Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Case Reports
Congenital external carotid-internal carotid artery anastomosis diagnosed by MR angiography.
We present what we believe is the first report of external carotid-internal carotid artery anastomosis, which forms a large arterial ring at the proximal cervical internal carotid artery (ICA). If the small channel of the proximal cervical ICA is occluded, the remaining large channel of the external carotid artery may be diagnosed as a nonbifurcating cervical carotid artery.
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Though pial arteriovenous fistulae (PAVF) are an uncommon cerebrovascular disorder, their presentation with subarachnoid hemorrhage (SAH) is not rare. PAVF near the craniocervical junction are rare and may have a worse outcome. ⋯ Cerebral angiography revealed 2 AVF, a symptomatic PAVF located at the craniocervical junction and fed from the anterior spinal artery and incidental dural AVF (DAVF) originate from the left occipital and middle meningeal arteries. These fistulae were treated with different endovascular techniques, including Onyx and platinum coil embolization into the feeding arteries of the DAVF and PAVF, respectively.
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Primary intracranial malignant fibrous histiocytoma (MFH) is an extremely rare entity. A few reported cases have been associated with factors such as a previous history of radiation therapy or surgical trauma. We report on a rare case of intracerebral MFH in a previously healthy 47-year-old man, which was initially presumed to be a high-grade glioma. Conventional as well as advanced magnetic resonance sequences, including diffusion-weighted image and perfusion-weighted image, were used in characterization of the mass.
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Case Reports
DWI findings of optic nerve ischemia in the setting of central retinal artery occlusion.
A 67-year-old African-American male with untreated hypertension, hyperlipidemia, and diabetes mellitus presented with sudden, staggering, progressive loss of vision in his left eye over the course of 8 days. Ophthalmologic and fluorescein angiography exams confirmed central retinal artery conclusion, but revealed no embolus. Magnetic resonance imaging of the brain serendipitously revealed restricted diffusion within the distal left optic nerve, illustrating a more proximal occlusion, which matched the fluorescein angiographic findings. Extensive workup revealed no embolic source, postulating primary hypertension as the underlying etiology.
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Hippocampus is selectively susceptible to ischemic damage and it could be, in some conditions, considered as a border zone of brain ischemia. ⋯ The hypoperfusion induced by a cardiac arrest or an internal carotid dissection with an incomplete circle of Willis promotes hippocampal ischemia in the territories of the anterior choroidal artery and the longitudinal terminal segments of the hippocampal arteries.