13 research outputs found
Cortical laminar necrosis after subarachnoid hemorrhage
ΠΠΎΡΡΠΈΠΊΠ°Π»Π½Π°ΡΠ° Π»Π°ΠΌΠΈΠ½Π°ΡΠ½Π° Π½Π΅ΠΊΡΠΎΠ·Π° Π΅ ΡΡΠ΄ΠΊΠΎ Π½Π°Π±Π»ΡΠ΄Π°Π²Π°Π½Π° ΠΏΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½Ρ ΡΠ»Π΅Π΄ Π΅ΠΌΠ±ΠΎΠ»ΠΈΠ·ΠΈΡΠ°Π½Π΅ Π½Π° ΠΌΠΎΠ·ΡΡΠ½Π° Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΠ°. Π‘ΡΠΎΠ±ΡΠ°Π²Π°ΠΌΠ΅ ΡΠ»ΡΡΠ°ΠΉ Π½Π° 51-Π³ΠΎΠ΄ΠΈΡΠ½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠ°, ΠΊΠΎΡΡΠΎ ΡΠ»Π΅Π΄ Π΅ΠΌΠ±ΠΎΠ»ΠΈΠ·Π°ΡΠΈΡ Π½Π° ΠΌΠΎΠ·ΡΡΠ½Π°ΡΠ° Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΠ° Π½Π° Π΄ΡΡΠ½Π°ΡΠ° ΡΡΠ΅Π΄Π½Π° ΠΌΠΎΠ·ΡΡΠ½Π° Π°ΡΡΠ΅ΡΠΈΡ ΠΎΡΡΠ°Π²Π° Π² ΠΊΠΎΠΌΠ°ΡΠΎΠ·Π½ΠΎ ΡΡΡΡΠΎΡΠ½ΠΈΠ΅.ΠΡ ΠΈΠ·Π²ΡΡΡΠ΅Π½ΠΈΡ ΡΠ΄ΡΠ΅Π½ΠΎ-ΠΌΠ°Π³Π½ΠΈΡΠ΅Π½ ΡΠ΅Π·ΠΎΠ½Π°Π½Ρ ΠΈΠΌΠ°ΡΠ΅ Π²ΠΈΡΠΎΠΊ ΠΈΠ½ΡΠ΅Π½Π·ΠΈΡΠ΅Ρ Π½Π° ΡΠΈΠ³Π½Π°Π»Π° Π² ΡΠ΅ΠΌΠΏΠΎΡΠ°Π»Π½ΠΈΡ Π»ΠΎΠ± Π½Π° ΠΌΠΎΠ·ΡΠΊΠ° Π½Π° T2- ΠΈΠ·ΠΎΠ±ΡΠ°ΠΆΠ΅Π½ΠΈΡΡΠ°, ΠΈ Π»ΠΈΠ½Π΅Π°ΡΠ΅Π½ Ρ
ΠΈΠΏΠ΅ΡΠΈΠ½ΡΠ΅Π½Π·ΠΈΡΠ΅Ρ ΠΏΠΎ ΠΏΡΠΎΡΠ΅ΠΆΠ΅Π½ΠΈΠ΅ Π½Π° ΠΌΠΎΠ·ΡΡΠ½ΠΈΡΠ΅ ΠΊΠΎΡΠ°ΡΠ° Π½Π° T1-ΠΈΠ·ΠΎΠ±ΡΠ°ΠΆΠ΅Π½ΠΈΡΡΠ° Ρ Π΄ΠΈΡΡΠ·Π½ΠΎ ΡΡΠΈΠ»Π²Π°Π½Π΅ Π½Π° ΠΌΠΎΠ·ΡΡΠ½Π°ΡΠ° ΠΊΠΎΡΠ°.Cortical laminar necrosis has rarely been observed in a patient after coil embolization. We report a 51-year-old female patient who became comatose after the embolization of an aneurysm in the right middle cerebral artery. There were high signal intensities in the temporal brain on T2-weighted MRI images and linear hyperintensities along the cerebral cortices on T1-weighted images with a diffuse gyriform enhancement
Embolization of bronchial arteries in cases of life-threatening bleeding
Massive hemoptysis is a frightening and potentially life-threatening clinical event. Hemoptysis represents a sigΒnificant clinical entity with high morbidity and potential mortality. Bronchial artery angiography with embolization has become a mainstay in the treatment of hemoptysis. Bronchial artery embolization offers a minimally invasive procedure for even the most compromised patient serving as first-line treatment for hemorrhage as well as providing a bridge to more definitive medical or surgical intervention focused upon the etiology of the hemorrhage
Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies
ΠΡΠ²ΠΎΡΠ΅Π½Π°ΡΠ° Ρ
ΠΈΡΡΡΠ³ΠΈΡ Π΅ Π·Π»Π°ΡΠ΅Π½ ΡΡΠ°Π½Π΄Π°ΡΡ Π·Π° Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π½Π° Ρ
Π΅ΠΏΠ°ΡΠΎΡΠ΅Π»ΡΠ»Π°ΡΠ΅Π½ ΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌ (ΠΠ‘Π‘) ΠΈ ΡΠ΅ΡΠ½ΠΎΠ΄ΡΠΎΠ±Π½ΠΈ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΈ ΠΎΡ ΡΠ°ΠΊ Π½Π° Π΄Π΅Π±Π΅Π»ΠΎΡΠΎ ΡΠ΅ΡΠ²ΠΎ. ΠΠ½Π΅Ρ ΡΠ΅ΡΠ½ΠΎΠ΄ΡΠΎΠ±Π½Π°ΡΠ° ΡΠ΅Π·Π΅ΠΊΡΠΈΡ Π΅ Π²ΡΠ΅ ΠΎΡΠ΅ ΡΠ°ΠΌΠΎ Π»Π΅ΡΠ΅Π±Π΅Π½ Π²Π°ΡΠΈΠ°Π½Ρ Π·Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ ΡΠ°ΠΊ Π½Π° ΡΠ΅ΡΠ½ΠΈΡ Π΄ΡΠΎΠ±, Ρ 5-Π³ΠΎΠ΄ΠΈΡΠ½Π°ΡΠ° ΠΏΡΠ΅ΠΆΠΈΠ²ΡΠ΅ΠΌΠΎΡΡ ΠΌΠ΅ΠΆΠ΄Ρ 25-60%, Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠ΅ Ρ 0% 5-Π³ΠΎΠ΄ΠΈΡΠ½Π° ΠΏΡΠ΅ΠΆΠΈΠ²ΡΠ΅ΠΌΠΎΡΡ Π±Π΅Π· Π½ΠΈΠΊΠ°ΠΊΠ²ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠ΅. Π‘Π°ΠΌΠΎ 5-15% ΠΎΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Ρ ΠΠ‘Π‘ ΠΈΠ»ΠΈ Ρ ΡΠ΅ΡΠ½ΠΎΠ΄ΡΠΎΠ±Π½ΠΈ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΈ ΠΌΠΎΠ³Π°Ρ Π΄Π° Π±ΡΠ΄Π°Ρ ΠΏΠΎΠ΄Π»ΠΎΠΆΠ΅Π½ΠΈ Π½Π° ΡΠ΅ΡΠ½ΠΎΠ΄ΡΠΎΠ±Π½Π° ΡΠ΅Π·Π΅ΠΊΡΠΈΡ ΠΏΠΎΡΠ°Π΄ΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡ: Π³ΠΎΠ»ΡΠΌ Π±ΡΠΎΠΉ ΡΡΠΌΠΎΡΠΈ, ΡΡΠΌΠΎΡΠΈ Π½Π° ΡΡΡΠ΄Π½ΠΎΠ΄ΠΎΡΡΡΠΏΠ½ΠΈ ΠΌΠ΅ΡΡΠ°, Π½Π΅Π΄ΠΎΡΡΠ°ΡΡΡΠ΅Π½ ΡΠ΅ΡΠ½ΠΎΠ΄ΡΠΎΠ±Π΅Π½ ΠΎΠ±Π΅ΠΌ Π·Π° ΡΠ΅Π·Π΅ΠΊΡΠΈΡ.Open surgery is a gold standard for treating hepatocellular carcinoma (HCC) and hepatic metastases of colorectal cancer. Today, liver resection is still only a radically option for patients with liver cancer, with a 5-year survival rate of 25-60%, compared with 0% 5-year survival without any treatment. Only 5-15% of patients with HCC or liver metastases may undergo hepatic resection due to different contraindications: a large number of tumors, tumors in hard-to-reach places, insufficient hepatic volume for resection
Neurotoxicity of cancer agents
ΠΠ΅Π²ΡΠΎΡΠΎΠΊΡΠΈΡΠ½ΠΈΡΠ΅ Π΅ΡΠ΅ΠΊΡΠΈ Π½Π° Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΡΡΠ° ΡΠ΅ ΠΏΠΎΡΠ²ΡΠ²Π°Ρ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»Π½ΠΎ ΡΠ΅ΡΡΠΎ ΠΈ ΡΠ° ΠΏΡΠΈΡΠΈΠ½Π° Π·Π° ΠΌΠΎΠ΄ΠΈΡΠΈΠΊΠ°ΡΠΈΡ Π½Π° Π΄ΠΎΠ·Π°ΡΠ° Π½Π° ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΈΡΠ΅ - Π΄ΠΎΠ·ΠΎΠ»ΠΈΠΌΠΈΡΠΈΡΠ°ΡΠ° ΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡ. Π ΠΈΡΠΊΡΡ ΠΎΡ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ Π½Π° Π½Π΅Π²ΡΠΎΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡ ΡΠ΅ ΡΠ²Π΅Π»ΠΈΡΠ°Π²Π° Ρ ΠΏΠΎΠ²ΠΈΡΠ°Π²Π°Π½Π΅ Π½Π° ΠΏΡΠΈΠ»ΠΎΠΆΠ΅Π½Π°ΡΠ° Π΄ΠΎΠ·Π° ΠΈ Π·Π° ΡΠ°Π·Π»ΠΈΠΊΠ° ΠΎΡ ΠΌΠΈΠ΅Π»ΠΎΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡΡΠ° (ΠΎΡΠ½ΠΎΠ²Π½ΠΈΡ ΠΎΠ³ΡΠ°Π½ΠΈΡΠ°Π²Π°Ρ ΡΠ°ΠΊΡΠΎΡ ΠΏΡΠΈ ΠΏΠΎΠ²Π΅ΡΠ΅ΡΠΎ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ½ΠΈ ΡΠ΅ΠΆΠΈΠΌΠΈ), ΠΊΠΎΡΡΠΎ ΠΌΠΎΠΆΠ΅ Π΄Π° Π±ΡΠ΄Π΅ ΠΏΡΠ΅ΠΎΠ΄ΠΎΠ»ΡΠ½Π° Ρ ΡΠ°ΡΡΠ΅ΠΆΠ½ΠΈ ΡΠ°ΠΊΡΠΎΡΠΈ ΠΈΠ»ΠΈ ΡΡΠ°Π½ΡΠΏΠ»Π°Π½ΡΠ°ΡΠΈΡ Π½Π° ΠΊΠΎΡΡΠ΅Π½ ΠΌΠΎΠ·ΡΠΊ, Π½ΡΠΌΠ° ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅, ΠΊΠΎΠ΅ΡΠΎ Π΄Π° Ρ ΠΎΠ³ΡΠ°Π½ΠΈΡΠΈ.ΠΡΠΎΡΠΈΠ²ΠΎΡΡΠΌΠΎΡΠ½ΠΈΡΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΈ Π²ΠΎΠ΄ΡΡ Π΄ΠΎ Π΄Π²Π° ΡΠΈΠΏΠ° ΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡ - ΠΏΠ΅ΡΠΈΡΠ΅ΡΠ½Π° Π½Π΅Π²ΡΠΎΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡ, ΡΡΡΡΠΎΡΡΠ° ΡΠ΅ ΠΎΡΠ½ΠΎΠ²Π½ΠΎ ΠΎΡ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠ½Π° Π½Π΅Π²ΡΠΎΠΏΠ°ΡΠΈΡ ΠΈ ΡΠ΅Π½ΡΡΠ°Π»Π½Π° Π½Π΅Π²ΡΠΎΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡ, ΠΊΠΎΡΡΠΎ Π²ΠΊΠ»ΡΡΠ²Π° ΠΎΡ Π½Π΅Π·Π½Π°ΡΠΈΡΠ΅Π»Π½ΠΈ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΠΈ ΡΠ²ΡΠ΅ΠΆΠ΄Π°Π½ΠΈΡ ΠΈ Π΄Π΅ΡΠΈΡΠΈΡΠΈ Π΄ΠΎ Π΅Π½ΡΠ΅ΡΠ°Π»ΠΎΠΏΠ°ΡΠΈΡ Ρ Π΄Π΅ΠΌΠ΅Π½ΡΠΈΡ ΠΈΠ»ΠΈ Π΄ΠΎΡΠΈ ΠΊΠΎΠΌΠ°.ΠΠ΅ ΡΡΡΠ΅ΡΡΠ²ΡΠ²Π°Ρ ΡΡΠ²ΡΡΠ΄Π΅Π½ΠΈ Π°Π»Π³ΠΎΡΠΈΡΠΌΠΈ Π·Π° ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΈ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ° Π½Π° Π½Π΅Π²ΡΠΎΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡΡΠ°, ΠΏΡΠΈΡΠΈΠ½Π΅Π½Π° ΠΎΡ ΠΏΡΠΎΡΠΈΠ²ΠΎΡΡΠΌΠΎΡΠ½ΠΈΡΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΈ. ΠΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ΡΠΎ ΠΎΡΠ½ΠΎΠ²Π½ΠΎ ΡΠ΅ ΡΠ²Π΅ΠΆΠ΄Π° Π΄ΠΎ ΡΠ΅Π΄ΡΠΊΡΠΈΡ Π½Π° Π΄ΠΎΠ·Π°ΡΠ° ΠΈΠ»ΠΈ ΠΎΡΠ»Π°Π³Π°Π½Π΅ Π²ΡΠ² Π²ΡΠ΅ΠΌΠ΅ΡΠΎ Π½Π° ΠΏΡΠΈΠ»ΠΎΠΆΠ΅Π½ΠΈΠ΅ΡΠΎ, ΠΎΡΠΎΠ±Π΅Π½ΠΎ ΠΏΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ, ΠΊΠΎΠΈΡΠΎ ΡΠ° Ρ ΠΏΠΎ-Π²ΠΈΡΠΎΠΊ ΡΠΈΡΠΊ ΠΎΡ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ Π½Π° Π½Π΅Π²ΡΠΎΡΠΎΠΊΡΠΈΡΠ½ΠΈ ΡΡΡΠ°Π½ΠΈΡΠ½ΠΈ Π΅ΡΠ΅ΠΊΡΠΈ. ΠΠ° ΡΠΎΠ·ΠΈ Π΅ΡΠ°ΠΏ Π½Π΅ ΡΡΡΠ΅ΡΡΠ²ΡΠ²Π°Ρ Π½Π΅Π²ΡΠΎΠΏΡΠΎΡΠ΅ΠΊΡΠΈΠ²Π½ΠΈ Π°Π³Π΅Π½ΡΠΈ, ΠΊΠΎΠΈΡΠΎ ΡΠ΅ ΠΏΡΠ΅ΠΏΠΎΡΡΡΠ²Π°Ρ Π·Π° ΡΡΠ°Π½Π΄Π°ΡΡΠ½Π° ΡΠΏΠΎΡΡΠ΅Π±Π° ΠΏΡΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ Π½Π° Π½Π΅Π²ΡΠΎΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡ.Neurotoxic side effects of chemotherapy occur frequently and are often a reason to limit the dose of chemotherapy. Chemotherapy dosing is often limited due to a frequently occurring side effect of the treatment - neurotoxic. The risk of neurotoxicity is increased by the possibility of higher dose usage, since bone marrow toxicity (the major limiting factor in most chemotherapeutic regimens) can be overcome with growth factors or bone marrow transplantation.Chemotherapy may cause both peripheral neurotoxicity, consisting mainly of a peripheral neuropathy, and central neurotoxicity, ranging from minor cognitive deficits to encephalopathy with dementia or even coma. Neurotoxicity caused by the chemotherapy can be of two types - peripheral, mainly consisting of peripheral neuropathy and central, from minor cognitive deficits through encephalopathy with dementia to even coma.Data management and neuroprotective agents are still in discussion and there are no current accepted guidelines yet. Management mainly consists of cumulative dose-reduction or lower dose-intensities, especially in patients who are at higher risk to develop neurotoxic side effects. None of the specific neuroprotective agents can be recommended in daily practice for standard use at the moment, and further studies are needed to confirm their beneficial effects
Minimally invasive ablative techniques of liver tumors
Π‘Π°ΠΌΠΎ 5-15% ΠΎΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Ρ ΠΠ‘Π‘ ΠΈΠ»ΠΈ Ρ ΡΠ΅ΡΠ½ΠΎΠ΄ΡΠΎΠ±Π½ΠΈ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΈ ΠΌΠΎΠ³Π°Ρ Π΄Π° Π±ΡΠ΄Π°Ρ ΠΏΠΎΠ΄Π»ΠΎΠΆΠ΅Π½ΠΈ Π½Π° ΡΠ΅ΡΠ½ΠΎΠ΄ΡΠΎΠ±Π½Π° ΡΠ΅Π·Π΅ΠΊΡΠΈΡ, ΠΏΠΎΡΠ°Π΄ΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡ: Π³ΠΎΠ»ΡΠΌ Π±ΡΠΎΠΉ ΡΡΠΌΠΎΡΠΈ, ΡΡΠΌΠΎΡΠΈ Π½Π° ΡΡΡΠ΄Π½ΠΎ Π΄ΠΎΡΡΡΠΏΠ½ΠΈ ΠΌΠ΅ΡΡΠ°, Π½Π΅Π΄ΠΎΡΡΠ°ΡΡΡΠ΅Π½ ΡΠ΅ΡΠ½ΠΎΠ΄ΡΠΎΠ±Π΅Π½ ΠΎΠ±Π΅ΠΌ Π·Π° ΡΠ΅Π·Π΅ΠΊΡΠΈΡ. ΠΠ°ΡΠΈΠ°Π½ΡΠΈΡΠ΅ Π·Π° ΠΏΠ΅ΡΠΊΡΡΠ°Π½Π½ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΌΠΎΠ³Π°Ρ Π΄Π° Π±ΡΠ΄Π°Ρ: Π₯ΠΈΠΌΠΈΡΠ½Π°ΡΠ° Π°Π±Π»Π°ΡΠΈΡ: ΠΈΠ½ΠΆΠ΅ΠΊΡΠΈΡΠ°Π½Π΅ Π½Π° Π΅ΡΠ°Π½ΠΎΠ» ΠΈΠ»ΠΈ ΠΎΡΠ΅ΡΠ½Π° ΠΊΠΈΡΠ΅Π»ΠΈΠ½Π°; Π’Π΅ΡΠΌΠ°Π»Π½Π°ΡΠ° Π°Π±Π»Π°ΡΠΈΡ: (Π°) ΠΊΡΠΈΠΎΡ
ΠΈΡΡΡΠ³ΠΈΡΠ½ΠΈ Π°Π±Π»Π°ΡΠΈΡ (CSA/ΠΠ₯Π): ΠΈΠ·ΠΏΠΎΠ»Π·Π²Π°Π½Π΅ Π½Π° ΡΠ΅ΡΠ΅Π½ Π°Π·ΠΎΡ, Π°ΡΠ³ΠΎΠ½, ΠΈΠ»ΠΈ NO2; (Π±) ΠΊΠΎΠ°Π³ΡΠ»Π°ΡΠΈΠΎΠ½Π½Π°ΡΠ°: ΠΈΠ·ΠΏΠΎΠ»Π·Π²Π°Π½Π΅ Π½Π° ΡΠ°Π΄ΠΈΠΎΡΠ΅ΡΡΠΎΡΠ΅Π½ ΡΠΎΠΊ (RFA/Π Π€Π); ΠΠΈΠΊΡΠΎΠ²ΡΠ»Π½ΠΎΠ²Π° Π°Π±Π»Π°ΡΠΈΡ (MWA/ΠΠ); Π»Π°Π·Π΅ΡΠ½Π° ΠΈΠ½ΡΠ΅ΡΡΡΠΈΡΠΈΠ°Π»Π½Π° ΡΠ΅ΡΠΌΠΎΡΠ΅ΡΠ°ΠΏΠΈΡ (ΠΠΠ’Π’) ΠΈΠ»ΠΈ Π²ΠΈΡΠΎΠΊΠΎΠΈΠ½ΡΠ΅Π½Π·ΠΈΠ²Π΅Π½ ΡΠΎΠΊΡΡΠΈΡΠ°Π½ ΡΠ»ΡΡΠ°Π·Π²ΡΠΊ (HIFU/ ΠΠ€Π£); ΠΠ΅ΠΎΠ±ΡΠ°ΡΠΈΠΌΠ° Π΅Π»Π΅ΠΊΡΡΠΎΠΏΠΎΡΠ°ΡΠΈΡ (IRE).Only 5-15% of patients with HCC or liver metastases may undergo hepatic resection due to different contraindications: a large number of tumors, tumors in hard-to-reach places, insufficient hepatic volume for resection. The options for percutaneous treatment can be: Chemical Ablation: Injection of Ethanol or Acetic Acid; Thermal ablation: (a) cryosurgical ablation (CSA): use of liquid nitrogen, argon, or NO2; (b) Coagulation: Radio Frequency Ablation (RFA); Microwave ablation (MWA); Laser Interstitial Thermotherapy (LITT) or High Intensive Focused Ultrasound (HIFU); Irreversible electroporation (IRE)
Spontaneous thrombosis of type II vein of Galen aneurysmal malformation: a case report
Vein of Galen malformations (VGAMs) are rare and complex congenital brain vascular anomalies that pose significant diagnostic and treatment challenges. The natural history of this type of vascular anomaly is very poor, with many patients succumbing to complications such as congestive heart failure, hydrocephalus, and brain parenchymal injury. Although the clinical course of most VGAMs was considered unfortunate, with meticulous imaging, a group of lesions with a more placid presentation and course can be identified. We present a case of spontaneous thrombosis of VGAM where no embolization or surgical repair was attempted, with excellent clinical outcomes. This case also highlights the possibility of spontaneous thrombosis in VGAM, even in the absence of clinical symptoms, and emphasizes the importance of a regular imaging follow-up in patients with known vascular malformations
Developmental venous anomaly causing obstructive hydrocephalus due to aqueductal stenosis: Π° case report
Cerebral developmental venous anomalies are asymptomatic benign cerebrovascular malformations that are commonly found accidentally on brain magnetic resonance imaging. It is not uncommon for cerebrospinal fluid flow to be obstructed at the level of the aqueduct of Sylvius, causing an obstructive non-communicating hydrocephalus. Most notable reasons for such an obstruction at that level are tumors, congenital etiology, or post-inflammatory gliotic atresia. Herein we present the case of a 65-year-old male patient with an unusual symptomatic developmental venous anomalies causing stenosis and obstruction of the aqueduct of Sylvius at the level of the mesencephalon. Features of this case are discussed together with its implications, including recognizing, diagnosing, and treating such a finding
Spontaneous thrombosis of type II vein of Galen aneurysmal malformation: a case report
Vein of Galen malformations (VGAMs) are rare and complex congenital brain vascular anomalies that pose significant diagnostic and treatment challenges. The natural history of this type of vascular anomaly is very poor, with many patients succumbing to complications such as congestive heart failure, hydrocephalus, and brain parenchymal injury. Although the clinical course of most VGAMs was considered unfortunate, with meticulous imaging, a group of lesions with a more placid presentation and course can be identified. We present a case of spontaneous thrombosis of VGAM where no embolization or surgical repair was attempted, with excellent clinical outcomes. This case also highlights the possibility of spontaneous thrombosis in VGAM, even in the absence of clinical symptoms, and emphasizes the importance of a regular imaging follow-up in patients with known vascular malformations
Spontaneous Direct Carotid-Cavernous Fistula in an Elderly Patient
We describe the case of an 83-year-old woman with left-sided ophthalmoplegia. She had no family history of connective tissue disease. The computed tomography study found a dilated left cavernous sinus. The conventional cerebral panangiography confirmed the diagnosis - a direct carotid-cavernous fistula (CCF), with no evidence of ruptured aneurysm. The woman underwent endovascular treatment with coiling of the cavernous sinus in combination with application of the Onyx embolic agent in the fistula. During the first 48 hours after the embolization the local pain, exophthalmos and conjunctival injection of the left eye were significantly ameliorated. The pulsatile tinnitus on the left disappeared and the ptosis of the left eyelid partially recovered. Selective angiography is the best method for the diagnosis and classification of CCF. Currently, treatment is possible with low mortality and morbidity rates. The endovascular intervention is able to completely occlude the fistula and maintain adequate blood fl ow through the carotid artery
Critical Angiographic and Sonographic Analysis of Intra Aneurysmal and Downstream Hemodynamic Changes After Flow Diversion
IntroductionSuccessful treatment of intracranial aneurysms after flow diversion (FD) is dependent on the flow modulating effect of the device. We aimed to investigate the intra-aneurysmal and parent vessel hemodynamic changes, as well as the incidence of silent emboli following treatment with various FD devices.MethodsWe evaluated the appearance of the eclipse sign in nine distinct phases of cerebral angiography before and immediately after FD placement in correlation with aneurysm occlusion. Angiographic and clinical data of consecutive procedures were analyzed retrospectively. Patients who had successful FD procedure without adjunctive coiling, visible eclipse sign on post embolization angiography, and reliable follow-up angiographic data were included in the analysis. Detailed analysis of hemodynamic data from transcranial doppler after FD was performed in selected patients, such as monitoring for silent emboli.ResultsAmong all patients (N = 65) who met inclusion criteria, complete aneurysm occlusion at 12 months was achieved in 89% (58/65). Eclipse sign prior to FD was observed in 42% (27/65) with unchanged appearance in 4.6% (3/65) of the treated patients. None of these three patients achieved complete aneurysm occlusion. Among all analyzed variables, such as aneurysm size, device type used, age, and appearance of the eclipse sign pre- and post-FD, the most reliable predictor of permanent aneurysm occlusion at 12 months was earlier, prolonged, and sustained eclipse sign visibility in more than three angiographic phases in comparison to the baseline (p < 0.001). Elevation in flow velocities within the ipsilateral vascular territory was noted in 70% (9/13), and bilaterally in 54% (7/13) of the treated patients. None of the patients had silent emboli.ConclusionsIntra-aneurysmal and parent vessel hemodynamic changes after FD can be reliably assessed by the cerebral angiography and transcranial doppler with important implications for the prediction of successful treatment