removed without problems in test occlusion. The third patient underwent a permanent carotid occlusion because of bleeding complications (in spite of poor clinical tolerance of the test occlusion). In the fourth patient, only intraoperative neuromonitoring with MSSEP's was conducted before permanent carotid occlusion. All four patients did not show any neurological deficits after resection of the ICA. Neurophysiological monitoring played an important role in predicting cerebral complications after permanent occlusion of the ICA.

  2. 双侧甲状腺切除加双侧颈部淋巴结清扫术后引发吉兰-巴雷综合征一例报告并文献复习%Guillain-Barré Syndrome in a Patient after Bilateral Thyroidectomy plus Bilateral Cervical Lymph Node Dissection:One Case Report and Literature Review

    Institute of Scientific and Technical Information of China (English)

    赵红; 王苏平; 宋品; 李莉; 刘赞华; 李淑敏

    2015-01-01

    双侧甲状腺切除加双侧颈部淋巴结清扫术后并发吉兰-巴雷综合征( Guillain-Barré syndrome,GBS)的病例在临床上较为少见,且GBS发病早期易被漏诊。本文报道了1例甲状腺癌伴甲状旁腺腺瘤患者,行双侧甲状腺切除加双侧颈部淋巴结清扫术后并发GBS的临床诊治经过,并复习相关文献。提示外科手术可以为GBS的诱因,临床医生应警惕术后GBS的发生,避免漏诊和误诊。%Guillain-Barré syndrome( GBS)is clinically rare as a postoperative complication occurs after bilateral thyroidectomy plus bilateral cervical lymph node dissection,and missed diagnosis often occurs at its early stage. The article presents the diagnosis and treatment of GBS as postoperative complication in a patient with thyroid cancer concurrent with parathyroid tumor after bilateral thyroidectomy plus bilateral cervical lymph node dissection. The relevant literature is also reviewed. Surgical operations could induce GBS. More attention should be paid to the diagnosis and treatment of postoperative GBS,preventing its missed diagnosis and misdiagnosis.

  3. Dissecção robótica da artéria torácica interna direita por esternotomia mediana Robotic dissection of the right internal thoracic artery through median sternotomy

    Directory of Open Access Journals (Sweden)

    Fabio Biscegli Jatene

    2010-06-01

    Full Text Available A utilização de sistemas robóticos em cirurgia cardíaca visa à diminuição do trauma operatório. A revascularização do miocárdio totalmente endoscópica, assistida por robô DaVinci (Intuitive Surgical, Sunnyvale, Califórnia é factível e seu aprendizado deve ser realizado em etapas. O primeiro passo é o preparo da artéria torácica interna esquerda, já por via totalmente endoscópica. O caso apresentado propõe a dissecção da artéria torácica interna direita por esternotomia completa. Propõe um novo passo rumo ao procedimento completamente endoscópico, visando à diminuição de lesões decorrentes da curva de aprendizado.The use of robotic systems in cardiac surgeries aims at decreasing the surgical trauma.The use of robotic systems in cardiac surgeries aims at decreasing the surgical trauma. The totally endoscopic myocardial revascularization, assisted by the DaVinci robot (Intuitive Surgical, Sunnyvale, California is feasible and the learning process must be carried out in steps. The first step is the preparation of the left internal thoracic artery, through the totally endoscopic approach. The case presented here proposes the dissection of the right internal thoracic artery through complete sternotomy. It proposes a new step directed at the totally endoscopic procedure, aiming at decreasing the injuries caused by the learning curve.

  4. O tratamento operatório da dissecção aórtica crônica tipo A em pacientes submetidos à revascularização cirúrgica do miocárdio Surgical treatment of chronic type A aortic dissection in patients undergoing coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    João Carlos Leal

    2010-09-01

    Full Text Available O tratamento operatório da dissecção aórtica é um desafio para o cirurgião cardíaco, sobretudo nos pacientes submetidos a operação cardíaca prévia. Nosso objetivo neste relato de caso é demonstrar como tratamos a dissecção aórtica crônica tipo A em paciente revascularizado utilizando cânulas arterial e venosa percutâneas.Surgical treatment of aortic dissection is a challenge for the cardiac surgeon, especially in patients undergoing cardiac operations. Our objective in this case report is to demonstrate how we treat the chronic type A aortic dissection in patients revascularized using percutaneous arterial and venous cannulae.

  5. Exome Sequencing Identifies SMAD3 Mutations as a Cause of Familial Thoracic Aortic Aneurysm and Dissection with Intracranial and Other Arterial Aneurysms

    Science.gov (United States)

    Regalado, Ellen S.; Guo, Dong-chuan; Villamizar, Carlos; Avidan, Nili; Gilchrist, Dawna; McGillivray, Barbara; Clarke, Lorne; Bernier, Francois; Santos-Cortez, Regie L.; Leal, Suzanne M.; Bertoli-Avella, Aida M.; Shendure, Jay; Rieder, Mark J.; Nickerson, Deborah A; Milewicz, Dianna M.

    2014-01-01

    Rationale Thoracic aortic aneurysms leading to acute aortic dissections (TAAD) can be inherited in families in an autosomal dominant manner. As part of the spectrum of clinical heterogeneity of familial TAAD, we recently described families with multiple members that had TAAD and intracranial aneurysms or TAAD and intracranial and abdominal aortic aneurysms inherited in an autosomal dominant manner. Objective To identify the causative mutation in a large family with autosomal dominant inheritance of TAAD with intracranial and abdominal aortic aneurysms by performing exome sequencing of two distantly related individuals with TAAD and identifying shared rare variants. Methods and Results A novel frame shift mutation, p. N218fs (c.652delA), was identified in the SMAD3 gene and segregated with the vascular diseases in this family with a LOD score of 2.52. Sequencing of 181 probands with familial TAAD identified three additional SMAD3 mutations in 4 families, p.R279K (c.836G>A), p.E239K (c.715G>A), and p.A112V (c.235C>T) resulting in a combined LOD score of 5.21. These four mutations were notably absent in 2300 control exomes. SMAD3 mutations were recently described in patients with Aneurysms Osteoarthritis Syndrome and some of the features of this syndrome were identified in individuals in our cohort, but these features were notably absent in many SMAD3 mutation carriers. Conclusions SMAD3 mutations are responsible for 2% of familial TAAD. Mutations are found in families with TAAD alone, along with families with TAAD, intracranial aneurysms, aortic and bilateral iliac aneurysms segregating in an autosomal dominant manner. PMID:21778426

  6. Clinical presentation and treatment in 10 cases with spontaneous cervicocerebral arterial dissection%自发性头颈部动脉夹层10例患者临床特点及药物疗效

    Institute of Scientific and Technical Information of China (English)

    赵洪芹; 王伟; 李宏; 赵诚; 潘旭东

    2009-01-01

    Objective To describe clinical features and evaluate drug therapy in casses with spontaneous cervicocerebral arterial dissection(SCAD).Methods Ten cases of sCAD who visited Qingdao University Medical College during 2005-2008 were retrospectively reviewed and the risk factors.clinic manifestations,characteristic signs in imagine and outcome of drug therapy were summarized and analyzed.Results In 10 cases.risk factors related to sCAD included hypertension in 3 cases,recent respiratory tract infection in 3 Cases.fibromuscular dysplasia in 2 cases.Clinic manifestations in 9 cases presented as ischemic cerebral diseases and in one case ag migraine.DSA examination on the affected arteries revealed "string sign"of a long segment of narrowed lumen in 3 cases.intimal flap in 3 cases and dissecting aneurysm in 2 cases.Anticoagulation with heparin Was used to treat sCAD in 5 cases.followed by warfarin in 2 cases and antiplatelet with aspirin in 3 cases.Aspirin only Was used in 3 cases.The above eight cases receiving antithrombotic treatment (antiplatelet or anticoagulation) all reached good recovery.Two cases with dissecting aneurysm were not given antithrombotic treatment. Conclusions Diagnosis of sCAD may depend on clinical manifestations and characteristic signs on DSA examination. Anticoagulation or antiplatelet therapies are effective treatment in sCAD.%目的 探讨自发性头颈部动脉夹层(SCAD)临床特点及药物疗效.方法 对2005-2008年10例经DSA确诊的SCAD患者的危险因素、临床表现、DSA特征及药物疗效进行分析.结果 10例SCAD患者中,3例有高血压病史,3例病前上呼吸道感染史,2例合并肌纤维发育不良.临床特点:除1例表现为偏头痛外,其余均表现为缺血性脑血管病.DSA检查发现3例表现为颈内动脉长段鼠尾状狭窄,3例可见到内膜瓣,2例为夹层动脉瘤.5例患者进行肝素抗凝治疗,之后2例予华法林治疗,3例予抗血小板治疗;3例单用阿司匹林进行抗血

  7. Report of an unusual combination of arterial, venous and neural variations in a cadaveric upper limb.

    Science.gov (United States)

    Troupis, Theodore G; Michalinos, Adamantios; Manou, Vasiliki; Vlastos, Dimitrios; Johnson, Elizabeth O; Demesticha, Theano; Skandalakis, Panayiotis

    2014-01-01

    In this study an unusual combination of arterial, venous and neural variations discovered during dissection of cervical, axillary and brachial area of a cadaver is described. Variations are thoroughly described and literature is briefly reviewed. Lateral cord of brachial plexus was not formed; Eight Cervical root divided into anterior and posterior division before uniting with First Thoracic root and Upper Trunk was unusually short. Axillary artery gave origin to a superficial brachial artery and then continued as deep brachial artery. Multiple variations in typical axillary artery branches were present including existence of inferior pectoral artery. Cephalic vein was absent. A variety of interventions, from relative simple as central venous catheter placement to most complicated as brachial plexus injury repair demand thorough knowledge of area's regional anatomy. Familiarity with anatomic variations allows more precise and careful interventions. Research on these variations is valuable for anatomists and embryologists but also for clinicians because it may provide useful information for non - typical cases but also helps in raising a high level of suspicion.

  8. 针灸治疗椎动脉型颈椎病临床进展%Acupuncture and moxibustion for treatment of cervical spondylosis of ver-tebral artery type clinical progress

    Institute of Scientific and Technical Information of China (English)

    王维芳

    2013-01-01

    椎动脉型颈椎病是由于椎动脉受到压迫和刺激导致的供血不足,引起一系列临床症状。其发病原因较多,患者症状多样,主要包括头面部症状,如偏头痛、耳鸣、听力减退、眩晕等,部分患者还会出现视力障碍等,严重地影响患者的生活质量。目前临床对椎动脉型颈椎病的治疗方法较多,包括西医药物治疗、西医手术治疗、中医药物治疗、中医按摩治疗、中医针灸治疗等。其中中医针灸治疗椎动脉型颈椎病已有较长的历史,且取得了较好的效果。本文对针灸治疗椎动脉型颈椎病进行了综述,以供学者参考和借鉴。%In vertebral artery type of cervical spondylosis of vertebral artery is due to oppression and stimula-tion leads to insufficient blood supply ,cause a series of clinical symptoms .Its causes are diverse,symptoms, including facial symptoms ,such as migraine,tinnitus,hearing loss,vertigo,some patients also have visual im-pairment ,seriously affecting the quality of life of patients .Current clinical on vertebral artery type of cervical spondylosis treated many methods , including western medicine , western medicine treatment , Chinese medi-cine is the treatment of operation ,Chinese massage therapy ,acupuncture and moxibustion therapy .The tradi-tional Chinese medicine acupuncture and moxibustion for treatment of cervical spondylosis of vertebral artery type has a long history ,and achieved good results .The acupuncture and moxibustion for treatment of cervical spondylosis of vertebral artery type are reviewed ,for scholars and reference .

  9. Spontaneous isolated dissection of the superior mesenteric artery:multi-slice computed tomographic angiography findings in seven cases%MSCT血管成像对孤立性肠系膜上动脉夹层的诊断价值

    Institute of Scientific and Technical Information of China (English)

    陈则君; 谢旭纲; 孟宪平; 朱建新; 王伯元

    2011-01-01

    目的:探讨MSCT血管成像诊断孤立性肠系膜上动脉夹层(SISAMD)的临床应用价值.方法:对7例急性肠缺血患者行MSCT血管成像,采用容积再现(VR)、多平面重组(MPR)、曲面重组(CPR)及最大密度投影(MIP)重组图像,由两位经验丰富的心血管影像医师评估夹层的部位和范围.结果:SISAMD与主动脉夹层CT血管成像(CTA)表现相同,CTA清晰显示撕裂内膜5例,破裂口均位于肠系膜上动脉(SMA)近心端.根据Yun分型:Ⅰ型1例,Ⅱa型3例,Ⅱb型2例,Ⅲ型1例.SMA直径增粗2例,SMA周围脂肪间隙模糊2例,局部回肠壁增厚、水肿2例,升结肠扩张、积液1例,腹腔及盆腔内少量积液2例.结论:MSCTA能清晰显示病变特征和累及范围,是孤立性肠系膜上动脉夹层首选的检查方法.%Objective : To asscss the value of multi-slice computed tomographic angiography (MSCTA) in the diagno sis of spontancous isolated dissection of superior mesenteric artery (SMA). Methods:7 patients with clinically suspected a cute mesenteric ischemia underwent MSCTA. Multiplanar and three-dimensional images were obtained by imaging postpro cessing techniques including volume rendering technique (VRT) , multiplanar reconstruction (MPR) , curved planar reforma tion (CPR) and maximum intensity projection (MIP) on a workstation. Image reading was performed in consensus by two experienced cardiovascular radiologists. Results: According to Yun's classification,there were one case of type Ⅰ , three type Ⅱ a,two type Ⅱ b and one type Ⅲ . Spontaneous isolated dissection of SMA displays the same MSCTA features as aortic dis section. Intimal flaps were seen in five patients,with intimal tears at the proximal SMA. Other MSCTA findings associated with spontaneous isolated dissection of SMA were enlarged diameter of the SMA (n=2) ,increased attenuation of the fat a round the SMA (n=2) ,local ileum wall thickening due to edema (n=2) , dilated ascending colon (n=1) and hemorrhagic

  10. Intravenous thrombolysis or endovascular therapy for acute ischemic stroke associated with cervical internal carotid artery occlusion: the ICARO-3 study.

    Science.gov (United States)

    Paciaroni, Maurizio; Inzitari, Domenico; Agnelli, Giancarlo; Caso, Valeria; Balucani, Clotilde; Grotta, James C; Sarraj, Amrou; Sung-Il, Sohn; Chamorro, Angel; Urra, Xabier; Leys, Didier; Henon, Hilde; Cordonnier, Charlotte; Dequatre, Nelly; Aguettaz, Pierre; Alberti, Andrea; Venti, Michele; Acciarresi, Monica; D'Amore, Cataldo; Zini, Andrea; Vallone, Stefano; Dell'Acqua, Maria Luisa; Menetti, Federico; Nencini, Patrizia; Mangiafico, Salvatore; Barlinn, Kristian; Kepplinger, Jessica; Bodechtel, Ulf; Gerber, Johannes; Bovi, Paolo; Cappellari, Manuel; Linfante, Italo; Dabus, Guilherme; Marcheselli, Simona; Pezzini, Alessandro; Padovani, Alessandro; Alexandrov, Andrei V; Shahripour, Reza Bavarsad; Sessa, Maria; Giacalone, Giacomo; Silvestrelli, Giorgio; Lanari, Alessia; Ciccone, Alfonso; De Vito, Alessandro; Azzini, Cristiano; Saletti, Andrea; Fainardi, Enrico; Orlandi, Giovanni; Chiti, Alberto; Gialdini, Gino; Silvestrini, Mauro; Ferrarese, Carlo; Beretta, Simone; Tassi, Rossana; Martini, Giuseppe; Tsivgoulis, Georgios; Vasdekis, Spyros N; Consoli, Domenico; Baldi, Antonio; D'Anna, Sebastiano; Luda, Emilio; Varbella, Ferdinando; Galletti, Giampiero; Invernizzi, Paolo; Donati, Edoardo; De Lodovici, Maria Luisa; Bono, Giorgio; Corea, Francesco; Sette, Massimo Del; Monaco, Serena; Riva, Maurizio; Tassinari, Tiziana; Scoditti, Umberto; Toni, Danilo

    2015-02-01

    The aim of the ICARO-3 study was to evaluate whether intra-arterial treatment, compared to intravenous thrombolysis, increases the rate of favourable functional outcome at 3 months in acute ischemic stroke and extracranial ICA occlusion. ICARO-3 was a non-randomized therapeutic trial that performed a non-blind assessment of outcomes using retrospective data collected prospectively from 37 centres in 7 countries. Patients treated with endovascular treatment within 6 h from stroke onset (cases) were matched with patients treated with intravenous thrombolysis within 4.5 h from symptom onset (controls). Patients receiving either intravenous or endovascular therapy were included among the cases. The efficacy outcome was disability at 90 days assessed by the modified Rankin Scale (mRS), dichotomized as favourable (score of 0-2) or unfavourable (score of 3-6). Safety outcomes were death and any intracranial bleeding. Included in the analysis were 324 cases and 324 controls: 105 cases (32.4 %) had a favourable outcome as compared with 89 controls (27.4 %) [adjusted odds ratio (OR) 1.25, 95 % confidence interval (CI) 0.88-1.79, p = 0.1]. In the adjusted analysis, treatment with intra-arterial procedures was significantly associated with a reduction of mortality (OR 0.61, 95 % CI 0.40-0.93, p = 0.022). The rates of patients with severe disability or death (mRS 5-6) were similar in cases and controls (30.5 versus 32.4 %, p = 0.67). For the ordinal analysis, adjusted for age, sex, NIHSS, presence of diabetes mellitus and atrial fibrillation, the common odds ratio was 1.15 (95 % IC 0.86-1.54), p = 0.33. There were more cases of intracranial bleeding (37.0 versus 17.3 %, p = 0.0001) in the intra-arterial procedure group than in the intravenous group. After the exclusion of the 135 cases treated with the combination of I.V. thrombolysis and I.A. procedures, 67/189 of those treated with I.A. procedures (35.3 %) had a favourable outcome, compared to 89/324 of

  11. Horner syndrome due to vertebral artery stenosis.

    Science.gov (United States)

    Kim, Chul Han

    2013-11-01

    The author reports a rare case of Horner syndrome in a patient who resulted from stenosis of the vertebral artery after blunt trauma. A 31-year-old man was transferred to our department for evaluation of left medial orbital wall and nasal bone fractures. Five days ago, he was hospitalized due to multiple second to fourth rib fractures of the right chest following blunt trauma of the face, neck, and chest. Surgery was performed. Ten days later, he complained of drooping of the right eyelid. Physical examination revealed a discrete miosis and ptosis with normal levator function in the right eye. A workup for Horner syndrome was performed. Magnetic resonance angiography of the head and neck revealed a stenosis of the distal part of the right vertebral artery without the abnormality of carotid artery. He wore a cervical collar and underwent anticoagulation. However, Horner syndrome was not resolved over the next 12 months. Acute traumatic Horner syndrome may be associated with vertebral artery dissection in which the possibility of life-threatening injury can be masked.

  12. Preoperative assessment of vascular anatomy of inferior mesenteric artery by volume-rendered 3D-CT for laparoscopic lymph node dissection with left colic artery preservation in lower sigmoid and rectal cancer

    Institute of Scientific and Technical Information of China (English)

    Michiya Kobayashi; Satoshi Morishita; Takehiro Okabayashi; Kana Miyatake; Ken Okamoto; Tsutomu Namikawa; Yasuhiro Ogawa; Keijiro Araki

    2006-01-01

    AIM: To determine the distance between the branching point of the left colic artery (LCA) and the inferior mesenteric artery (IMA) by computed tomography (CT) scanning, for preoperative evaluation before laparoscopic colorectal operation.METHODS: From February 2004 to May 2005, 100patients (63 men, 37 women) underwent angiography performed with a 16-scanner multi-detector row CT unit (Toshiba, Aquilion 16). All images were analyzed on a workstation (AZE Ltd, Virtual Place Advance 300). The distance from the root of the IMA to the bifurcation of the LCA was measured by curved multi-planar reconstruction on a workstation.RESULTS: The IMA could be visualized in all the cases,but the LCA was missing in two patients. The mean distance from the root of the IMA to the root of the LCA was 42.0 mm (range, 23.2-75.0 mm). There were no differences in gender, arterial branching types, body weight, height, and body mass index.CONCLUSION: Volume-rendered 3D-CT is helpful to assess the vascular branching anatomy for laparoscopic surgery.

  13. Diagnosis and treatment of vertebral artery injury in cervical spine surgery%颈椎手术中并发椎动脉损伤的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    王少波; 孙宇; 刁垠泽; 李迈; 张凤山

    2012-01-01

    目的 探讨颈椎手术中并发椎动脉损伤的发生原因、治疗及预防.方法 回顾性分析2002年10月至2012年4月颈椎手术中并发椎动脉损伤的7例患者资料,男6例,女1例;年龄23~65岁,平均48.9岁;脊髓型颈椎病5例,颈椎外伤合并C4.5半脱位1例,氟骨症致颈椎管狭窄1例.椎动脉损伤均为单侧,左侧4例,右侧3例.分析颈椎手术中并发椎动脉损伤的原因、处理过程及预后.结果 颈椎前路手术4例,其中2例用环钻减压时偏离中线损伤椎动脉,1例切除稚间盘时刮匙过于偏外损伤椎动脉,1例颈椎外伤患者由于C4,5半脱位造成椎动脉迂曲,减压时冲击式咬骨钳损伤椎动脉.颈椎后路手术3例,其中2例为行C4侧块螺钉固定时钻头偏外损伤椎动脉;1例氟骨症致颈椎管狭窄者在切除寰椎后弓时咬骨钳损伤椎动脉,术中出现椎动脉损伤后,迅速填塞压迫止血并关闭伤口,但术后4周发生迟发性出血,采用椎动脉栓塞止血及颈后路血肿清除术治疗.7例患者均未发生脑梗塞,其中2例患者术后出现-过性头晕.结论 椎动脉损伤是颈椎手术的严重并发症,其损伤原因与手术失误、解剖变异等有关;采用直接压迫及椎动脉栓塞治疗效果确切.%Objective To investigate cause,diagnosis,treatment and prevention of vertebral artery injury in cervical spine surgery.Methods Data of 7 patients with vertebral artery injury caused by cervical spine surgery from October 2002 to April 2012 were retrospectively analyzed.There were 6 males and 1 female,aged from 23 to 65 years (average,48.9 years).The reasons of cervical spine surgery were as follows:cervical spondylotic myelopathy (5 cases),traumatic subluxation of C4 and C5 (1 case),and cervical spinal stenosis due to skeletal fluorosis (1 case).All cases had unilateral vertebral artery injury,including 4 cases in the left side and 3 cases in the right side.The cause,treatment and prognosis of

  14. Mulligan手法结合按摩治疗椎动脉型颈椎病疗效观察%Effects of Mulligan technique combined with massage in the treatment of cervical spondylosis of vertebral artery type

    Institute of Scientific and Technical Information of China (English)

    黄一琳; 董睿; 李西林

    2015-01-01

    目的:探讨Mulligan手法结合按摩治疗椎动脉型颈椎病的临床效果。方法采用随机数字表法将64例椎动脉型颈椎病患者分为观察组和对照组各32例。两组患者均采用颈椎牵引、按摩及超短波治疗,观察组加用Mulligan手法。于治疗前、治疗10次后采用经颅多普勒超声(TCD)及椎动脉型颈椎病功能评定量表(FSCSA)对患者进行评测。结果两组患者治疗后的椎动脉(VA)、基底动脉(BA)平均血流速度(Vm)与治疗前比较差异均有统计学意义(P<0.01),观察组优于对照组(P<0.01);两组患者的功能评分均改善,与治疗前比较差异均有统计学意义(P<0.01),观察组优于对照组(P<0.01)。结论 Mulligan手法结合按摩治疗椎动脉型颈椎病能显著改善患者的椎-基底动脉血流动力学及躯体、心理、社会生活功能,临床疗效优于单用按摩。%Objective To investigate the effects of Mulligan technique combined with traditional Chinese massage in the treatment of cervical spondylosis of vertebral artery type. Methods Sixty-four patients with cervical spondylosis of vertebral artery type were randomly divided into study group (n=32) and control group (n=32). Both groups were treated with cervical traction and traditional Chinese massage and ultrashort wave therapy. In addition, the study group was also treated with Mulligan technique. Transcranial dopple (TCD) and functional scale for cervical spon-dylosis of vertebral artery type (FSCSA) were used to assess the changes before and after treatment. Results The mean blood flow velocity (Vm) of vertebral artery (VA) and basilar artery (BA) and the FSCSA score in both groups were im-proved after treatment (P<0.01), especially in the study group (P<0.01). Conclusion Mulligan technique combined with massage is more effective in the treatment of cervical spondylosis of vertebral artery type than simply massage.

  15. Incidental spontaneous coronary dissection: An interventionist′s dilemma

    Directory of Open Access Journals (Sweden)

    Akshyaya Pradhan

    2015-01-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is an uncommon entity, frequently presenting as ST-elevation myocardial infarction (MI or sudden cardiac death. It is usually reported in association with pregnancy and has a high mortality. We present here a case of asymptomatic dissection of the right coronary artery, incidentally detected, in a young normotensive male when coronary angiography was done following acute anterior wall MI. This patient had none of the risk factors to which SCAD is generally ascribed. While management of the infarct-related artery was clear-cut, whether or not to intervene for this nonocclusive dissection was a difficult decision. A conservative approach was finally adopted for the spontaneous dissection and the patient is faring well till date.

  16. 手法推拿治疗椎动脉型颈椎病的研究%Studies on a manipulation′s effectiveness to cervical spondylosis of the vertebral artery type

    Institute of Scientific and Technical Information of China (English)

    付梓新; 袁经琳

    2001-01-01

    目的 探讨袁经琳导师经验手法治疗椎动脉型颈椎病的临床疗效、作用机理。方法 对随机的两组椎动脉型颈椎病患者分别用本手法和复方丹参进行治疗对照。结果 本手法疗法能通过纠正椎动脉型颈椎病患者异常X线表现,降低患者异常增高之血液粘稠度,缓解其椎动脉痉挛,从而达到明显改善其临床症状体征以至临床治愈的目的。结论 本手法安全、合理、疗效显著。%objeetive To probe the curative effect of my tutor′s manipulation to cervical spondylosis of the vertebral artery type and search for it′s mechanism.Method The curative effect of manipulation were compared with that of component Danshen.Result The manipulation had cured cervical spondylosis of the vertebral artery type or relieyed their symptoms by correcting their abnormal X-ray ,decreasing their blood and plasma viscosity and relaxed the tension of V-A,Conclusion This manipulation is safe,rational and efficient.

  17. 领式切口保留颈丛择区性颈部淋巴结清扫术治疗分化型甲状腺癌112例分析%Preservation of the cervical plexus with a selective neck dissection through a low-collar incision in patients with differentiated thyroid carcinoma: an analysis of 112cases

    Institute of Scientific and Technical Information of China (English)

    孙团起; 吴毅

    2011-01-01

    Objective To determine the utility and experiences of preserving the cervical plexus in selective neck dissections for differentiated thyroid carcinoma (DTC). Methods Preservation of the cervical plexus was used for selective neck dissection through a low-collar incision in 112 cases of DTC from January 2009 to December 2010 in the Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center. Results The most common site of cervical lymph node metastases was level Ⅵ (78.8%), followed by level Ⅳ (72.9%) and Ⅲ (60.2%). The metastasis rates in level Ⅱ and ⅤB were 43.8% and 16.9%, respectively. No impairment of sensation of ears, lower necks and upper shoulders was found. There was no local recurrence at the time of follow-up for 1 to 25 months. Conclusion If utilized in the appropriate patient population, a selective neck dissection through a low-collar incision for DTC can be a successful alternative to the modified or radical neck dissection. It could be performed in N1b patients when there is no level ⅤA lymph node metastasis, or when the metastasis is not aggressive.%目的 总结领式切口保留颈丛的择区性颈部淋巴结清扫术在分化型甲状腺癌中的应用和经验.方法 复旦大学附属肿瘤医院头颈外科2009年1月至2010年12月期间对112例临床考虑颈侧区转移(CN1b)甲状腺癌病人在原发灶根治的同时施行了领式切口保留颈丛的择区性颈部淋巴结清扫术.结果 颈部淋巴结转移主要分布在Ⅵ区(78.8%)、Ⅳ区(72.9%)、Ⅲ区(60.2%)、Ⅱ区(43.8%)和ⅤB区(16.9%).病人术后均无明显耳部、下颈部和肩部感觉异常.术后经1~25个月随访无局部复发.结论 对于临床考虑颈侧区转移(CN1b)或穿刺证实颈侧区转移的分化型甲状腺癌,在没有ⅤA区转移或没有淋巴结明显外侵的首次手术病人,领式切口保留颈丛的择区性颈清扫可以作为替代根治性或改良性颈清扫的一种选择.

  18. Significado prognóstico do número de linfonodos no esvaziamento cervical eletivo no câncer de língua e soalho de boca Prognostic significance of the number of lymph nodes in elective neck dissection for tongue and mouth floor cancers

    Directory of Open Access Journals (Sweden)

    Ali Amar

    2012-04-01

    Full Text Available A presença de linfonodos metastáticos é aspecto relevante no tratamento do câncer na cabeça e pescoço, resultando em 50% de redução na sobrevida. OBJETIVO: Avaliar o número de linfonodos removidos no esvaziamento cervical e sua relação com o prognóstico. MÉTODOS: Estudo retrospectivo de 143 pacientes portadores de carcinoma epidermoide de língua e soalho bucal, cujo exame histológico evidenciou ausência de metástases linfonodais. Desses, 119 eram masculinos e 24 femininos, com idade média de 54 anos. Quanto ao sítio do tumor primário, 65 eram na língua e 78 no soalho bucal. A distribuição do estádio T foi de quatro T1, 84 T2, 36 T3 e 19 T4. Foram realizados 176 esvaziamentos cervicais, sendo unilateral em 110 casos e bilateral em 33. Desses, 78 radicais e 98 seletivos. Os pacientes foram separados em três grupos, de acordo com os percentis 33 e 66 do número de linfonodos ressecados. RESULTADOS: O número médio de linfonodos ressecados foi de 27, sendo 24 nos esvaziamentos seletivos e 31 nos completos. Não foram observadas diferenças estatisticamente significantes quando relacionado aos estádios T e N. CONCLUSÕES: O maior número de linfonodos dissecados no esvaziamento cervical identifica um grupo de melhor prognóstico nos casos pN0.The presence of metastatic lymph nodes is a relevant aspect in the treatment of head and neck cancer, bringing about a 50% reduction in survival. OBJECTIVE: To assess the number of lymph nodes removed in the neck dissection and their relationship with the prognosis. METHODS: A retrospective study involving 143 patients with tongue and mouth floor epidermoid carcinoma, which histological exam showed no lymph node metastases. Among those, 119 were males and 24 females, with mean age of 54 years. As to the primary tumor site, 65 were in the tongue and 78 in the mouth floor. T stage distribution was of four T1, 84 T2, 36 T3 and 19 T4. We carried out 176 neck dissections, unilateral in 110

  19. Endovascular treatment of ruptured intracranial vertebral artery dissection aneurysms%血管内介入治疗已破裂颅内椎动脉夹层动脉瘤

    Institute of Scientific and Technical Information of China (English)

    刘鑫; 刘敏; 徐锐; 张红

    2015-01-01

    目的:探讨不同血管内介入方式治疗已破裂颅内椎动脉夹层动脉瘤的可行性、安全性及临床疗效。方法2009年1月~2014年3月,血管内介入治疗17例患者共17个已破裂颅内椎动脉夹层动脉瘤。9个小脑下后动脉(PI‐CA)近端的夹层动脉瘤采用椎动脉闭塞技术(电解脱弹簧圈联合机械微弹簧圈栓塞)闭塞夹层段椎动脉。2个累及PICA及6个PICA远端夹层动脉瘤采用单支架(n=6)或双支架(n=2)辅助弹簧圈栓塞技术重建夹层段椎动脉。术后评估夹层动脉瘤即刻闭塞程度,进行长期影像学及临床随访评估治疗效果。结果所有夹层动脉瘤均通过椎动脉闭塞或重建技术栓塞,手术技术成功率为100%,未发生术中出血、血栓形成等手术相关并发症。9例接受椎动脉闭塞技术患者术后病变即刻完全闭塞率达100%,1例患者术后出现患侧耳廓疼痛,1例患者出现复视,对症治疗1周内均缓解,1例患者出现患侧外展神经麻痹,2月后自行缓解。8例接受椎动脉重建技术患者术后病变即刻完全闭塞2例,次全闭塞6例,均无后循环缺血症状。所有患者随访6~36月,影像学及临床预后良好。结论根据夹层动脉瘤与PICA关系,选择相应的介入治疗方式治疗已破裂颅内椎动脉夹层动脉瘤是安全、有效的。%Objective To explore the feasibility ,safety ,and effect of different endovascular strategies in treating rup‐tured intracranial vertebral artery dissection aneurysms .Methods A total of 17 patients with 17 ruptured intracranial ver‐tebral artery dissection aneurysms (VADAs) were treated by endovascular embolization between January 2009 and March 2014 .9 patients with PICA‐proximal VADAs were treated by deconstructive technique .Guglielmi detachable coils were used to embolize the aneurysm lumen .Mechanical coils were used to embolize the parent artery .2 patients with

  20. [Aortic valve replacement as an independent predictive factor for later development of aortic dissection].

    Science.gov (United States)

    von Kodolitsch, Y; Simic, O; Bregenzer, T; Dresler, C; Haverich, A; Nienaber, C A

    1998-08-01

    Dissection of the ascending aorta (type A) following later after aortic valve replacement has been described with increasing frequency. This study analyzes the role of aortic valve replacement for the evolution of late dissection. In a series of 80 consecutive patients with type A dissection, a previous aortic valve replacement had been performed in 12 cases (15%). In addition to arterial hypertension (p syndrome (p factor for type A dissection. Dissection occurred 3 +/- 4 years after aortic valve replacement with a clinical and anatomical profile similar to classic dissection as proven by comparison to a group of 62 patients with classic dissection associated with arterial hypertension or Marfan syndrome. With 75% and 66%, respectively, 30 day and 1 year survival of patients with dissection following later after aortic valve replacement was similar to patients with classic type A dissection. Extensive thinning and/or fragility (p associated with a high risk for late dissection; this finding was substantiated by comparison to a control group of 10 consecutive patients with a similarly dilated aortic root but no dissection. Type and diameter of valve prostheses, cross-clamp time, NYHA functional class, and left ventricular ejection fraction were unrelated to late dissection. Previous aortic valve replacement is an independent predisposing factor for a dissection of the ascending aorta later. At the time of aortic valve replacement, prophylactic replacement or wrapping of the ascending aorta should be considered in patients with a thinned/fragile aortic wall even without a markedly dilated aortic root.

  1. Cervical mimic coronary artery disease treated by tuina and chiropractic therapy in 30 cases%推拿配合整脊手法治疗颈型类冠心病30例

    Institute of Scientific and Technical Information of China (English)

    叶勇

    2012-01-01

    Objective To observe the clinical efficacy of tuina and chiropractic therapy in treating cervical mimic coronary artery disease. Methods Treatment group were treated by tuina and chiropractic therapy and control group were treated by traditional tuina therapy. The clinical efficacy? Score of symptoms and signs 、cervical vertebra physiology degree of curve were observed and compared between two groups. Results The total effective rate was 90.0% in treatment group and 66. 67% in control group after 1 treatment course,two groups of the difference was statistically significant (P<0.05); There was a statistically significant difference in the score of symptoms and signs and cervical vertebra physiology degree of curve between two groups after 1 treatment course(P<0.05). Conclusion Tuina and chiropractic therapy is effective to treat cervical mimic coronary artery disease.%目的 观察推拿配合颈椎整脊手法治疗颈型类冠心病的临床疗效.方法 试验组采用推拿配合颈椎整脊手法调整,对照组采用传统推拿手法,1个疗程后比较临床疗效、症状、体征积分及颈椎生理曲度.结果 2组治疗后,试验组总有效率90.0%,对照组总有效率66.67%,两组比较有显著性差异(P<0.05);症状、体征积分比较、颈椎生理曲度比较均有显著性差异(P<0.05).结论 推拿手法配合颈椎整脊手法治疗颈型类冠心病优于单纯推拿手法.

  2. 人体全颈椎及椎动脉流固耦合模型的构建%Construction of a human cervical spine with bilateral vertebral artery fluid-solid coupling model

    Institute of Scientific and Technical Information of China (English)

    王辉昊; 沈知彼; 邓真; 王宽; 詹红生

    2015-01-01

    目的:建立全颈椎生物力学数字仿真研究平台。方法:参考大量解剖学数据和人体颈椎标本的实验数据,应用逆向工程原理对序列螺旋CT 图片进行处理,分别构建颈椎椎体、椎动脉、韧带、椎间盘、关节面软骨和终板等结构模型,并从解剖形态和活动功能两方面验证该模型与人体生理状态的一致性。结果:构建了人体颈椎三维有限元模型,该模型椎体表面应力集中规律、双侧椎动脉血管壁所受应力特点以及血流速度—时间变化曲线等内容与文献报道的人体颈椎标本实验结果趋势一致,并能合理解释相对应的临床现象。结论:成功构建了人体全颈椎三维有限元流固耦合模型,该模型能为深入了解人体颈椎及其附属结构的生物力学机制提供新的研究思路。%Objective: To construct a human cervical spine with bilateral vertebral artery fluid-solid coupling model .Methods: Helical CT images under the principle of reverse engineering and meshed in finite element model ( FEM ) related software were used to establish a human cervical spine with bilateral vertebral artery fluid-solid coupling model . In the process of modeling of vertebral body , vertebral artery , ligament , intervertebral disc , cartilage and endplate large anatomic data and cadaver experiments results were referenced .From the morphology and function the simulation of model with real physiological status was tested .Results: The study showed that the stress concentration on the surface of vertebral body and the blood wall of the bilateral vertebral artery , and the result of the volume flow rate-time curve of bilateral vertebral artery of the model were consistent with the published literatures .This model was well consistent with the clinical phenomenon .Conclusion: The three-dimensional FEM of the human cervical spine established by the introduced method has been effectively verified.The modeling

  3. 推拿治疗椎动脉型颈椎病的血液流变特性的变化%The Change of Hemorheological Characteristics Based on Massage Therapy on Cervical Spondylosis of Vertebral Artery Type

    Institute of Scientific and Technical Information of China (English)

    邹明; 虞亚明; 陈伟; 秦学飞; 唐启华; 池继敏; 张峰; 徐文

    2012-01-01

    目的 通过推拿手法治疗椎动脉型颈椎病,以改善患者的血液流变特性,观察临床疗效.方法 选取44例患者,于治疗前后测定患者的血液流变学指标,并对患者症状、功能进行评分.结果 椎动脉型颈椎病患者的全血黏度、全血还原黏度、红细胞刚性指数、变形指数、电泳指数高于正常对照组,经推拿治疗后,患者血液流变指标得到明显改善,临床疗效明显,有效率达93.2%.结论 推拿手法对椎动脉型颈椎病有明显的临床治疗作用,有效改善患者血液的高浓、高黏、高聚的血液流变特性.%Objective Through massage therapy on cervical spondylosis of vertebral artery type,we improved the patient's hemorheological characteristics and observed curative effect.Methods Before and after treatment,we detected 44 cases of indexes of hemorheological characteristics and assessed patients,symptoms and funtion scores.Results The whole blood viscosity,whole blood reduced viscosity,erythrocyte rigidity index and deformation index,electrophoresis index in cervical spondylosis of vertebral artery type patients were higher than those of normal group. After massage therapy,patients significantly improved their hemorheological indicators and clinical efficacy.We achieved effective rate of 93.2%.Conclusion Massage therapy on cervical spondylosis of vertebral artery type has obvious clinical effect and significantly improve the patient' s high concentration and high viscosity,high cohesive of hemorheological characteristics.

  4. Cervical Cancer

    Science.gov (United States)

    ... the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The ... for a long time, or have HIV infection. Cervical cancer may not cause any symptoms at first. Later, ...

  5. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2007-03-06

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

  6. [Thoracic aortic dissection revealed by systemic cholesterol embolism].

    Science.gov (United States)

    Braem, L; Paule, P; Héno, P; Morand, J J; Mafart, B; La Folie, T; Varlet, P; Mioulet, D; Fourcade, L

    2006-10-01

    Systemic cholesterol embolism is a rare complication of atherosclerosis, and has various presentations. Arterial catheterisms are a common cause. However, the association with an aortic dissection has been exceptionally reported. We report the observation of a 70 year-old man, with coronary artery disease, hypertension, diabetes and dyslipidemia. Six months before hospitalization, a coronary angioplasty was performed due to recurrent angina. The association of purpuric lesions on the feet, with acute renal failure confirmed cholesterol embolism syndrome. Transoesophageal echocardiography showed a dissection of the descending thoracic aorta associated with complex atheroma. The evolution was marked by the pulpar necrosis of a toe and by a worsening of the renal failure, requiring definitive hemodialysis. Further echographic control highlighted the rupture of the intimal veil of the dissection. Cholesterol embolism syndrome may reveal an aortic dissection in patients without thoracic symptoms. In such cases, transoesophageal echocardiography is a useful and non-invasive examination.

  7. Clinical value of MRI concerning dissection of the supraaortic vessels; Wertigkeit der MRT bei posttraumatischer Dissektion supraaortaler Gefaesse

    Energy Technology Data Exchange (ETDEWEB)

    Pauls, S.; Goerich, J.; Kraemer, S. [Abt. fuer Diagnostische Radiologie, Univ. Ulm (Germany); Hartwig, E. [Unfall- und Wiederherstellungschirurgie, Univ. Ulm (Germany)

    2002-03-01

    Purpose: Evaluation of the potential of MRI concerning dissection of the supra-aortic vessels after cervical trauma. Patients and methods: During the time period from August 1998 to February 2001, 148 patients with trauma were examined by means of MRI scan of the neck / cervical spine or skull concerning morphology of the cervical spine as well as the brain tissue. MRI sequences were weighted T{sub 1} and T{sub 2} before and after contrast medium in transverse and sagittal slices. Additional time of flight (TOF) sequences and contrast-enhanced angiography were acquired. The MRI images were examined by two experienced radiologists when tied consensus was reached. Results: 7 patients (4,7%) with a total of 9 dissections of the vertebral and/or internal carotid artery were found; diagnosis was done on TOF images, contrast enhances MR-angiography, transversal T{sub 1}- and T{sub 2}-weighted sequences as well as T{sub 1}-weighted images post-contrast medium. Therapy was changed accordingly in 4 cases and anticoagulation initiated. Conclusion: All patients with cervical injuries should be screened by MRI including MR-angiography, T{sub 1}-weighted images pre- and post-contrast agent to achieve a sure diagnosis concerning the precise size of the dissection. MRI has proven to be an excellent diagnostic tool for our patient group. (orig.) [German] Ziel: Beurteilung der Bedeutung der MRT bezueglich der Dissektionen supraaortaler Gefaesse im Rahmen cervicaler Traumata. Patienten und Methode: Im Zeitraum von August 1998 bis Februar 2001 wurden an unserer Klinik 148 Patienten mit Traumata zugewiesen, welche zur Abklaerung einer Gefuegestoerung der HWS bzw. Ausschluss einer Myelonaffektion eine MRT-Untersuchung des Halses / der HWS oder Schaedels erhielten. Es wurden jeweils T{sub 1}- und T{sub 2}-gewichtete Sequenzen in transversaler und sagittaler Schnittfuehrung vor und nach Kontrastmittelgabe angefertigt. Zusaetzlich wurden TOF-Sequenzen sowie kontrastunterstuetzte

  8. 椎动脉型颈椎病康复介入87例%Rehabilitation intervention on 87 cases of vertebral artery type of cervical syndrome

    Institute of Scientific and Technical Information of China (English)

    郝焕平; 卫珍梅; 耿建红

    2003-01-01

    @@ INTRODUCTION The reason for physical rotation compression on vertebral artery atG is that there isn' t intervertebral joints between at-lantoepistrophic transverse processes. At rear of vertebral artery be-tween atlantoepistrophic transverse processes is covered by inferioroblique muscle which originates from spinous process of axis andended at transverse process of atlas. When head rotates towardsright, inferior oblique muscle of left side will rotate towards left andforward which muscle belly enters interspace of first transverse pro-cess and compress vertebral artery. At the same time, right vertebralartery enters rear of atlantoepistrophic spinous process and isn' tcompressed that ensures blood supply of basal artery. When head andneck resume neutral position, inferior obhque muscle is replaced andcompression on left vertebral artery is decompressed, so inferioroblique muscle is the anatomic base of physical compression onvertebral compression.

  9. THE COURSE OF DISSECTING ANEURYSM OF THE AORTA

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    N. A. Kosheleva

    2016-01-01

    Full Text Available Research objective. To define features of a course of dissecting aortic aneurysm now.Materials and methods. 11 clinical records of the patients with the established diagnosis of dissecting aortic aneurysm who have come to Regional clinical hospital of Saratov for 2015 are analysed.Results. Along with traditional risk factors, such as the male, existence of arterial hypertension are revealed also additional risk factors, in particular, regular heavy lifting. Gender features in localization of dissecting aortic aneurysm are defined: at men more often of dissecting aortic aneurysm of an aorta is localized in the abdominal aorta, at women in the thoracic region.Conclusions. Additional risk factor of stratification of dissecting aortic aneurysm in the thoracic region at women is the systematic raising of weights.

  10. Clinical values of surgery plus superselective arterial infusion chemotherapy on treating cervical cancer%介入化疗联合手术在子宫颈癌治疗中的价值

    Institute of Scientific and Technical Information of China (English)

    李环; 吴瑞芳; 马喆; 杨瑞; 李瑞珍; 楼宝阳; 曾荔苹

    2012-01-01

    目的 探讨超选择动脉插管灌注化疗(介入化疗)联合手术在子宫颈癌治疗中的临床应用价值.方法 将北京大学深圳医院自2002年4月至2010年1月间收治的ⅠB2~ⅡB期患者共84例作为介入化疗组,采取先介入化疗后手术的方案(8例未行手术),同期ⅠB1~ⅡA期直接手术的对照组82例患者作比较.结果 介入化疗有效76例,占90.5%;药物血液系统毒副反应中,白细胞无减少者47例(61.8%),血红蛋白无下降者59例(77.6%);所有患者手术切除顺利,手术后按照相同的标准辅以化放疗.两组患者手术时间、出血量、并发症等比较,差异无统计学意义(P>0.05).介入化疗组术后患者5年存活率达83.9%%.结论 介入化疗联合手术在临床上应用于局部晚期子宫颈癌,安全、有效,为ⅡB期的患者创造手术条件,可提高宫颈癌患者的治疗效果,改善患者的生活质量,具有良好的应用前景.%Objective To study the clinical significance of surgery plus superselective arterial infusion chemotherapy in the treatment of cervical carcinoma. Methods 84 cervical cancer patients of stage ⅠB2, ⅡB and ⅡB. who underwent operation after arterial infusion chemotherapy form April 2002 to January of 2010 consisted integrated treatment group (8 cases without surgery) (AIC group), while 82 patients who only received surgery in the same time were served as control group. Results The effective rate of arterial infusion chemotherapy was 90.5%. The toxicity including 61.8% grade 0 leucopenia and 77. 6% grade 0 anemia. After arterial infusion chemotherapy, all the surgery were satisfied. There was no significant difference between the two groups in the operation time, bleeding volume and complications (P>0.05). The 5 years survival rate in AIC group was over 83.9%. Conclusion Surgery plus superselective arterial infusion chemotherapy is safe and effective for treating advanced stage cervical cancer. It can

  11. Dissecção aguda de artéria coronária após troca de valva aórtica Disección aguda de arteria coronaria tras reemplazo de válvula aórtica Acute coronary artery dissection after aortic valve replacement

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    Fernando de Paula Machado

    2010-02-01

    Full Text Available A dissecção de aorta pode ocorrer tardiamente após cirurgia de troca de valva aórtica e raramente no primeiro mês pós-operatório. A dissecção de artéria coronariana é rara e normalmente ocorre depois de angiografia coronariana. Relata-se um caso raro de dissecção de artéria coronária, seguido de infarto do miocárdio, no pós-operatório imediato de troca de valva aórtica com correção e evolução bem-sucedidas.La disección de aorta puede ocurrir tardíamente tras cirugía de reemplazo de válvula aórtica y raramente en el primer mes postoperatorio. La disección de arteria coronaria es rara y normalmente ocurre después de angiografía coronaria. Se relata un caso raro de disección de arteria coronaria, seguido de infarto de miocardio, en el postoperatorio inmediato de reemplazo de válvula aórtica con corrección y evolución exitosas.Late aortic dissection can occur after aortic valve replacement surgery, but rarely in the first postoperative month. Coronary artery dissection is rare and usually occurs after coronary angiography. We report a rare case of coronary artery dissection followed by myocardial infarction in the immediate postoperative period of a successful aortic valve replacement with a good postoperative evolution.

  12. Systematization, distribution and territory of the caudal cerebral artery on the brain's surface of the turkey (Meleagris gallopavo

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    Amarílis Díaz de Carvalho

    2014-10-01

    Full Text Available Thirty Meleagris gallopavo heads with their neck segments were used. Animals were contained and euthanized with the association of mebezonium iodide, embutramide and tetracaine hydrochloride (T 61, Intervet by intravenous injection. The arterial system was rinsed with cold saline solution (15°C, with 5000IU heparin and filled with red-colored latex. The samples were fixed in 20% formaldehyde for seven days. The brains were removed with a segment of cervical spinal cord and after, the dura-mater was removed and the arteries dissected. The cerebral carotid arteries, after the intercarotid anastomosis, were projected around the hypophysis, until they reached the tuber cinereum and divided into their terminal branches, the caudal branch and the rostral branch. The rostral branch was projected rostrolateralwards and gave off, in sequence, two collateral branches, the caudal cerebral and the middle cerebral arteries and the terminal branch was as cerebroethmoidal artery. The caudal cerebral artery of one antimere formed the interhemispheric artery, which gave off dorsal hemispheric branches to the convex surface of both antimeres. Its dorsal tectal mesencephalic branch, of only one antimere, originated the dorsal cerebellar artery. In the interior of the cerebral transverse fissure, after the origin of the dorsal tectal mesencephalic artery, the caudal cerebral artery emitted occipital hemispheric branches, pineal branches and medial hemispheric branches, on both antimeres. The caudal cerebral artery's territory comprehended the entire surface of the dorsal hemioptic lobe, the rostral surface of the cerebellum, the diencephalic structures, the caudal pole and the medial surface of the cerebral hemisphere and in the convex surface, the sagittal eminence except for its most rostral third. Due to the asymmetry found in the caudal cerebral arteries' ramifications, the models were classified into three types and their respective subtypes.

  13. Systematization, description and territory of the caudal cerebral artery of the brain in broad-snouted Caiman (Caiman latirostris

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    Lygia Almeida

    2011-09-01

    Full Text Available Thirty heads with the neck segment of Caiman latirostris were used. The animals were provided from a creation center called Mister Caiman, under the authorization of the Brazilian Institute of Environment and Renewable Natural Resources (Ibama. Animals were sacrificed according to the slaughtering routine of the abattoir, and the heads were sectioned at the level of the third cervical vertebra. The arterial system was washed with cold saline solution, with drainage through jugular veins. Subsequently, the system was filled with red colored latex injection. Pieces were than fixed in 20% formaldehyde, for seven days. The brains were removed, with a spinal cord segment, the duramater removed and the arteries dissected. At the level of the hypophysis, the internal carotid artery gave off a rostral branch, and a short caudal branch, continuing, naturally, as the caudal cerebral artery. This artery projected laterodorsalwards and, as it overpassed the optic tract, gave off its I (the first central branch. Penetrated in the cerebral transverse fissure, emitting the diencephalic artery and next its II (second central branch. Still inside the fissure, originated occipital hemispheric branches and a pineal branch. Emerged from the cerebral transverse fissure, over the occipital pole of the cerebral hemisphere. Projected rostralwards, sagital to the cerebral longitudinal fissure, as interhemispheric artery. This artery gave off medial and convex hemispheric branches to the respective surfaces of the cerebral hemispheres, anastomosed with its contralateral homologous, forming the common ethmoidal artery. This artery entered the fissure between the olfactory peduncles, emerging ventrally and dividing into ethmoidal arteries, right and left, which progressed towards the nasal cavities, vascularizing them. The territory of the caudal cerebral artery included the most caudal area of the base of the cerebral hemisphere, its convex surface, the olfactory

  14. Is dissection humane?

    OpenAIRE

    Hasan, Tabinda

    2011-01-01

    Dissection is being jeopardized in the modern medical education. It has unrelentingly faced the lashes of time and has been the scapegoat for numerous convenient curricula reforms and subjective biases. The cadaver is unparallel in establishing core knowledge among the medical community and it needs to be appreciated in a new light in the “cyber anatomy” realm of today. This article elucidates the medical and ethical validity of continuing human body dissection in medicine which outweighs all...

  15. Cervical Angina

    Science.gov (United States)

    Sussman, Walter I.; Makovitch, Steven A.; Merchant, Shabbir Hussain I.

    2015-01-01

    Cervical angina has been widely reported as a cause of chest pain but remains underrecognized. This series demonstrates the varied clinical presentation of patients with cervical angina, the delay in diagnosis, and the extensive cardiac examinations patients with this condition typically undergo prior to a definitive diagnosis. Recognition of this condition in patients with acute chest pain requires a high index of suspicion and an awareness of the common presenting features and clinical findings of cervical angina. PMID:25553225

  16. Endovascular rescue from arterial rupture and thrombosis during middle cerebral artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, J.Y.; Chung, Y.S. [Department of Neurosurgery, College of Medicine, Pundang CHA Hospital, 351 Yatap-ding, Pundang-gu, 463-712, Sungnam (Korea); Lee, B.H. [Department of Interventional Neuroradiology, College of Medicine, Pundang CHA Hospital, 351 Yatap-dong, Pundang-gu, 463-712, Sungnam (Korea); Kim, O.J. [Department of Emergency Medicine, College of Medicine, Pundang CHA Hospital, 351 Yatap-dong, Pundang-gu, 463-712, Sungnam (Korea)

    2003-08-01

    Intravascular stents are being used with increasing frequency in interventional neuroradiology. Iatrogenic arterial rupture is an uncommon but serious complication. We present a case of arterial rupture and subarachnoid haemorrhage during middle cerebral artery stenting, treated by emergency additional, overlapping stenting and balloon tamponade of the dissected vessel. Thrombotic occlusion of the artery was managed by intra-arterial abciximab. Normal vessel patency was re-established within 20 min and the patient recovered with no neurological deficit. (orig.)

  17. Variant origin of right testicular artery – a rare case

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    Salve VM

    2010-02-01

    Full Text Available Testicular arterial anatomy is important for testicular and renal surgeries. It may vary at the origin and arise from renal artery, suprarenal artery or lumbar artery. During routine dissection of 52-year-old male cadaver; the right testicular artery arising from right aberrant renal artery was found. Anatomical variation of testicular arteries is reported to be 4.7%. Presence of aberrant renal artery is seen in 13–16% of cases only. The origin of right testicular artery from right aberrant renal artery is very rare. Thus knowledge of this type of variation is very important in avoiding complications during operative surgeries.

  18. 放疗联合双侧髂内动脉灌注化疗治疗晚期宫颈癌%Analysis of curative effect of radiotherapy combined with bilateral internal iliac arterial infusion chemotherapy on advanced cervical cancer

    Institute of Scientific and Technical Information of China (English)

    苏永强; 刘英杰; 李俊

    2016-01-01

    Objective To analyze the effects of radiotherapy combined with bilateral internal iliac arterial infusion chemotherapy on advanced cervical cancer .Methods Fifty patients with advanced cervical cancer from January 2012 to December 2013 were selected as the research objects .They were randomly divided into two groups , the control group was only given radiotherapy treatment , the observation group were given bilateral internal iliac artery infusion chemotherapy treatment based on the control group , followed-up 1 year after treatment , and then compared the clinical efficacy , adverse reactions and the follow-up results of two groups .Results The effective rate in the observation group was 84%, and 56%in the control group, the difference was significant(P0.05).In addition, the main side effects of observation group were myelosuppression and gastrointestinal tract reaction , major adverse reactions in control group were delayed injury and intestinal injury of urinary system .Conclusions The effect of radiotherapy combined with bilateral in-ternal iliac arterial infusion chemotherapy on advanced cervical cancer is definite , can effectively improve the survival rate of 1 year, significantly reduce the recurrence rate in 1 year, is worth clinical promotion .%目的:分析放疗联合双侧髂内动脉灌注化疗治疗晚期宫颈癌的疗效。方法以解放军第一五二中心医院2012年1月至2013年12月收治的50例晚期宫颈癌患者为研究对象,随机将其分为两组,对照组患者给予单纯放疗治疗,观察组患者在对照组基础上联合双侧髂内动脉灌注化疗治疗,治疗后随访1年,比较两组临床疗效、不良反应及随访结果。结果观察组治疗有效率为84.0%,对照组为56.0%,两组比较差异有统计学意义(P<0.05)。观察组1年复发率、转移率分别为24.0%、16.0%,对照组为52.0%、44.0%,两组比较差异有统计学意义(P<0.05),两组1年生存

  19. Xuesetong Tablets Combined with Traction Physiotherapy for Treating 80 Cases of Cervical Spondylosis of Vertebral Artery Type%血塞通片联合牵引理疗治疗椎动脉型颈椎病80例

    Institute of Scientific and Technical Information of China (English)

    贺红霞

    2012-01-01

    Objective To investigate the efficacy of Xuesetong Tablets combined with the traction physiotherapy for treating 80 cases of cervical spondylosis of vertebral artery type. Methods 160 cases of cervical spondylosis of vertebral artery type were randomly divided into 2 groups, 80 cases in each group. The control group was given the traction physiotherapy combined with oral Betahistine Tablets 6 mg once,3 times daily,while the treatment group was treated with the traction physiotherapy combined with Xuesetong Tablets 50-100 mg once,3 times daily,for successive 4 weeks. The clinical symptoms,therapy efficacy and side effects were observed and recorded by transcranial Doppler (TCD ) detection before and after treatment. Results After 4 - week treatment,the clinical symptoms detected by TCD were significantly improved in the treatment group compared to the control group with statistical difference between the two groups ( P < 0. 05 ). The total effective rate was 90.00% in the treatment group,which was significantly higher than 73.75% in the control group, showing statistical difference between them(P < 0. 05 ). There are no obvious adverse reactions in the course of treatment. Conclusion Traction physiotherapy combined with Xuesetong Tablets has a significant clinical effect in the treatment of cervical spondylosis of vertebral artery type with less side effects,which can be popularized in clinical practice.%目的 观察应用血塞通片联合牵引理疗治疗椎动脉型颈椎病80例.方法 将诊断明确的160例患者随机均分为2组各80例.对照组采用牵引理疗联合口服倍他司汀片每次6mg、3次/d.治疗组采用牵引理疗联合血塞通片口服治疗,1次50~100mg、3次/d,连续治疗4周.观察并记录两组患者经颅多普勒检查(TCD)治疗前后变化情况、疗效以及药物副作用.结果 治疗4周后,治疗组患者症状TCD检查显示比对照组均显著改善,且差异有统计学意义(P<0.05).治疗组总有效率为90

  20. 祛痛膏对椎动脉型颈椎病祛痛的临床疗效分析%A clinical analysis of treating vertebral artery type of cervical spondylosis with the Qutong ointment

    Institute of Scientific and Technical Information of China (English)

    韩福祥; 秘兴锋; 司俊梅; 李清云; 田秀华; 李忠伟; 赵雪艳; 赵广声

    2014-01-01

    Objective: To study clinical efficacy of the Qutong ointment on vertebral artery type of cervical spondylosis. Methods: 60 patients with vertebral artery type of cervical spondylosis, according to the odd and even number method, were randomly divided into control group and observation group, 30 cases respectively. The control group was given the Jingfukang granule, the observation group was treated by the Qutong ointment. Clinical effects and symptoms were compared in both. Results: The total efficacy in the control (66.67%) was obviously lower than that in the observation (93.33%). The difference was statistically significant (P<0.05). Symptomatic rates of vertigo, discomfort in neck, headache, blurred vision, fatigue, amnesia, instability of gait, purple tongue, white tongue fur and deep thready pulse were observed in both, the difference was statistically significant (P<0.05). Conclusion: The Qutong ointment was effective on vertical artery type of cervical spondylosis, showed lower symptomatic rate, and was worthy of clinical recommending.%目的:探讨祛痛膏对椎动脉型颈椎病祛痛的临床疗效。方法:将60例椎动脉型颈椎病患者按照奇偶数字法随机地均分为对照组与观察组,各30例。对照组口服颈复康颗粒治疗,观察组则采用自制祛痛膏治疗。比较两组临床治疗效果及治疗前后症状发生率。结果:对照组临床治疗总有效率为66.67%,显著低于观察组(93.33%)(P<0.05);两组治疗前后眩晕、颈部不适、头痛、视物模糊、倦怠乏力、健忘、步态不稳、舌暗、舌苔白及脉沉细等症状发生率差异均具有统计学意义(P<0.05~0.01),且观察组治疗后上述症状发生率均显著低于对照组治疗后(P<0.05)。结论:祛痛膏对椎动脉型颈椎病祛痛的临床疗效显著,且临床症状发生率也显著降低,值得在临床上加以推广及应用。

  1. 密集型触骨针法治疗椎动脉型颈椎病临床观察%Clinical Observation on Treatment Vertebral Artery Type of Cervical Spondylosis by Intensive Acupuncture of Contact Bone

    Institute of Scientific and Technical Information of China (English)

    李浩炜; 邓灵芝; 郑辉; 敬胜伟; 孙力

    2015-01-01

    目的:观察密集型触骨针法治疗椎动脉型颈椎病的疗效。方法将180例椎动脉型颈椎病患者分为治疗组90例,对照组90例。治疗组密集型触骨针法治疗;对照组用普通针刺治疗,3个疗程后对比疗效、治疗前后症状与体征积分。结果两组有效率分别为98.2%、70%,P<0.05,治愈率分别为70%、30%,P<0.01;两组治疗前后积分差异具有统计学意义,P=0.000<0.01;两组治疗后积分比较差异具有统计学意义,治疗组在缓解症状上明显优于对照组,P值分别为0.002、0.001、0.005、0.003<0.01。结论密集型触骨针法治疗椎动脉型颈椎病疗效显著,能明显缓解症状。%Objective To observe the curative effect of intensive contacting bone acupuncture treatment of vertebral artery type of cervical spondylosis.Methods 180 cases of vertebral artery type of cervical spondylosis patients were divided into the treatment group of 90 cases, 90 cases in the control group , respectively with intensive contact-bone acupuncture therapy and common acupuncture , after 3 courses of treatment comparison efficacy , score of symptoms and signs before and after treatment .Results the effective rate in the 2 groups is respectively 98.2%, 70%, P<0.05, the cure rate was 70%, 30%, P<0.01; Difference of score has statistical significance before and after treatment in 2 groups, P=0.000<0.01;There is statistical significant in difference of score between the 2 groups after treatment, the treatment group in the relief of symptoms was significantly better than the control group , P =0.002, 0.001, 0.005, 0.003 <0.01.Conclusion the therapeutic effect of intensive contacting bone acupuncture treatment of vertebral artery type cervical spondylosis is significant , the therapy can significantly relieve the symptoms .

  2. Therapeutic Observation of Acupuncture at Myofascial Trigger Points for Cervical Spondylosis of Vertebral Artery Type%针刺肌筋膜触发点治疗椎动脉型颈椎病疗效观察

    Institute of Scientific and Technical Information of China (English)

    王翀敏; 陈红薇; 王延武; 岳红; 朱敏

    2015-01-01

    目的:观察针刺肌筋膜触发点治疗椎动脉型颈椎病的临床疗效。方法将98例椎动脉型颈椎病患者随机分为治疗组51例和对照组47例。治疗组采用针刺肌筋膜触发点治疗,对照组采用注射消炎镇痛液治疗。比较两组治疗前后旋颈试验阳性率、眩晕评分及头项部疼痛VAS评分。结果两组治疗后VAS评分、旋颈试验阳性率及眩晕评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后VAS评分、旋颈试验阳性率及眩晕评分与对照组比较,差异具有统计学意义(P<0.05)。治疗组总有效率为96.1%,对照组为76.6%,两组比较差异具有统计学意义(P<0.05)。结论针刺肌筋膜触发点能改善椎动脉型颈椎病患者眩晕及头项部疼痛症状。%Objective To observe the therapeutic efficacy of acupuncture at myofascial trigger points (MTrPs) in treating cervical spondylosis of vertebral artery type. Methods Ninety-eight patients with cervical spondylosis of vertebral artery type were randomized into a treatment group of 51 cases and a control group of 47 cases. The treatment group was intervened by acupuncture at the MTrPs, while the control group was by injection of medical solution for anti-inflammation and analgesia. The positive rate of rotate-cervix test, dizziness score, and visual analogue scale (VAS) of the head and neck pain were compared before and after intervention. Results After intervention, the positive rate, dizziness score, and VAS score were significantly changed in both groups (P<0.05). There were significant differences in comparing the positive rate, dizziness score, and VAS score between the two groups after intervention (P<0.05). The total effective rate was 96.1%in the treatment group versus 76.6%in the control group, and the difference was statistically significant (P<0.05). Conclusion Acupuncture at the MTrPs can improve the dizziness and head-neck pain in patients with

  3. 小针刀治疗椎动脉型颈椎病眩晕的临床观察%Clinical Observation on Small Needle- knife for Treatment of Vertigo Caused by Cervical Spondylosis of Vertebral Artery Type

    Institute of Scientific and Technical Information of China (English)

    林海瑞

    2012-01-01

    目的:探讨小针刀治疗椎动脉型颈椎病眩晕症的临床疗效和治疗机理.方法:将160例椎动脉型颈椎病眩晕症患者随机分为小针刀组(80例)和传统组(80例),小针刀组采用小针刀松解治疗,传统组采用常规体针进行操作,连续治疗两个疗程后两组进行疗效对比,并观察两组治疗前后症状积分的变化.结果:小针刀组总有效率95%,传统组为80%,差异有统计学意义(P<0.01),治疗后两组临床症状积分比较差异有统计学意义(P<0.01).结论:小针刀对椎动脉型颈椎病眩晕症疗效确切,优于常规针刺疗法.%Objective: To explore the clinical therapeutic effect and mechanisms of small needle - knife for treating the vertigo caused by cervical spondylosis of vertebral artery type. Methods:One hundred sixty cases were randomly divided into small needle - knife group and traditional group, 80 cases in each group. The small needle - knife group was treated by small needle - knife releasing therapy. The traditional group was treated by common acupuncture. After two courses of treatment,observe the clinical effect between two groups, and clinical symptom score of both groups were observed before and after treatment. Results: The total effective rate in small needle - knife group and traditional group were 95% and 80% , and there was a significant difference between groups(P <0. 01 ).. After treatment clinical symptom score in both groups had a significant difference ( P < 0. 01). Conclusion: Small needle - knife has a definite therapeutic effect on vertigo caused by cervical spondylosis of vertebral artery type. Small needle - knife is superior to the common acupuncture.

  4. Bilateral accessory thoracodorsal artery.

    Science.gov (United States)

    Natsis, Konstantinos; Totlis, Trifon; Tsikaras, Prokopios; Skandalakis, Panagiotis

    2006-09-01

    The subscapular artery arises from the third part of the axillary artery and gives off the circumflex scapular and the thoracodorsal arteries. Although anatomical variations of the axillary artery are very common, the existence of a unilateral accessory thoracodorsal artery has been described in the literature only once. There are no reports of bilateral accessory thoracodorsal artery, in the literature. In the present study, a bilateral accessory thoracodorsal artery, originating on either side of the third part of the axillary artery, is described in a 68-year-old female cadaver. All the other branches of the axillary artery had a typical origin, course, distribution and termination. This extremely rare anatomical variation apart from the anatomical importance also has clinical significance for surgeons in this area. Especially, during the dissection or mobilization of the latissimus dorsi that is partly used for coverage problems in many regions of the body and also in dynamic cardiomyoplasty, any iatrogenic injury of this accessory artery may result in ischemia and functional loss of the graft.

  5. Cervical dysplasia - series (image)

    Science.gov (United States)

    ... to detect cervical cancer. Limited or early cervical cancer (carcinoma in situ, or cervical intraepithelial neoplasia, or dysplasia) requires treatment with ablation therapy, usually in the form of ...

  6. TRAPEZOID SHAPED OMOHYOIDEUS MUSCLE: An Anatomic Variation seen in Functional Neck Dissection

    OpenAIRE

    Lokman Uzun; Numan Kokten; Gul Ozbilen Acar

    2015-01-01

    Omohyoid muscle (Om) is an important anatomical landmark in cervical lymph node partition, neck dissection for head and neck cancers and cervical spine surgery. It consists of two bellies united at an angle by an intermediate tendon. Variations in the origin and insertion of the muscle, absence or duplication of the superior or inferior bellies, aberrant position in relation to IJV and sternocleideomastoid muscle have been reported. We report a rare anatomical variation of the Om in this repo...

  7. Study of basilar artery hemodynamic changes in cervical rotation and flexion by color Doppler ultrasound%彩色多普勒超声对正常人头颈部分别向左右转动后基底动脉血流的观察

    Institute of Scientific and Technical Information of China (English)

    杨玉杰; 李敬府; 白志勇; 王金锐

    2009-01-01

    Objective To evaluate the basilar artery hemodynamical changes in cervical rotation and ventral flexion by color Doppler flow imaging(CDFI). Methods Basilar artery blood flow were detected during cervical With cervical right lateral,left lateral rotation and ventral flexion, the detection ratio of basilar artery by ultrasound were 89% ,84% ,81% respectively. There were no difference in statistics between the detction ratio of three kinds during cervical flexion,peak systolic velocity(PSV) and end-diastolic velocity(EDV) decreased apparently during left lateral rotation,which did not change during right lateral rotation. No changing was found with resistant index between the three kinds of cervical position. Conclusions The hemodynamic changing of basilar artery during cervical rotation and flexion could be detected by CDFI accurately,which might be useful in clinical study.%目的 应用彩色多普勒超声评价正常人头颈部分别向左右转动后基底动脉(BA)血流动力学参数.方法 应用彩色多普勒超声对62例正常人在俯卧位低头以及头颈部分别向左右转动90°后三种姿势下,观察BA血流,并对其血流动力学指标进行对比分析.结果 ①三种姿势下BA的检出率:俯卧位低头为89%,头颈部左转为84%,头颈部右转为81%,三种姿势下BA血流的显示率比较差异无统计学意义(P>0.05).②椎动脉颁段内径:左侧大于右侧[左侧(0.34±0.06)cm对右侧(0.32±0.05)cm,P0.05),三种姿势下阻力指数差异无统计学意义(P>0.05).结论 彩色多普勒超声对BA检出率高,能够准确清晰地显示不同姿势下BA的血流动力学情况,提示正常人头颈部向左转时对BA血流有影响,对研究椎-基底动脉系血流动力学有着重要的临床意义.

  8. 多层螺旋CT对孤立性肠系膜上动脉夹层的诊断价值及与数字减影血管造影的对比分析%Comparison of diagnostic value between multislice CT and digital subtraction angiography in isolated supe-rior mesenteric artery dissection

    Institute of Scientific and Technical Information of China (English)

    张杨贵; 何旭升; 温志玲; 陈珊红; 高振华; 许俊丽

    2016-01-01

    目的:探讨64层螺旋CT血管成像及后处理技术对孤立性肠系膜上动脉夹层(SISMAD)的诊断价值,及与数字减影血管造影对比分析。方法回顾分析17例使用64层螺旋CT及数字减影血管造影(DSA)所发现的孤立性肠系膜上动脉夹层,结合横断位原始图像及各后处理方法重建图像,分析其影像征像。结果64层螺旋CT血管成像动脉期能清晰显示肠系膜上动脉及其低密度的内膜片,真假腔及破裂口显示良好,夹层累及范围,是否存在血栓及累及分支血管,术后追踪观察方便、准确。结论多层螺旋CT能清晰显示孤立性肠系膜上动脉夹层的病变特征,其检出率、并发症显示优于DSA,并能较好地指导DSA介入治疗及预后观察,是孤立性肠系膜上动脉夹层首选的无创检查方法。%Objective To compare the diagnostic value between 64-slice CT and digital subtraction angiogra-phy (DSA) in isolated superior mesenteric artery (SISMAD) dissection. Methods Retrospective study was taken in 17 patients with SMA Dissection, evidenced by both 64-slice CT and DSA,analyze the eikonic signs according to trans-verse view and reconstruction images. Results In artetial phase, multislice CT could clearly showed superior mesen-teric artery, its hypodense intimal orifice, true and false double lumen and oral cleft, intercalated bed range involved, with or without thrombus and lateral branch blood vessels could be indicated well, which had great convenience to follow-up postoperative. Conclusion Multislice CT, an atraumatic mothod for SMA dissection, could clearly present its pathological changes. It also has better detection rate and less complication compared with DAS. Moreover, multi-slice CT could help to direct treatment by DSA.

  9. Clinical observation for the improvement of motion of range of cervical spine on rotationtraction manipulation treating cervical spongdylosis of the vertebral artery type%旋提手法改善椎动脉型颈椎病颈椎活动度的临床观察

    Institute of Scientific and Technical Information of China (English)

    魏戌; 高景华; 朱立国; 罗杰; 王尚全; 谢利民; 李俊杰

    2012-01-01

    目的:通过观察颈椎活动度治疗前后的变化,评价旋提手法治疗椎动脉型颈椎病的疗效.方法:共计纳入椎动脉型颈椎病患者195例,随机分配到试验组和对照组,试验组采用旋提手法,对照组采用牵引疗法.应用头盔式颈椎活动仪于治疗前和治疗后第1、3、5、7、9、11、13天及治疗后1、3个月共9个时间点观测颈椎的前屈、后伸、左右侧屈、左右旋转的活动度.结果:颈椎活动度的程度比较,第3次访视起,试验组颈椎活动度计分改善较对照组明显(P<0.05);颈椎活动度的数值比较,前屈活动度改善两组无显著统计学差异,后伸活动度从第1个月随访起,左右侧屈活动度从第3次访视起,左右侧旋活动度从第7次访视起,试验组均优于对照组(P<0.05);两组疗效及与时间交互作用比较,试验组优于对照组(P<0.05),随着治疗次数增加,试验组、对照组的颈椎活动度均有显著改善(P<0.001).结论:旋提手法对于改善椎动脉型颈椎病患者的颈椎活动度有效,颈椎活动度程度、数值是量化颈椎功能和评价手法疗效的重要指标.%Objective: To observe the range of motion(ROM) of cervical spine pre and post treatment, and evalulate the effect on rotation-traction manipulation treating cervical spongdylosis of the vertebral artery type. Methods: 195 patients with cervical spongdylosis of the vertebral artery type were randomly allocated to testing group(treated by rotation-traction manipulation) and control group(treated by traction). ROM of cervical spine in both groups were measured before and on the 1st, 3rd, 5th, 7th, 9th, 11th, 13th day and 1st, 3st month after the treatment. Results: For the comparison of ROM degree, from the 3rd visiting point on, the testing group which improved the score of ROM was better than the control group(P<0.05). As far as the comparison of ROM numerical value is concerned, there was no difference in anteflexion

  10. CHIMNEY TECHNOLOGY IN STANFORDB TYPE OF ABDOMINAL AORTIC ANEURYSM AND AORTIC DISSECTION INVOLVING THE CLINICAL APPLICATION OF RENAL ARTERY PROSTHESIS%烟囱技术在 StanfordB 型主动脉夹层和腹主动脉瘤累及肾动脉修复术的临床应用

    Institute of Scientific and Technical Information of China (English)

    王厚生

    2015-01-01

    Objective Type chimney technology in StanfordB abdominal aortic aneurysm and aortic dis‐section involving the renal artery (juxtarenal aortic aneurysms ,JAA) application feasibility and safety of repair .Methods Jan 2010 to jan 2013 ,21 cases of diagnosis and treatment of abdominal aortic aneurysm and aortic dissection StanfordB type involving patients with renal artery ,w hich StanfordB type ,including 13 cases of aortic dissection ,abdominal aortic aneurysm involvement of 8 cases of renal artery .All patients were performed CT enhanced scan ,before they are confirmed by femoral artery puncture aortic angiogra‐phy ,coated stents improperness internal isolation in parallel "chimney" technology to protect important branch artery .Results All patients were successfully repair the aorta and guarantee important branch such as subclavian artery and renal artery flow .Conclusion The clinical application of "chimney" technology solves the lumen of isolated from surgery to repair the aortic lesions at the same time avoid the other im‐portant branch of isolated vascular perfusion ,and to solve the primary disease of coated stent provides ef‐fective proximal anchoring area , even can help eliminate the leakage , to ensure the operation curative effect .%目的:探讨烟囱技术在StanfordB型主动脉夹层和腹主动脉瘤累及肾动脉(juxtarenal aortic aneurysms ,JAA)修复术的应用的可行性和安全性。方法2010年01月至2013年01月诊治21例StanfordB型主动脉夹层和腹主动脉瘤累及肾动脉的患者,其中StanfordB型主动脉夹层13例,腹主动脉瘤累及肾动脉8例。所有患者均行先C T 增强扫描,后经股动脉穿刺主动脉造影证实,植入覆膜支架行腔内隔绝术并行“烟囱”技术保护重要分支动脉。结果所有患者均成功修复主动脉并保证重要分支动脉如锁骨下动脉和肾动脉通畅。结论“烟囱”技术的临床应用解决了腔内隔绝术修复主动

  11. Treatment of carotid artery aneurysms with covered stents; Aneurysmabehandlung der Arteria carotis interna mit gecoverten Stents

    Energy Technology Data Exchange (ETDEWEB)

    Rohr, A.; Alfke, K.; Doerner, L.; Jansen, O. [UKSH Kiel (Germany). Neurochirurgie Neuroradiologie; Bartsch, T.; Stingele, R. [UKSH Kiel (Germany). Neurologie

    2007-10-15

    Purpose: Evaluation of the use of covered stents in treating pseudoaneurysms of the cervical and intracranial/extradural carotid artery and determination of the periprocedural and short- to mid-term complication rate. Materials and Methods: 8 patients with 9 spontaneous dissecting aneurysms of the cervical carotid artery - 5 of which were symptomatic - plus one patient with ofthalmoplegia due to an aneurysm of the cavernous carotid artery were studied. While the latter was treated with a PTFE-covered balloon-mounted stainless steel stent (Jostent/Graftmaster), a self-expanding PTFE-covered Nitonol Stent (Symbiot) was used in all other cases. Intervention was performed with local anesthesia. Aspirin and Clopidogrel were both used as antiplatelet drugs. Clinical signs and symptoms and vascular imaging with DS, MR, CT angiography and ultrasound were recorded during patient follow-up, with a mean follow-up period of 14.6 months (4 - 30). Results: We were able to treat 8 out of 10 aneurysms (80 %) using covered stents. The aneurysms were immediately occluded and the associated stenoses of the parent vessel were eliminated. No clinically relevant complications occurred during the procedure or in the follow-up interval. In two cases, elongation of the carotid artery prevented the stent from being positioned over the aneurysm neck. These cases were shown to be stable with the use of antiplatelet drugs. Conclusion: Covered stents can be used in the treatment of pseudoaneurysms of the carotid artery as an alternative to long-term antithrombotic medication or surgery. In our study treatment was effective (80 %) and free of complications in the short- and mid-term follow-up. Possible indications, technique and the use of imaging modalities for patient follow-up are discussed. (orig.)

  12. Cervical Laminoplasty

    Science.gov (United States)

    ... spine showing extension of the spine following a cervical laminoplasty. B) Post-operative lateral x-rays of the same patient showing flexion. Note that the range of motion is maintained after the laminoplasty and that no ...

  13. Cervical spondylosis

    Science.gov (United States)

    Cervical osteoarthritis; Arthritis - neck; Neck arthritis; Chronic neck pain; Degenerative disk disease ... therapist). Sometimes, a few visits will help with neck pain. Cold packs and heat therapy may help your ...

  14. 裸支架腔内血管重建术治疗孤立性肠系膜上动脉夹层动脉瘤%Percutaneous endovascular reconstruction with endovascular stent placement for isolated spontaneous dissection of the superior mesenteric artery

    Institute of Scientific and Technical Information of China (English)

    苏浩波; 顾建平; 楼文胜; 何旭; 陈亮; 陈国平; 宋进华; 汪涛; 徐克

    2011-01-01

    目的 评价裸支架载瘤动脉腔内血管重建术治疗孤立性肠系膜上动脉夹层的安全性和疗效.方法 2007年至2010年对5例经腹部CT血管成像(CTA)及数字减影血管造影(DSA)明确诊断的肠系膜上动脉夹层动脉瘤患者行裸支架载瘤动脉腔内血管重建术治疗.按照Sakamoto血管影像学分型,Ⅰ、Ⅱ型各1例,Ⅲ型3例.患者术后继续给予抗凝、抗血小板治疗,术后1、3、6个月进行CTA或血管造影随访.结果 5例患者手术均获成功,其中支架联合弹簧圈栓塞2例,双支架重叠技术3例,无并发症发生.4例症状性患者术后3周内症状消失.5例患者术后3 ~ 6个月时肠系膜上动脉CTA及DSA显示动脉瘤腔不显影,支架腔内血流通畅.随访3 ~ 12个月(平均7.8个月)夹层动脉瘤无复发.结论 裸支架载瘤动脉腔内血管重建术是治疗孤立性肠系膜上动脉夹层安全、有效的方法.%Objective To evaluate the safely arid efficacy of percutaneous endovaseular reconstruction with endovaseular slent placement for Isolated spontaneous dissection of the superior mesenteric artery. Methods Five patients with Isolated spontaneous dissection of the superior mesenteric artery were enrolled in tliis study. The diagnosis was confirmed by abdominal computed tomography auglography (CTA ) and percutaneous transcatheter digital subtraction angiography (DSA ) in all the five patients. One asymptomatic case was discovered by medical examination, which was classified to type I (Sakamoto angiographic categorization). The other four cases were admitted to hospital with acute abdominal pain and diarrhea, which were classified to type JI( 1 case ) and type UK 3 cases). Fasting together with antiplatelet and antieoagulation therapy was initially employed. Then, percutaneous endovaseular reconstruction with stenting was carried out and the patients were kept on antiplatelet therapy. Follow-up checkups with CTA or DSA were conducted at 1. 3 and 6

  15. Rare anatomic variation of left gastric artery and right hepatic artery in a female cadaver.

    Science.gov (United States)

    Troupis, Theodore; Chatzikokolis, Stamatis; Zachariadis, Michael; Troupis, George; Anagnostopoulou, Sofia; Skandalakis, Panayiotis

    2008-05-01

    The present report describes a rare case in which the left gastric artery arises directly from the abdominal aorta and the right hepatic artery from the superior mesenteric artery, as observed during the dissection of a female cadaver. The left gastric artery usually rises as one of the three branches of the celiac trunk, which was originally described by Haller in 1756, whereas the right hepatic artery usually originates from the proper hepatic artery. The knowledge of the typical anatomy of the abdominal arteries, and their variations, is especially important due to the numerous interventions performed in the abdominal area.

  16. Acute aortic dissection: be aware of misdiagnosis

    Directory of Open Access Journals (Sweden)

    Asteri Theodora

    2009-02-01

    Full Text Available Abstract Background Acute aortic dissection (AAD is a life-threatening condition requiring immediate assessment and therapy. A patient suffering from AAD often presents with an insignificant or irrelevant medical history, giving rise to possible misdiagnosis. The aim of this retrospective study is to address the problem of misdiagnosing AD and the different imaging studies used. Methods From January 2000 to December 2004, 49 patients (41 men and 8 women, aged from 18–75 years old presented to the Emergency Department of our hospital for different reasons and finally diagnosed with AAD. Fifteen of those patients suffered from arterial hypertension, one from giant cell arteritis and another patient from Marfan's syndrome. The diagnosis of AAD was made by chest X-ray, contrast enhanced computed tomography (CT, transthoracic echocardiography (TTE and coronary angiography. Results Initial misdiagnosis occurred in fifteen patients (31% later found to be suffering from AAD. The misdiagnosis was myocardial infarction in 12 patients and cerebral infarction in another three patients. Conclusion Aortic dissection may present with a variety of clinical manifestations, like syncope, chest pain, anuria, pulse deficits, abdominal pain, back pain, or acute congestive heart failure. Nearly a third of the patients found to be suffering from AD, were initially otherwise diagnosed. Key in the management of acute aortic dissection is to maintain a high level of suspicion for this diagnosis.

  17. Bionic electrical stimulation of brain with medium frequency electrotherapy for treatment of cervical spondylopathy of vertebral artery type%脑仿生电刺激配合中频电疗治疗椎动脉型颈椎病

    Institute of Scientific and Technical Information of China (English)

    何南

    2012-01-01

    目的:观察脑仿生电刺激配合中频电疗(MFE)对椎动脉型颈椎病(CSA)的治疗作用.方法:CSA患者300例,随机分为观察组和对照组各150例,2组均给予药物对症支持治疗,观察组加用脑仿生电刺激配合MFE.治疗前后采用经颅多普勒(TCD)检测基底动脉(BA)、椎动脉(VA)、大脑中动脉(MCA)、大脑前动脉(ACA)平均血流速度.结果:治疗2周后,观察组BA、VA、MCA及ACA平均血流速度均较治疗前及对照组治疗后明显增快(P<0.05),对照组治疗前后比较差异无统计学意义.治疗后及6个月后随访,2组临床疗效比较,观察组总有效率均明显高于对照组(P<0.01).结论:脑仿生电刺激配合MFE对CSA患者有明显的治疗作用,可有效缓解眩晕等临床症状.%Objective:To observe the curative effectiveness of the brain bionic electrical stimulation in combination with medium frequency electrotherapy (MFE) on cervical spondylosis of vertebral artery type (CSA). Methods; Three hundreds CSA patients were randomly divided into observation group and control group (n = 150 each group). Both groups were given drug administration. The patients in observation group were given the brain bionic electrical stimulation combined with MFE additionally. Before and after treatment, transcranial Doppler (TCD) was used to measure mean blood flow velocity of basilar artery (BA) , vertebral artery (VA), middle cerebral artery (MCA) and the anterior cerebral artery(ACA). Results; After treatment for 2 weeks, the mean blood flow velocity of BA,VA, MCA and ACA in observation group was significantly increased as compared with pretreatment and control group after treatment(P<0. 05). There was no significant difference of the mean blood flow velocity in the control group before and after treatment. During a follow-up period of six months, the overall clinical effective rate in observation group was significantly higher than in control group (P<0. 01). Conclusion;The brain bionic

  18. Cervical vertigo%颈性眩晕

    Institute of Scientific and Technical Information of China (English)

    何及; 樊东升; 孙宇

    2011-01-01

    Cervical vertigo refers to a syndrome with a chief complaint of vertigo arising from cervical verteprae discomfort. In general, cervical vertigo is correlated with but not always caused by cervical spondylopathy,which mainly includes vertebral arterial and sympathetic cervical spondylosis. The vertebral artery insufficiency caused by compression from lateral displacement of the intervertebral dise is very rare, while the sympathetic cervical spondylosis caused by the vertebral instability is much more common. Rigorous criteria have been developed for diagnosis of the latter. Conservative therapy is mainly recommended for treatment of cervical vertigo.%颈性眩晕通常与颈椎病有关,但不一定完全由颈椎病所致.与颈性眩晕有关的主要是椎动脉型和交感型颈椎病.由椎间盘侧突压迫导致的椎动脉供血不足非常罕见,由椎体不稳引起的交感型颈椎病较多,但后者也有其严格的诊断标准.治疗以保守治疗为主.

  19. Spontaneous coronary dissection associated with myocardial bridge causing acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    GE Jun-bo; HUANG Zhe-yong; LIU Xue-bo; QIAN Ju-ying

    2008-01-01

    @@ Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischemia, myocardial infarction and sudden cardiac death.1-10 This disease mainly occurs in young women with oral contraceptive or during the peripartum period,without risk factors for coronary artery disease.

  20. Establishment of the functional scale for cervical spondylosis of vertebral artery type%建立椎动脉型颈椎病的功能评定量表

    Institute of Scientific and Technical Information of China (English)

    魏毅; 梁伟雄; 蔡业峰

    2005-01-01

    BACKGROUND: At present, the scale for evaluating cervical vertigo symptoms and functions applied in clinic can evaluate the overall curative effect in patients with cervical spondylosis of vertebral artery type (CSA).However, this scale lacks the content of functional status and emotional function for evaluating daily life function.OBJECTIVE: To develop a functional scale for cervical spondylosis of vertebral artery type (FS-CSA) including functional status and emotional function based on the vertigo disorder scale made abroad.DESIGN: Cross-sectional survey, interview evaluation after pretest, internal consistency, retest consistency and construct validity were measured by the method of Chronbach's c, Pearson correlation coefficients and factor analysis, respectively.SETTING: Clinical Epidemiology/DME Center, Guangzhou University of Traditional Chinese Medicine.PARTICIPANTS: Totally 111 consecutive patients with CSA, 30 men and 81 women aged 31 to 72 years, in the Clinic for Cervical Spondylosis of Guangdong Provincial Hospital of Traditional Chinese Medicine were recruited from May 2001 to March 2002. Altogether 36 patients had risk factors of vertebral-base artery atherosclerosis. There were 14 cases of mild vertigo, 61 cases of moderate vertigo, and 36 cases of severe vertigo. Informed consent was obtained from the participants.METHODS: FS-CSA was made according to clinical actual condition Functional status (going for a walk during the day by yourself, walking around the house in the dark, doing strenuous housework, social activity,traveling for business or recreation, getting into or out of bed, reading books or newspaper; each item was divided into three categories "No,anxious, worried about your illness, and feeling frustrated; each item consisted of three categories "No, Sometimes, and Yes"). Patients with CSA were evaluated by means of interview and 14 of them were retested. Internal consistency, construct validity and correlation coefficients of the scale

  1. One case of acute myocardial infarction caused by spontaneous left and right coronary artery dissection%自发性左右冠状动脉夹层致急性心肌梗死1例

    Institute of Scientific and Technical Information of China (English)

    王蒙; 高东学; 徐庆国; 张迅英

    2013-01-01

    A 49-year-old woman has suffered from paroxysmal palpitation, chest pain and stuffiness for more than 10 years and aggravated for one month. The ECG manifested V2 -V4 lead ST segment depressed 0. 1 - 0. 2 mV and T wave inverted. The initial diagnosis was unstable angina pectoris. Three days after admission, chest pain and stuffiness aggravated suddenly with headache, fever and dysphoria. The immediate ECG was V2-V6 lead ST segment depressed 0. 05-0. 15 mV, aVR lead ST segment elevated 0. 1 mV, high sensitive cardiac troponin elevated, echocardiography showed that the motion of anterolateral wall and apex section reduced, selective CAG found spontaneous LAD and RCA dissection. Clinical symptoms disappeared completely after PCI one week later.

  2. Acute aortic dissections with pregnancy in women with ACTA2 mutations.

    Science.gov (United States)

    Regalado, Ellen S; Guo, Dong-chuan; Estrera, Anthony L; Buja, L Maximilian; Milewicz, Dianna M

    2014-01-01

    Mutations in ACTA2 predispose to thoracic aortic aneurysms and dissection as well as coronary artery and cerebrovascular disease. Here we examined the risk of aortic dissections, stroke and myocardial infarct with pregnancy in women with ACTA2 mutations. Of the 53 women who had a total of 137 pregnancies, eight had aortic dissections in the third trimester or the postpartum period (6% of pregnancies). One woman also had a myocardial infarct that occurred during pregnancy that was independent of her aortic dissection. Compared to the population-based frequency of peripartum aortic dissections of 0.6%, the rate of peripartum aortic dissections in women with ACTA2 mutations is much higher (8 out of 39; 20%). Six of these dissections initiated in the ascending aorta (Stanford type A), three were fatal. Three women had ascending aortic dissections at diameters less that 5.0 cm (range 3.8-4.7 cm). Aortic pathology showed mild to moderate medial degeneration of the aorta in three women. Of note, five of the women had hypertension either during or before the pregnancy. In summary, the majority of women with ACTA2 mutations did not have aortic or other vascular complications with pregnancy. However, these findings show that pregnancy is associated with significant risk for aortic dissection in women with ACTA2 mutations. Women with ACTA2 mutations who are planning to get pregnant should be counseled about this risk of aortic dissection, and proper clinical management should be initiated to reduce this risk.

  3. Seatbelt sign as an indication for four-vessel computed tomography angiogram of the neck to diagnose blunt carotid artery and other cervical vascular injuries.

    Science.gov (United States)

    Dhillon, Ramandeep Singh; Barrios, Cristobal; Lau, Cecilia; Pham, Jacqueline; Bernal, Nicole; Kong, Allen; Lekawa, Michael; Dolich, Matthew

    2013-10-01

    Computed tomography angiography (CTA) of the neck has become the most common modality for diagnosing blunt carotid artery injury (BCAI). The protocol at our institution includes CTA on trauma patients with a seatbelt sign. The purpose of this study is to evaluate whether a solitary seatbelt sign is an indication for CTA of the neck to diagnose BCAI. We conducted a retrospective review of patients from 2000 to 2010 who received CTAs as a result of a seatbelt sign performed at our Level I trauma center. Four hundred eighteen patients received CTAs based on the presence of a seatbelt sign. Two hundred twenty-six had skeletal injuries, obvious soft tissue injuries, and/or positive findings on imaging, including 11 positive vascular findings with two BCAIs found. Patients with noncarotid vascular injuries on CTA had a higher Injury Severity Score than patients with solitary seatbelt signs (11.4 ± 7.6 vs 3.4 ± 4.2, P injuries and/or positive findings on standard trauma imaging. This suggests that a protocol for CTA of the neck for patients with a seatbelt sign can be reserved for those with associated injuries on physical examination and/or findings on standard trauma imaging.

  4. A Case of Acute Aortic Dissection Type B Associated with Cushing's Syndrome

    Science.gov (United States)

    Petramala, Luigi; Cotesta, Dario; Sapienza, Paolo; Zinnamosca, Laura; Moroni, Enrico; di Marzio, Luca; De Toma, Giorgio; Letizia, Claudio

    2009-01-01

    We report a case of a 63-year-old man, with a previous history of hypertension and glucose intolerance associated troncular obesity that was emergently admitted to our Institution for evaluation of a severe, constant posterior chest pain which radiated anteriorly and dyspnoea with a suspected diagnosis of acute aortic dissection. A CT scan of thorax and abdomen demonstrated a dissection starting just below left succlavian artery and extending downward to the left renal artery, involving the celiac tripod and superior mesenteric artery. The dissection was classified as Stanford B, De Bakey III. Moreover, CT scan of abdomen revealed incidentally a left adrenal tumor of 25 mm of diameter. An emergent prosthetic graft was placed just below the origin of the left succlavian artery up-to the diaphragmatic hiatus. Furthermore, a diagnostic evaluation of the mass revealed an increase of cortisol production, and a diagnosis of Cushing's syndrome was done and the patient underwent an adrenalectomy via laparotomic approach. We report an association of acute aortic dissection of acute aortic dissection type B associated to Cushing's syndrome. Keywords Cushing's syndrome; Adrenocortical adenoma; Aortic dissection type B PMID:22505966

  5. Similar dissection of sets

    CERN Document Server

    Akiyama, Shigeki; Okazaki, Ryotaro; Steiner, Wolfgang; Thuswaldner, Jörg

    2010-01-01

    In 1994, Martin Gardner stated a set of questions concerning the dissection of a square or an equilateral triangle in three similar parts. Meanwhile, Gardner's questions have been generalized and some of them are already solved. In the present paper, we solve more of his questions and treat them in a much more general context. Let $D\\subset \\mathbb{R}^d$ be a given set and let $f_1,...,f_k$ be injective continuous mappings. Does there exist a set $X$ such that $D = X \\cup f_1(X) \\cup ... \\cup f_k(X)$ is satisfied with a non-overlapping union? We prove that such a set $X$ exists for certain choices of $D$ and $\\{f_1,...,f_k\\}$. The solutions $X$ often turn out to be attractors of iterated function systems with condensation in the sense of Barnsley. Coming back to Gardner's setting, we use our theory to prove that an equilateral triangle can be dissected in three similar copies whose areas have ratio $1:1:a$ for $a \\ge (3+\\sqrt{5})/2$.

  6. A case report: accessory right renal artery

    Directory of Open Access Journals (Sweden)

    Patasi B

    2009-10-01

    Full Text Available Anatomical variations in the origin of the arteries in the abdominal area are very common. The arteries that show frequent variations include the celiac trunk, renal and gonadal arteries. During a routine dissection of a male cadaver, one main and one inferior accessory renal artery were found in the abdominal region. We discovered that the inferior accessory renal artery that originated from the right anterolateral aspect of abdominal aorta was running into the lower pole of the right kidney. The origin of the main right renal artery and the inferior accessory right renal artery were 19.8 mm and 53 mm below the superior mesenteric artery, respectively. The inferior accessory right renal artery ran directly into the inferior pole of the right kidney, in the area where the accessory right renal vein was leaving the right kidney. These anatomical variations and anomalies are important to know before any therapeutic or diagnostic procedures are performed in the abdominal area.

  7. Medical image of the week: acute aortic dissection

    Directory of Open Access Journals (Sweden)

    Desai H

    2015-06-01

    Full Text Available No abstract available. Article truncated after 150 words. An 85-year-old gentleman with the past medical history significant for hypertension, smoking, and coronary artery disease presented to the emergency department (ED with complains of sudden onset of chest pain. His pain was described as squeezing and radiating to the back, associated with nausea and vomiting. His chest pain improved with nitroglycerin in ED. Chest x-ray showed a tortuous aortic knob and widened mediastinum. He underwent a CT angiogram, which showed, Stanford Type B aortic dissection, from distal aortic arch to renal arteries (Figure 1. He was managed in the hospital conservatively with tight blood pressure control given the type of dissection and no surgical intervention was done. He was uneventfully discharged with follow up arranged with vascular surgery. Aortic dissection is classified by Stanford Criteria as Type A which involves the ascending aorta and arch and Type B when it involves the descending aorta. Type A dissection is a ...

  8. The clinical study of volumetric CT in cervical spondylosis of vertebral artery type%容积CT对椎动脉型颈椎病的临床应用研究

    Institute of Scientific and Technical Information of China (English)

    周俊芬; 王仁法; 刘玉林; 陈宪; 张照喜

    2014-01-01

    目的:探讨多层螺旋CT(MSCT)后重组技术显示椎动脉型颈椎病(CSA)病因的应用价值。方法:对128例临床诊断为CSA的患者进行 MSCT检查,将原始数据进行高级血管分析(AVA)、容积再现(VR)、最大密度投影(MIP)等后处理技术重组并结合原始图像进行分析。采用卡方检验评价上述3种后处理方法对CSA病因的显示率。结果:128例CSA患者重组结果及统计学分析显示,AVA与VR对钩椎关节增生的显示率,AVA 分别与 VR、MIP 对椎动脉(VA )钙化的显示率,AVA与 MIP 对 VA 狭窄的显示率间差异均有统计学意义(P<0.05)。结论:MSCT 可作为无创性诊断CSA的一种简便、优良的影像学检查方法。各种后处理方法显示病因均有其优势,AVA能提高病因的显示率,最终诊断需结合原始图像进行综合分析。%Objective:To explore the application value of multislice spiral CT (MSCT)angiography in diagnosis of cervical spondylosis of vertebral artery type (CSA).Methods:Enhanced 64-MDCT scanning was performed in 128 clinically diagnosed patients with CSA.Images were post-processed by using volume rendering (VR),maximum intensity projection (MIP)and advanced vessel analysis (AVA).The display rate of pathological changes of CSA was compared withχ2 test. Results:AVA,MIP and VR were performed in 128 patients.The differences of display rate were statistically significant be-tween AVA and VR in proliferation of Luschka joint (P<0.05).In demonstration of vertebral artery calcification,there was statistical significant difference between AVA and VR,and between AVA and MIP (P<0.05).In demonstration of vertebral artery stenosis,there was statistical significant difference between AVA and MIP (P<0.05).Conclusion:MDCT is an effective,noninvasive and simple imaging technique with high image quality.Every kind of post-processing method has its advantages.AVA can improve the display rate of

  9. Modeling plaque fissuring and dissection during balloon angioplasty intervention.

    Science.gov (United States)

    Gasser, T Christian; Holzapfel, Gerhard A

    2007-05-01

    Balloon angioplasty intervention is traumatic to arterial tissue. Fracture mechanisms such as plaque fissuring and/or dissection occur and constitute major contributions to the lumen enlargement. However, these types of mechanically-based traumatization of arterial tissue are also contributing factors to both acute procedural complications and chronic restenosis of the treatment site. We propose physical and finite element models, which are generally useable to trace fissuring and/or dissection in atherosclerotic plaques during balloon angioplasty interventions. The arterial wall is described as an anisotropic, heterogeneous, highly deformable, nearly incompressible body, whereas tissue failure is captured by a strong discontinuity kinematics and a novel cohesive zone model. The numerical implementation is based on the partition of unity finite element method and the interface element method. The later is used to link together meshes of the different tissue components. The balloon angioplasty-based failure mechanisms are numerically studied in 3D by means of an atherosclerotic-prone human external iliac artery, with a type V lesion. Image-based 3D geometry is generated and tissue-specific material properties are considered. Numerical results show that in a primary phase the plaque fissures at both shoulders of the fibrous cap and stops at the lamina elastica interna. In a secondary phase, local dissections between the intima and the media develop at the fibrous cap location with the smallest thickness. The predicted results indicate that plaque fissuring and dissection cause localized mechanical trauma, but prevent the main portion of the stenosis from high stress, and hence from continuous tissue damage.

  10. Acute aortic dissection type A discloses Corpus alienum

    Directory of Open Access Journals (Sweden)

    Kolat Philipp

    2009-01-01

    Full Text Available Abstract We report an unusual case of an aortic type A dissection with a corpus alienum which compresses the right ventricle. The patient successfully underwent an aortic root replacement in deep hypothermia with re-implantation of the coronary arteries using a modified Bentall procedure and the resection of the corpus alienum. Intraoperative finding reveals 3 greatly adhered gauze compresses, which were most likely forgotten in the operation 34 years ago.

  11. Acute aortic dissection type A discloses Corpus alienum

    Science.gov (United States)

    Popov, Aron Frederik; Baryalei, Mersa Mohammed; Schmitto, Jan Dieter; Hinz, Jose; Wiese, Christoph Hermann; Raab, Björn; Kolat, Philipp; Schoendube, Friedrich Albert; Seipelt, Ralf

    2009-01-01

    We report an unusual case of an aortic type A dissection with a corpus alienum which compresses the right ventricle. The patient successfully underwent an aortic root replacement in deep hypothermia with re-implantation of the coronary arteries using a modified Bentall procedure and the resection of the corpus alienum. Intraoperative finding reveals 3 greatly adhered gauze compresses, which were most likely forgotten in the operation 34 years ago. PMID:19121214

  12. "Dissection" of a Hair Dryer

    Science.gov (United States)

    Eisenstein, Stan; Simpson, Jeff

    2008-01-01

    The electrical design of the common hair dryer is based almost entirely on relatively simple principles learned in introductory physics classes. Just as biology students dissect a frog to see the principles of anatomy in action, physics students can "dissect" a hair dryer to see how principles of electricity are used in a real system. They can…

  13. 易被误诊为冠状动脉夹层的光学干涉断层成像影像特点分析及其临床意义%Characteristics and its clinical significance of the optical coherence tomography image which is easily to be misdiagnosed as coronary artery dissection

    Institute of Scientific and Technical Information of China (English)

    罗明华; 关怀敏; 解金红; 陈玉善; 李兴渊; 邱承杰; 宗永华

    2013-01-01

    目的 通过对1例冠心病患者的冠脉造影结果及酷似夹层表现的冠脉光学相干断层扫描(OCT)的影像特点进行分析,探讨当前急性冠脉综合征的临床诊断及抗血小板治疗策略的困惑.方法 回顾性分析1例急性前间壁心肌梗死患者的临床及影像学资料并进行相关文献复习.结果 患者发病后2个月冠脉造影检查显示左前降支发出第一对角支后局限狭窄70%,对冠脉造影“正常”的部位处使用敏感度更高的OCT检查发现了“夹层样”的影像.结论 临床上表现为心绞痛而冠脉造影正常的患者可能会漏诊;这些分割是否会影响冠心病患者的临床预后仍需研究;该病例的发现对于延长急性冠脉综合征非介入治疗患者的抗血小板疗程提供了临床依据.%Objective To discuss the confusion about diagnosis and dual antiplatelet therapy of acute jtoronary syndrome by analysis of characteristics of coronary angiography and the optical coherence tomography image which is easily to be misdiagnosed as coronary artery dissection. Methods To retrospectively analyze the clinical features and the characteristics of coronary angiography and the optical co-herencje tomography image of a case who admitted with acute anteroseptal myocardial infarction and review relative literatures. Results Coronary angiography shows 70% portion of narrowness at the second segment of LAD, OCT imaging detected "dissection-like" image at the site of where coronary angiography shows '"normal". Actually, we consider the "dissection" as the fiber remnant of thrbmbolysis by carefully identification. Conclusion Coronary angiography shows "normal" doesn' t mean really normal, some patient with coronary artery disease may be missed diagnosis. The fiber remnant of thrombosis found may affect thr prognosis of patient with ACS. The finding of the case provides evidence for prolongation of dual anti-platelet therapy for patients with ACS not treated

  14. Cervical Cancer Stage IVA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IVA Add to My Pictures View /Download : Small: 756x576 ... Large: 3150x2400 View Download Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; drawing and inset ...

  15. Automatic Dissection Of Plantlets

    Science.gov (United States)

    Batchelor, B. G.; Harris, I. P.; Marchant, J. A.; Tillett, R. D.

    1989-03-01

    Micropropagation is a technique used in horticulture for generating a monoclonal colony of plants. A tiny plantlet is cut into several parts, each of which is then replanted. At the moment, the cutting is performed manually. Automating this task would have significant economic benefits. A robot designed to dissect plants would need to be equipped with intelligent visual sensing. This article is concerned with the image acquisition and processing techniques which such a machine might use. A program, which can calculate where to cut a plant with an "open" structure, is presented. This is expressed in the ProVision language, which is described in another article presented at this conference. (Article 1002-65)

  16. What Lies behind the Ischemic Stroke: Aortic Dissection?

    Directory of Open Access Journals (Sweden)

    Turgut Deniz

    2014-01-01

    Full Text Available Introduction. Some cases with aortic dissection (AD could present with various complaints other than pain, especially neurological and cardiovascular manifestations. AD involving the carotid arteries could be associated with many clinical presentations, ranging from stroke to nonspecific headache. Case Report. A 71-year-old woman was admitted to emergency department with vertigo which started within the previous one hour and progressed with deterioration of consciousness following speech disorder. On arrival, she was disoriented and uncooperative. Diffusion magnetic resonance imaging (MRI of brain was consistent with acute ischemia in the cerebral hemisphere. Fibrinolytic treatment has been planned since symptoms started within two hours. Echocardiography has shown the dilatation of ascending aorta with a suspicion of flap. Computed tomography (CT angiography has been applied and intimal flap has been detected which was consistent with aortic dissection, intramural hematoma of which was reaching from aortic arch to bilateral common carotid artery. Thereafter, treatment strategy has completely changed and surgical invention has been done. Conclusion. In patients who are admitted to the emergency department with the loss of consciousness and stroke, inadequacy of anamnesis and carotid artery involvement of aortic dissection should be kept in mind.

  17. Decreased expression of fibulin-4 in aortic wall of aortic dissection.

    Science.gov (United States)

    Huawei, P; Qian, C; Chuan, T; Lei, L; Laing, W; Wenlong, X; Wenzhi, L

    2014-02-01

    In this research, we will examine the expression of Fibulin-4 in aortic wall to find out its role in aortic dissection development. The samples of aortic wall were obtained from 10 patients operated for acute ascending aortic dissection and five patients for chronic ascending aortic dissection. Another 15 pieces of samples from patients who had coronary artery bypass were as controls. The aortic samples were stained with aldehyde magenta dyeing to evaluate the arrangement of elastic fibers. The Fibulin-4 protein and mRNA expression were both determined by Western blot and realtime quantitative polymerase chain reaction. Compared with the control group, both in acute and chronic ascending aortic dissection, elastic fiber fragments increased and the expression of fibulin-4 protein significantly decreased (P= 0.045 < 0.05). The level of fibulin-4 mRNA decreased in acute ascending aortic dissection (P= 0.034 < 0.05), while it increased in chronic ascending aortic dissection (P=0.004 < 0.05). The increased amounts of elastic fiber fragments were negatively correlated with the expression of fibulin-4 mRNA in acute ascending aortic dissection. In conclusion, in aortic wall of ascending aortic dissection, the expression of fibulin-4 protein decreased and the expression of fibulin-4 mRNA was abnormal. Fibulin-4 may play an important role in the pathogenesis of aortic dissection.

  18. Endovascular repair for a huge vertebral artery pseudoaneurysm caused by Behcet's disease

    Institute of Scientific and Technical Information of China (English)

    DONG Zhi-hui; FU Wei-guo; GUO Da-qiao; XU Xin; CHEN Bin; JIANG Jun-hao; YANG Jue; SHI Zheng-yu; WANG Yu-qi

    2006-01-01

    @@ Behcet's disease (BD), a multisystem chronic autoimmune process of unknown etiology,usually leads to arterial impairment. Isolated case reports have described BD-related arterial dissections, pseudoaneurysms or aneurysms.1-4 Recently, we successfully treated a huge vertebral artery pseudoaneurysm (VAPA) in a patient with BD by stent-grafting with preservation of the affected vertebral artery.

  19. Artery to Cystic Duct: A Consistent Branch of Cystic Artery Seen in Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Arshad Rashid

    2015-01-01

    Full Text Available Uncontrolled arterial bleeding during laparoscopic cholecystectomy is a serious problem and may increase the risk of bile duct damage. Therefore, accurate identification of the anatomy of the cystic artery is very important. Cystic artery is notoriously known to have a highly variable branching pattern. We reviewed the anatomy of the cystic artery and its branch to cystic duct as seen through the video laparoscope. A single artery to cystic duct with the classical “H-configuration” was demonstrated in 161 (91.47% patients. This branch may cause troublesome bleeding during laparoscopic dissection in the hepatobiliary triangle. Careful identification of artery to cystic duct is helpful in the proper dissection of Calot’s triangle as it reduces the chances of hemorrhage and thus may also be helpful in prevention of extrahepatic biliary radical injuries.

  20. Multiple vascular anomalies involving testicular, suprarenal arteries and lumbar veins

    Directory of Open Access Journals (Sweden)

    P Jyothsna

    2012-01-01

    Full Text Available Testicular arteries arise from the abdominal aorta and the inferior suprarenal artery from the renal artery. There are reports about variant origin and course of these arteries. Accessory testicular artery is also a common finding but its providing origin to inferior suprarenal artery is an important observation. During a routine dissection of abdomen of approximately 55-year-old male cadaver, unique vascular abnormality was observed. On the left side, a common arterial trunk originating from abdominal aorta immediately branched to give rise to superior testicular and inferior suprarenal arteries, the former after a short course hooked by the left suprarenal vein. In addition, the left suprarenal vein, second left lumbar vein, and left testicular vein joined to form a common trunk which drained into the left renal vein. A sound knowledge of vascular variations in relation to the kidney and suprarenal gland is important to surgeons dissecting the abdominal cavity.

  1. Multidetector CT of hepatic artery pathologies.

    Science.gov (United States)

    Karaosmanoglu, D; Erol, B; Karcaaltincaba, M

    2012-01-01

    The hepatic artery can be involved by a variety of pathology and diseases.Today MDCT enables high quality imaging of the hepatic artery using axial, MIP and volume rendered images. We illustrate MDCT findings of anatomical variations, aneurysm, dilatation, dissection, arteriovenous fistula, thrombosis and stenosis. Aneurysms can be saccular, fusiform and multiple and may develop due to atherosclerosis, vasculitis, trauma and biopsy. Dilatation of hepatic artery can be seen in portal hypertension, Osler-Weber-Rendu disease and hemangiomatosis. Hepatic artery can be occluded after trauma and transplantation. Dissection develops due to atherosclerosis, Marfan and Ehler Danlos syndromes and during pregnancy. Arteriovenous fistula can be congenital and acquired. We conclude that various hepatic artery pathologies can be confidently diagnosed by MDCT.

  2. Coronary ostial involvement in acute aortic dissection: detection with 64-slice cardiac CT.

    LENUS (Irish Health Repository)

    Ryan, E Ronan

    2012-02-01

    A 41-year-old man collapsed after lifting weights at a gym. Following admission to the emergency department, a 64-slice cardiac computed tomography (CT) revealed a Stanford Type A aortic dissection arising from a previous coarctation repair. Multiphasic reconstructions demonstrated an unstable, highly mobile aortic dissection flap that extended proximally to involve the right coronary artery ostium. Our case is an example of the application of electrocardiogram-gated cardiac CT in directly visualizing involvement of the coronary ostia in acute aortic dissection, which may influence surgical management.

  3. Muscular Arrangement and Muscle Attachment Sites in the Cervical Region of the American Barn Owl (Tyto furcata pratincola)

    OpenAIRE

    2015-01-01

    Owls have the largest head rotation capability amongst vertebrates. Anatomical knowledge of the cervical region is needed to understand the mechanics of these extreme head movements. While data on the morphology of the cervical vertebrae of the barn owl have been provided, this study is aimed to provide an extensive description of the muscle arrangement and the attachment sites of the muscles on the owl's head-neck region. The major cervical muscles were identified by gross dissection of cada...

  4. The Pathomorphological Change of the Initial Segment of Vertebral Artery Related with Cervical Vertigo%颈性眩晕的椎动脉起始段(V1段)血管形态病理学改变

    Institute of Scientific and Technical Information of China (English)

    范炳华; 许丽; 林敏; 李伟; 汪芳俊; 徐泉珍

    2014-01-01

    [目的]探索颈性眩晕的椎动脉起始段(V1段)血管形态病理学改变。[方法]回顾1999年至2011年以头晕为主症,符合寰枕痛、恶心(呕吐)、耳鸣(耳塞)、视物模糊(视物旋转)4项症状中2项以上,经颅多普勒检测有椎-基底动脉血流速增快或减慢患者1680例,分析这些患者的椎-基底动脉CT血管造影三维重建技术(3D-CTA)的血管形态影像资料,观察椎动脉V1段血管形态病理学改变情况。[结果]颈性眩晕患者椎动脉V1段血管形态病理学有椎动脉纤细、椎动脉痉挛、椎动脉穿孔位置异常、椎动脉走行迂曲、椎动脉起始源异常、椎动脉瘤(或伴钙化)6种改变。[结论]颈性眩晕的椎动脉V1段存在6种血管形态病理学改变,根据这些病理改变,有助于在临床上判断预后,选择不同手法进行针对性地治疗,并指导患者在生活中的注意事项。%Objective] To explore the pathomorphological change of the initial segment of vertebral artery(V1 part) related with cervical vertigo. [Method] Review 1680 cases who had vertigo as primary symptom, associated with either 2 or more symptoms as fol ows: neck pain, nausea(or vomit), tinnitus(or ear stuffiness), blurred vision(or rotation). Al the cases had TCD examination which showed over fast or too slow blood flow speed, and 3D-CTA examination(Three-Dimensional Computed Tomography Angiography). The pathomorphological change of the initial segment of vertebral artery was observed through 3D-CTA technology. [Results] There were 6 kinds of pathomorphological changes in the initial segment of vertebral artery. They were tenuous vertebral artery, spasm vertebral artery, abnormal position of vertebral artery entering cervical transverse foramen, circuitous vertebral artery, abnormal initiating terminal, vertebral artery aneurysm(or associated with calcification).[Conclusion]There are 6 kinds of pathomorphological changes in the

  5. Clinical analysis of look up shake and correction method combined with traditional Chinese medicine iontophoresis in the treatment of cervical spondylosis of vertebral artery type%仰头摇正法配合中药离子导入治疗椎动脉型颈椎病的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    罗卫泉; 小燕

    2014-01-01

    Objective To study the the clinical efficacy of Look up shake and correction method combined with of traditional Chinese medicine iontophoresis in treatment of vertebral artery type of cervical spondylosis. Methods 120 cases patients with vertebral artery type of cervical spondylosis in our hospital clinic from March 2010 to March 2013 were selected and randomly divided into the treatment group and the control group,treatment group Look up shake and correction method and iontophoresis treatment with traditional Chinese medicine,the control group with cervical relaxation massage,traction and TDP irradiation treatment,the clinical efficacy of the two groups were compared,and to make the results of the statistical analysis. Results Effective clinical treatment group was 95%,significantly better than the control group,the treatment efficiency of 90%. Conclusion With traditional Chinese medicine Look up shake and correction method and iontophoresis for the treatment of cervical vertebral artery disease have better clinical results, and it can be widely used in clinical practice.%目的:研究仰头摇正法配合中药离子导入治疗椎动脉型颈椎病的临床疗效。方法选取2010年3月~2013年3月于我院门诊就诊的椎动脉型颈椎病患者120例,随机分为治疗组和对照组,治疗组采用仰头摇正法配合中药离子导入进行治疗,对照组采用颈椎按摩手法放松、牵引及TDP照射治疗,对两组的临床疗效进行对比,并作出统计学分析。结果治疗组的临床有效率达95%,明显优于对照组的治疗有效率90%。结论仰头摇正法配合中药离子导入对于治疗椎动脉型颈椎病有较好的临床效果,可以在临床上推广使用。

  6. Endovascular repair for abdominal aortic aneurysm followed by type B dissection.

    Science.gov (United States)

    Shingaki, Masami; Kato, Masaaki; Motoki, Manabu; Kubo, Yoji; Isaji, Toshihiko; Okubo, Nobukazu

    2016-10-01

    An 86-year-old man with an abdominal aortic aneurysm was diagnosed with type B aortic dissection accompanied by a patent false lumen that started at the distal arch of the thoracic aorta and terminated at the left common iliac artery. Meticulous preoperative assessment detected 3 large intimal tears in the descending aorta, abdominal aortic aneurysm, and left common iliac artery. We performed single-stage thoracic and abdominal endovascular aneurysm repair and concomitant axillary-axillary bypass. The abdominal aortic aneurysm with type B aortic dissection was successfully treated using a single-stage endovascular stent graft, without any complications due to the careful preoperative examinations.

  7. Non-atheromatous arterial stenoses in atypical haemolytic uraemic syndrome associated with complement dysregulation

    NARCIS (Netherlands)

    C. Loirat; M.A. Macher; M. Elmaleh-Berges; T. Kwon; G. Deschênes; T.H.J. Goodship; C. Majoie; J.C. Davin; R. Blanc; J. Savatovsky; J. Moret; V. Fremeaux-Bacchi

    2010-01-01

    Results. Stenoses of both carotid arteries, left subclavian and vertebral arteries, several intracranial, right humeral, several coronary, and all pulmonary arteries were demonstrated. At the age of 13 years, left subclavian and right cervical carotid arteries were occluded. Right carotid recanaliza

  8. Brain morphometry and arterial circuit formation in New Zealand rabbits

    Directory of Open Access Journals (Sweden)

    Janaina de Oliveira Portugal

    2014-06-01

    Full Text Available This article aims to describe the main ramifications of basilar artery, arterial circuit formation, and brain morphometry in adult rabbits of both sexes. We performed cannulation of the thoracic aorta through lateral incision, fixation with 10% formaldehyde solution, and filling of the arterial system with colored latex solution. We performed craniotomy, brain removal and morphometry, as well as dissection for observing the main ramifications of the basilar artery and arterial circuit formation. Mean and standard error of the basilar artery length were1.293 cm ± 0.024 in females and 1.227 cm ± 0.025 in males. In all rabbits dissected, the basilar artery stemmed from the anastomosis of vertebral arteries, right and left, giving rise to the caudal cerebellar artery, varied branches to bulb and pons, terminal branches, and rostral cerebellar arteries. Arteries at the base of the brain depended on the carotid and vertebral-basilar systems. The arterial brain circuit was rostrally closed in 10 males and 12 females and caudally closed in all animals dissected.

  9. Paediatric dissecting posterior cerebral aneurysms: report of two cases and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, Pedro; Goulao, Augusto [Garcia de Orta Hospital, Neuroradiology Department, Almada (Portugal)

    2006-08-15

    Intracranial aneurysms in the paediatric population are uncommon, accounting for 2% to 6% of all aneurysms, and spontaneous arterial dissection is rarely reported as the cause of aneurysms in children, especially in the posterior cerebral artery. Two cases of paediatric spontaneous posterior cerebral artery dissecting aneurysms are reported, one in a 33-month-old male child presenting with aneurysmal rupture and subarachnoid haemorrhage and the other in a 9-year-old boy with an unruptured aneurysm. The first child was successfully treated by endovascular parent vessel occlusion without neurological deficit and in the second a spontaneous thrombosis of the aneurysm and its parent artery occurred associated with hydrocephalus and a favourable outcome. Dissecting aneurysms are dynamic lesions with variable and unpredictable evolution and close follow-up and/or early treatment is warranted. Spontaneous arterial dissection is a rare, probably still under-recognized, cause of intracranial aneurysms that may be responsible for a significant number of aneurysms and spontaneous aneurysmal thromboses in children. (orig.)

  10. 飞腾八法配挑针治疗椎动脉型颈椎病的临床研究%Clinical Research on the Method of Flight and Teasing Needle in Treatment of Vertebral Artery Type of Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    崔光豪; 何春珂; 郭敏; 刘放

    2016-01-01

    目的:探讨飞腾八法配挑针治疗椎动脉型颈椎病的有效性及安全性,从而为治疗及预防椎动脉型颈椎病的新方法及途径。方法方便选取回顾性分析2015年3月—2016年2月该院门诊就诊或者疗区治疗的50例椎动脉型颈椎病患者,将其随机分为治疗组和对照组。治疗组采用飞腾八法配挑针法,对照组采用普通循经针刺法,对比观察实验组与对照组之间眩晕、颈肩痛、头痛、日常生活及工作、心理及社会适应及椎-基底动脉彩色多普勒检查情况。结果治疗组总有效率为88.0%,明显高于对照组56.0%,治疗前后椎-基底动脉血流变数据比较,LVA,RVA及BA均产生显著差异,差异有统计学意义(P<0.01)。结论飞腾八法配挑针治疗椎动脉型颈椎病其疗效确定、操作简便、无不良反应,不受诊疗条件限制,便于大范围推广,不但可以为患者减少负担,更可为社会节约医疗开支,对整体医疗水平提高有一定意义。%Objective To discuss the effectiveness and safety of the method of flight and teasing needle in treatment of ver-tebral artery type of cervical spondylosis thus providing a new method and way of the treatment and prevention of vertebral artery type of cervical spondylosis. Methods 50 cases of patients with vertebral artery type of cervical spondylosis treated in clinics or treatment area of our hospital from March 2015 to February 2016 were retrospectively analyzed and randomly di-vided into two groups, the treatment group were treated with the method of flight and teasing needle, the control group were treated with common needle point method along the facial nerves, and the dizziness, neck and shoulder pain, daily life and work, psychological and social adaptation, color Doppler examination of vertebral-basilar artery of the two groups were com-pared and observed. Results The total effective rate in the treatment group was obviously higher

  11. [Successful treatment of a cervical heterotopic pregnancy following an in vitro fertilization procedure].

    Science.gov (United States)

    Elena, Hernán E; Elena, Alfredo F; Miola, Anselmo; Glujovsky, Demian; Sueldo, Carlos E

    2016-01-01

    A 37-year-old nulligravida infertile female had a cervical heterotopic pregnancy following an in vitro fertilization procedure. Early intervention on the 6th week of gestation with a manual vacuum aspirator reached to remove the cervical pregnancy. Ligation of the descending cervical branches of the uterine arteries and a cervical cerclage, were placed before the aspiration, for prevention of possible hemorrhage. Successful removal of the cervical pregnancy was achieved with only mild bleeding. An intrauterine pregnancy progressed to viability without complications, resulting in a vaginal delivery of a preterm live-birth at 35.4 weeks, of a male that weighted 2740 g.

  12. Safety evaluation during rotational manipulation of the cervical spine in the patients with arteriosclerosis by sonography on the vertebral arteries%椎动脉超声对动脉硬化患者颈椎旋转手法治疗的安全性评价

    Institute of Scientific and Technical Information of China (English)

    滕红林; 王靖; 张纯武; 吴春雷; 朱旻宇; 赵亮; 吕超

    2011-01-01

    目的:通过对伴有动脉硬化中老年患者进行模拟旋颈状态下颈椎椎动脉超声检查,权衡手法的好处和潜在的风险,为临床医师对颈椎采取手法治疗前提供参考.方法:对208例动脉硬化患者进行彩色多普勒超声检查,观察椎动脉的狭窄程度以及血流充盈程度,血流频谱形态等.测量血流参数[收缩期峰值血流速度 (VMAX)、舒张末期流速(VMIN)、平均血流速度(VTAMX)]、反映血管舒缩和阻力状况的阻力指数(RI)、反映血管顺应性和血管弹性的搏动指数(PI).结果:超声显示在旋颈状态下VA血流变细,血管迂曲及局部受压狭窄;伴有动脉粥样硬化者,可见血管内膜粗糙,管壁增厚,回声增强,有动脉粥样硬化小斑块形成及管腔狭窄,椎骨段VA走形迂曲,VA平均内径<3 mm.在过屈位旋颈后血流减少甚至部分患者彩色血流中断而不显像.在正常仰卧位时所测得的血流参数与对照组相比差异无统计学意义,经左右旋颈45°后,检测所得两组血流动力学参数与对照组相比开始出现差异,当过屈位旋颈45°后,两组血流动力学参数呈现显著性差异.结论:彩色多谱勒超声可以观察椎动脉形态的变化并对血流进行定量测定,其检查操作便捷,敏感性高,可以作为颈椎手法前筛查潜在VA损伤的动脉硬化患者的方法之一.%Objective :To weight the pros and cons before rotatory manipulation of the cervical spine in the patients with arteriosclerosis. Methods :208 cases with arteriosclerosis underwent sonography to explore the course and stenosis of the vertebral arteries. The VMAX,VMIN, VTMAX and RI were also measured. Results: The results showed the decreased blood stream and local compression of the VA during the rotatory manipulation of the cervical spine. In cases with arteriosclerosis, coarse inner membrane, thickening of the arterial wall and increased echogenicity were found. The blood stream decreased or even

  13. Dissecção espontânea das artérias carótidas e vertebrais em uma população multiétnica Spontaneous carotid and vertebral arteries dissection in a multiethnic population

    Directory of Open Access Journals (Sweden)

    Alexandre Pieri

    2007-12-01

    Full Text Available A dissecção espontânea das artérias carótidas e vertebrais (DEACV é considerada uma causa rara de acidente vascular cerebral, particularmente em países com população multiétnica. O objetivo desse estudo foi avaliar características clínicas e de neuroimagem dos pacientes com DEACV em uma população multiétnica. Foram estudados 66 pacientes com diagnóstico de DEACV em dois hospitais terciários de São Paulo. Aplicou-se um questionário inicial e os pacientes foram seguidos prospectivamente. Dos pacientes estudados, 82% eram brancos, 53% eram homens e a média de idade foi 41,7 anos. Os fatores de risco cardiovasculares mais freqüentes foram hipertensão arterial e tabagismo. Outros aspectos avaliados foram história prévia de enxaqueca, tratamento inicial e prognóstico. Concluiu-se que apesar da população estudada ser multiétnica, houve um marcante predomínio de brancos. A análise das características clínicas e de neuroimagem dos pacientes com DEACV possibilita um melhor conhecimento da doença, levando a um diagnóstico precoce e tratamento mais adequado.Spontaneous dissection of the carotid and vertebral arteries (SDCVA is considered a rare cause of stroke, particularly in countries with multiethnic population. The objective was to evaluate the clinical and neuroimaging features of patients with SDCVA from a multiethnic population. Sixty-six patients diagnosed with SDCVA were studied at two tertiary hospitals at São Paulo. An initial questionnaire was completed and patients were followed prospectively. Among the patients studied, 82% were caucasian, 53% were male and the average age was 41.7 years old. The most frequent cardiovascular risk factors found were systemic hypertension and tobacco use. Other aspects evaluated were history of previous migraine, initial treatment and prognosis. In conclusion, although the population studied was multhiethnic, there was a marked predominance of caucasians. The analysis of

  14. Congenital absence of the internal carotid artery and the basilar artery with persistent trigeminal artery associated with coarctation of the aorta

    Energy Technology Data Exchange (ETDEWEB)

    Jaeger, H.J.; Mehring, U.M.; Gissler, H.M.; Mathias, K.D. [Dept. of Diagnostic Radiology, Staedtische Kliniken Dortmund (Germany); Dept. of Radiology and MicroTherapy, Univ. of Witten/Herdecke (Germany)

    2000-11-01

    We report a case of congenital absence of the cervical and petrous part of the left internal carotid artery, the middle and proximal part of the basilar artery, and the V4 segment of the left vertebral artery associated with a left persistent trigeminal artery and a coarctation of the aorta. The left cerebral vessels are supplied via the anterior communicating artery and the left persistent trigeminal artery. The coexisting coarctation of the aorta led to a subclavian steal phenomenon. The alteration of the cerebral hemodynamics has to be taken in consideration when performing cerebral angiography and surgical correction in such a case. (orig.)

  15. Aberrant right vertebral artery originating from the aortic arch distal to the left subclavian artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Soo Heui; Baek, Hye Jin [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2014-03-15

    We present a rare case of an aberrant right vertebral artery originated from the distal aortic arch. This issue has been incidentally detected on a preoperative CT angiography after a stabbing injury of the cervical spinal cord. Normally, the right vertebral artery originates from the right subclavian artery. Therefore, in this case report we will review the incidence and the embryological mechanism of this aberrant course of the right vertebral artery and we will discuss as well the clinical importance of this variation.

  16. 子宫颈癌患者子宫动脉插管与静脉全身化疗两种途径新辅助化疗的效果对比%Comparison of effectiveness between intra-arterial and intra-venous neoadjuvant chemotherapy in stage Ⅰb2-Ⅱ b cervical carcinoma

    Institute of Scientific and Technical Information of China (English)

    曹冬焱; 杨佳欣; 沈铿; 向阳; 潘凌亚; 郎景和; 吴鸣; 黄惠芳

    2008-01-01

    Objective To compare the effect between intra-arterial and intra-venous neoadjuvant chemotherapy(NACT)in stage Ⅰb2-Ⅱ b cervical carcinoma.Methods A retrospective analysis Was done on 52 cases of intra-venous NACT and 95 eases of intm-arterial NACT for stage Ⅰ b2-Ⅱ b cervical carcinoma treatad in Peking Union Medical College Hospital from 1999.ResulIs The response rate of intraveHous NACT and intra-arterial NACT was 88%(46/52)and 79%(75/95).and the operative rate after NACT Was 81%(42/52)and 72%(68/95)respectively(P>0.05).There were no significant differences in surgery time,blood loss and pest-operative morbidity between these two groups.Pathological parametrial positive rate after NACT in arterial group(6%)Was significantly lower than that of venous group (50%,P>0.05).The venous group had very similar recurrence rates(13%vs 17%)and death rates (9%VS 12%)when compared with the arterial group(P>0.05).Conclusions The intra-arterial and intra-venous NACT for stage Ⅰ b2-Ⅱb cervical carcinoma show similar response rate.operative rate and surgical difficulties.Arterial NACT shows a better effect on parametrial infiltration.%目的 比较不同途径新辅助化疗对Ⅰ b2~Ⅱ b期官颈癌的疗效.方法 对北京协和医院1999年以来收治的147例Ⅰ b2~Ⅱ b期行新辅助化疗的宫颈癌患者的临床病理资料进行同顾性分析,其中,经静脉全身化疗者(静脉组)52例,经子宫动脉插管化疗者(动脉组)95例.结果 静脉组患者经新辅助化疗后总反应率为88%(46/52),动脉组为79%(75/95),两组比较,差异无统计学意义(P>0.05).静脉组患者新辅助化疗后可手术率为81%(42/52),动脉组为72%(68/95),两组比较,差异无统计学意义(P>0.05).两组患者新辅助化疗后手术时间、出血量和并发症发生率相近.Ⅱ b期患者经新辅助化疗后手术,术后病理检查发现官旁仍有肿瘤浸润者动脉组显著低于静脉组(分别为6%、50%,P0.05)分别比较,

  17. Iatrogenic aortic root and left main dissection during non-emergency coronary surgery: a solution applicable to heavily calcified coronary arteries†.

    Science.gov (United States)

    Kieser, Teresa M; Spence, Frank P; Kowalewski, Richard

    2016-02-01

    Dissection of the left main coronary artery during coronary artery bypass graft (CABG) surgery is a rare, potentially lethal complication, usually diagnosed at post-mortem. During the cross-clamp period of a 4-vessel coronary artery bypass graft procedure in a 74-year old hypertensive woman, retrograde dissection occurred in a diffusely diseased marginal artery when perfused with cardioplegic solution at a pressure of 140-150 mmHg through a vein graft. The dissection extended back to the left main artery, included the posterior proximal ascending aorta and then down the left anterior descending artery (LAD). Transoesophageal echocardiography (TOE) confirmed the left main dissection and showed anterior-septal-lateral akinesis in a previously normally functioning left ventricle (LV). The circumferentially calcified proximal LAD was grafted with a saphenous vein by carving an oval area of calcium creating an elliptical opening in the artery wall. Normal LV function returned and, in the area of the left main dissection, there was only thickening with no colour flow. Eight months postoperatively cardiac catheterization showed normal LV function, patent vein grafts to the right coronary artery and proximal LAD, left internal mammary artery to distal LAD and an occluded sequential marginal vein graft. Twelve years postoperatively, the patient is well with Class I angina, on medication. There is no previous documentation of a diagnosed and successfully treated left main dissection during CABG surgery. Since this case using the technique of creating an oval opening in a circumferentially calcified coronary artery (with an otherwise satisfactory lumen), the author has been using this technique to bypass otherwise non-bypassable arteries; this technique may be useful to help patients with severe calcific coronary artery disease.

  18. Professional parachuting: the risk of acute aortic dissection.

    Science.gov (United States)

    Buchholz, Stefan; Quaden, René Bombien; Schmitz, Christoph; Überfuhr, Peter

    2011-09-01

    Acute aortic dissection is a rare disease, but if it occurs rapid diagnosis and therapy are needed. It is usually seen in elderly patients with long-term persistent arterial hypertension. In younger patients, it is mainly caused by congenital connective tissue disorders, such as Marfan syndrome, or by trauma. We present here a 34-year-old male patient with an acute type A aortic dissection. This patient was a professional parachutist and had carried out a large number of parachute jumps during his lifetime. He was admitted to the emergency department with acute chest pain. The symptoms were not related in time to a parachute jump. During a computed tomography scan, an aortic dissection was diagnosed. The patient was immediately referred to the operating room, and the ascending aorta was replaced by a conduit. After a regular postoperative course, the patient was discharged and recovered completely. Although acute aortic dissection is rare in young patients, it has to be considered in cases of acute chest pain. An immediate diagnosis and adequate therapy are essential to offer the patient a good clinical outcome and long-term survival.

  19. TRAPEZOID SHAPED OMOHYOIDEUS MUSCLE: An Anatomic Variation seen in Functional Neck Dissection

    Directory of Open Access Journals (Sweden)

    Lokman Uzun

    2015-12-01

    Full Text Available Omohyoid muscle (Om is an important anatomical landmark in cervical lymph node partition, neck dissection for head and neck cancers and cervical spine surgery. It consists of two bellies united at an angle by an intermediate tendon. Variations in the origin and insertion of the muscle, absence or duplication of the superior or inferior bellies, aberrant position in relation to IJV and sternocleideomastoid muscle have been reported. We report a rare anatomical variation of the Om in this report. This variation was observed during neck dissection of a 58 years-old male patient with laryngeal carcinoma. It was noticed that, the superior belly of Om was in a trapezoid shaped unilaterally.

  20. Ischemic stroke: carotid and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  1. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening; Cervical cancer - HPV vaccine ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

  2. Aberrant cervical thymus mimicking thyroid on ultrasonography: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Sub; Park, Ju Hyun; Kim, Bong Soo; Park, Ji Kang; Choi, Jae Hyuck [Jeju National Univ. Hospital/Jeju National Univ. School of Medicine, Jeju (Korea, Republic of)

    2012-10-15

    Aberrant cervical thymus is rarely reported in adults. We report a case of solid aberrant cervical thymus in a 27 year old female, which was found incidentally on ultrasonography for the evaluation of the thyroid cancer. On ultrasonography, the lesion was found between the left thyroid and common carotid artery without any remarkable interface echo, and had similar echogenicity to the thyroid. The lesion extended to the upper pole of the left thyroid.

  3. 椎动脉型颈椎病应用平眩汤加以通络醒脑针刺法的疗效评价%Therapeutic Effect of Pingxuan Decoction with Meridian-regulating and Consciousness-restoring Acupuncture in Treatment of Vertebral Artery Type of Cervical Syndrome

    Institute of Scientific and Technical Information of China (English)

    王永新

    2016-01-01

    Objective To evaluate the therapeutic effect of Pingxuan decoction with meridian-regulating and consciousness-restoring acupuncture in the treatment of vertebral artery type of cervical syndrome.Methods72 patients with vertebral artery type of cervical syndrome were given the treatment of Pingxuan decoction,while 36 patients in the experimental group were given the treatment of meridian-regulating and consciousness-restoring acupuncture. The therapeutic effect and the change in the symptom score before and after the treatment were compared between two groups.Results The overal response rate of patients in the experimental group was 91.7%,which was higher than 66.7% of patients in the control group(P<0.05). The improvement on the symptom score of patients in the experimental group was better than that in the control group(P<0.05).Conclusion Pingxuan decoction with meridian-regulating and consciousness-restoring acupuncture in the treatment of vertebral artery type of cervical syndrome can improve the clinical symptoms with the definite therapeutic effect.%目的:评析平眩汤加以通络醒脑针刺法治疗椎动脉型颈椎病的疗效。方法72例椎动脉型颈椎病患者患者均予以平眩汤治疗,实验组36例加以通络醒脑针刺法治疗,比较两组疗效及治疗前后症状积分变化。结果实验组的临床总有效率为91.7%,高于对照组的66.7%(P<0.05);治疗后实验组的症状积分改善幅度优于对照组(P<0.05)。结论平眩汤加以通络醒脑针刺法治疗椎动脉型颈椎病有助于改善临床症状,疗效确切。

  4. 经络脊柱推拿疗法对椎动脉型颈椎病的临床价值分析%Clinical Value Analysis in Spinal Massage Therapy of Main and Collateral Channels for Cervical Spondylosis of Vertebral Artery Type

    Institute of Scientific and Technical Information of China (English)

    涂小刚

    2013-01-01

    Objective:To investigate the clinical value of spinal massage therapy with main and collateral channels for cervical spondylosis of verte-bral artery type. Methods:104 patients with cervical spondylosis of vertebral artery type were randomly divided into treatment group and control group, control group was treated with infusion of conventional western medicine, treatment group with spinal massage therapy of main and collateral channels, to observe the clinical efficacy of two groups. Results:The excellent and good rate and total effective rate of treatment group were 67.3%and 94.2%, higher than that of the control group by 32.7%and 59.6%(P<0.05). Conclusion:There is significant efficacy in spinal massage therapy of main and collateral channels treating cervical spondylosis of vertebral artery type, being worth the clinical promotion with higher clinical value.%  目的:探讨经络脊柱推拿疗法治疗椎动脉型颈椎病的临床价值。方法:将104例椎动脉型颈椎病患者随机分成治疗组和对照组,对照组采用常规西药滴注治疗,治疗组采用经络脊柱推拿治疗,观察两组临床疗效。结果:治疗组优良率及总有效率分别为67.3%、94.2%,高于对照组的32.7%、59.6%(P<0.05)。结论:经络脊柱推拿疗法治疗椎动脉型颈椎病疗效显著,具有较高的临床治疗价值,值得临床推广。

  5. 澳式手法结合龙氏正骨手法治疗椎动脉型颈椎病疗效观察%Observation effect of Maitland combined with Long′s therapy on Cervical spondylosis of vertebral artery type

    Institute of Scientific and Technical Information of China (English)

    伍国维

    2013-01-01

    Objective: To observe the therapcutic effect of Maitland combined with Long’s therapy on cervical spondylosis of vertebral artery type. Methods:90 patients with cervical spondylosis of vertebral artery type were randomly divided into treatment group and control group with each 45 cases in each group. The patients of the treatment group were treatmented with Maitland combined with Long’s therapy, And those of the control group were treatmented with Medium Frequency Electrotherapy combined with Traction.The therapeutic effects of two groups were compared. Results:the total effective rate of the treatment group was 91.1%that the control group was 71.1% There was a significant difference between two groups(P﹤0.05). Conclusion :The effect of Maitland combined with Long′s therapy on cervical spondylosis of vertebral artery type is superior to medium frequency electrotherapy combined with traction.%目的:探讨澳式手法结合龙氏正骨手法治疗椎动脉型颈椎病治疗效果。方法:椎动脉型颈椎病90例按随机数字表法随机分为治疗组和对照组各45例,治疗组采用澳式手法结合龙氏正骨手法,对照组采用中频电疗加牵引,比较两组患者的疗效。结果:治疗组患者总有效率为91.1%,对照组71.1%,两组间差异有显著性意义(P<0.05)。结论:澳式手法结合龙氏正骨手法治疗椎动脉型颈椎病治疗效果优于中频加牵引。

  6. PERSISTENT MEDIAN ARTERY IN THE CARPAL TUNNEL

    Directory of Open Access Journals (Sweden)

    Raviprasanna.K.H

    2014-09-01

    Full Text Available Introduction: Persistent median artery originates from the anterior interosseous artery in proximal one-third of the forearm and accompanies median nerve. Median artery may regress in the forearm or enter palm through the carpal tunnel deep to flexor retinaculum of wrist and supply palm by anastomosing with the superficial palmar arch. Objective: In present study the objective was to study presence of persistent median artery accompanying median nerve and its termination Materials and Methods: The study included 50 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. These specimens fixed in 10% formalin were finely dissected and persistent median artery was traced from origin to termination. Results: Out of 50 human cadaver specimens, persistent median artery was present in 4 specimens (8%. All the 4 median arteries originated from anterior interosseous artery and were of palmar type which reached palm. Out of 4 median arteries, 3 median arteries (6% took part in completion of superficial palmar arch, supplying the distal aspect of palm and 1 median artery (2% directly supplied radial two and half fingers without forming arch. Conclusion: Knowledge of unusual variations helps in proper treatment of disorders of the median nerve. Presence of persistent median artery usually will be asymptomatic but may cause symptoms of carpal tunnel syndrome or pronator teres syndrome when subjected to compression. Rarely this artery can be taken for reconstruction

  7. How I do it: transapical cannulation for acute type-A aortic dissection

    Directory of Open Access Journals (Sweden)

    Alexiou Christos

    2008-01-01

    Full Text Available Abstract Aortic dissection is the most frequently diagnosed lethal disease of the aorta. Half of all patients with acute type-A aortic dissection die within 48 hours of presentation. There is still debate as to the optimal site of arterial cannulation for establishing cardiopulmonary bypass in patients with type-A aortic dissection. Femoral artery cannulation with retrograde perfusion is the most common method but because of the risk of malperfusion of vital organs and atheroembolism related to it different sites such as the axillary artery, the innominate artery and the aortic arch are used. Cannulation of these sites is not without risks of atheroembolism, neurovascular complications and can be time consuming. Another yet to be popularised option is the transapical aortic cannulation (TAC described in this article. TAC consists of the insertion of the arterial cannula through the apex of the left ventricle and the aortic valve to lie in the sinus of Valsalva. Trans-oesophageal guidance is necessary to ensure correct placement of the cannula. TAC is an excellent method of establishing cardiopulmonary bypass as it is quick, provides a more physiological method of delivering antegrade arterial flow and is the only method to assure perfusion of the true lumen.

  8. Anomalous branching pattern of common hepatic artery: a case report

    Directory of Open Access Journals (Sweden)

    Sushant S. Das

    2014-08-01

    Full Text Available A number of hepatic artery variations exists which is continuously proving a hindrance for the surgeons and radiologists. During routine dissection in the subhepatic region in 50 year old male cadaver for undergraduate teaching, a variation in the branching pattern of common hepatic artery was noticed. We observed an unusual branching of the common hepatic artery into seven terminal branches, of which two were left hepatic arteries, two were right gastric arteries and the remaining three were right hepatic artery, cystic artery and gastroduodenal artery. Hepatic artery proper was absent. Embryological basis of these variations were discussed. The present case is a rarity and will further throw light on the knowledge of the hepatic artery variations, thus assisting surgeons and radiologists in various surgical and diagnostic procedures. [Int J Res Med Sci 2014; 2(4.000: 1740-1742

  9. Cervical Cystic Hydroma%小儿颈部囊状水瘤

    Institute of Scientific and Technical Information of China (English)

    齐毓秀; 郑毓珊; 邹大卫

    1982-01-01

    @@ 我院外科自1975年~1980年共收治小儿颈部囊状水瘤38例,分析和讨论如下: 临床资料 一、一般资料:男性29例;女性9例.年龄最小为5天,最大为9岁.1岁以下16例,1~3岁9例,3岁以上13例.%Authors reported 38 cases of cervical cystic hydroma in children.One was treated by thorough incision of all the cysts and drained by rubber tissue,3 were operated on by resection but leaving parts of the cystic wall adhering to the carotid artery and jugular unresected.Follow-up of the incised case for 2 years and 4.5 years for the other 3 respectively revealed no recurrence.24 cases were operated on by thorough resection without any visible cyst wall left and parotidectomies were performed simultaneously in three cases,owing to the destruction of the glands by invading cysts.Facial paralysis occurred in these three parotidectomies,because of the damage of the mandibular bfanch of the nerve.The authors emphasized the importance of wide incision in all cases and preservation parts of the cyst wall adhering to the carotid artery,jugular vein,vagus nerve and facial nerve and thus keep them from damaging.The methods of dissecting the carotid artery,jugular vein and vagus nerve were also discussed in detail.

  10. Principles for Management of Intraoperative Acute Type A Aortic Dissection.

    Science.gov (United States)

    Gukop, Philemon; Chandrasekaran, Vankatachalam

    2015-12-01

    Intraoperative Type A aortic dissection is a rare pathology with incidence of 0.06-0.32%. It is associated with a high mortality between 30-50%. Some associated risk factors, including hypertension, enlarged aorta, peripheral vascular disease, advanced age, atheroma, and high arterial pressure on cardiopulmonary bypass, have been identified. Modification of these risk factors could reduce the incidence of this event. Prompt diagnosis and management, with the aid of intraoperative trans-esophageal echocardiography and/or epi-aortic ultrasound has been shown to reduce the mortality to 17%. We illustrate the principles of management of this pathology with the case of a 62-year-old female who developed acute Type A aortic dissection while undergoing minimally invasive mitral valve repair.

  11. SEXUAL FUNCTIONING AND QUALITY OF LIFE IN CERVICAL CANCER SURVIVORS AFTER SURGERY AND RADIOTHERAPY

    Directory of Open Access Journals (Sweden)

    Prashant R Kumbhaj

    2014-04-01

    Conclusion: Cervical cancer survivors treated with radiotherapy had worse sexual functioning than did those treated with radical hysterectomy and lymph node dissection. Appropriate measures like Pelvic exercises, Yoga, vaginal dilators, vaginal cream should be used to decrease radiotherapy related side effects on sexual functioning. Cervical cancer survivors treated with surgery alone can expect overall quality of life and sexual function not unlike that of peers without a history of cancer. [Natl J Med Res 2014; 4(2.000: 116-118

  12. Unusual magnetic resonance characteristics of a cerebellopontine angle epidermoid cyst with upper cervical spinal canal extension.

    Science.gov (United States)

    Teo, Beng-Tiong; Lin, Chao-chun; Chiou, Tsung-Lang; Chen, Shang-Chi; Yen, Pao-Sheng

    2006-08-01

    We present a 27-year-old woman with an epidermoid cyst at the cerebellopontine (CP) angle with caudal extension into the upper cervical spinal canal. The lesion showed unusual hyperintensity on T1-weighted images, and hypointensity on T2-weighted images. We used microneurosurgical techniques for tumour dissection and excision. To our knowledge, this is the fifth example in Index Medicus/MEDLINE of histopathologically proven CP angle epidermoid with cervical spine extension.

  13. Coronary stenting with cardiogenic shock due to acute ascending aortic dissection

    Institute of Scientific and Technical Information of China (English)

    Yuichi; Hanaki; Kazuhiko; Yumoto; Seigen; I; Hajime; Aoki; Tomoyuki; Fukuzawa; Takahiro; Watanabe; Kenichi; Kato

    2015-01-01

    A 65-year-old man developed chest pain under cardiogenic shock. Coronary angiography revealed severe stenosis from the ostium of the left main coronary artery(LMCA) to the left anterior descending artery(LAD). Intravascular ultrasound(IVUS) identified a large hematoma that originated from the aorta and extended into the LAD, thereby compressing the true lumen. Type A aortic dissection(TAAD) that involved the LMCA was diagnosed by IVUS. Coronary stenting was performed via the LMCA to the proximal LAD, which resulted in coronary blood flow restoration and no further propagation of dissection. Elective surgical aortic repair was performed 2 wk after the stenting. LMCA stenting under IVUS guidance is effective for prompt diagnosis and precise stent deployment in patients with cardiogenic shock due to TAAD with LMCA dissection.

  14. Dissecting Sub-epicardial Hematoma Due to Coronary Perforation and Non-developing Stent

    Institute of Scientific and Technical Information of China (English)

    Guo Hangyuan; Xing Yangbo; Lee JongDae

    2007-01-01

    We report a 65-year-old man who presented with anastomotic perforation of the distal right coronary artery due to stent deployment, complicated by a small and stable dissecting sub-epicardial hematoma,and non-developing stent. The cause was unknown.

  15. A Simple Dissection Method for the Conduction System of the Human Heart

    Science.gov (United States)

    Yanagawa, Nariaki; Nakajima, Yuji

    2009-01-01

    A simple dissection guide for the conduction system of the human heart is shown. The atrioventricular (AV) node, AV bundle, and right bundle branch were identified in a formaldehyde-fixed human heart. The sinu-atrial (SA) node could not be found, but the region in which SA node was contained was identified using the SA nodal artery. Gross…

  16. 不同重建阈值构建宫颈癌动脉血管网数字化三维模型对癌灶血供分析的影响%The influence to reconstruct the digital three-dimensional model and analysis the characteristic of blood supply of arteries network in cervical cancer by different threshold

    Institute of Scientific and Technical Information of China (English)

    陆琳; 王建平; 唐雷; 钟世镇; 段慧; 陈春林; 刘萍; 王黎; 陈兰; 王俊; 李维丽; 陈瑞莹

    2014-01-01

    目的:拟比较不同重建阈值的在体宫颈癌动脉血管网数字化三维模型的血供比例,评估模型的应用价值。方法通过采集2010年4月至2012年12月于南方医科大学南方医院妇科住院的36例宫颈癌患者的CTA数据集,导入三维重建软件后分别设定重建阈值为80 HU、100 HU和120 HU后利用Mimics软件构建在体宫颈癌动脉血管网数字化三维模型;利用线切割及面切割工具对三维模型进行立体切割,并计算子宫及子宫各部分的血管容积及血供比例,比较三种不同重建阈值所构建的在体宫颈癌动脉血管网数字化三维模型的血供特点。结果(1)通过Mimics软件计算得出,子宫总体血管容积、宫体血管容积、宫颈血管容积,宫体左/右侧部血管容积、宫颈左/右侧部血管容积随重建阈值降低而增加,差异具有统计学意义(P0.05)。结论宫颈癌动脉血管网数字化三维模型中子宫各部分血供比例不受重建阈值的变化而变化,能更客观准确的反映宫颈癌的动脉血供特点,为后续临床应用提供了稳定的模型基础。%Objective Intends to compare the proportion of the blood supply of uterine arteries digital three-dimensional model of cervical cancer reconstructed by different threshold, and assess the applicative value of the models. Method The 36 CTA datasets of patients with cervical cancer were obtained from April 2010 to December 2012. All the patients were from the department of Obstetrics and Gynecology in Nanfang Hospital of Southern medical university. The uterine arteries digital three-dimensional models of cervical cancer were built on different reconstructive threshold such as 80 Hu, 100 Hu and 120 HU by Mimics software. Then the models were cut into different parts of uterus by using the line cutting and surface cutting tools, and the vascular volume and the proportion of blood supply were calculated to compare the

  17. ``Dissection'' of a Hair Dryer

    Science.gov (United States)

    Eisenstein, Stan; Simpson, Jeff

    2008-12-01

    The electrical design of the common hair dryer is based almost entirely on relatively simple principles learned in introductory physics classes. Just as biology students dissect a frog to see the principles of anatomy in action, physics students can "dissect" a hair dryer to see how principles of electricity are used in a real system. They can discover how engineers solve problems such as how to vary between low and high heat and fan speed by simply moving the position of a single switch. Principles of alternating versus direct current, series and parallel circuits, electrical safety, voltage dividing, ac rectification, power, and measurement of resistance and continuity all come in to play.

  18. Developmental biomechanics of the human cervical spine.

    Science.gov (United States)

    Nuckley, David J; Linders, David R; Ching, Randal P

    2013-04-05

    Head and neck injuries, the leading cause of death for children in the U.S., are difficult to diagnose, treat, and prevent because of a critical void in our understanding of the biomechanical response of the immature cervical spine. The objective of this study was to investigate the functional and failure biomechanics of the cervical spine across multiple axes of loading throughout maturation. A correlational study design was used to examine the relationships governing spinal maturation and biomechanical flexibility curves and tolerance data using a cadaver human in vitro model. Eleven human cadaver cervical spines from across the developmental spectrum (2-28 years) were dissected into segments (C1-C2, C3-C5, and C6-C7) for biomechanical testing. Non-destructive flexibility tests were performed in tension, compression, flexion, extension, lateral bending, and axial rotation. After measuring their intact biomechanical responses, each segment group was failed in different modes to measure the tissue tolerance in tension (C1-C2), compression (C3-C5), and extension (C5-C6). Classical injury patterns were observed in all of the specimens tested. Both the functional (pcervical spine throughout maturation and elucidated age, spinal level, and mode of loading specificity. These data support our understanding of the child cervical spine from a developmental perspective and facilitate the generation of injury prevention or management schema for the mitigation of child spine injuries and their deleterious effects.

  19. Adjacent Segment Pathology after Anterior Cervical Fusion.

    Science.gov (United States)

    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon; Kim, Sung Kyu

    2016-06-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion.

  20. Unusual presentation of aortic dissection: post-coital acute paraplegia with renal failure.

    Science.gov (United States)

    Galabada, Dinith P; Nazar, Abdul L M

    2014-09-01

    We report the case of a 45-year-old chronic smoker who presented with acute paraplegia occurring during coitus and subsequently developed acute renal failure (ARF) requiring dialysis. He had absent peripheral pulses in the lower limbs with evidence of acute ischemia. Doppler study showed dissecting aneurysm of thoracic aorta, thrombotic occlusion of the distal aorta from L1 level up to bifurcation and occlusion of the right renal artery by a thrombus that was confirmed by magnetic resonance imaging of the spine. He was not subjected to any vascular intervention as his lower limbs were not salvageable due to delay in the diagnosis. Post-coital aortic dissection and aortic dissection presenting with acute paraplegia and ARF are very rare. This is probably the first case report with post-coital acute aortic dissection presenting with paraplegia and ARF. This case emphasizes the importance of a careful examination of peripheral pulses in patients presenting with ARF and paraplegia.

  1. Unusual presentation of aortic dissection: Post-coital acute paraplegia with renal failure

    Directory of Open Access Journals (Sweden)

    Dinith P Galabada

    2014-01-01

    Full Text Available We report the case of a 45-year-old chronic smoker who presented with acute paraplegia occurring during coitus and subsequently developed acute renal failure (ARF requiring dialysis. He had absent peripheral pulses in the lower limbs with evidence of acute ischemia. Doppler study showed dissecting aneurysm of thoracic aorta, thrombotic occlusion of the distal aorta from L1 level up to bifurcation and occlusion of the right renal artery by a thrombus that was confirmed by magnetic resonance imaging of the spine. He was not subjected to any vascular intervention as his lower limbs were not salvageable due to delay in the diagnosis. Post-coital aortic dissection and aortic dissection presenting with acute paraplegia and ARF are very rare. This is probably the first case report with post-coital acute aortic dissection presenting with paraplegia and ARF. This case emphasizes the importance of a careful examination of peripheral pulses in patients presenting with ARF and paraplegia.

  2. [Chronic type A aortic dissection associated with Turner syndrome; report of a case].

    Science.gov (United States)

    Tanaka, Hideyuki; Kozaki, Tomofumi; Kume, Masazumi; Miyamoto, Shinji

    2014-12-01

    Aortic dissection is a critical but rare complication of Turner syndrome. This report describes a case of chronic aortic dissection in a patient with Turner syndrome. A 54-year-old woman, suffering from mild back pain for 1 month, was referred to our hospital with a diagnosis of Stanford type A chronic aortic dissection and a bicuspid aortic valve with moderate regurgitation. Computed tomography revealed aortic dissection, involving all arch branches, extending from the ascending to the abdominal aorta. The true lumen of the brachial artery was nearly obstructed by the thrombosed false lumen. Elective aortic arch repair and aortic valve replacement were successfully performed. The patient was diagnosed with 45, XO Turner syndrome after surgery. Taking aortopathy of Turner syndrome into consideration, surveillance of the residual aorta was performed. No rapidly progressive dilatation of the residual aorta was detected during the 6 years' follow-up.

  3. Modifications to the transverse Caspar cervical retractor blades optimized for a single-level anterior cervical discectomy.

    Science.gov (United States)

    Geisler, F H; Tamargo, R J; Weingart, J D

    1993-02-01

    A modification of the transverse Caspar cervical soft-tissue retractor blades for their use in a single-level anterior cervical discectomy is presented. These modified retractor blades are similarly inserted into the elevated anterior mesial portion of the longus colli muscles. However, they allow a smaller skin incision, less soft-tissue dissection, and do not require use of the superior and inferior smooth retractor blades, while providing the same surgical vision and operative ability in the disc space as does the four-bladed Caspar retractor system.

  4. Description of the celiac artery in domestic pigeons (Columba livia

    Directory of Open Access Journals (Sweden)

    Cibele Geeverghese

    2012-06-01

    Full Text Available This paper aimed to define the origin and distribution of the celiac artery and its collateral branches in 15 fowls from the Columba livia species, which were obtained from the Zoonosis Control Center of Brasilia, Brazil. In order to mark the arterial system of the specimens, the left brachiocephalic trunk was canullated and a colored water-latex solution was injected there. Afterwards, fowls were fixed in a 10% v/v formaldehyde solution and dissected with appropriate equipment, presenting the results described in this paper. The celiac artery originated from the ventral face of the descendent aorta. The first collateral branch arose from the celiac artery itself, forming the esophageal artery. Then, the celiac artery has bifurcated into two branches, named left and right branches of the celiac artery. The left branch emitted the proventricular ventral artery, followed by the splenic arteries, proventricular dorsal artery, and the left hepatic artery. The left branch has bifurcated into two branches, known as ventral and left gastric arteries. The right branch emitted the right hepatic artery, followed by the ileal artery and the right gastric artery. Finally, the right branch turned into the pancreaticoduodenal artery. Our findings showed a great similarity with the avian lineages of the Gallus gallus species, except for the lack of ileocecal artery, cystic branches, and dorsal gastric artery.

  5. Jugular neck dissection for NO neck supraglottic carcinoma

    Directory of Open Access Journals (Sweden)

    Petrović Željko

    2004-01-01

    Full Text Available Appropriate management of patients with supraglottic laryngeal carcinoma and negative findings in the neck is still controversial. A prospective and retrospective study comprised 193 patients who were treated primary surgically between 1976 and 1993. They all had clinically and ultrasound negative findings on the neck (NO. Supraglottic carcinomas usually spread regionally. Metastases develop in the jugular group, between level II-IV. The incidence of metastases has been reported to vary from 12 to 62.5%. The size and localization of the primary tumor, its histological grade, genotype of the malignant cells, imunological and other elucidated factors can all affect the incidence of regional spread. AIM Aim of this study was to specify the incidence of occult cervical metastases; to analyze the distribution of occult metastases related to tumor localization; to specify the distribution of occult metastases related to local spread; to analyze the distribution of occult metastases according to localization in the neck. RESULTS All patients had primary surgery of primary tumor and bilateral jugular, selective neck dissection at the level II-IV with histological examination of removed lymphoid tissue. Out of 193 patients, metastatic deposits were detected in 35(18%. Occult metastases were found in patients with carcinoma of the epilarynx in 19% (14/72 of cases, and in 17% (21/121 patients with carcinoma of the supraglottis excluding the epilarynx. This difference in frequency is not statistically significant. The incidence of occult metastases in epilaryngeal tumors did not depend on the degree of local spread. Even relatively small tumors (T1 and T2 yielded occult metastases in 33% (5/15, and 24% (6/25 of patients, respectively. In patients with T1 tumors localized at the supraglottis, excluding the epilarinx, occult metastases were not found. In the supragiottis excluding the epilarynx increased local spread was associated an increase of occult

  6. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  7. Cervical Cancer Screening

    Science.gov (United States)

    ... are at increased risk for HPV infections. Other risk factors for cervical cancer include: Giving birth to many children. Smoking cigarettes. Using oral contraceptives ("the Pill"). Having a weakened immune system . Cervical Cancer Screening ...

  8. Cervical Cancer Stage IVB

    Science.gov (United States)

    ... of the body, such as the lymph nodes, lung, liver, intestine, or bone. Stage IVB cervical cancer. Topics/Categories: Anatomy -- Gynecologic Cancer Types -- Cervical Cancer Staging Type: Color, ...

  9. Elective neck dissection in oral squamous cell carcinoma of the upper maxilla:necessary?

    Institute of Scientific and Technical Information of China (English)

    Manuel Moreno-Sánchez

    2016-01-01

    Aim: Surgical treatment of clinically negative neck in maxillary squamous cell carcinoma (SCC) of the upper jaw is controversial. The purpose of this systematic review was to define the incidence of cervical metastasis and to assess if elective neck dissection is justified when the neck is not primarily affected.Methods: An electronic literature search was conducted in several databases, including MEDLINE, EMBASE, and Cochrane Central databases, for articles written in English. Results: Twenty-eight articles were included in the review. The overall cervical metastases rate was 33% and the total initial cervical metastases rate was 16%. Interestingly, the author found that 71% of patients with cervical metastases from maxillary SCC carcinoma were T3/T4 stage. Conclusion:This review shows the need for a change in the management of the N0 neck in SCC arising in the maxillary alveolus and hard palate. Elective neck dissection should be performed in patients with T3/T4 tumours with clinic or radiographic negative necks (N0c).

  10. Dissection and preparation of viscera for plastination

    OpenAIRE

    Creus Tacies, Xavier

    2014-01-01

    Póster 1- Get a better understanding of the sistem coronary dissection, one of the most important from the point of anatomical and functional aspects. 2- Learn the plastination technique applying on a previously dissected equine heart.

  11. [Dissection is still important when learning anatomy].

    Science.gov (United States)

    Knudsen, Britt Mejer; Søe, Niels H; Jensen, Nina Vendel; Langebæk, Rikke; Dahlin, Lars B

    2013-05-20

    Dissection and prosection require a donation programme of cadavers for education and research. The importance of maintaining the donation programme and the significance of dissection as a teaching method when learning anatomic structures and obtaining surgical skills are evaluated.

  12. Animal Rights Activism Threatens Dissection.

    Science.gov (United States)

    Holden, Constance

    1990-01-01

    Discussed is the movement against the use of dissections in science laboratories. Examples of protests across the United States are included. Compared is the plight of using animals in a biology classroom and the demise of the teaching of evolution in some areas. (KR)

  13. CHARACTERIZATION OF PATIENTS WITH ENDOVASCULAR TREATMENT OF DISSECTING ANEURYSMS OF POSTERIOR CEREBRAL CIRCULATION IN CARTAGENA DE INDIAS

    OpenAIRE

    Rueda-Tamayo Leidy; Almeida-Pérez Rafael; De la Rosa-Manjarrez Ginna; Orozco-Gómez Fernando; Carrasquilla-Meléndez Rubén

    2015-01-01

    Introduction: the intracraneal aneurysms are local and permanent dilations in the artery. Objective: to describe the clinical, imagenologic and effectiveness of endovascular treatment in terms of its independence and mortality in patients with dissecting aneurysms of posterior cerebral circulation in Cartagena. Methods: a descriptive study was carried out with patients 18 years or older with a diagnosis of dissecting aneurysms of posterior cerebral circulation who received ...

  14. Surgical management for Stanford type A aortic dissection: direct cannulation of real lumen at the level of the Botallo's ligament by Seldinger technique.

    Science.gov (United States)

    Göbölös, Laszlo; Philipp, Alois; Foltan, Maik; Wiebe, Karsten

    2008-12-01

    A 50-year-old man was diagnosed with Stanford type A acute aortic dissection with cerebral malperfusion and unconsciousness. This clinical presentation was investigated by computed tomography which revealed a severe type A dissection involving all limb arteries. Successful operative treatment based on the direct arterial cannulation of the real lumen of dissected aorta at the level of Botallo's ligament by Seldinger technique achieves an appropriate perfusion and rapid cooling of the instable patient. To our knowledge this is the first reported case in the literature.

  15. [Modern treatment of type B dissections

    DEFF Research Database (Denmark)

    Klitfod, L.; Baekgaard, N.; Just, S.

    2008-01-01

    Rapid classification is essential in the management of aortic dissections, as Type A dissections require surgery, while the optimal treatment of Type B dissections is controversial. Medical treatment with antihypertensive medication and analgesics has so far been the main treatment of uncomplicated...... Type B dissections, while surgery has been reserved for complications and persistent pain in spite of medical treatment. Endovascular techniques are less invasive than open repair and show promising early results Udgivelsesdato: 2008/9/8...

  16. Tolosa-Hunt syndrome masquerading as a carotid artery dissection

    Directory of Open Access Journals (Sweden)

    Taylor EJ

    2014-04-01

    Full Text Available Elise J Taylor,1 Ursula M Anders,1 Joseph R Martel,1–4 James B Martel1–4 1Research Center, Martel Eye Medical Group, Rancho Cordova, 2Graduate Medical Education, California Northstate University College of Medicine, Elk Grove, 3Department of Ophthalmology, Sutter Medical Health, Sacramento, 4Department of Ophthalmology, Dignity Health, Carmichael, CA, USA Purpose: To demonstrate the difficulties of diagnosing a patient with Tolosa-Hunt syndrome (THS due to its complicated presentation and extensive diagnostic testing, and how to manage the treatment of a patient in an emergent setting. Patients and methods: A female patient with THS affecting the left eye was examined using two magnetic resonance imaging (MRI scans. The patient was treated with high-dose methylprednisolone (Solu-Medrol® and prednisone. A follow-up MRI and magnetic resonance angiogram (MRA was also performed 4 months later. Results: The second MRI scan disclosed a 5x9x10 mm lesion in the left superior orbital fissure/cavernous sinus. After administration of methylprednisolone and prednisone, the patient’s pain completely resolved, and the left eye regained full duction and eyelid mobility. The MRI and MRA obtained after the treatment showed no abnormalities. Conclusion: The rarity of THS makes it difficult to diagnose, especially when there is a question of accuracy and reproducibility of the testing performed. An ophthalmologic consultation in such cases is crucial. Keywords: granulomatous lesion, painful ophthalmoplegia, idiopathic orbital inflammation, multiple cranial nerve palsies  

  17. [Resistant arterial hypertension and coarctation of the aorta].

    Science.gov (United States)

    Martínez-Quintana, Efrén; Rossique-Delmas, Pilar; Rodríguez-González, Fayna

    2014-01-01

    Coarctation of the aorta accounts for around 5 percent of all congenital heart defects. Many of these patients develop arterial hypertension, and occasionally resistant arterial hypertension, despite adequate correction. This may lead to potentially fatal complications such as heart failure, aortic dissection, cerebrovascular events, or myocardial infarction. Therefore, a correct diagnosis must be made and an appropriate treatment started to reduce arterial hypertension, arteriosclerotic vascular disease, as well as the increased risk of cardiovascular morbidity and mortality.

  18. A Dissecting Competition for Medical Students

    Science.gov (United States)

    Samalia, Latika; Stringer, Mark D.

    2012-01-01

    After repeated requests from medical students for more cadaver dissection opportunities, a voluntary dissecting "competition" was initiated for the third year medical students in 2006. This has been held annually on five occasions since, offering up to 30 dissection stations and accommodating an average of 53 students (range 40-66) per year,…

  19. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

    2012-09-15

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass

  20. [The biomechanics of hyperextension injuries of the subaxial cervical spine].

    Science.gov (United States)

    Stein, G; Meyer, C; Ingenhoff, L; Bredow, J; Müller, L P; Eysel, P; Schiffer, G

    2016-05-24

    Hyperextension injuries of the subaxial cervical spine are potentially hazardous due to relevant destabilization. Depending on the clinical condition, neurologic or vascular damage may occur. Therefore an exact knowledge of the factors leading to destabilization is essential. In a biomechanical investigation, 10 fresh human cadaver cervical spine specimens were tested in a spine simulator. The tested segments were C4 to 7. In the first step, physiologic motion was investigated. Afterwards, the three steps of injury were dissection of the anterior longitudinal ligament, removal of the intervertebral disc/posterior longitudinal ligament, and dissection of the interspinous ligaments/ligamentum flavum. After each step, the mobility was determined. Regarding flexion and extension, an increase in motion of 8.36 % after the first step, 90.45 % after the second step, and 121.67 % after the last step was observed. Testing of lateral bending showed an increase of mobility of 7.88 %/27.48 %/33.23 %; axial rotation increased by 2.87 %/31.16 %/45.80 %. Isolated dissection of the anterior longitudinal ligament led to minor destabilization, whereas the intervertebral disc has to be seen as a major stabilizer of the cervical spine. Few finite-element studies showed comparable results. If a transfer to clinical use is undertaken, an isolated rupture of the anterior longitudinal ligament can be treated without surgical stabilization.

  1. Neck dissection: then and now.

    NARCIS (Netherlands)

    Ferlito, A.; Rinaldo, A.; Silver, C.E.; Shah, J.P.; Suarez, C.; Medina, J.E.; Kowalski, L.P.; Johnson, J.T.; Strome, M.; Rodrigo, J.P.; Werner, J.A.; Takes, R.P.; Towpik, E.; Robbins, K.T.; Leemans, C.R.; Herranz, J.; Gavilan, J.; Shaha, A.R.; Wei, W.I.

    2006-01-01

    The significance of metastatic disease in the lymph nodes of the neck as a critical independent prognostic factor in head and neck cancer has long been appreciated. Although 19th century surgeons attempted to remove involved cervical lymph nodes at the time of resection of the primary cancer, a syst

  2. Vertebral artery aneurysm--a unique hazard of head banging by heavy metal rockers. Case report.

    Science.gov (United States)

    Egnor, M R; Page, L K; David, C

    A 15-year-old drummer in a neighborhood rock music band suffered a traumatic true aneurysm of the cervical vertebral artery from violent head and neck motion. He underwent excision of the aneurysm after distal and proximal ligation of the artery. He is neurologically normal 1 year after surgery. The mechanisms of injury caused by extremes of cervical motion, as well as 5 previously reported cases of extracranial vertebral artery aneurysm from closed trauma, are discussed. Excision of vertebral artery aneurysms in patients with emboli from a mural thrombus is recommended. The consequences of vertebral artery ligation and the indications for distal reconstruction are discussed.

  3. Right Gastroepiploic Artery as an Alternative for Arterial Reconstruction in Living Donor Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Klaus Steinbrück

    2014-01-01

    Full Text Available Background. An adequate blood flow is directly related to graft survival in living donor liver transplantation. However, in some cases, unfavorable conditions prevent the use of the hepatic artery for arterial reconstruction. Herein, we report a case in which the recipient right gastroepiploic artery was used as an option for arterial reconstruction in adult-to-adult living donor liver transplantation. Case Report. A 62-year-old woman, with cirrhosis due to hepatitis B associated with hepatocellular carcinoma, was submitted to living donor liver transplantation. During surgery, thrombosis of the hepatic artery with intimal dissection until the celiac trunk was observed, which precluded its use in arterial reconstruction. We decided to use the right gastroepiploic artery for arterial revascularization of the liver graft. Despite the discrepancy in size between donor hepatic artery and recipient right gastroepiploic artery, anastomosis was performed successfully. Conclusions. The use of the right gastroepiploic artery as an alternative for arterial revascularization of the liver graft in living donor liver transplantation should always be considered when the hepatic artery of the recipient cannot be used. For performing this type of procedure, familiarity with microsurgical techniques by the surgical team is necessary.

  4. Aneurysms of medium-sized arteries in Marfan syndrome.

    Science.gov (United States)

    Awais, Mazen; Williams, David M; Deeb, G Michael; Shea, Michael J

    2013-11-01

    Marfan syndrome is a relatively common connective tissue disorder that causes skin, ocular, skeletal, and cardiovascular abnormalities. High morbidity and mortality occur with aortic aneurysm and dissection. Other large-artery aneurysms, including carotid, subclavian, and iliac artery aneurysms, have also been associated with Marfan syndrome. It is not clear whether small- to medium-sized artery aneurysms are associated with Marfan syndrome. This report describes 4 patients with Marfan syndrome who have associated small- to medium-sized artery aneurysms with several complications. Additional investigations are needed to determine whether Marfan syndrome can cause small- to medium-sized artery aneurysms and how patients with these aneurysms should be treated.

  5. Contribution of embryology in the understanding of cervical venous system anatomy within and around the transverse foramen: a review of the classical literature.

    Science.gov (United States)

    Magro, Elsa; Sénécail, Bernard; Gentric, Jean-Christophe; Alavi, Zarrin; Palombi, Olivier; Seizeur, Romuald

    2014-07-01

    Anatomic arrangement of venous system within the transverse foramen is a controversial topic among authors. Precise knowledge of this arrangement is necessary in imaging where vertebral artery dissection is suspected, as well as in surgical approaches of cervical spine. This knowledge objective cannot be achieved without a prerequisite knowledge of primitive venous system. We present here an update on the development of the transverse foramen venous system through a literature review. Our review of the classical literature aimed at synthesis of available related embryological knowledge and relating this synthesis to cervical vertebrae anatomy. Our findings with regard to different primitive descriptions were consistent and often complementary across the studies. The description has varied from a single vertebral vein to a single vein divided at certain areas, or even to a confluence of venous plexus. In this manner, the embryonic knowledge for instance on venous system can help us to better understand the segmental development of vertebral veins and their plexus arrangement. Furthermore, the cranial-caudal embryology, in particular of the nervous system, conveys the initial plexiform arrangement of vertebral veins, which ends into a single venous trunk joining the subclavian vein.

  6. Vertebrobasilar dissection with subarachnoid hemorrhage: a retrospective study of 29 patients

    Energy Technology Data Exchange (ETDEWEB)

    Ramgren, B; Cronqvist, M; Holtaas, S; Larsson, E-M [Center for Medical Imaging and Physiology, Lund University Hospital, Department of Neuroradiology, Lund (Sweden); Romner, B; Brandt, L [Lund University Hospital, Department of Neurosurgery, Lund (Sweden)

    2005-02-01

    We have reviewed initial diagnostic features, treatment, and outcome in 29 patients with acute subarachnoid hemorrhage due to non-traumatic vertebrobasilar artery dissection diagnosed in our hospital between 1993 and 2003. The dissections occurred in the vertebral artery in 19 patients, the posterior inferior cerebellar artery (PICA) in two patients, the basilar artery in four patients, and in the vertebral artery extending into the PICA in four patients. A pseudoaneurysm was found in 20 patients. Clinical manifestations typically included sudden onset of moderate to severe headache, nuchal rigidity, and drowsiness. Fourteen patients were treated conservatively. Fifteen patients underwent endovascular treatment with either parent artery occlusion (13 patients) or aneurysmal coil occlusion with preservation of the parent artery (2 patients). Re-bleeding occurred within 12 days and before treatment in nine patients. Eight of these had a pseudoaneurysm. No patient bled after endovascular treatment. Poor grade and early re-bleeding were associated with less favorable outcome. Outcome at 6 months did not differ significantly between endovascular and conservative treatment. Altogether, good recovery was achieved for 16 patients, moderate disability was seen in one, severe disability in four, and eight patients (27%) died. The absence of bleeding subsequent to endovascular treatment in this study suggests that endovascular treatment may be a rational approach in these patients at high risk of re-bleeding, especially those with a pseudoaneurysm. (orig.)

  7. Anterior cervical plating

    Directory of Open Access Journals (Sweden)

    Gonugunta V

    2005-01-01

    Full Text Available Although anterior cervical instrumentation was initially used in cervical trauma, because of obvious benefits, indications for its use have been expanded over time to degenerative cases as well as tumor and infection of the cervical spine. Along with a threefold increase in incidence of cervical fusion surgery, implant designs have evolved over the last three decades. Observation of graft subsidence and phenomenon of stress shielding led to the development of the new generation dynamic anterior cervical plating systems. Anterior cervical plating does not conclusively improve clinical outcome of the patients, but certainly enhances the efficacy of autograft and allograft fusion and lessens the rate of pseudoarthrosis and kyphosis after multilevel discectomy and fusions. A review of biomechanics, surgical technique, indications, complications and results of various anterior cervical plating systems is presented here to enable clinicians to select the appropriate construct design.

  8. A case of carotid dissection having significant benefit from thrombolytic treatment

    Directory of Open Access Journals (Sweden)

    Sibel Güler

    2016-01-01

    Full Text Available Ischemic stroke due to carotid artery dissection is more common among young people and it accounts about 2-5% of all strokes. A 56 year old left landed male patient was evaluated for left-sided hemiparesis and aphasia in the emergency department. His cranial CT was assessed normal and NIH score was assessed 24 then he undergone thrombolytic therapy. His NIH score was decreased to 14 after 24 hours. At extracranial dupplex USG, cranial MRI and MR-Angiography, done the same day there were findings for carotid dissection. At MR-anjio repeated 5 days later, partial recanalization were seen. At control cranial CT only striocapsüler infarct was seen. There was no any evidence of bleeding as complication. Here we present a rare case of extracranial carotid artery dissection case undergone IV thrombolytic therapy and want to take attention that in carotid dissection IV thrombolytic therapy is quiet safe and there is no difference of complication such as hemorrhage and the prognosis is no different then those with no carotid dissection.

  9. Reflections on dissection: leave no student behind.

    Science.gov (United States)

    Skandalakis, John E

    2008-01-01

    Dissection is being reduced--and even removed--from the medical curriculum in Australia, New Zealand, the United Kingdom, Ireland, and the United States. Dissection's contribution to the curriculum is too important to be diminished. To understand the human body, students must dissect. To avoid anatomical complications, future surgeons need the knowledge they can gain from dissection. Cadavers reveal the uniqueness of each body and the body's strength and fragility, which cannot be learned from books or computers. Cadavers offer surgical skill-building opportunities and confrontation with death. For all its strengths, however, dissection alone does not teach everything the student needs to know. Other educational tools (books, CT and MRI, animation of developmental processes) successfully fill in gaps of knowledge. Surgeons and educators must recognize the threat that decreased dissection poses to our students and patients. They must take steps to support dissection in the medical curriculum or, if it has disappeared, to bring it back.

  10. Acute spontaneous isolated dissection of abdominal aorta

    Directory of Open Access Journals (Sweden)

    Ali Akbar beigi

    2009-09-01

    Full Text Available

    • Aortic dissection occurs when the layers of the aorta separate as a result of extra luminal cavity of blood through an intimal tear. Dissection limited to the abdominal aorta is rare. Unfortunately, the appropriate management of dissecting aneurysm of abdominal aorta is not documented yet. A 43 years old man was admitted to Al-zahra hospital in Isfahan with sudden onset of periumbilical abdominal pain. CT scan confirmed infrarenal dissection of abdominal aorta. Performing laparotomy, aorta was repaired using bifurcate collagen-coated Dacron graft. Surgical intervention with synthetic graft is recommended in patients with dissecting aortic aneurysm of infrarenal segments where the extent of dissection is limited and accessible.
    • Keywords: Aneurysm, Aortic dissection, Aortic aneurysm abdominal surgery.

  11. Debranching Solutions in Endografting for Complex Thoracic Aortic Dissections

    Energy Technology Data Exchange (ETDEWEB)

    Goksel, Onur Selcuk, E-mail: onurgokseljet@gmail.com [Istanbul University, Istanbul Medical Faculty, Cardiovascular Surgery, Istanbul (Turkey); Guven, Koray [Istanbul University, Istanbul Medical Faculty, Radiology, Istanbul (Turkey); Karatepe, Celalettin [Mustafa Kemal Medical Faculty, Cardiovascular Surgery, Istanbul (Turkey); Gok, Emre [Istanbul University, Istanbul Medical Faculty, Cardiovascular Surgery, Istanbul (Turkey); Acunas, Bulent [Istanbul University, Istanbul Medical Faculty, Radiology, Istanbul (Turkey); Cinar, Bayer [Medical Park Hospital, Istanbul (Turkey); Alpagut, Ufuk [Istanbul University, Istanbul Medical Faculty, Cardiovascular Surgery, Istanbul (Turkey)

    2014-08-15

    Conventional surgical repair of thoracic aortic dissections is a challenge due to mortality and morbidity risks. We analyzed our experience in hybrid aortic arch repair for complex dissections of the aortic arch. Between 2009 and 2013, 18 patients (the mean age of 67 ± 8 years-old) underwent hybrid aortic arch repair. The procedural strategy was determined on the individual patient. Thirteen patients had type I repair using trifurcation and another patient with bifurcation graft. Two patients had type II repair with replacement of the ascending aorta. Two patients received extra-anatomic bypass grafting to left carotid artery allowing covering of zone 1. Stent graft deployment rate was 100%. No patients experienced stroke. One patient with total debranching of the aortic arch following an acute dissection of the proximal arch expired 3 months after TEVAR due to heart failure. There were no early to midterm endoleaks. The median follow-up was 20 ± 8 months with patency rate of 100%. Various debranching solutions for different complex scenarios of the aortic arch serve as less invasive procedures than conventional open surgery enabling safe and effective treatment of this highly selected subgroup of patients with complex aortic pathologies.

  12. UNILATERAL VARIATION IN THE BRANCHING PATTERN OF RIGHT AXILLARY ARTERY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    A.K.Manicka Vasuki

    2015-09-01

    Full Text Available Axillary artery and its branches are prone to have variations in their course. Knowledge about such variations are important for Radiologists in imaging techniques, Surgeons,Orthopedicians and Anesthetists in performing surgeries in the axilla and giving regional nerve blocks in the axilla.During dissection of a cadaver in the department of Anatomy, PSG IMS &R, Coimbatore, We observed a variation in the third part of right Axillary artery. From the common trunk, Subscapular artery, Anterior and Posterior circumflex humeral arteries and Profunda brachii artery arose. Third part of Axillary artery continued down as brachial artery. We are highlighting the variation in this study.

  13. Left-sided portal hypertension: Successful management by laparoscopic splenectomy following splenic artery embolization

    Directory of Open Access Journals (Sweden)

    Damiano Patrono

    2014-01-01

    CONCLUSION: Splenic artery embolization may be a valuable adjunct in case of left-sided portal hypertension requiring splenectomy, allowing a safe dissection of the splenic vessels even by laparoscopy.

  14. Lymph node dissection for Siewert II esophagogastric junction adenocarcinoma

    Science.gov (United States)

    Duan, Xiao-Feng; Yue, Jie; Tang, Peng; Shang, Xiao-Bin; Jiang, Hong-Jing; Yu, Zhen-Tao

    2017-01-01

    Abstract The present study was aimed to investigate the application of right thansthoracic Ivor–Lewis (IL), left transthoracic (LTT), and left thoracoabdominal (LTA) approach in Siewert type II adenocarcinoma of esophagogastric junction (AEG). The data of 196 patients with Siewert type II AEG received surgical resection in our cancer center between January 2014 and April 2016 was retrospectively analyzed. Finally, 136 patients met the inclusion criteria were enrolled in the study and divided into the IL (47 cases), LTT (51 cases), and LTA group (38 cases). Clinical and short-term treatment effects were compared among the 3 groups. The patients with weight loss, diabetes, and heart disease increased in the LTT group (P = 0.054, P = 0.075, and P = 0.063, respectively). Operation time was significantly longest in the IL group (P  0.05), but the dissection rate of the hepatic artery, splenic artery, and celiac trunk lymph nodes was significantly highest in the IL group (P  0.05). Compared with the traditional left transthoracic approach, the Ivor–Lewis approach did not increase the perioperative mortality and complication rates in Siewert type II AEG, but obtained satisfactory length of the proximal surgical margin, and was better than the left transthoracic approach in thoracic and abdominal lymph node dissection. However, the advantages of Ivor–Lewis procedure requires further follow-up and validation through prospective randomized controlled trials. PMID:28207537

  15. Acute Aortic Dissection Mimicking STEMI in the Catheterization Laboratory: Early Recognition Is Mandatory

    Directory of Open Access Journals (Sweden)

    Alessio Arrivi

    2012-01-01

    Full Text Available Coronary malperfusion due to type A aortic dissection is a life-threatening condition where timely recognition and treatment are mandatory. A 77-year-old woman underwent an acute evolving type A aortic dissection mimicking acute myocardial infarction. Two pathophysiologic mechanisms are discussed: either thrombosis migrating from a previously treated giant aneurism of proximal left anterior descending or a local arterial complication due to left main stenting. Recognition of these occurrences in the catheterization laboratory is important to look immediately for surgery.

  16. Delayed Surgery for Aortic Dissection after Intravenous Thrombolysis in Acute Ischemic Stroke

    Science.gov (United States)

    Choi, Nari; Yoon, Jee-Eun; Park, Byoung-Won; Chang, Won-Ho; Kim, Hyun-Jo; Lee, Kyung Bok

    2016-01-01

    We report a case of aortic dissection masquerading as acute ischemic stroke followed by intravenous thrombolysis. A 59-year-old man presented with dizziness. After examination, the patient had a seizure with bilateral Babinski signs. Soon after identifying multiple acute infarctions in both hemispheres on diffusion-weighted brain magnetic resonance (MR) imaging, tissue plasminogen activator (t-PA) was administered. Both common carotid arteries were invisible on MR angiography, and subsequent chest computed tomography revealed an aortic dissection. The emergency operation was delayed for 13 hours due to t-PA administration. The patient died of massive bleeding. PMID:27734002

  17. A fiber-optic retractor for harvesting the internal mammary artery.

    Science.gov (United States)

    Angelini, G D; Azzu, A A

    1990-08-01

    A retractor for exposure and dissection of the internal mammary artery incorporating a fiber-optic transillumination system is presented. The device, which can be converted to a standard sternal retractor, has also proved valuable in improving illumination during procedures on the mitral valve and in facilitating dissection of fibrous adhesions from the anterior surface of the heart at reoperation.

  18. The clinical characteristics and therapy of syndrome of craniocerebral- cervical vertebral injury

    Institute of Scientific and Technical Information of China (English)

    LIU Sheng; LIU Yuan-xin; WANG Cheng

    2005-01-01

    Objective: To explore the clinical characteristics and new treatment for syndrome of craniocerebral-cervical vertebral injury. Methods: The clinical data of 52 patients with head injury accompanied by neck injury were analyzed retrospectively. Results: Craniocerebral injury could result in damage to cervical vertebrae, muscles, vessels and nerves, and even cause vertebral artery injury, which may lead to insufficient blood-supply of vertebral-basal artery. All patients were treated with cervical vertebral traction and the results were good. Conclusions: Acute craniocerebral injury with symptom of insufficient blood-supply of vertebral-basal artery, evident neurosis and atlas-axis half-dislocation in X-ray should be treated by cervical vertebral traction, which will yield better outcome.

  19. Isolated spontaneous dissection of the celiac trunk in a patient with bicuspid aortic valve

    Directory of Open Access Journals (Sweden)

    Abdel-Rauf Zeina

    2010-05-01

    Full Text Available Abdel-Rauf Zeina1, Alicia Nachtigal1, Anton Troitsa2, Gil Admon2, Nina Avshovich31Department of Radiology, 2Department of Surgery A, 3Department of Internal Medicine C, Hillel Yaffe Medical Center, Hadera, Israel. Hillel Yaffe Medical Center is affiliated with the Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, IsraelAbstract: Isolated spontaneous dissection of celiac trunk is a rare entity. The spontaneous dissection of the visceral artery occurs without aortic dissection. The most consistent presenting symptom is acute onset abdominal pain. Complications consist of ischemia, aneurysm formation, and rupture. We report an exceptional case of an isolated spontaneous dissection of the celiac trunk which occurred in a 49 year old male with a previously undiagnosed bicuspid aortic valve (BAV. We also describe the classical appearance in different imaging modalities with a particular emphasis on multidetector computed tomography, and discuss the clinical manifestation and its relationship to BAV.Keywords: celiac trunk dissection, isolated spontaneous dissection, CT angiography, bicuspid aortic valve, MRA

  20. Cervical insufficiency and cervical cerclage.

    Science.gov (United States)

    Brown, Richard; Gagnon, Robert; Delisle, Marie-France; Gagnon, Robert; Bujold, Emmanuel; Basso, Melanie; Bos, Hayley; Brown, Richard; Cooper, Stephanie; Crane, Joan; Davies, Gregory; Gouin, Katy; Menticoglou, Savas; Mundle, William; Pylypjuk, Christy; Roggensack, Anne; Sanderson, Frank; Senikas, Vyta

    2013-12-01

    Objectif : La présente directive clinique a pour but de fournir un cadre de référence que les cliniciens pourront utiliser pour identifier les femmes qui sont exposées aux plus grands risques de connaître une insuffisance cervicale, ainsi que pour déterminer les circonstances en présence desquelles la mise en place d’un cerclage pourrait s’avérer souhaitable. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans PubMed ou MEDLINE, CINAHL et The Cochrane Library en 2012 au moyen d’un vocabulaire contrôlé (p. ex. « uterine cervical incompetence ») et de mots clés appropriés (p. ex. « cervical insufficiency », « cerclage », « Shirodkar », « cerclage », « MacDonald », « cerclage », « abdominal », « cervical length », « mid-trimester pregnancy loss »). Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles. Aucune restriction n’a été appliquée en matière de date ou de langue. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en janvier 2011. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. Valeurs : La qualité des résultats est évaluée au moyen des critères décrits dans le rapport du Groupe d’étude canadien sur les soins de santé préventifs (Tableau). Recommandations 1. Les femmes qui sont enceintes ou qui planifient connaître une grossesse devraient faire l’objet d’une évaluation visant les facteurs de

  1. Aberrant cervical vasculature anastomosis as cause of neck pain and successful treatment with embolization technique.

    Science.gov (United States)

    He, Lucy; Ladner, Travis R; Cobb, Mark; Mocco, J

    2016-01-27

    We report a patient with non-dermatomal radiating neck pain without focal neurologic deficit. Traditional workup could not identify an anatomic or biomechanical cause. Imaging showed a deep cervical vessel centered in the region of pain. Angiography later identified an aberrant anastomosis of this vessel with the occipital artery. Subsequent endovascular embolization of this arterial trunk resulted in complete pain relief.

  2. Robotic Salvage Lymph Node Dissection After Radical Prostatectomy

    Directory of Open Access Journals (Sweden)

    Fabio C. M. Torricelli

    2015-08-01

    Full Text Available ABSTRACTIntroduction and objective:Radical prostatectomy is a first-line treatment for localized prostate cancer. However, in some cases, biochemical recurrence associated with imaging-detected nodal metastases may happen. Herein, we aim to present the surgical technique for salvage lymph node dissection after radical prostatectomy.Materials and Methods:A 70 year-old asymptomatic man presented with a prostate-specific antigen (PSA of 7.45ng/ mL. Digital rectal examination was normal and trans-rectal prostate biopsy revealed a prostate adenocarcinoma Gleason 7 (3+4. Pre-operative computed tomography scan and bone scintigraphy showed no metastatic disease. In other service, the patient underwent a robotic-assisted radical prostatectomy plus obturador lymphadenectomy. Pathologic examination showed a pT3aN0 tumor. After 6 months of follow-up, serum PSA was 1.45ng/mL. Further investigation with 11C–Choline PET/CT revealed only a 2-cm lymph node close to the left internal iliac artery. The patient was counseled for salvage lymph node dissection.Results:Salvage lymph node dissection was uneventfully performed. Operative time was 1.5 hour, blood loss was minimal, and there were no intra- or postoperative complications. The patient was discharged from hospital in the 1st postoperative day. After 12 months of follow-up, his PSA was undetectable with no other adjuvant therapy.Conclusion:Robotic salvage pelvic lymph node dissection is an effective option for treatment of patients with biochemical recurrence after radical prostatectomy and only pelvic lymph node metastasis detected by C11-Choline PET/CT.

  3. Treatment Option Overview (Cervical Cancer)

    Science.gov (United States)

    ... Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) depends on ...

  4. Anatomical study of encephalic arterial circuit in Eira barbara

    Directory of Open Access Journals (Sweden)

    Breno Costa de Macedo

    2014-06-01

    Full Text Available Eira barbara is a mustelid with a wide distribution in Latin America, and it is commonly known as the grey-headed tayra. In view of the lack of information regarding the anatomy of mustelids, as well the importance of a vascular model for the understanding of neurological lesions in the central nervous system, this study aimed to determine the morphology and composition of the encephalic arterial circuit of E. barbara, to provide data for future studies. Accordingly, we used two young male specimens, obtained from the area of the Paragominas Bauxite Mine, PA, Brazil, donated to LaPMA after their death. The arterial system was filled with red-colored neoprene latex, and the specimens were then fixed in 10% formaldehyde and dissected for systematization of the blood vessels. The specimens showed the arterial circuit in the base of the brain supplied by the internal carotid arteries and basilar artery. The internal carotid artery, after crossing the dura mater, continued cranially giving rise to the medial cerebral arteries and ending as cranial cerebral arteries that anastomose, closing the arterial circuit rostrally. The caudal communicating arteries integrated the basilar artery with the arterial circle and gave rise to the caudal cerebral and rostral cerebellar arteries. The basilar artery formed the main branches, the medial and caudal cerebellar arteries.

  5. A Rare Variant of the Ulnar Artery with Important Clinical Implications: a Case Report

    OpenAIRE

    Casal Diogo; Pais Diogo; Toscano Tiago; Bilhim Tiago; Rodrigues Luís; Figueiredo Inês; Aradio Sónia; Angélica-Almeida Maria; Goyri-O’Neill João

    2012-01-01

    Abstract Background Variations in the major arteries of the upper limb are estimated to be present in up to one fifth of people, and may have significant clinical implications. Case presentation During routine cadaveric dissection of a 69-year-old fresh female cadaver, a superficial brachioulnar artery with an aberrant path was found bilaterally. The superficial brachioulnar artery originated at midarm level from the brachial artery, pierced the brachial fascia immediately proximal to the elb...

  6. Cervical Total Disc Arthroplasty

    OpenAIRE

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc...

  7. Acupoints for cervical spondylosis

    OpenAIRE

    Zhu, Jihe; Arsovska, Blagica; Vasileva, Dance; Petkovska, Sofija; Kozovska, Kristina

    2015-01-01

    Cervical spondylosis is a chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck, as well as the contents of the spinal canal. This is one of the most common degenerative disorders of the spine. The disease can be symptomatic and asymptomatic. Symptoms that are distinctive for cervical spondylosis are: tingling, numbness and weakness in the limbs, lack of coordination, stiff neck, shoulder pain, occipital pain, vertigo, poor...

  8. Preventing cervical cancer globally.

    Science.gov (United States)

    Schmeler, Kathleen M

    2012-11-01

    Cervical cancer is one of the leading causes of cancer and cancer-related deaths among women worldwide. More than 85% of cases and deaths occur in the developing world where the availability of effective screening is limited. In this issue of the journal, Pierce and colleagues (beginning on page 1273) describe a novel technique using a high-resolution microendoscope (HRME) to diagnose cervical dysplasia. This perspective reviews the limitations of existing cervical cancer screening methods currently in use in low-resource settings and the potential for HRME imaging to contribute to cervical cancer prevention in the developing world.

  9. Virtual dissection of pig carcasses

    DEFF Research Database (Denmark)

    Vester-Christensen, Martin; Erbou, Søren Gylling Hemmingsen; Hansen, Mads Fogtmann;

    2009-01-01

    This paper proposes the use of computed tomography (CT) as a reference method for estimating the lean meat percentage (LMP) of pig carcasses. The current reference is manual dissection which has a limited accuracy due to variability between butchers. A contextual Bayesian classification scheme...... is applied to classify volume elements of full body CT-scans of pig carcasses into three tissue types. A linear model describes the relation between voxels and the full weight of the half carcass, which can be determined more accurately than that of the lean meat content. Two hundred and ninety-nine half pig...

  10. Acute arterial occlusion - kidney

    Science.gov (United States)

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidney can often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury or trauma to ...

  11. Facial nerve paralysis after cervical traction.

    Science.gov (United States)

    So, Edmund Cheung

    2010-10-01

    Cervical traction is a frequently used treatment in rehabilitation clinics for cervical spine problems. This modality works, in principle, by decompressing the spinal cord or its nerve roots by applying traction on the cervical spine through a harness placed over the mandible (Olivero et al., Neurosurg Focus 2002;12:ECP1). Previous reports on treatment complications include lumbar radicular discomfort, muscle injury, neck soreness, and posttraction pain (LaBan et al., Arch Phys Med Rehabil 1992;73:295-6; Lee et al., J Biomech Eng 1996;118:597-600). Here, we report the first case of unilateral facial nerve paralysis developed after 4 wks of intermittent cervical traction therapy. Nerve conduction velocity examination revealed a peripheral-type facial nerve paralysis. Symptoms of facial nerve paralysis subsided after prednisolone treatment and suspension of traction therapy. It is suspected that a misplaced or an overstrained harness may have been the cause of facial nerve paralysis in this patient. Possible causes were (1) direct compression by the harness on the right facial nerve near its exit through the stylomastoid foramen; (2) compression of the right external carotid artery by the harness, causing transient ischemic injury at the geniculate ganglion; or (3) coincidental herpes zoster virus infection or idiopathic Bell's palsy involving the facial nerve.

  12. Proposal of anatomical terminology to call the arteries of the base of the encephalon in the monkey (Cebus paella L., 1766 Nomenclatura proposta para denominar as artérias da base do encéfalo do macaco-prego (Cebus apella L., 1766

    Directory of Open Access Journals (Sweden)

    Jussara Rocha Ferreira

    2001-05-01

    Full Text Available Arteries of the encephalon basis of 30 monkeys (Cebus paella were studied. Arteries were injected with colored latex, fixed in formaldehyde solution at 10% and dissected under magnifying lenses. Since the animals died from natural causes they had been previously used in other experiments. Human and veterinary anatomical terminology and literature were used as a reference for the determination of vessels studied in the primates. Arteries of the encephalon base represent division branches of three vascular pedicules: the right and left internal carotid arteries and the basilar system. Vessels in the basilar system of the animal were called vertebral arteries; anterior spinal artery; anterior and posterior cerebelar arteries; pontine arteries; satellite cerebelar arteries; caudal and cranial cerebelar arteries. The basilar artery bifurcates into two posterior cerebral arteries (100%. The caudal area of the encephalon’s arterial circuit is thus constituted. Linking between the vertebro-basilar and the carotid segments is done by the posterior communicating artery, that caudally anastomizes (100% with the posterior cerebral artery. The internal carotid artery gives origin to the posterior communicating artery. The right and left internal carotid artery (intracranial portion compounds the carotid system. The following vessels were identified: middle cerebral artery; anterior cerebral artery; interhemispheric artery; olfactory arteries. Results report that Cebus paella presents an arterial pattern of relative morphological stabilityEstudaram-se as artérias da base do encéfalo do Cebus apella em 30 animais, vindos a óbito por morte natural no Zoológico de São Paulo e coletados durante 10 anos. O material recebeu injeção de látex corado, fixado em formol a 10%, e foi dissecado sob lupa. Encontramos dificuldade e denominar estes vasos. As terminologias anatômicas humana e veterinária e a recuperação da literatura nos serviram de base para

  13. 龙氏治脊疗法结合针刺治疗椎动脉型颈椎病60例临床观察%Clinical observation on treating 60 cases of cervical spondylosis of vertebral artery type by acupuncture plus the Long’s chiropractic therapy

    Institute of Scientific and Technical Information of China (English)

    谭周纯; 洪文

    2016-01-01

    目的:观察龙氏治脊疗法结合针刺治疗椎动脉型颈椎病的临床疗效。方法:将120例椎动脉型颈椎病患者随机分为两组,治疗组采取龙氏治脊疗法结合针灸治疗。对照组采取针刺治疗。结果:治疗组痊愈率与总有效率分别为50.00%和91.67%。而对照组痊愈率与总有效率则分别为26.67%和68.33%。两组比较,差异均有显著性意义(P<0.05),治疗组疗效优于对照组。结论:龙氏治脊疗法结合针刺治疗椎动脉型颈椎病疗效明显优于单用针刺,值得临床进一步推广应用。%Objective: To observe clinical efcacy of acupuncture plus the Long’s chiropractic therapy on cervical spondylosis of vertebral artery type. Methods: 120 patients were randomly divided into two groups; the treatment group was given acupuncture plus the Long’s chiropractic therapy. The control group was treated by acupuncture. Results: The efciency and the total efciency were 50.00%and 91.67% respectively in the treatment group; and were 26.67% and 68.33% respectively in the control group (P<0.05); and efcacy in the treatment group was better. Conclusion: Acupuncture plus the Long’s chiropractic therapy on cervical spondylosis of vertebral artery type shows a good effect, and is worthy of promotion.

  14. Effective observation on treating 53 cases of cervical spondylosis of vertebral artery type with the Pingxuan decoction plus chiropractic%平眩汤联合整脊推拿治疗椎动脉型颈椎病53例的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈荣凯

    2016-01-01

    Objective: To observe clinical efficacy of the Pingxuan decoction plus chiropractic on cervical spondylosis of vertebral artery type. Methods: 53 patients in our hospital were divided into the control group (27 cases) and the observation group (26 cases). The control group was treated by chiropractic; the observation group was given the Pingxuan decoction more. Clinical efficiency in two groups was compared. Results: The total efficiency in the observation group was 96.30%, and 57.69% in the control group. Satisfactory rate in the observation group was 100.00%, and 61.54% in the control group (P﹤0.05). Conclusion: The Pingxuan decoction plus chiropractic on cervical spondylosis of vertebral artery type could relieve clinical symptoms, decrease adverse effects, and was worthy of promotion.%目的::观察分析平眩汤联合整脊推拿治疗椎动脉型颈椎病的临床疗效。方法:选取我院2013年7月-2015年7月收治的椎动脉型颈椎病患者53例为对象,随机分为对照组和观察组,对照组27例,观察组26例。对照组采用传统的推拿治疗,观察组采用平眩汤联合整脊推拿治疗,比较分析两组患者的临床治疗效果。结果:观察组总有效率为96.30%,对照组为57.69%(P﹤0.05);观察组治疗满意度为100.00%,对照组为61.54%(P﹤0.05)。结论:采用平眩汤联合整脊推拿治疗椎动脉型颈椎病,能减轻患者的临床症状,且不良反应发生率较低,具有临床推广价值。

  15. Successful treatment for acute aortic dissection in pregnancy---bentall procedure concomitant with cesarean section

    Directory of Open Access Journals (Sweden)

    Xu Demin

    2011-10-01

    Full Text Available Abstract Acute aortic type A dissection is a life-threatening disease that requires immediate surgical intervention. When dissection occurs during pregnancy, it is of high risk for both the mother and the fetus. In this study, we reported two cases of acute aortic dissection in late pregnancy at 28 weeks and 32 weeks of gestation respectively. After the two patients underwent a cesarean section and delivered a baby, we performed composite graft replacement of the aortic valve, aortic root and ascending aorta, with re-implantation of the coronary arteries into the graft (Bentall procedure instead of repairing the arch with deep hypothermia and circulation arrest. Both mothers and children survived and recovered well.

  16. Evaluation of Educator & Student Use of & Attitudes toward Dissection & Dissection Alternatives

    Science.gov (United States)

    Osenkowski, Pamela; Green, Che; Tjaden, Anne; Cunniff, Peggy

    2015-01-01

    Animal dissection has been routinely practiced in American biology classrooms for decades. With technological advancements, more states adopting student choice measures, and increased awareness about ethical concerns surrounding dissection, many useful dissection alternatives have been developed. To understand the current use of animal dissection…

  17. Análise comparativa dos fluxos da artéria torácica interna esquerda dissecada na forma pediculada versus a forma esqueletizada em cirurgia de revascularização do miocárdio Comparative analysis of the flows of left internal thoracic artery grafts dissected in the pedicled versus skeletonized manner for myocardial revascularization surgery

    Directory of Open Access Journals (Sweden)

    Gustavo Peressoni Castro

    2005-03-01

    Full Text Available OBJETIVO: Comparar os fluxos livres, os calibres e os comprimentos da artéria torácica interna esquerda (ATIE pediculada (P e esqueletizada (E no transoperatório antes e depois da aplicação do vasodilatador tópico (VT. MÉTODOS: Em ensaio clínico randomizado e cego foram estudados 50 pacientes submetidos a cirurgia de revascularização miocárdica eletivas quanto ao emprego da ATIE in situ nas formas P ou E. Dos 25 pacientes no grupo pediculada (GP, 16 eram do sexo masculino, apresentando angina classe II e III (NYHA e fração de ejeção (FE de 50,8 ± 9,2%. No grupo esqueletizada (GE, 19 pacientes eram do sexo masculino, possuindo angina classe II e FE de 46,8 ± 9,3%. As medidas foram realizadas pré-circulação extracorpórea e divididas em duas fases: fase 1 (antes e fase 2 (após 15 min da aplicação da papaverina tópica a 2,5 mg/ml a 37ºC. Durante as aferições, eram monitoradas a pressão arterial média, pressão venosa central e freqüência cardíaca. RESULTADOS: O GP apresentou fluxo de 46±16 e 77±28 ml/min e calibre de 1,4±0,1 e 1,7±0,1 mm nas fases 1 e 2, e o GE, 57±27 e 97±35 ml/min de fluxo e 1,4±0,1 e 1,8±0,2 mm de calibre, respectivamente, não havendo diferenças significativas no desfecho comprimento. CONCLUSÃO: ATIE E demonstrou um aumento significativo no fluxo e calibre, após o uso de VT com p=0,03 e p=0,01 respectivamente, comparados com a ATIE P.OBJECTIVE: To compare the free blood flow, caliber, and length of the left internal thoracic artery (LITA, dissected in the pedicled (P and skeletonized (S manners, during surgery before and after topical vasodilator (TV application. METHODS: A randomized, blind, clinical trial was carried out with 50 patients undergoing elective myocardial revascularization to assess the use of the LITA in situ in its pedicled or skeletonized form. The 25 patients in the pedicled group (GP had NYHA class II or III angina, ejection fraction (EF of 50.8±9.2%, and 16 were

  18. A survival case of painless chronic type A aortic dissection with a history of stroke and anticoagulant use.

    Science.gov (United States)

    Tugcu, Aylin; Yildirimturk, Ozlem; Demiroglu, I C Cemsid; Aytekin, Saide

    2010-10-01

    We report the case of a patient with completely painless chronic aortic dissection, who presented to another hospital with a left hemiparesia 3 months ago and received anticoagulation therapy with a diagnosis of ischemic stroke. Most of her symptoms had resolved when she presented to our outpatient clinic except for numbness of her left hand and dysphasia. Physical examination found a diastolic murmur at the left sternal border and a bruit over the right carotid artery. Transthoracic echocardiography and carotid sonography demonstrated aortic dissection with extension into the internal right carotid artery and severe aortic regurgitation. Surgery was performed successfully and the patient was discharged. This case emphasizes that the diagnosis of a completely painless aortic dissection with only neurologic symptoms at presentation can be extremely difficult and should always be considered as a cause of ischemic stroke to avoid catastrophic antithrombolytic or anticoagulation therapy.

  19. [Intact cervical pregnancy].

    Science.gov (United States)

    Habek, D; Bobic, M V; Dosen, L

    2003-01-01

    The authors describe a case of intact cervical pregnancy in a 24-year-old secundigravida. The patient was treated successfully with Methotrexate. Conservative treatment is the first choice in the therapy of uncomplicated cervical pregnancy. Conservative and operative therapeutic procedures are discussed.

  20. CIRCLE OF WILLIS: VARIANT FORMS AND THEIR EMBRYOLOGY USING GROSS DISSECTION AND MAGNETIC RESONANCE ANGIOGRAPHY

    Directory of Open Access Journals (Sweden)

    Bishwajeet Saikia

    2014-06-01

    Full Text Available Background: The circle of Willis is a large arterial anastomotic ring present at the base of the brain uniting the internal carotid and the vertebrobasilar systems. Branches from the internal carotid and vertebral arteries anastomose to form an arterial circle in the basal cisterns and then distribute to supply the brain. The anatomy of the circle is known to vary significantly; the vessels may be absent or sufficiently narrowed altering the hemodynamics of the circle of Willis and affecting its role as a collateral route. These variant forms can be correlated to their phylogeny and embryology. Prior knowledge of these variant forms is important in pathologies and treatment (e.g. parent artery occlusion for carotid aneurysms resulting occlusion of carotid and vertebral arteries. Context and purpose: Our study was undertaken to observe and compare the morphology of circle of Willis using two entirely different methods; gross dissection (GD and Magnetic resonance angiography (MRA and to correlate the variant patterns encountered with the possible underlying developmental events. Gross dissection was carried out in 70 human cadavers and equal numbers of MRA’s of healthy individuals were studied retrospectively. Results: Only 31 cases (22.14% presented with a complete circle of Willis, out of which 14 (20% were cadaveric specimen and 17 (24.18% were in MRA group. Unilateral hypoplastic posterior communicating artery was the most common variation observed in our study (19.28%. Conclusions: The wide variation in completeness of the circle of Willis in general population is similar to earlier observations. Review of phylogeny and embryology makes us familiar with variant forms which would be otherwise difficult to recognize and may be misinterpreted. MRA and gross dissection findings despite certain variations are comparable.

  1. Internal carotid dissection caused by an elongated styloid process (Eagle syndrome).

    Science.gov (United States)

    Sveinsson, Olafur; Kostulas, Nikolaos; Herrman, Lars

    2013-06-11

    Eagle syndrome (symptoms associated with an elongated styloid process (SP)) is commonly divided into two presentations. First, the so-called classic Eagle syndrome where patients can present with unilateral sore throat, dysphagia, tinnitus, unilateral facial and neck pain and otalgia. Second, there is the vascular or stylocarotid form of Eagle syndrome in which the elongated SP is in contact with the extracranial internal carotid artery. We describe two cases of internal carotid artery dissection associated with an elongated SP. One is a patient with ischaemic stroke and another with transient ischaemic attacks caused by an elongated SP. A surgical resection of the SP was performed on the former patient. Both patients were treated with anticoagulation and recovered well. A literature search only revealed two prior descriptions of carotid dissection in the context of an elongated SP.

  2. Aortic dissection-induced acute flaccid paraplegia treated with cerebrospinal fluid drainage

    Directory of Open Access Journals (Sweden)

    Eduardo Leal Adam

    2012-03-01

    Full Text Available Acute aortic dissection is a life-threatening event in which prompt and correctdiagnosis is associated with better outcomes. In most cases, there is chestor back pain. However, in rare cases, patients have little or no pain andother symptoms are more conspicuous at presentation. The autors reportsthe case of a 47-year-old female patient who sought medical attention forsudden-onset paraplegia. The physical examination was normal except forbilateral lower limb flaccid paralysis, with abolition of deep tendon reflexes andparaesthesia in both feet. Computed tomography showed aortic dissection,with partial thrombosis of the false lumen, starting after the emergence of theleft subclavian artery and extending, toward the bifurcation of the aorta, to theleft iliac artery. After cerebrospinal fluid drainage, the evolution was favorable.

  3. Immediate bail-out TAP-stenting for the treatment of iatrogenic aortocoronary dissection involving left main bifurcation

    Institute of Scientific and Technical Information of China (English)

    Edmundo Patricio Lopes Lao; Shao-Ping Nie; Chang-Sheng Ma

    2013-01-01

    Iatrogenic aortocoronary dissection is a rare but potentially disastrous complication of percutaneous coronary intervention. The left main dissection extending into distal bifurcation involving both the left anterior descending and left circumflex is a complex and vital complication, which is classified as Eshtehardi Type II dissection. We presented a case of iatrogenic left main coronary artery dissection with upcoming closure of both major branches, which was successfully managed by immediate bail-out TAP-stenting. The 77-year-old patient was discharged without any complication, and 1-year follow-up indicated stent patency and favorable clinical result. Immediate bail-out stenting is a feasible and reasonable initial management for this lethal complication.

  4. Transposition of Great Arteries with Intramural Coronary Artery: Experience with a Modified Surgical Technique

    Directory of Open Access Journals (Sweden)

    Amit Mishra

    2016-02-01

    Full Text Available Abstract Objective: Transposition of the great arteries is a common congenital heart disease. Arterial switch is the gold standard operation for this complex heart disease. Arterial switch operation in the presence of intramural coronary artery is surgically the most demanding even for the most experienced hands. We are presenting our experience with a modified technique for intramural coronary arteries in arterial switch operation. Methods: This prospective study involves 450 patients undergoing arterial switch operation at our institute from April 2006 to December 2013 (7.6 years. Eighteen patients underwent arterial switch operation with intramural coronary artery. The coronary patterns and technique used are detailed in the text. Results: The overall mortality found in the subgroup of 18 patients having intramural coronary artery was 16% (n=3. Our first patient had an accidental injury to the left coronary artery and died in the operating room. A seven-day old newborn died from intractable ventricular arrhythmia fifteen hours after surgery. Another patient who had multiple ventricular septal defects with type B arch interruption died from residual apical ventricular septal defect and sepsis on the eleventh postoperative day. The remainder of the patients are doing well, showing a median follow-up duration of 1235.34±815.26 days (range 369 - 2730. Conclusion: Transposition of the great arteries with intramural coronary artery is demanding in a subset of patients undergoing arterial switch operation. We believe our technique of coronary button dissection in the presence of intramural coronary arteries using coronary shunt is simple and can be a good addition to the surgeons' armamentarium.

  5. Transposition of Great Arteries with Intramural Coronary Artery: Experience with a Modified Surgical Technique

    Science.gov (United States)

    Mishra, Amit; Jain, Anil; Hinduja, Manish; Wadhawa, Vivek; Patel, Ramesh; Vaidhya, Nikunj; Rodricks, Dayesh; Patel, Hardik

    2016-01-01

    Objective: Transposition of the great arteries is a common congenital heart disease. Arterial switch is the gold standard operation for this complex heart disease. Arterial switch operation in the presence of intramural coronary artery is surgically the most demanding even for the most experienced hands. We are presenting our experience with a modified technique for intramural coronary arteries in arterial switch operation. Methods: This prospective study involves 450 patients undergoing arterial switch operation at our institute from April 2006 to December 2013 (7.6 years). Eighteen patients underwent arterial switch operation with intramural coronary artery. The coronary patterns and technique used are detailed in the text. Results: The overall mortality found in the subgroup of 18 patients having intramural coronary artery was 16% (n=3). Our first patient had an accidental injury to the left coronary artery and died in the operating room. A seven-day old newborn died from intractable ventricular arrhythmia fifteen hours after surgery. Another patient who had multiple ventricular septal defects with type B arch interruption died from residual apical ventricular septal defect and sepsis on the eleventh postoperative day. The remainder of the patients are doing well, showing a median follow-up duration of 1235.34±815.26 days (range 369 - 2730). Conclusion: Transposition of the great arteries with intramural coronary artery is demanding in a subset of patients undergoing arterial switch operation. We believe our technique of coronary button dissection in the presence of intramural coronary arteries using coronary shunt is simple and can be a good addition to the surgeons' armamentarium. PMID:27074270

  6. Percutaneous coronary intervention following repair of type B aortic dissection: a report of 8 cases

    Institute of Scientific and Technical Information of China (English)

    Quanmin Jing; Xiaozeng Wang; Yaling Han; Bo Luan; Geng Wang; Xiaojiang Liu; Hongxu Jin

    2008-01-01

    Objective Patients with aortic dissection have a significant incidence of coronary artery disease.The purpose of this study is to evaluate the safety and feasibility of percutaneous coronary stent in patients who have undergone endovascular stent,and to assess the effect of anti-coagulant and anti-platelet treatment on patients' thrombosis process.Methods From January 2005 to July 2007,8 patients who had undergone endovascular stent-graft during the past 1 to 7 months for type B aortic dissection repair,underwent percutaneous coronary intervention (PCI) because of coexisting coronary artery disease.Anti-coagulant and anti-platelet treatments were administrated after PCI according to the standard protocol.Patients were followed up for a mean period of 23 months.Clinical and false lumen status data were collected during the follow-up.Results PCI were technically successful in all 8 patients and no severe complications such as death,paraplegia,renal failure occurred during hospitalization.Complete false lumen thrombosis was observed in 5 patients and incomplete false lumen thrombosis in the remained 3 patients at the end of follow up.There were no major complications such as death,dissection rupture or aneurysm development occurred during the follow-up period.Conclusion Our data implied that PCI can be safely performed in patients with type B aortic dissection who have undergone endovascular stent-graft,without interrupting the thrombosis process.

  7. Operated DeBakey type III dissecting aortic aneurysm: review of 12 cases

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Hi Eun; Lee, Ghi Jai; Oh, Sang Joon; Yoon, Sei Ra; Shim, Jae Chan; Kim, Ho Kyun; Han, Chang Yul [Inje University, Seoul Paik Hospital, Seoul (Korea, Republic of)

    1995-06-15

    We evaluated the indications of operation and radiologic findings in 12 operated DeBakey type III aortic dissections. We retrospectively reviewed radiologic findings of 12 operated DeBakey type III aortic dissections, using CT, MRI, or aortography, and correlations were made with clinical course of the patients. Three cases were uncomplicated dissections. There were aneurysm rupture in 4 cases, impending rupture in 4 cases, occlusion of common iliac artery in 2 cases, occlusion of renal artery in 1 case, and compression of bronchus and esophagus by dilated aorta in 1 case. Associated clinical sign and symptoms were chest and back pain in 12 cases, claudication in 3 cases, dyspnea and dysphagia in 1 case, hoarseness in 1 case, and hemoptysis in 1 case. Post-operative complications were death from aneurysm rupture in 1 case, paraplegia in 2 cases, acute renal failure in 3 cases, and hemopericardium in 1 case. Although medical therapy is preferred in management of DeBakey type III aortic dissection, surgical treatment should be considered in patients with radiological findings of aortic rupture, impending rupture, occlusion of aortic major branches.

  8. Spontaneous internal carotid dissection in a 38-year-old woman: a case report

    Directory of Open Access Journals (Sweden)

    Kareem Abed

    2015-10-01

    Full Text Available This case report describes a patient found to have amaurosis fugax as a result of non-traumatic internal carotid dissection. Monocular blindness can be due to multiple causes including keratitis, acute glaucoma, vitreous hemorrhage, uveitis, retinal vascular occlusion, retinal detachment, optic neuropathy, trauma, or vascular malformations. In the setting of headache, neck pain, and an otherwise normal ophthalmic examination, this case report highlights the importance of recognizing transient ischemic attack and carotid artery dissection in the differential diagnosis. To further clarify the diagnosis, carotid ultrasound may aid diagnosis as was seen in this case, where decreased internal carotid artery velocities were found and subsequent CT angiography of the neck confirmed a diagnosis of carotid dissection. If a dissection is present, progression of symptoms may indicate impending cerebral infarction and warrant immediate attention. Antiplatelet therapy is the first-line treatment with anticoagulation, thrombolysis, and surgery reserved for cases of recurrent, progressive symptomatic episodes. Surgical options include endovascular repair such as angioplasty, stent placement, embolization, surgical revascularization, and bypass.

  9. 颈椎椎前筋膜的解剖特点及其与周围结构的关系%Anatomic features office prevertebral fascia and its significance in the anterior cervical approach

    Institute of Scientific and Technical Information of China (English)

    单建林; 姜恒; 李放

    2011-01-01

    目的 观察颈椎椎前筋膜的解剖特点及其与周围结构的关系,优化颈前手术入路.方法 成人厂J体标本22具.在环状软骨下缘水平横形切断气管、食管.观察椎前筋膜在椎体前方的移行,观察右侧喉返神经、甲状腺F动脉穿出椎前筋膜处与颈椎椎体水平的对应关系和与颈动脉鞘的位置关系.在同水平横行切开椎前筋膜、颈动脉鞘及其内容.横断面观察椎前筋膜的层次、质地、各层次向两侧的移行及与颈动脉鞘的关系,观察颈动脉鞘的形态及体验游离椎前筋膜的难易.结果 颈椎椎前筋膜分为深、浅两层,浅层致密,深层薄弱,二层容易相互分离,颈动脉鞘内侧直接与椎前筋膜浅层相移行.右侧喉返神经均在胸1椎体水平自颈动脉鞘内缘穿出椎前筋膜,甲状腺F动脉约在颈6椎体水平自颈动脉鞘内缘穿出椎前筋膜.结论 颈椎椎前筋膜的解剖特点及其与周围结构的关系可被利用使颈前手术入路更合理和安全.%Objective To make the anterior cervical approach more reasonable and safer by means of investigating the anatomic features of the prevertebral fascia and its anatomic relationships to surrounding organs. Methods Twenty-two embalmed cadavers were dissected. At the level of cricoid cartilage the trachea and esophagus were divided and pulled aside to observe the lateral transition and continuation of the prevertebral fascia and observe the location and corresponding level to the cervical vertebra where the inferior thyroid artery and the fight recurrent laryngeal nerve exit from the prevertebral fascia and its location relationship to the carotid sheath. At the same level the carotid sheath and its content and the prevertebral fascia were cut transversely to observe the layers and texture of the prevertebral fascia and transition of each layer, the morphology of the carotid sheath and its relationship to each layer of the prevertebral fascia were observed

  10. Clinical features in patients with simultaneous cerebral arterial and venous lesions (with literature survey

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    Lee Peng Chew

    2014-01-01

    Full Text Available Nowadays, only few cases of simultaneous cerebral arterial and venous thrombosis were reported. However, there might be high probability of coexisted cerebral arterial and venous changes. It is worthy to study the reasons and frequency of these coexisted vascular changes contributing to the development of clinical pictures. We analyzed 12 cases of simultaneous cerebral and/or neck vascular changes based on vascular images and ultrasonography which were divided into 4 groups: coexistence of simultaneous arterial and venous thrombosis; venous thrombosis with arterial hypoplasia; arterial thrombosis, arteritis or dissections with venous sinus hypoplasia; coexistence of arterial and venous hypoplasia.

  11. 自发性脑动脉夹层致脑梗死临床及影像分析%A analysis for clinical and imaging feature of spontaneous cerebral infarction caused by cerebrovascular dissections

    Institute of Scientific and Technical Information of China (English)

    胡珏; 赵志鸿; 陈海

    2012-01-01

    Objective To explore the clinical and imaging feature of cerebral infarction caused by spontaneous cerebrovascular dissections. Methods The clinical, cerebrovascular ultrasonography and imaging date from seven patients with cerebral infarction caused by spontaneous cerebrovascular dissections confirmed by digital subtraction angiography were analyzed retrospectively. Results There were three male and four female cases aged from 33 to 52 years with average of 42.9 ±6.6. Six patients had pain in homolateral head and neck as first symptom . Two patients had TIA before cerebral infarction. Four patients with anterior-circulation infarction showed hemiparalysis , among which one showed paroxysmal blurred vision of right eye. Three patients with posterior - circulation infarction. Two complained with dizziness, and speech unclealy while one showed Wallenberg syndrome. Computed tomography angiogram were finished in two cases and the severe stenosis accompanied localized extension of the right ICA or the left VA were shown respectively. One case had a cervical vertebrae MRI scanning and the right vertebral artery appeared as a linear filling defect with a double lumen. Internal cervical artery dissections occurred in cervical segment (three case) and petrous segment (one case). The sites of vertebral artery (VA) dissections were V2 segment in two cases and V4 segment in one case. DSA showed severe stenosis (string sign) with localized extension, a flame-shaped occlusion, a dissecting aneurysm, a segmental stenosis proximal to a dissecting aneurysm (string-and-pearl sign) . Anticoagulant therapy was given in 5 patients and antiplatelet treatment was given in 2. NIHSS was from 0 score to 9 scores ( average score 2.9 ± 3.3 ) on the admission and from 0 score to 6 scores (average score 1.1 ±2.3) on discharge. After follow up of 3 ~ 12 months, Modified Rankin Scale scores were 0 in five cases and 1 in one case and 2 in one case. Conclusion Cerebral infarction caused by

  12. Successful staged operation for acute type A aortic dissection with paraplegia.

    Science.gov (United States)

    Ando, Takashi; Abe, Hiroyuki; Nagata, Tokuichiro; Makuuchi, Haruo

    2013-06-01

    A 75-year-old man presented with both paraplegia and acute occlusion of the abdominal aorta at onset. Extraanatomical bypass was performed following spinal drainage. After 3 days, the ascending aorta replaced under cardiopulmonary bypass using the extraanatomical bypass graft for arterial cannulation. The abdominal aorta was replaced after 6 months. A staged operation is one of the options for acute aortic dissection with paraplegia and acute occlusion of the abdominal aorta.

  13. Quick Dissection of the Segmental Bronchi

    Science.gov (United States)

    Nakajima, Yuji

    2010-01-01

    Knowledge of the three-dimensional anatomy of the bronchopulmonary segments is essential for respiratory medicine. This report describes a quick guide for dissecting the segmental bronchi in formaldehyde-fixed human material. All segmental bronchi are easy to dissect, and thus, this exercise will help medical students to better understand the…

  14. Keeping Dissection Alive for Medical Students

    Science.gov (United States)

    Chambers, James; Emlyn-Jones, Daniel

    2009-01-01

    Traditional dissection teaching is being reduced in a number of medical schools, particularly in the United Kingdom. In response to this, 12 medical students from Warwick University, UK, traveled to the Island of Grenada for an intensive extracurricular dissection course at St. George's University. This course not only benefited the host…

  15. Vertebral Arter Dissection%椎动脉夹层分离

    Institute of Scientific and Technical Information of China (English)

    李志立; 杨树东; 哈志远

    2008-01-01

    The vertebral artery dissection may be associated with the structural abnormalities of vascular wall or enviromental factors.The symptoms are usually caused by the luminal stenosis or the formation of blood clot,including the pain in posterior neck or mastoid region with local neurological deficits.The diagnostic methods for vertebral artery dissection include digital subtraction angiogaphy,magnetic resonance imaging,CT angiograpby and color Doppler ultrasonography.Anticoagulation is the main treatment option for most patients with vertebral artery dissection.%椎动脉夹层分离可能与血管壁结构异常或环境因素有关.症状通常由夹层分离造成管腔狭窄或血凝块形成所致,包括颈后或乳突区疼痛伴随局部神经功能障碍.椎动脉夹层分离的诊断方法包括数字减影血管造影、MRI、CT血管造影以及彩色多普勒超声等.治疗以抗凝为主.

  16. Anatomical variation of the origin of the left vertebral artery

    OpenAIRE

    Patasi B; Yeung A; Goodwin S; Jalali A

    2009-01-01

    This paper presents and describes the anatomical variation of the left vertebral artery originating from the arch of aorta as a case report. This variation was found in one of the cadavers at the Division of Clinical and Functional Anatomy, Faculty of Medicine, University of Ottawa. During routine dissection of a male cadaver, in the superior mediastinum and the neck we observed an atypical origin of the left vertebral artery. Atypical origin was compared to the typical origin of the left ver...

  17. Anatomical Variation of Equine Internal Maxillary Artery: a Case Study

    Directory of Open Access Journals (Sweden)

    Ernesto Andrés Dalmau Barros

    2012-12-01

    Full Text Available A thematic block is taught in the Veterinary Medicine Program at La Salle University’s Faculty of Agricultural Sciences that is relevant to the basic disciplinary training of future veterinarians. It is the theoretical and practical subject of the anatomy of the head of domestic species, which includes the head of horses. The study is addressed by testing the theory in the exercise of a dissection, and the exploration of the different structures that make up the head. This regional and systematic study includes angiology of the head, where emphasis is made on the branches of the common carotid artery as main vessel that irrigates the head. The common carotid artery ends in the occipital, internal carotid and external carotid arteries; the last one splits into two main terminal branches, namely: the internal maxillary artery and the superficial temporal. Generally, the internal maxillary artery follows a path that is repeated in almost all specimens that are dissected as described by different authors; however, in some cases there may variations in the path of the artery, such as in its branches. The purpose of this work is to inform about a case that arose in a regular class in the anatomy lab during dissection of a horse head where arteries were being studied macroscopically. Dissection showed a variation in the normal path of the internal maxillary artery at the level of lateral pterygoid muscle. The case involves an 11-year old mare that was put down by unqualified personnel outside the campus, and whose head was later severed and sent to the gross anatomy labs of the Veterinary Medicine program at the Faculty of Agricultural Sciences. Given its provenance, it was not possible to know the anamnesis, nor the history of the animal.

  18. Time-resolved CT angiography in aortic dissection

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    Meinel, Felix G., E-mail: felix.meinel@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Nikolaou, Konstantin, E-mail: konstantin.nikolaou@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Weidenhagen, Rolf, E-mail: rolf.weidenhagen@med.uni-muenchen.de [Department of Surgery, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Hellbach, Katharina, E-mail: katharina.hellbach@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Helck, Andreas, E-mail: andreas.helck@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Bamberg, Fabian, E-mail: fabian.bamberg@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Reiser, Maximilian F., E-mail: maximilian.reiser@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Sommer, Wieland H., E-mail: wieland.sommer@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany)

    2012-11-15

    Objectives: We performed this study to assess feasibility and additional diagnostic value of time-resolved CT angiography of the entire aorta in patients with aortic dissection. Materials and methods: 14 consecutive patients with known or suspected aortic dissection (aged 60 {+-} 9 years) referred for aortic CT angiography were scanned on a dual-source CT scanner (Somatom Definition Flash; Siemens, Forchheim, Germany) using a shuttle mode for multiphasic image acquisition (range 48 cm, time resolution 6 s, 6 phases, 100 kV, 110 mAs/rot). Effective radiation doses were calculated from recorded dose length products. For all phases, CT densities were measured in the aortic lumen and renal parenchyma. From the multiphasic data, 3 phases corresponding to a triphasic standard CT protocol, served as a reference and were compared against findings from the time-resolved datasets. Results: Mean effective radiation dose was 27.7 {+-} 3.5 mSv. CT density of the true lumen peaked at 355 {+-} 53 HU. Compared to the simulated triphasic protocol, time-resolved CT angiography added diagnostic information regarding a number of important findings: the enhancement delay between true and false lumen (n = 14); the degree of membrane oscillation (n = 14); the perfusion delay in arteries originating from the false lumen (n = 9). Other additional information included true lumen collapse (n = 4), quantitative assessment of renal perfusion asymmetry (n = 2), and dynamic occlusion of aortic branches (n = 2). In 3/14 patients (21%), these additional findings of the multiphasic protocol altered patient management. Conclusions: Multiphasic, time-resolved CT angiography covering the entire aorta is feasible at a reasonable effective radiation dose and adds significant diagnostic information with therapeutic consequences in patients with aortic dissection.

  19. Does thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI caused by the spontaneous coronary dissection?

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    Jović Zoran

    2015-01-01

    Full Text Available Introduction. Spontaneous coronary artery dissection (SCAD is a very rare disease with poor prognosis. It mainly affects young women free of risk factors for coronary artery disease (CAD and women during the peripartum period. The prognosis for myocardial infarction caused by SCAD is poor, management is often difficult and guidelines still missing. Case report. We presented a woman with acute myocardial infarction of anterior wall of the left ventricle, caused by spontaneous dissection of medial segment of the left anterior descending coronary artery. We treated the patient with thrombolytic therapy and performed coronary angiography after that. Finally we decided to do nothing more. Two years later we performed coronary angiography again and founded the coronary artery normal. We also analyzed 19 cases publiched from 1996 to 2012 when coronary artery dissection had been treated with thrombolytic agent. Analysis revealed only one case of 19, with complication after treating SCAD with thrombolysis. Conclusion. Sometimes, regarding myocardial infarction in young women with no risk factors for CAD, especially in young women in peripartum, we should think about SCAD. The presented case, like eight others, demonstrates that good clinical outcomes can be achieved with thrombolysis. In spite of all this, we still need more data to verify that thrombolysis does not have to harm the therapy for SCAD. For the time being thrombolytic therapy could be an option.

  20. Variations in Transverse Foramina of Cervical Vertebrae: Morphology & Clinical Importance

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    Vaishakhi Gonsai

    2015-12-01

    Full Text Available Background: The purpose of this study is to investigate variations in transverse foramina in the cervical vertebrae and its morphological and clinical importance. Materials and Method : The variations in the number and size of transverse foramina was studied in total 200 human dried cervical vertebrae, which were taken from the Department of Anatomy, B.J.Medical College, Ahmedabad. All the vertebrae were observed for variation in number and size of transverse foramina. Results: Out of 200 cervical vertebrae, complete double transverse foramina were observed in 40 vertebrae (20%, among them unilateral double foramina were found in 31 vertebrae (15.5% and the bilateral double foramina were found in 9 vertebrae (4.5%. Incomplete double transverse foramina were observed in 22 vertebrae (11%, among them unilateral double foramina were found in 16 vertebrae (8% and bilateral double foramina were observed in 6 vertebrae (3%. Conclusion: Complete unilateral double transverse foramina of cervical vertebrae were more common than bilateral. Also unilateral small size transverse foramina of cervical vertebrae were also common. This variation is important for the neurosurgeon during cervical surgery. Under such condition the course of the vertebral artery may be distorted. It is also useful for Radiologist during CT and MRI scan.

  1. Extended lymph node dissection in robotic radical prostatectomy: Current status

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    Sameer Chopra

    2016-01-01

    Full Text Available Introduction: The role and extent of extended pelvic lymph node dissection (ePLND during radical prostatectomy (RP for prostate cancer patients remains unclear. Materials and Methods: A PubMed literature search was performed for studies reporting on treatment regimens and outcomes in patients with prostate cancer treated by RP and extended lymph node dissection between 1999 and 2013. Results: Studies have shown that RP can improve progression-free and overall survival in patients with lymph node-positive prostate cancer. While this finding requires further validation, it does allow urologists to question the former treatment paradigm of aborting surgery when lymph node invasion from prostate cancer occurred, especially in patients with limited lymph node tumor infiltration. Studies show that intermediate- and high-risk patients should undergo ePLND up to the common iliac arteries in order to improve nodal staging. Conclusions: Evidence from the literature suggests that RP with ePLND improves survival in lymph node-positive prostate cancer. While studies have shown promising results, further improvements and understanding of the surgical technique and post-operative treatment are required to improve treatment for prostate cancer patients with lymph node involvement.

  2. Anatomia do sulco da artéria vertebral Vertebral artery groove anatomy

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    Max Franco de Carvalho

    2009-01-01

    Full Text Available INTRODUÇÃO: Diversas técnicas cirúrgicas têm sido realizadas na região craniocervical devido a diversas patologias. Durante o acesso cirúrgico a essa região existe um risco potencial de lesão iatrogênica da artéria vertebral, relacionado ao acesso lateral amplo e à avaliação inadequada da anatomia local. Variações no trajeto da artéria vertebral ocasionam maior risco de lesão vascular. O estudo pré-operatório por imagem da anatomia da artéria vertebral e do seu sulco tem sido realizado para aumentar a segurança cirúrgica. OBJETIVO: Estudar a morfometria da artéria vertebral no atlas através da tomografia computadorizada do sulco da artéria vertebral (SAV em 30 atlas isolados de cadáveres. MATERIAIS E MÉTODOS: O SAV e suas relações com a linha média foram avaliados através de oito medidas lineares e duas angulares, bilateralmente. A média, valor máximo e mínimo, e desvio padrão foram calculados para cada parâmetro. RESULTADOS: O SAV apresentou uma maior largura e maior espessura do lado esquerdo (pINTRODUCTION: Several surgical techniques have been carried through in the skull-cervical region due to various pathologies. During the surgical access to this region, a potential risk of iatrogenic injury of the vertebral artery exists, related to extended lateral access and the inadequate evaluation of the local anatomy. Variations in the groove of the vertebral artery lead to a greater risk of vascular injury during surgery. Preoperative image study of the vertebral artery anatomy and its groove has been realized to enhance surgical safety. OBJECTIVE: to study the morphometry of atlas vertebral artery on computed tomography scan images of the vertebral artery groove (VAG in 30 dry atlas. METHODS: VAG and its relationship with the midline were evaluated through eight linear and two angular measures, bilaterally. The average, maximum and minimum values, and standard deviation were calculated for each parameter

  3. Cervical spine CT scan

    Science.gov (United States)

    ... defects of the cervical spine Bone problems Fracture Osteoarthritis Disc herniation Risks Risks of CT scans include: ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  4. Cervical Radiculopathy (Pinched Nerve)

    Science.gov (United States)

    ... help relieve pain, strengthen neck muscles, and improve range of motion. In some cases, traction can be used to ... Learn more about surgery for radiculopathy online at Cervical ... a wide range of musculoskeletal conditions and injuries. All articles are ...

  5. Immunotherapy for Cervical Cancer

    Science.gov (United States)

    In an early phase NCI clinical trial, two patients with metastatic cervical cancer had a complete disappearance of their tumors after receiving treatment with a form of immunotherapy called adoptive cell transfer.

  6. Familial Thoracic Aortic Aneurysm with Dissection Presenting as Flash Pulmonary Edema in a 26-Year-Old Man

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    Sabry Omar

    2014-01-01

    Full Text Available We are reporting a case of familial thoracic aortic aneurysm and dissection in a 26-year-old man with no significant past medical history and a family history of dissecting aortic aneurysm in his mother at the age of 40. The patient presented with cough, shortness of breath, and chest pain. Chest X-ray showed bilateral pulmonary infiltrates. CT scan of the chest showed a dissection of the ascending aorta. The patient underwent aortic dissection repair and three months later he returned to our hospital with new complaints of back pain. CT angiography showed a new aortic dissection extending from the left carotid artery through the bifurcation and into the iliac arteries. The patient underwent replacement of the aortic root, ascending aorta, total aortic arch, and aortic valve. The patient recovered well postoperatively. Genetic studies of the patient and his children revealed no mutations in ACTA2, TGFBR1, TGFBR2, TGFB2, MYH11, MYLK, SMAD3, or FBN1. This case report focuses on a patient with familial TAAD and discusses the associated genetic loci and available screening methods. It is important to recognize potential cases of familial TAAD and understand the available screening methods since early diagnosis allows appropriate management of risk factors and treatment when necessary.

  7. Dolor cervical incoercible

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    Adrián F Narváez-Muñoz

    2014-03-01

    Astrocytomas are relatively common glial neoplasm of the central nervous system, but only a small percentage of them are located in the spinal cord, with a predilection for the cervical and dorsal regions. In most cases, extend longitudinally, affecting several cord segments. Pain is a frequent symptom of local character bone segments involving the tumor, associated with sensory deficit and / or motor. The following is the case of a 60 year old woman with cervical cord astrocytoma extended to the brainstem.

  8. Blood supply to the thoracolumbar spinal cord in the laboratory mouse using corrosion and dissection techniques.

    Science.gov (United States)

    Flesarova, Slavka; Mazensky, David; Teleky, Jana; Almasiova, Viera; Holovska, Katarina; Supuka, Peter

    2016-01-01

    Mice are used frequently as experimental models in the study of ischemic spinal cord injury. The aim of the present study was to describe the arterial blood supply to the thoracolumbar spinal cord in the mouse. The study was carried out on 20 adult mice using the corrosion and dissection technique. Dorsal intercostal arteries were found as branches of the thoracic aorta: as 7 pairs in 80% of cases, as 8 pairs in 15% of cases and as 9 pairs in 5% of cases. The paired lumbar arteries arising from the abdominal aorta were present as 5 pairs in all cases. Along the entire thoracic and lumbar spinal regions, we observed left-sided branches entering the ventral spinal artery in 64.2% and right-sided branches in 35.8% of cases. Along the entire thoracic and lumbar spinal regions, the branches entering the dorsal spinal arteries were left-sided in 60.8% of cases and right-sided in 39.2% of cases. We found some variations in the site of origin of the artery of Adamkiewicz and in the number of dorsal spinal arteries. Documenting the anatomical variations in spinal cord blood supply in the laboratory mouse will aid the planning of future experimental studies and in determining the clinical relevance of such studies.

  9. LECTURE ON ACUPUNCTURE PartⅠ Clinical Acupuncture Lecture Thirty-fiveCervical Spondylopathy

    Institute of Scientific and Technical Information of China (English)

    罗汀; 王卫; 徐力

    2004-01-01

    @@ Cervical spondylopathy, also known as cervical syndrome, is a commonly encountered disease in the middle-aged and elderly people. This disease mostly results from the retrograde affection of the cervical intervertebral disc and hyperosteogeny of the cervical vertebrae. This hyperplastic substance may stimulate and give rise to oppression to the surrounding spinal cord, nerve roots, blood vessels and sympathetic nerves, resulting in a series of symptoms as numbness, pain, etc. in the neck, shoulder and the upper limbs. The cervical vertebra of the human spine is smallest in the size, weakest in the strength, higher in the motor range and frequency, and bigger in the bearing of per unit area. Along with the increasing of people's age and the accumulated aftereffect of chronic and acute injury, the pulpiform nucleus of the cervical intervertebral disc presents retrograde affection, dehydration, bulge and rupture of the fibrous ring, narrowing of the intervertebral space, and reduction in the stability of cervical vertebrae due to injury and slackening of intervertebral ligaments to stretch and to induce compression upon periosteum. All these changes may lead to break of blood vessels to cause bleeding and hematoma. With the organization of hematoma and calcium salt deposit, osteophyte is formed at last. When the protruded intervertebral disc and hyperplastic osteophyte stimulate and oppress the surrounding spinal nerve root, vertebral artery or spinal cord, the resultant injury, aseptic inflammation, reactions after renovation, etc. will generate a series of clinical symptoms of cervical spondylopathy. In Western medicine, there are five types of cervical spondylopathy including stiff-neck type, nerve root type, spinal cord type, vertebral artery type and sympathetic nerve type. The stiff-neck type, nerve root type and vertebral artery type will be introduced in this article.

  10. [Microvascular anastomoses in cervical esophageal reconstruction].

    Science.gov (United States)

    Takushima, A; Harii, K; Asato, H

    2001-09-01

    Ischemia or hemostasis in the gastric, jejunal, and colonic pedicle after esophagectomy is believed to contribute significantly to postoperative complications. With the advent of microvascular anastomoses, many surgeons have adopted vascular augmentation (supercharge) as a means of avoiding these difficulties. Microsurgical free tissue transfer represented by the free jejunum and forearm flap also plays an important role in esophageal reconstruction. In this paper, the authors introduce the technical points important for successful revascularization including the choice of recipient vessels, setting up of the reconstructive materials, and postoperative monitoring. In cases of gastric pull-up elevated via posterior mediastinum, the left gastroduodenal vessels are anastomosed to the cervical transverse or superior thyroidal vessels. In cases of duodenal or colonic pull-up elevated via the anterosternal route, the vascular pedicles are anastomosed to the internal mammary vessels which are dissected by resecting the costal cartilage. When the free jejunum flap is used, the cervical transverse or superior thyroidal vessels are most frequently used as recipients. Postoperative monitoring of free flaps is performed using Doppler ultrasound or through a small skin incision made above the transferred tissue. Although gastric or colonic pull-up is difficult to monitor, color Doppler sonography permits quantitative analysis of blood flow and may be a useful option.

  11. Superior thyroid artery origin in Caucasian Greeks: A new classification proposal and review of the literature.

    Science.gov (United States)

    Natsis, Konstantinos; Raikos, Athanasios; Foundos, Ioannis; Noussios, George; Lazaridis, Nikolaos; Njau, Samouel N

    2011-09-01

    Studies on the origin of the superior thyroid artery, define that it could originate either from the external carotid artery, (at the level of common carotid bifurcation), or from the common carotid artery. However, there is a classical anatomic knowledge that the superior thyroid artery is a branch of the external carotid artery. Variability in the anatomy of the superior thyroid artery was studied on 100 carotids. Moreover, a review about the origin of superior thyroid artery between recent and previous cadaveric, autopsy, and angiographic studies, on adults and fetuses, was carried out. The superior thyroid artery originated from the external carotid artery in 39% and at the level of carotid bifurcation and common carotid artery in 61% of cases. The anterior branches of the external carotid artery were separate in 76% of cases, while common trunks between the arteries were found in 24% of the specimens. A new classification proposal on the origin of the superior thyroid artery is also suggested. In this study, the origin of superior thyroid artery is considered at the level of the carotid bifurcation and not from the external carotid artery as stated in many classical anatomy textbooks. This has a great impact on the terminology when referring to the anterior branches of the external carotid artery, which could be termed as anterior branches of the cervical carotid artery. Head and neck surgeons must be familiar with anatomical variations of the superior thyroid artery in order to achieve a better surgical outcome.

  12. Left testicular artery arching over the ipsilateral renal vein

    Institute of Scientific and Technical Information of China (English)

    Munekazu Naito; Hayato Terayama; Yoichi Nakamura; Shogo Hayashi; Takayoshi Miyaki; Masahiro Itoh

    2006-01-01

    Aim: To report two cases of the left testicular artery arching over the left renal vein (LRV) before running downward to the testis. Methods: The subjects were obtained from two Japanese cadavers. During the student course of gross-anatomical dissection, the anatomical relationship between the testicular vessels and the renal vein was specifically observed. Results: The arching left testicular artery arose from the aorta below the LRV and made a loop around the LRV, which appeared to be mildly compressed between the arching artery and the psoas major muscle.Conclusion: Clinically, compression of the LRV between the abdominal aorta and the superior mesenteric artery occasionally induces LRV hypertension, resulting in varicocele, orthostatic protenuria and hematuria. Considering that the incidence of a left arching testicular artery is higher than that of a right one, an arching left artery could be an additional cause of LRV hypertension.

  13. Laparoscopic anatomy and dissection of the pelvis.

    Science.gov (United States)

    Kadar, N

    1997-03-01

    All anatomically important pelvic structures lie embedded in the fatty-fibrous connective tissue of the retroperitoneum from which they can be freed by blunt dissection in the correct tissue planes. By relying on fixed laparoscopic landmarks, the correct surgical planes of dissection can be found, and all vital structures freed and identified by a systematic dissection consisting of a precise sequence of operative steps. Once the retroperitoneal dissection has been completed and all vital structures identified, most gynaecological operations can be carried out safely and without much difficulty laparoscopically. A non-anatomical approach to laparoscopic pelvic surgery may be easier to learn, but it is neither very versatile nor very safe except in the simplest of cases.

  14. Dissecting aortic aneurysm in maintenance hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Ounissi M

    2009-01-01

    Full Text Available The dissecting aortic aneurysm (DAA is a rare pathology that may result in fatal outcome. We report follow up of three cases of DAA patients undergoing maintenance hemo-dialysis who were managed conservatively.

  15. Animal Rights Groups Target High School Dissection.

    Science.gov (United States)

    Trotter, Andrew

    1992-01-01

    Two groups leading the charge against dissection are People for the Ethical Treatment of Animals (PETA) and the Student Action Corps for Animals (SACA). Protests by student and community members remain the movement's strongest weapon. (MLF)

  16. Type B Aortic Dissection: Management Updates

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    Naghmeh Moshtaghi

    2009-12-01

    Full Text Available Acute aortic dissection (AAD is the most frequent catastrophic event of the aorta; it occurs nearly three times as frequently as the rupture of abdominal aortic aneurysm. Sixty percent of dissection cases are classified as proximal or type A and 40% as distal or type B, according to the Stanford Classification. The most frequent causes of death in acute type B dissection are aortic rupture and malperfusion syndrome.We herein review recent data suggesting different management modalities of type B aortic dissection, including medical, surgical, and endovascular treatments. Although medical therapy is still the standard approach in uncomplicated cases, there are subgroups of patients who may benefit from endovascular management. Endovascular techniques or surgery are valuable options for complicated cases. Hybrid suites, multidisciplinary approaches, and good imaging techniques can be considered as the key to success in this regard.

  17. Extended lymph node dissection for prostate cancer.

    Science.gov (United States)

    Jeschke, Stephan; Burkhard, Fiona C; Thurairaja, Ramesh; Dhar, Nivedita; Studer, Urs E

    2008-05-01

    Lymph node status is an important determinant for the management of patients with newly diagnosed prostate cancer. Given the significant limitations of cross-sectional and functional preoperative imaging in the detection of small metastases, pelvic lymph node dissection remains the only reliable staging method in clinically localized prostate cancer. Although lymph node dissection is a well-established form of staging in prostate cancer, controversy remains about indications and the surgical extent of the procedure. Reported practices vary from omitting pelvic lymph node dissection in low-risk disease to routine pelvic lymph node dissection in all radical prostatectomy patients. This review highlights the recent literature concerning pelvic lymphadenectomy in prostate cancer with respect to anatomical extent and oncologic outcome.

  18. [Gross anatomy dissection and the legal control].

    Science.gov (United States)

    Yamashina, Shohei; Shibata, Yosaburo

    2010-12-01

    In Japan, dissection of human body is generally prohibited by the Penal Code, i.e. the criminal law. However, the Postmortem Examination and Corpse Preservation Act allows for the dissection of the body in very limited situations, that include gross anatomy dissection and pathological and forensic autopsy in medical and dental schools. Growing numbers of co-medical schools have been founded more recently in Japan, and not a small number of co-medical schools try to adopt human body dissection in the course of anatomy education. The present short communication reminds us of the ways of thinking of the Postmortem Examination and Corpse Preservation Act and the Act on Body Donation for Medical and Dental Education in order that anatomy education in medical as well as co-medical schools takes place under the regulation by these two laws.

  19. Posterior cervical foraminotomy: anatomic study in cadavers

    Directory of Open Access Journals (Sweden)

    Luizio Augusto Arantes Júnior

    2014-03-01

    Full Text Available OBJECTIVE: This study was designed to use different segments of the cervical spine in cadavers to determine how much lateral mass should be resected for adequate foraminal decompression. METHODS: Six cadavers were used. The region of the cervical spine from C1 to the C7-T1 transition was dissected and exposed. The lateral mass of each vertebra was measured bilaterally before the foraminotomy in the following segments: C2-C3, C3-C4, C4-C5, C5-C6 and C6-C7. The procedure was performed with a high-speed drill and through surgical microscopy. Three foraminotomies were performed (F1, F2, F3 in each level. Lateral masses were measured after foraminotomy procedures and compared to the initial measurement, creating a percentage of lateral mass needed for decompression.. The value of the entire surface was defined as 100%. RESULTS: There was a statistical difference between the amounts of the resected lateral mass through each foraminotomy (F1, F2, F3 at the same level. However, there was no statistical significant difference among the different levels. The average percentage of resection of the lateral masses in F2 were 27.7% at C2-C3, 24.8% at C3-C4, 24.4% at C4-C5 and 23.8% and 31.2% at C5-C6 and C6-C7, respectively. In F3, the level that needed greater resection of the lateral masses was C6-C7 level, where the average resection ranged between 41.2% and 47.9%. CONCLUSION: In all segments studied, the removal of approximately 24 to 32% of the facet joint allowed adequate exposure of the foraminal segment, with visualization of the dural sac and the exit of the cervical root.

  20. [Application of multiple-branch prostheses in reconstruction of the aortic arch in DeBakey Type I aortic dissection].

    Science.gov (United States)

    Cherniavskiĭ, A M; Alsov, S A; Marchenko, A V; Smolianinov, K A; Sizov, G G; Zotov, A S

    2006-01-01

    Over the period from January 2002 to March 2005, a total of 78 patients were operated on for DeBakey type I aortic dissection. Of these, five patients underwent prosthetic reconstruction of the aortic arch and brachiocephalic arteries (BCA), performed with the help of the Dacron prosthesis Gelweave four-branch plexus Vascutek. The major indication for using this prosthesis was the extending of the dissection into the BC As, with various degree of obstruction thereof. The overwhelming majority of the patients were men (80 %). The patients' average age amounted to 44.3+/-5.6 years (ranging from 36 to 57 years). In three cases, the aortic dissection was of chronic course, with acute and subacute dissection being diagnosed in the remaining two cases. The median-sternotomy access, and additional approaches to the left and right common carotid arteries were used in order to carry out prosthetic reconstruction of the ascending branch, aortic arch, right subclavian artery, right common carotid artery (CCA) and left CCA with the help of the multiple-branch prosthesis. Protection of the brain consisted of craniocerebral hypothermia, hypothermal circulatory arrest in a combination with retrograde cerebral perfusions through the vena cava superior. The duration of the circulatory arrest averagely amounted to 59.2+/-4 min, with the mean time of artificial circulation equalling 230.6+/-19.7 min, and the time of aortic occlusion was 193.1+/-11 minutes. None of the patients developed either neurological or haemorrhagic complications postoperatively. Hence, the surgical technique using multiple-branch prostheses for prosthetic reconstruction of the aortic arch in type I aortic dissection with BCA obstruction proved to be effective and safe.

  1. Aortic Dissection Cases Presenting with Neurological Deficit

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    Sibel Mumcu

    2014-06-01

    Full Text Available Aortic dissection can be fatal in case of underdiagnosis, and early treatment is essential for the survival. Although acute onset of chest or back pain is most common presenting symptoms, some patients might present with atypical findings such as acute stroke, mesenteric ischaemia, renal failure or myocardial infarction. Here, we report two cases presenting emergency room with atypical findings of aortic dissection which diagnosis is made during etiologic work up for ischemic stroke.

  2. Visceral hybrid reconstruction of thoracoabdominal aortic aneurysm after open repair of type a aortic dissection by the Bentall procedure with the elephant trunk technique: A case report

    Directory of Open Access Journals (Sweden)

    Marjanović Ivan

    2014-01-01

    Full Text Available Introduction. Reconstruction of chronic type B dissection and thoracoabdominal aortic aneurysm (TAAA remaining after the emergency reconstruction of the ascending thoracic aorta and aortic arch for acute type A dissection represents one of the major surgical challenges. Complications of chronic type B dissection are aneurysmal formation and rupture of an aortic aneurysm with a high mortality rate. We presented a case of visceral hybrid reconstruction of TAAA secondary to chronic dissection type B after the Bentall procedure with the elephant trunk technique due to acute type A aortic dissection in a high-risk patient. Case report. A 62 year-old woman was admitted to our institution for reconstruction of Crawford type I TAAA secondary to chronic dissection. The patient had had an acute type A aortic dissection 3 years before and undergone reconstruction by the Bentall procedure with the elephant trunk technique with valve replacement. On admission the patient had coronary artery disease (myocardial infarction, two times in the past 3 years, congestive heart disease with ejection fraction of 25% and chronic obstructive pulmonary disease. On computed tomography (CT of the aorta TAAA was revealed with a maximum diameter of 93 mm in the descending thoracic aorta secondary to chronic dissection. All the visceral arteries originated from the true lumen with exception of the celiac artery (CA, and the end of chronic dissection was below the origin of the superior mesenteric artery (SMA. The patient was operated on using surgical visceral reconstruction of the SMA, CA and the right renal artery (RRA as the first procedure. Postoperative course was without complications. Endovascular TAAA reconstruction was performed as the second procedure one month later, when the elephant trunk was used as the proximal landing zone for the endograft, and distal landing zone was the level of origin of the RRA. Postoperatively, the patient had no neurological deficit and

  3. Radiological detection of extracapsular spread in head and neck squamous cell carcinoma (HNSCC) cervical metastases

    Energy Technology Data Exchange (ETDEWEB)

    Url, C., E-mail: christoph.url@i-med.ac.at [Department of Otorhinolaryngology – Head and Neck Surgery, Medical University Innsbruck (Austria); Schartinger, V.H.; Riechelmann, H.; Glückert, R. [Department of Otorhinolaryngology – Head and Neck Surgery, Medical University Innsbruck (Austria); Maier, H. [Department of Pathology, Medical University Innsbruck (Austria); Trumpp, M.; Widmann, G. [Department of Radiology, Medical University Innsbruck (Austria)

    2013-10-01

    Background: Extracapsular spread of cervical lymph nodes deteriorates the prognosis of patients with head and neck squamous cell carcinoma. Postoperative radiochemotherapy is superior to postoperative radiotherapy alone in patients with histologically proven extracapsular spread. If extracapsular spread can be detected preoperatively, patients may favor primary radiochemotherapy instead of primary surgery plus postoperative radiochemotherapy. Methods: Computed tomography (CT) scans of nodal positive head and neck squamous cell carcinoma patients treated between 2008 and 2010 with comprehensive neck dissection as part of first line surgical treatment were retrospectively scanned for extracapsular spread by two blinded radiologists. If a positive lymph node was identified by the pathologist, CT scans were assessed for extracapsular spread retrospectively. CT criteria for Extracapsular spread were apparent fat and soft tissue infiltration or infiltration of sternocleidomastoid muscle, internal jugular vein or carotid artery. Radiologic judgment was compared with histological evidence of extracapsular spread and specificity and sensitivity of CT detection was calculated. Results: Forty-nine patients with histologically proven positive lymph nodes (pN+) were included. Extracapsular spread was histologically proven in 17 cases; the number of all affected lymph nodes was not listed. Radiologist 1 found extracapsular spread in CT scans of 15/49 patients and radiologist 2 in 16/49 patients (Cohen's kappa = 0.86; p < 0.01). Sensitivity of radiologic extracapsular spread detection was 73% (95% confidential index (CI): 44.0–89.7%) and specificity 91% (75.0–98.0%). Conclusion: Extracapsular spread depicted on computed tomography using strict criteria has high specificity.

  4. Percutaneous endovascular stent-graft treatment of aortic aneurysms and dissections: new techniques and initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Do Yun; Choi, Dong Hoon; Kang, Sung Gwon; Lee, Kwang Hoon; Won, Jong Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of); Kang, Sung Gwon [Chosun University College of Medicine, Gwangju (Korea, Republic of); Won, Je Whan [Aju University College of Medicine, Suwon (Korea, Republic of); Song, Ho Young [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2003-01-01

    To evaluate the feasibility, safety and effectiveness of a newly designed percutaneously implanted separate stent-graft (SSG) for the treatment of aortic aneurysms and dissections. Using a percutaneous technique, SSG placement (in the descending thoracic aorta in 26 cases and infrarenal abdominal aorta in 24) was attempted in 50 patients with aortic aneurysms (n=27) or dissection (n=23). All SSGs were individually constructed using self-expandable nitinol stents and a Dacron graft, and were introduced through a 12 F sheath and expanded to a diameter of 20-34 mm. In all cases, vascular access was through the femoral artery. The clinical status of each patient was monitored, and postoperative CT was performed within one week of the procedure and at 3-6 month intervals afterwards. Endovascular stent-graft deployment was technically successful in 49 of 50 patients (98%). The one failure was due to torsion of the unsupported graft during deployment. Successful exclusion of aneurysms and the primary entry tears of dissections was achieved in all but three patients with aortic dissection. All patients in whom technical success was achieved showed complete thrombosis of the thoracic false lumen or aneurysmal sac, and the overall technique success rate was 92%. In addition, sixteen patients demonstrated complete resolution of the dissected thoracic false lumen (n=9) or aneurysmal sac (n=7). Immediate post-operative complications occurred at the femoral puncture site in one patient with an arteriovenous fistula, and in two, a new saccular aneurysm developed at the distal margin of the stent. No patients died, and there was no instance of paraplegia, stroke, side-branch occlusion or infection during the subsequent mean follow-up period of 9.4 (range, 2 to 26) months. In patients with aortic aneurysm and dissection, treatment with a separate percutaneously inserted stent-graft is technically feasible, safe, and effective.

  5. Clinical Research of EA on Jiaji Acupoint of Neck combined with Tendon ;Regulation for Vertebral Artery Type of Cervical Spondylosis%电针颈夹脊穴配合理筋手法治疗椎动脉型颈椎病临床研究

    Institute of Scientific and Technical Information of China (English)

    王小丽; 张芙蓉; 吴松; 陈双平

    2016-01-01

    s:Objective To observe the clincal efficacy of electro acupuncture ( EA ) on Jiaji acupoint combined tendom regulation in treatment of cervical vertebral artery disease.Methods 70 cases of patients with cervical vertebral artery were randomly divided into treat-ment group and control group, 35 cases in each group.Treatment group received EA on Jiaji acupoint combined with tendon regulation, con-trol group received conventional western medicine to improve blood supply,nutrition nerve, intravenous injection was given, once per day, 7d as a course, evaluate the efficiency after 2 couses.Results The total effective rate was 91.4% in control group and 74.3% in control group, the difference was significant (P<0.05); contrast vertigo score decreased in both groups, treatment group decreased more signifi-cantly, compared with before treatment, the differences were statistically significant (P<0.05);compared with control group, the difference was significant (P<0.05).Conclusion EA on Jiaji acupoint combined with tendom regulation can significantly improve the CSA in pa-tients with dizziness and symptoms of head and neck pain, it is more effective than conventional treatment.%目的:观察电针颈夹脊穴配合理筋手法治疗椎动脉型颈椎病的临床疗效。方法将70例椎动脉型颈椎病随机分为治疗组和对照组,每组各35例。治疗组采用电针颈夹脊穴配合理筋手法治疗。对照组采用西医常规治疗,以改善供血、营养神经为主要原则,给予静脉注射治疗,每日1次。7d为1疗程,连续治疗2个疗程后评定疗效。结果治疗组总有效率为91.4%,对照组总有效率为74.3%,两组总有效率比较,经统计学处理,差异有显著性意义( P<0.05);在眩晕评分的对比中,两组治疗后评分呈下降趋势,治疗组下降更为明显,与治疗前比较,差异均有显著性意义(P<0.05);与对照去治疗后比较,经统计学处理

  6. Cervical perineural cyst masquerading as a cervical spinal tumor.

    Science.gov (United States)

    Joshi, Vijay P; Zanwar, Atul; Karande, Anuradha; Agrawal, Amit

    2014-04-01

    Tarlov (perineural) cysts of the nerve roots are common and usually incidental findings during magnetic resonance imaging of the lumbosacral spine. There are only a few case reports where cervical symptomatic perineural cysts have been described in the literature. We report such a case where a high cervical perineural cyst was masquerading as a cervical spinal tumor.

  7. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... are at increased risk for HPV infections. Other risk factors for cervical cancer include: Giving birth to many children. Smoking cigarettes. Using oral contraceptives ("the Pill"). Having a weakened immune system . Cervical Cancer Screening ...

  8. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  9. Comparison of curative effect between artery interventional embolization chemotherapy and intravenous chemotherapy preoperative in cervical cancer%宫颈癌术前动脉介入栓塞化学治疗和静脉化学治疗疗效比较

    Institute of Scientific and Technical Information of China (English)

    秦海霞; 夏永华; 杨君; 任艳芳; 华方方; 崔红凯; 潘莹

    2013-01-01

    Objective To compare the efficacy and adverse effect of two kinds of neoadjuvant chemotherapy pathway for Ⅰb2 -Ⅱb stage cervical cancer patients. Methods Retrospective analysis of the clinical data of 136 cases with Ⅰb2 - Ⅱb cervical squamous cell carcinoma. Fifty-eighty cases were given arterial interventional chemotherapy (intervention group) and 78 cases were given intravenous chemotherapy (systemic chemotherapy group). The clinical efficacy, adverse reaction of chemotherapy, operability and the interval time from chemotherapy to surgery were compared between the two groups. Results The effective rates in intervention group and systemic chemotherapy group were 84. 48% and 80. 77% respectively. There was no significant difference of effective rate between the two groups (P > 0. 05 ). The operability in the intervention group and systemic chemotherapy group were 96.55% and 93. 59% respectively. There was no significant difference of operability between the two groups (P >0. 05) . The length of stay before operation, adverse reaction of chemotherapy, and the time from chemotherapy to surgery in intervention group were less than those in systemic chemotherapy group (P < 0. 05) , but the total charge was higher than that in systemic chemotherapy group ( P < 0. 05 ). Conclusion The two kinds of neoadjuvant chemotherapy are safe and effective in treating patients with Ⅰb2 — Ⅱb stage cervical cancer. The arterial interventional chemotherapy has shorter course of treatment, less side effects, faster efficacy. As a method of preoperative adjuvant chemotherapy, it is more appropriate for cervical cancer patients with better economic conditions.%目的 比较2种新辅助化学治疗方法对Ⅰb2~Ⅱb期宫颈癌患者的疗效及化学治疗不良反应.方法 回顾性分析136例Ⅰb2~Ⅱb期宫颈鳞状细胞癌患者的临床资料,其中术前行动脉介入栓塞化学治疗(介入组)58例,静脉化学治疗(全身化学治疗组)78例,比较2组

  10. Spontant opstået halskardissektion

    DEFF Research Database (Denmark)

    Madsen, Charlotte; Bak, Søren

    2011-01-01

    Presenting two cases of spontaneous dissection of cervical arteries. A 54 year-old male suffered from left-sided Horner syndrome and severe headache. MR cerebrum revealed a left internal carotid artery dissection. A 57 year-old female with left vertebral artery dissection was admitted to hospital...

  11. INTERNAL ILIAC ARTERY LIGATION AFTER CAESERIAN HYSTERECTOMY IN POST - PARTUM HAEMORRHAGE LIFE SAVING PROCEDURE

    Directory of Open Access Journals (Sweden)

    Vijayalakshmi

    2015-07-01

    Full Text Available Internal iliac artery (Hypogastric supplies the pelvic viscera. Bilateral ligation of the internal iliac arteries is a safe, rapid and very effective method of controlling bleeding from genital tract. It is also helpful in massive broad ligament hematoma, in torn vessels retracted within th e broad ligament, and even in postoperative hemorrhage after abdominal or vaginal hysterectomy where there are no definitive bleeding points detectable. Bilateral ligation of internal iliac arteries is also helpful in life threatening hemorrhagic condition s like postpartum hemorrhage, placenta previa, cervical and vaginal tear, cervical pregnancy and uterine rupture etc.

  12. Evaluating dissection in the gross anatomy course: Correlation between quality of laboratory dissection and students outcomes.

    Science.gov (United States)

    Nwachukwu, Chika; Lachman, Nirusha; Pawlina, Wojciech

    2015-01-01

    Anatomy learned by active exploration through dissection has many proven benefits including improvement of anatomic knowledge. Decreased laboratory time may affect the quality of dissection and ultimately lower student performance in anatomy translating to lower knowledge acquisition. The aim of this study was to determine whether the quality of students' dissection in teams correlates with their performance in the gross anatomy course. Quality of dissections for each team enrolled in a gross anatomy course at Mayo Medical School was evaluated biweekly using a five-point rubric based on course learning objectives. Assessment of anatomic knowledge was based on sequential laboratory practice practical examination scores, achievements on daily audience response system (ARS) quizzes, and final practical, written, and National Board of Medical Examiners(®) (NBME(®) ) Gross Anatomy and Embryology Subject Examinations. Twelve teams comprising 48 students were included in the study. There was a positive correlation between dissection quality and practice practical examination score (R = 0.83) and a negative correlation between dissection quality and ARS quizzes (R = -0.985). Dissection teams with a passing score on their dissection evaluations (>70%) performed better on their final examinations. Based on an end of course survey, students agreed that dissection evaluations should continue to be a part of the course. This study showed that better quality of dissection was associated with higher scores on practice practical examinations, final practical, written, and NBME examinations. The study demonstrated a positive correlation between dissection evaluations, accompanied by formative feedback during the course, and higher scores on final course assessments.

  13. Liver Transplantation Utilizing Mixed Biologic and Synthetic Arterial Conduits

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    Marcio F. Chedid

    2016-01-01

    Full Text Available Arterial conduits are necessary in nearly 5% of all liver transplants and are usually constructed utilizing segments of donor iliac artery. However, available segments of donor iliac artery may not be lengthy enough or may not possess enough quality to enable its inclusion in the conduit. Although there are few reports of arterial conduits constructed solely utilizing prosthetic material, no previous reports of conduits composed of a segment of donor iliac artery and prosthetic material (mixed biologic and synthetic arterial conduits were found in the medial literature to date. Two cases reporting successful outcomes after creation of mixed biologic and prosthetic arterial conduits are outlined in this report. Reason for creation of conduits was complete intimal dissection of the recipient’s hepatic artery in both cases. In both cases, available segments of donor iliac artery were not lengthy enough to bridge infrarenal aorta to porta hepatis. Both patients have patent conduits and normally functioning liver allografts, respectively, at 4 and 31 months after transplant. Mixed biologic and synthetic arterial conduits constitute a viable technical option and may offer potential advantages over fully prosthetic arterial conduits.

  14. Invasive cervical resorption: treatment challenges

    OpenAIRE

    2012-01-01

    Invasive cervical resorption is a relatively uncommon form of external root resorption. It is characterized by invasion of cervical region of the root by fibrovascular tissue derived from the periodontal ligament. This case presents an invasive cervical resorption occurring in maxillary lateral incisor, following damage in cervical cementum from avulsion and intracoronal bleaching procedure. Flap reflection, debridement and restoration with glass ionomer cement were performed in an attempt to...

  15. Severe gastric variceal haemorrhage due to splenic artery thrombosis and consecutive arterial bypass

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    Wasmuth Hermann E

    2011-06-01

    Full Text Available Abstract Background Upper gastrointestinal haemorrhage is mainly caused by ulcers. Gastric varicosis due to portal hypertension can also be held responsible for upper gastrointestinal bleeding. Portal hypertension causes the development of a collateral circulation from the portal to the caval venous system resulting in development of oesophageal and gastric fundus varices. Those may also be held responsible for upper gastrointestinal haemorrhage. Case presentation In this study, we describe the case of a 69-year-old male with recurrent severe upper gastrointestinal bleeding caused by arterial submucosal collaterals due to idiopathic splenic artery thrombosis. The diagnosis was secured using endoscopic duplex ultrasound and angiography. The patient was successfully treated with a laparoscopic splenectomy and complete dissection of the short gastric arteries, resulting in the collapse of the submucosal arteries in the gastric wall. Follow-up gastroscopy was performed on the 12th postoperative week and showed no signs of bleeding and a significant reduction in the arterial blood flow within the gastric wall. Subsequent follow-up after 6 months also showed no further gastrointestinal bleeding as well as subjective good quality of life for the patient. Conclusion Submucosal arterial collaterals must be excluded by endosonography via endoscopy in case of recurrent upper gastrointestinal bleeding. Laparoscopic splenectomy provides adequate treatment in preventing any recurrent bleeding, if gastric arterial collaterals are caused by splenic artery thrombosis.

  16. Lingual and facial arteries arising from the external carotid artery in a common trunk.

    Science.gov (United States)

    Troupis, Theodore G; Dimitroulis, Dimitrios; Paraschos, Alexandros; Michalinos, Adamantios; Protogerou, Vassilis; Vlasis, Konstantinos; Troupis, George; Skandalakis, Panayiotis

    2011-02-01

    The present study describes analytically a rare case in which lingual and facial arteries arise together from an external carotid artery in a common trunk. Thirty anatomic dissections were performed on 15 cadavers in the macroscopic laboratory in the Department of Anatomy of the Medical School of National and Kapodistrian University of Athens. One common trunk from which originated lingual and facial arteries was found. The frequency of this morphology is measured at 6 per cent. The length of the common trunk is measured at 7.3 mm between its origin and i