1/26. Thrombosed varicose vein in the sternocleidomastoid muscle.A thrombosed varicose vein arising in the neck is quite rare. A 68-year-old Japanese male was referred to our hospital because of a mass in his left upper neck. The mass did not change in size in response to strain resulting from Valsalva's manouvre. magnetic resonance imaging (MRI) showed iso-signal intensity of the mass on T1-weighted images and a target-like signal arrangement (concentric hyper-, hypo-, hyper-signal intensity from outside to inside) on T2-weighted images. Surgical excision revealed that the tumour arose from the intramuscular small vein in the sternocleidomastoid muscle. The pathological examination revealed the mass to be a thrombosed varicose vein with capillarization in the dilated vein wall. The de-oxygenation and degradation of haemoglobin were thought to be responsible for these characteristic MRI findings. The concentric signal distribution on MRI strongly suggested this pathology.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
2/26. Persistent sciatic vessels, varicose veins, and lower limb hypertrophy: an unusual case or discrete clinical syndrome?Persistent sciatic artery is a rare congenital anomaly with a high incidence rate of aneurysmal degeneration and risk of thromboembolization or rupture. Despite a number of recognized associations, the presence of coexistent venous anomalies is extremely rare. We present the case of a 27-year-old woman with atypical left-sided varicose veins and soft tissue hypertrophy. Imaging showed persistence of both sciatic artery and vein. Whether these anomalies are an incidental finding or represent a discrete clinical syndrome remains unclear. We emphasize that unusual distribution varicose veins may be associated with underlying persistent sciatic vessels and recommend formal duplex scan assessment for these anomalies.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
3/26. Cardiac varix in relation to right atrial free wall presenting as a mass compressing the right atrium and mimicking a pericardial cyst.Cardiac varix is a rare entity. It is generally small and is in relation to the interatrial septum, often mistaken as cardiac myxoma. A 19-year-old girl, on evaluation of respiratory infection, was found to have a mass compressing the right atrium. Computed tomographic scan and magnetic resonance imaging suggested a differential diagnosis of pericardial cyst or hydatid cyst. Peroperatively, a large (8 x 6.5 x 5.5 cm) cystic lesion in relation to the right atrial free wall was found. The histopathology of the resected mass revealed it to be a cardiac varix. The case is notable for its large size and its location in relation to the right atrial free wall.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
4/26. Hemosiderotic fibrohistiocytic lipomatous lesion: clinical correlation with venous stasis.Hemosiderotic fibrohistiocytic lipomatous lesion (HFLL) is a recently proposed lipomatous entity. HFLL was originally suggested to be a benign reactive lesion arising due to an antecedent trauma. We report two patients with HFLL who also suffered from chronic vein insufficiency due to varicose involving deep veins of the low limbs. Both patients were middle-aged women with solitary, poorly circumscribed subcutaneous lesions on the lower extremities. Histopathological examination revealed typical features of HFLL. We think that the consistent clinical features such as advanced age, female sex predilection, and specific location along with distinctive histopathological features allow the suggestion that impaired blood circulation, to wit, venous stasis is involved in the pathogenesis of HFLL. We hypothesize that the proliferation of spindled fibroblastic and myofibroblastic cells and capillaries, erythrocyte extravasation, and hemosiderin deposition with lipomatous tissue of HFLL may simply represent an exaggerated tissue response to venous stasis in which elevated venous and capillary pressures, oxygen saturation, and edema stimulate the proliferation of the above mentioned elements and lead to erythrocyte extravasation. A similar histopathological pattern is seen in acroangiodermatitis of mali and vascular transformation of lymph node sinuses, and these conditions are also associated with impaired blood circulation.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
5/26. The 800-nm diode laser in the treatment of leg veins: assessment at 6 months.BACKGROUND: The efficacy of the 800-nm diode laser system in clearing leg veins was analyzed subjectively and objectively in a variety of leg veins. methods: A total of 10 women (age 25-55 years, skin types II-IV) with a variety of leg vein types were treated with an 800-nm diode laser. A sequence of pulses (5-8 stacked pulses, pulse duration 50 milliseconds, delay 50 milliseconds) was applied on a 3-mm spot (210-336 J/cm2 fluence, depending on vessel size). Treatment on the same vein was performed at intervals of 2 months until complete clearance was achieved (maximum: 3 treatments). The results were assessed at 6 months from the last treatment. patients evaluated their subjective improvement by means of a questionnaire to elicit the satisfaction index. In an independent objective assessment, the clearance index was based on the pretreatment and posttreatment clinical photography, also analyzed by a computer program. RESULTS: All patients completed the trial with mild but transient side effects. The patient 6-month assessments for very good, good, fair, poor, and worse were 1, 5, 3, 1, and 0, respectively. For the clinician-assessed clearance index, the numbers for the same grades were 2, 6, 2, 0, and 0, and for the computer assessment they were 1, 6, 2, 1, and 0. No patient scored worse in any assessment. The overall satisfaction index and clinician and computer clearance indexes were 60%, 80%, and 70%, respectively. LIMITATIONS: No control group could be obtained in this study. CONCLUSIONS: The 800-nm diode laser as used in the study may well offer an effective treatment method for leg veins that is comparatively pain and side-effect free. Best results were obtained in vessels of 3 to 4 mm in diameter located on the thigh, and in patients with phototype III skin. No correlation was seen between results and patient age.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
6/26. Epidural varix at the cervicothoracic junction: unusual cause of quadriplegia: a case report.STUDY DESIGN: A case report describing an unusual incident of quadriplegia in a young adult male caused by an epidural varix at the cervicothoracic junction. OBJECTIVE: To report an unusual case of quadriplegia caused by an epidural varix at the cervicothoracic junction. SUMMARY OF BACKGROUND DATA: Epidural varices are dilated tortuous elongated veins inside the central canal. In degenerative spinal stenosis, these varices are a result of venous stagnation and contribute to the pathogenesis of radicular pain. In the absence of stenosis, primary varicosities develop as a result of dynamic obstruction to venous outflow during spinal movements. A primary epidural varix can produce neurologic deficit similar to a space occupying lesion within the spinal canal. The myeloradiculopathy is of a slow progressive nature. MATERIAL AND methods: A young man presented with an acute onset flaccid quadriplegia in the absence of significant trauma. magnetic resonance imaging revealed an extradural space occupying lesion at the cervicothoracic junction that was diagnosed as an isolated epidural varix during surgery. RESULTS: No neurologic recovery occurred. Postoperative magnetic resonance imaging revealed a syrinx in the cervicothoracic cord. CONCLUSION: In the absence of other precipitating factors, the cord injury was attributed to the epidural varix. A temporary impedance to the venous outflow with the increase in the venous pressure has been hypothesized as the mechanism of cord injury.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
7/26. Long-pulsed Nd:YAG laser treatment of venous lakes: report of a series of 34 cases.BACKGROUND: Some venous lakes do not respond well to traditional vascular lasers. The Nd:YAG laser output at 1,064 nm is less well absorbed by hemoglobin but penetrates more deeply into tissue. OBJECTIVE: This study was undertaken to assess the effectiveness of the long-pulsed Nd:YAG on venous lakes. methods: Thirty-five consecutive adult patients presenting with a venous lake were studied. Four patients had failed to respond to polidocanol 1% sclerotherapy, and 1 patient to pulsed dye laser. Long-pulsed Nd:YAG was administered via a water-cooled tip. Either a 3-mm spot at 250 J/cm(2) and 55 ms or a 5-mm spot at 140 to 180 J/cm(2) was used depending on the size of the lesion. Clinical end points were characterized by hardening of the lesion, central blackening, minimal whitening of the periphery, and in most cases, an audible popping sound. Responses were assessed visually in 50% of cases or by phone contact in the remaining 50% if the lesion had completely disappeared. One patient was lost to follow-up. RESULTS: After a single treatment, 94% cleared completely; incomplete clearance occurred in 6%. There were no reported complications. CONCLUSIONS: The long-pulsed Nd:YAG laser is highly effective treatment for venous lakes of the lip and cheeks.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
8/26. Isolated cerebral varix with magnetic resonance imaging findings--case report.A rare case of isolated cerebral varix of the left deep sylvian vein was discovered incidentally in an 11-year-old boy by computed tomographic scanning, magnetic resonance (MR) imaging, and cerebral angiography. MR imaging was most useful in diagnosis of cerebral varix. review of 21 similar reported cases shows no significant in age, sex, location, or size character.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
9/26. Varix of the heart causing outflow tract obstruction.We report a case about a neonate who died of severe subaortic stenosis due to a giant vascular dilation of the left ventricular outflow tract. We emphasize the fatal result of this benign lesion and make differential diagnosis with haemangiomas and valvular blood cysts.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
10/26. varicose veins in congenital angiodysplasias.Three cases of Klippel--Trenaunay--Weber's syndrome are presented. The syndrome is characterized by cutaneous hemangioma, hypertrophy of an extremity and varicose veins. It is combined with angiodysplasias, either in the form of aplasia/hypoplasia of deep veins and/or in the form of arteriovenous shunts. The varicose veins will frequently be the dominant symptom, and it is emphasized that surgical treatment should not be instituted until the patient has been examined angiographically, with both phlebography and arteriography. The methods and the classification are discussed and the possibilities of treatment are outlined.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
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