1/14. Surgical treatment of internal carotid artery anterior wall aneurysm with extravasation during angiography--case report.A 54-year-old female presented subarachnoid hemorrhage from an aneurysm arising from the anterior (dorsal) wall of the internal carotid artery (ICA). During four-vessel angiography, an extravasated saccular pooling of contrast medium emerged in the suprasellar area unrelated to any arterial branch. The saccular pooling was visualized in the arterial phase and cleared in the venophase during every contrast medium injection. We suspected that the extravasated pooling was surrounded by hard clot but communicated with the artery. Direct surgery was performed but major premature bleeding occurred during the microsurgical procedure. After temporary clipping, an opening of the anterior (dorsal) wall of the ICA was found without apparent aneurysm wall. The vessel wall was sutured with nylon thread. The total occlusion time of the ICA was about 50 minutes. Follow-up angiography demonstrated good patency of the ICA. About 2 years after the operation, the patient was able to walk with a stick and to communicate freely through speech, although left hemiparesis and left homonymous hemianopsia persisted. The outcome suggests our treatment strategy was not optimal, but suture of the ICA wall is one of the therapeutic choices when premature rupture occurs in the operation.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
2/14. Magnetic resonance cystography with gadopenetate dimeglumine of a cystic craniopharyngioma in a child - a technical note.Large cystic craniopharyngiomas can be treated with chemotherapy injected directly into the cyst. Chemotherapy is toxic if it leaks from the cyst into the subarachnoid space. We present a child with a cystic craniopharyngioma following surgical placement of a catheter into the cystic component. Computed tomography following iodinated contrast injection into the cyst was inconclusive in determining the cyst wall integrity. Magnetic resonance following dilute gadopentetate dimeglumine injection into the cyst clearly defined a leak into the subarachnoid space. Coronal imaging was especially helpful. This technique is simple to perform and useful for clinical management.- - - - - - - - - - ranking = 2keywords = subarachnoid (Clic here for more details about this article) |
3/14. Active contrast extravasation in spontaneous rupture of hepatocellular carcinoma: a rare CT finding.Spontaneous rupture of hepatocellular carcinomas are uncommon but constitute a critical and life threatening condition. Diagnosis is important so that either surgery or emergency arterial embolisation can be considered for hepatic haemostasis. We describe active extravasation of intravenous contrast medium on CT in a patient who presented with intraperitoneal haemorrhage secondary to spontaneous rupture of hepatocellular carcinoma.- - - - - - - - - - ranking = 0.40073239980392keywords = haemorrhage (Clic here for more details about this article) |
4/14. Total spinal anaesthesia in association with insertion of a paravertebral catheter.An association between intercostal nerve block and the development of a total spinal is rare. Usually, subarachnoid injection is considered to have followed intraneural placement or inadvertent entrance into a dural cuff extending beyond an intervertebral foramen. We report a patient that followed injection of local anaesthetic into a paravertebral catheter sited at surgery in the thoracic paravertebral space of a patient undergoing thoracotomy. This was a life-threatening event that occurred on two occasions before the definitive diagnosis was made. It is considered likely that the paravertebral catheter entered an intervertebral foramen and the tip perforated the dura.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
5/14. Subdural block complicating spinal anesthesia?IMPLICATIONS:Features suggestive of subdural block appeared after an apparently normal subarachnoid block. The long bevel of the reusable Quincke-type spinal needle may have contributed to the development of this complication. We propose that spinal needles should have a smaller bevel to minimize the possibility of such a complication.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
6/14. rupture of an internal carotid artery aneurysm during angiography with leakage of contrast medium via an external ventricular drain.With a ruptured intracranial aneurysm producing subarachnoid haemorrhage (SAH) cerebral angiography is currently used for identification of the affected vessel. Aneurysm rerupturing is one of the more serious complications of cerebral angiography and has been frequently described. We report a 61-year-old man who presented with SAH who had rerupture of a large aneurysm of the internal carotid artery during angiography. A substantial amount of contrast medium escaped via a ventricular drain. The three main risk factors for rerupture of an aneurysm are: angiography performed within 6 h of the primary SAH, an aneurysm on the internal carotid artery and an unfavourable Glasgow coma score.- - - - - - - - - - ranking = 3.5853148377395keywords = subarachnoid haemorrhage, subarachnoid, haemorrhage (Clic here for more details about this article) |
7/14. Postembolization hemorrhage of a large and necrotic meningioma.Microparticulate embolization of meningiomas is a useful preoperative measure, but the potential risk of hemorrhagic complications should be recognized and balanced against the benefits. We report a case of subarachnoid hemorrhage occurring immediately after the embolization of a meningioma. Techniques for early diagnosis, such as CT, and early surgical intervention are crucial to a promising outcome. Large-size and necrotic or cystic components of a meningioma are probable risk factors that demand special consideration.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
8/14. Acute haemorrhage in patients with advanced head and neck cancer: value of endovascular therapy as palliative treatment option.AIMS: Acute or subacute haemorrhage is one of the most frightening complications in patients suffering from advanced head and neck cancer. Few articles report experience with superselective endovascular therapy for this purpose. Is endovascular therapy underestimated in the field of palliative head and neck cancer therapy? This study set out to investigate this question. patients AND methods: A review was undertaken of the clinical courses of seven patients (six men, one woman) suffering from incurable, advanced head and neck cancer (four pharyngeal, two laryngeal, one neck) and treated with superselective endovascular strategies as an emergency procedure for acute bleeding. RESULTS: All patients were successfully treated without evidence of neurological complication. patients reached a median survival of 20 weeks (range eight-168 weeks). Following endovascular treatment all patients were discharged from the hospital within several days. Three patients survived almost free of symptoms for several weeks and were able to stay at home with their families until their death. CONCLUSION: We conclude that in the field of palliative care, superselective endovascular therapy deserves to be considered alongside standard treatment options for the management of acute haemorrhage from advanced head and neck cancer.- - - - - - - - - - ranking = 2.4043943988235keywords = haemorrhage (Clic here for more details about this article) |
9/14. Retropharyngeal haemorrhage from a vertebral artery branch treated with distal flow arrest and particle embolisation.Retropharyngeal haematoma is a rare cause of rapid neck swelling that may result in fatal upper respiratory airway obstruction. Reported causes include trauma, surgery, retropharyngeal inflammation, carotid aneurysm, aberrant artery at the thoracic inlet and bleeding diathesis. We report a 90-year-old man who developed rapid and progressive neck swelling following a minor traumatic episode. Computed tomography showed a large low-density retropharyngeal haematoma extending from the skull base to the mediastinum, with suspected extravasation. The right vertebral artery angiogram confirmed contrast agent extravasation arising from a small branch artery. This was treated with temporary distal flow arrest and particle embolisation.- - - - - - - - - - ranking = 1.6029295992157keywords = haemorrhage (Clic here for more details about this article) |
10/14. rupture of intracranial aneurysms and ventricular opacification during carotid angiography.Two cases of rupture of intracranial aneurysms and opacification of the lateral ventricles occurring during carotid angiography are reported and x-rays of the haemorrhage from the aneurysms are presented. Though the possibility of this complications remains a real one, the early use of this valuable procedure should not be precluded.- - - - - - - - - - ranking = 0.40073239980392keywords = haemorrhage (Clic here for more details about this article) |
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