Neuroradiology
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The origin of the vertebral artery may be difficult to show on sonography or conventional angiography. Our aim was to evaluate the accuracy of CT angiography (CTA) in detecting arteriosclerotic changes in the first segment (V1) of the vertebral artery. We performed CTA and intra-arterial digital subtraction angiography (DSA) on 24 patients with vertebrobasilar insufficiency. ⋯ CTA revealed 4 stenoses in cases in which angiography proved inadequate, 11 zones of calcification and 5 cases of luminal reduction due to calcified plaques undetected on DSA. In the V1 segment DSA and CTA showed 3 stenoses, 9 cases of kinking, 1 of coiling and 4 stenoses due to kinking. CTA also demonstrated 4 additional stenoses, 2 cases of kinking and 3 stenoses due to kinking.
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Case Reports
Dural caroticocavernous fistula with both ophthalmic arteries arising from middle meningeal arteries.
A 60-year-old woman presented with a dural caroticocavernous fistula (CCF) in whom both by ophthalmic arteries arose from the middle meningeal arteries instead of from the internal carotid arteries. Transarterial embolisation of the CCF was contraindicated because of the risk of blindness. Transvenous coil embolisation was therefore performed. Bilateral origin of the ophthalmic artery from the middle meningeal artery is extremely rare.