11/537. Transverse cervical artery bypass pedicle for treatment of common carotid artery occlusion: new adjunct for revascularization of the internal carotid artery domain.OBJECTIVE: We present two cases of common carotid artery occlusion that were treated by vascular reconstruction using the transverse cervical artery. methods: Two patients with common carotid artery occlusion presented with transient ischemic attacks resulting from decreased cerebral blood flow on the affected side. Both patients underwent vascular reconstruction using the transverse cervical artery. The transverse cervical artery was anastomosed to the ipsilateral external carotid artery at its origin, as a pedicle graft. A superficial temporal artery-middle cerebral artery anastomosis was then performed. RESULTS: The postoperative courses were uneventful. The transverse cervical artery bypass grafts were patent, and cerebral blood flow increased to normal levels. CONCLUSION: Transverse cervical artery grafting provides a less tedious alternative to saphenous vein interposition grafting for revascularization of the internal carotid artery domain.- - - - - - - - - - ranking = 1keywords = cerebral (Clic here for more details about this article) |
12/537. Failure of a saphenous vein extracranial-intracranial bypass graft to protect against bilateral middle cerebral artery ischemia after carotid artery occlusion: case report.OBJECTIVE AND IMPORTANCE: We present the case of a patient who experienced bilateral middle cerebral artery infarctions after Hunterian ligation and trapping of a ruptured right cavernous aneurysm, despite a high-flow extracranial-intracranial bypass. This is a rare complication, and it highlights the need for further refinements in our understanding of the hemodynamic insufficiency created by major vessel sacrifice. CLINICAL PRESENTATION: The patient was a 59-year-old woman who experienced multiple episodes of massive epistaxis before undergoing angiography, which revealed left internal carotid artery occlusion and an irregular right cavernous aneurysm. The patient was then transferred to our center for treatment. The patient was neurologically intact at presentation, and her epistaxis was controlled by nasal packing. INTERVENTION: The patient underwent an extracranial-intracranial bypass from the external carotid artery to the M2 segment of the right middle cerebral artery, followed by trapping of the aneurysm. Despite evidence of graft patency, the patient experienced bilateral middle cerebral artery distribution infarctions after surgery. CONCLUSION: Although extracranial-intracranial bypasses protect the majority of patients who undergo carotid artery ligation from ischemic complications, this case demonstrates that hemodynamic insufficiency can occur even with a high-flow saphenous vein graft. Better ways to quantitate the hemodynamic needs of the brain after major vessel sacrifice may facilitate matching of the revascularization strategy to the specific needs of each patient, thus further reducing the likelihood of ischemic complications.- - - - - - - - - - ranking = 2.3337824280527keywords = cerebral, brain (Clic here for more details about this article) |
13/537. 'Fou rire prodromique' as the heralding symptom of lenticular infarction, caused by dissection of the internal carotid artery in a 12-year-old boy.A 12-year-old, right-handed boy experienced a pathological fit of laughter before a sudden right hemiplegia. magnetic resonance imaging showed a left basal ganglia infarction, induced by a left internal carotid dissection. Arteriography revealed an underlying fibromuscular dysplasia. This case study demonstrates that cerebral artery dissection can occur in children and that a basal ganglia infarction may be preceded by pathological laughter called 'fou rire prodromique'. The clinical and anatomical relationship of this paroxysmal event are discussed.- - - - - - - - - - ranking = 0.33333333333333keywords = cerebral (Clic here for more details about this article) |
14/537. Cerebral angioma and aneurysm of the cervical internal carotid artery.A case of internal carotid artery aneurysm in association with a congenital cerebral arterio-venous malformation is described. The carotid artery aneurysm was resected with primary anastomosis of the redundant artery, with satisfactory recovery.- - - - - - - - - - ranking = 0.33333333333333keywords = cerebral (Clic here for more details about this article) |
15/537. Monitoring of the extracranial and intracranial course of single emboli of cardiac origin: a preliminary report.Simultaneous monitoring of emboli in extracranial and intracranial arteries recorded with identical probes, in a patient with an artificial cardiac valve, allowed the identification and characterization of pairs of signals, which most likely represent single emboli flowing through the common carotid artery into the middle cerebral artery. This technique offers new insight into emboligenesis with obvious therapeutic implications.- - - - - - - - - - ranking = 0.33333333333333keywords = cerebral (Clic here for more details about this article) |
16/537. Tracheocarotid artery fistula infected with methicillin-resistant staphylococcus aureus.Massive life-threatening haemorrhage from a fistula between the trachea and a major blood vessel of the neck is a rare complication of the tracheostomy procedure, well-recognized by anaesthetists and otolaryngologists. Although the lesion is likely to be encountered at autopsy, it is not described in histopathological literature. The possible causes are discussed together with the macroscopic and microscopic appearances of the lesion. Suitable procedures for its identification and for obtaining appropriate histopathological blocks are suggested. Presence of methicillin-resistant staphylococcus aureus (MRSA) has not been documented before and might have contributed to the genesis of the fistula in this case.- - - - - - - - - - ranking = 0.1080177298768keywords = haemorrhage (Clic here for more details about this article) |
17/537. Spontaneous rupture of the common carotid artery presenting as a widened mediastinum.Spontaneous rupture of the common carotid artery is an extremely rare disorder. Presentation in an elderly gentleman as a widened mediastinum with cardiac compromise has not been previously reported. Emergency surgical exploration to decompress the airway revealed a 5-mm tear just proximal to the left common carotid artery bifurcation and a large para-oesophageal haematoma. The case is reviewed and the possible causes discussed.- - - - - - - - - - ranking = 0.0030428164827983keywords = haematoma (Clic here for more details about this article) |
18/537. Congenital Horner's syndrome resulting from agenesis of the internal carotid artery.OBJECTIVE: To report a patient with agenesis of the right internal carotid artery associated with ipsilateral, congenital Homer's syndrome. DESIGN: Case report. methods: A 30-year-old woman, with a past history of migraine headaches, underwent neuro-ophthalmologic and neuroradiologic evaluation for transient visual obscurations and congenital Horner's syndrome. RESULTS: A right, third-order neuron Horner's syndrome was confirmed with 1% hydroxyamphetamine topical drops. Cranial magnetic resonance imaging revealed an absent right internal carotid artery flow void, computed tomography demonstrated absence of the right carotid canal, and cerebral angiography confirmed absence of the right internal carotid artery. No atheromatous lesions were found and the results of coagulation studies were normal. CONCLUSIONS: Agenesis of the internal carotid artery is a rare cause of congenital Horner's syndrome. The cause of transient visual blurring in the current patient remains unproven.- - - - - - - - - - ranking = 0.33333333333333keywords = cerebral (Clic here for more details about this article) |
19/537. Direct caroticocavernous fistula and traumatic dissection of the ipsilateral internal carotid artery: endovascular treatment.After severe craniocerebral trauma a 14-year-old boy developed progressive exophthalmos with venous congestion and chemosis, due to a direct caroticocavernous fistula. Angiography revealed traumatic occlusion of the ipsilateral internal carotid artery and absence of the inferior petrosal sinus. After failure of an approach via the anterior and posterior communicating arteries, the cavernous sinus was successfully catheterised through the occluded internal carotid artery, and embolisation performed with coils.- - - - - - - - - - ranking = 0.33333333333333keywords = cerebral (Clic here for more details about this article) |
20/537. Internal carotid artery aneurysm visualized during successful endovascular treatment of carotid embolism.We herein present a case of an internal carotid artery embolism associated with a hidden internal carotid artery aneurysm. The aneurysm was visualized during successful endovascular treatment of the carotid embolism. In retrospect, the aneurysm was at risk of rupture during the procedure. In the endovascular treatment of cerebral embolism, the possibility that aneurysms are hidden by emboli must be borne in mind. Care should be taken not to injure unidentified arterial walls while advancing a catheter blindly.- - - - - - - - - - ranking = 0.33333333333333keywords = cerebral (Clic here for more details about this article) |
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