Interv Neuroradiol
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This report is a clinical and radiologic correlation of anterior spinal arterial distribution ischemia with a thoracic disc herniation affecting the artery of Adamkiewicz. We could only find one other similar reported case. A 38-year-old woman developed sudden onset of severe back pain and radiculopathy, followed by rapidly evolving paraparesis. ⋯ Selective spinal angiography performed 30 hours after onset revealed displacement of the left T9 radicular feeding artery by the disc herniation; at this time the artery was patent. The patient experienced some resolution of symptoms within the first 24 hours and was managed conservatively and made a significant recovery within two weeks. Appropriately located thoracic disc herniations can disturb the blood supply to the thoracolumbar spinal cord.
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This case illustrates the usefulness of an endovascular stent to treat a pseudoaneurysm of the cervical internal carotid artery. A 46-year-old male patient presented with a spontaneous dissection of the cervical internal carotid artery. ⋯ The patient sustained no neurological complications and the stenosis of treated carotid artery did not occur during the 6-month follow-up period. For internal carotid artery dissection, stent placement seems to be a reasonable therapeutic alternative to direct surgery.
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The aim of the study was to quantify embolisation in a vein of Galen malformation by intraluminal measurements of flow velocities in the feeding vessels and to test a new O.014-inch Doppler guide wire in the paediatric population. The examination was performed in a seven month old boy who presented with a vein of Galen malformation combined with congestive cardiac failure from birth. The measurements showed a decrease of the systolic and diastolic velocities and an increase in the effective downstream vascular resistance after closure of the high flow fistula. ⋯ The reduction of about 40% of the vein of Galen malformation estimated with morphological criteria was associated with a decrease of the diastolic velocity in the basilar artery of about 50%. The clinical improvement led to the discontinuance of most of the cardiac treatment over a few days. These measurements seem to offer the possibility to assess the necessary reduction of the shunt to relieve CCF in a vein of Galen malformation.