229 results on '"Spinal Artery"'
Search Results
2. Detection of the common origin of the radiculomedullary artery with the feeder of spinal dural arteriovenous fistula using slab maximum intensity projection image.
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Hiramatsu, Masafumi, Sugiu, Kenji, Yasuhara, Takao, Hishikawa, Tomohito, Haruma, Jun, Takahashi, Yu, Murai, Satoshi, Nishi, Kazuhiko, Yamaoka, Yoko, and Date, Isao
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ARTERIOGRAPHY , *SPINAL cord radiography , *ANGIOGRAPHY , *DIAGNOSTIC imaging , *DIGITAL subtraction angiography , *ARTERIOVENOUS fistula , *SPINAL cord , *SPINAL cord diseases , *DESCRIPTIVE statistics - Abstract
Purpose: Endovascular therapy to the spinal dural arteriovenous fistula (SDAVF) with a common origin of the radiculomedullary artery and the feeder of the shunt has the risk of spinal cord infarction. This study aimed to retrospectively assess the detection rate of normal spinal arteries from the feeder of SDAVF. Methods: We retrospectively collected the angiographic and clinical data of SDAVFs. This study included 19 patients with 20 SDAVF lesions admitted to our department between January 2007 and December 2018. We assessed the detection rate of normal radiculomedullary artery branched from the feeder of SDAVF between the period using the image intensifier (II) and flat panel detector (FPD) and evaluated the treatment results. Results: The detection rates of the radiculomedullary artery branched from the feeder of SDAVF were 10% (1/10 lesions) during the II period and 30% (3/10 lesions) during the FPD period. During the FPD period, all normal radiculomedullary arteries branched from the feeder were only detected on slab maximum intensity projection (MIP) images of rotational angiography, and we could not detect them in 2D or 3D digital subtraction angiography. All lesions that had a common origin of a normal radiculomedullary artery and the feeder were completely obliterated without complications. There was no recurrence during the follow-up period. Conclusions: The flat panel detector and slab MIP images seem to show the common origin of the normal radiculomedullary arteries from the feeder more accurately. With detailed analyses, SDAVF can be safety treated. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
3. Особливості мануальної терапії у пацієнтів із синдромом хребтової артерії
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medicine.medical_specialty ,Physical medicine and rehabilitation ,Muscle relaxation ,Quality of life ,Cerebral blood flow ,business.industry ,Biomechanics ,Medicine ,Disease ,Manual therapy ,business ,Spinal Artery ,Cervical spine - Abstract
Currently, the main factors in the occurrence of cerebral blood flow impairments in young people are changes in the cervical spine. Objective. To analyze the effectiveness of manual therapy in students with the syndrome of functional compression of the spinal artery due to a violation of biomechanics in the cervical spine. Methods. Theoretical analysis and generalization of literature sources, surveys, complex ultrasound investigation, methods of mathematical statistics. Results. Classes according to the developed program, which included therapeutic gymnastics, postisometric muscle relaxation and soft mobilization techniques to unlock functional blocks in the intervertebral motor segments of the cervical spine, showed a significant improvement in the clinical condition of the subjects. The results of the study indicated that the use of the proposed complex program, which includes manual therapy, reduces the clinical manifestations of the disease and in a short time restores patients' quality of life. Keywords: spinal artery syndrome, manual therapy, physical therapy.
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- 2021
4. 'Extra-cranial proximal pica aneurysm – a rare and surreptious cause of posterior fossa sah: case report and review of literature'
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Pavan K Verma, Priyadarshi Dikshit, Kuntal Kanti Das, Anant Mehrotra, Ashish R Sharma, and Awadhesh Kumar Jaiswal
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,General Medicine ,Clipping (medicine) ,medicine.disease ,Fourth ventricle ,Spinal Artery ,Aneurysm ,Posterior inferior cerebellar artery ,medicine.artery ,Angiography ,cardiovascular system ,medicine ,Surgery ,cardiovascular diseases ,Neurology (clinical) ,Pica (disorder) ,Radiology ,medicine.symptom ,business ,Craniotomy - Abstract
Background Extra-cranial posterior inferior cerebellar artery (PICA) aneurysms are rare with only 22 cases been reported so far. Intra-dural type of extra-cranial PICA aneurysm is even rarer with few case reports available. We report a previously unreported type of proximal PICA aneurysm in which the PICA aneurysm had intra-dural location at the C2 vertebral level. Case description A 51 year old gentleman presented with sub-arachnoid haemorrhage and intra-ventricular haemorrhage, predominantly involving the fourth ventricle and had no focal neurological deficit. CT angiogram was negative however a dedicated four vessel angiogram demonstrated an abnormal extracranial origin of right PICA at C1-C2 level, with associated aneurysm in its proximal segment. A C1 posterior arch excision with partial C2 laminectomy and clipping of the aneurysm was done. Conclusion Aneurysm associated with extracranial intra-dural PICA origin is a rare cause of SAH, and may not be detected with CT angiography. Such cases often require dedicated four vessel angiography, with careful study for any possibility of extra-cranial aneurysm. This variant has important surgical implication and requires preservation of the Lateral spinal artery (LSA-PICA communication), and that such aneurysm approached only with posterior cervical exposure without the need of a craniotomy. Such cases remind us the need to have an in-depth understanding of the variations of the posterior circulation.
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- 2021
5. Ruptured aneurysm arising at anterior spinal artery as the collateral circulation with bulbar artery supply to posterior inferior cerebellar artery treated by proximal occlusion and occipital artery-posterior inferior cerebellar artery bypass: a case report and literature review
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Dilok Tantongtip and Gahn Duangprasert
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Subarachnoid hemorrhage ,business.industry ,Anterior spinal artery ,Collateral Circulation ,Intracranial Aneurysm ,Fusiform Aneurysm ,Anatomy ,Aneurysm, Ruptured ,Subarachnoid Hemorrhage ,medicine.disease ,Collateral circulation ,Spinal Artery ,Posterior inferior cerebellar artery ,Aneurysm ,Cerebellum ,medicine.artery ,cardiovascular system ,medicine ,Humans ,Surgery ,Neurology (clinical) ,Occipital artery ,business ,Vertebral Artery - Abstract
The cases of aneurysms arising from collateral vessels that supply the posterior inferior cerebellar artery (PICA) are so exceptionally rare that there is no consensus on the optimal treatment. In this report, a patient was presented with subarachnoid hemorrhage caused by a fusiform aneurysm on the right anterior spinal artery, which formed an anastomosis network with bulbar artery and the vessels supplying to the right PICA. We chose to perform proximal occlusion on the anterior spinal and bulbar arteries, using occipital artery-PICA bypass. Our case was the first where proximal occlusion was used concurrently with vascular reconstruction to treat a ruptured aneurysm of collateral vessels supplying to PICA.
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- 2021
6. The short-term safety and effectiveness of a new distal perforating stent graft in Type B aortic dissection: a retrospective study
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Enshuai Zhu, Xili Zhang, Chunxin Yang, Huanjun Chen, Min Tian, Hailong Liu, Jiaping Wang, Yang Ying, Xunqiang Liu, Wenkai Ji, Min Ji, Jifeng Wang, Jing Tan, Cuihong Li, Jinhui Zhang, Liqiong Zhang, Xiaona Zhou, and Lei Cong
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Adult ,Male ,medicine.medical_specialty ,China ,Time Factors ,medicine.medical_treatment ,Lumen (anatomy) ,Thoracic endovascular aortic repair ,Chest pain ,Prosthesis Design ,Blood Vessel Prosthesis Implantation ,medicine.artery ,medicine ,Thoracic aorta ,Humans ,Diseases of the circulatory (Cardiovascular) system ,cardiovascular diseases ,Aged ,Retrospective Studies ,Paraplegia ,Aortic Aneurysm, Thoracic ,business.industry ,Spinal Cord Ischemia ,Research ,Endovascular Procedures ,Stent ,Middle Aged ,medicine.disease ,Spinal Artery ,Surgery ,Cardiac surgery ,Blood Vessel Prosthesis ,Aortic Dissection ,Treatment Outcome ,Type B aortic dissection ,RC666-701 ,Female ,Stents ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Intercostal arteries - Abstract
Background Spinal artery ischemia (SCI) events can result from over coverage of the descending thoracic aorta with a coated stent during Thoracic Endovascular Aortic Repair (TEVAR). The aim of this study was to determine whether a new distal perforating stent could reduce the incidence of spinal cord ischemia while remodeling the true lumen. Methods TBAD patients treated with Talos stent in the vascular surgery Department of Yan 'an Hospital affiliated to Kunming Medical University between December 2017 and October 2019 were retrospectively analyzed to investigate the short-term safety and effectiveness of Talos stent. Results A total of the 20 patients, including 14 males and 6 females, with an average age of 52.65 ± 8.98 years (range 37–68 years), were included in the analysis. Stent-grafts were successfully implanted in all patients under local anesthesia, with a technical success rate of 100%. The average operation time was 50.75 ± 13.01 min. A total of 2 cases (10%) presented chest pain associated with intercostal artery ischemia that was relieved on the 3rd and 5th postoperative day, respectively. Postoperative mean follow-up was 16.15 ± 3.99 months. No paraplegia or other complications occurred. And stenting did not induce new tears. No migration, deformation, or fracture of the stents occurred. There was a significant difference in the remolding of the true lumen preoperatively and at 12 months postoperatively (P Conclusions Talos stent has achieved satisfactory clinical treatment results in short term.
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- 2021
7. BRONCHIAL ARTERY EMBOLIZATION AS A THERAPEUTIC STRATEGY FOR MANAGEMENT OF MASSIVE HEMOPTYSIS
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Shaimaa Abdelsattar Mohammad, Laila Ahmad Abdurrahman, Heba Mounir Abdel Aziz, and Ayman Mohamed Ibrahim
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Mortality rate ,medicine.medical_treatment ,General Medicine ,Spinal Artery ,Bronchoscopy ,medicine.artery ,Etiology ,medicine ,Radiology ,Embolization ,Bronchial artery ,Prospective cohort study ,business ,Therapeutic strategy - Abstract
Background: Massive hemoptysis is an emergent and life-threatening condition with a high mortality rate. Bronchoscopy and MDCT scanning show significant contributing roles in delineating the etiology and the source of hemoptysis prior to bronchial artery arteriography.Aim of the work: To validate the role of the trans-catheter bronchial artery embolization in management of massive hemoptysis.Patients and Methods: Our study is a prospective cohort study that was held during the period between April 2017 and April 2019. The study included 20 patients who presented with massive hemoptysis refractory to supportive treatment measures with non-identifiable source of bleeding on fiber-optic bronchoscope. Patients were referred from chest department to angio unit.Results: Our findings are in accordance with the current literature supporting bronchial artery embolization as a safe and long-term non-invasive effective method of treatment for massive hemoptysis with a high initial rate of success. BAE may help to avoid surgery in patients who are not good surgical candidates. If hemoptysis recur in these patients, embolization can be safely performed with good response rate. If surgery is indicated, BAE can stabilize the patient prior to surgery.Conclusion: Advancements in angiographic equipment and technique continue to improve success rates, and with careful technique, it can be performed safely and with minimal risk. Embolization distal to the spinal artery may significantly decrease the number of complications and may allow a more thorough embolization.
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- 2021
8. Noninvasive Diagnosis of the Artery of Adamkiewicz
- Author
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Yoshioka, Kunihiro, Tanaka, Ryoichi, Ehara, Shigeru, Kazui, Teruhisa, editor, and Takamoto, Shinichi, editor
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- 2009
- Full Text
- View/download PDF
9. Clinical anatomy of the lumbar sinuvertebral nerve with regard to discogenic low back pain and review of literature
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José Ramón Sañudo, L. M. Hernández, Marko Konschake, Francisco J. Valderrama-Canales, Teresa Vázquez, S. Quinones, Clara Simon, Anto Abramovic, L. L. Aguilar, R. S. Tubbs, Jose Bouzada, and Paloma Aragonés
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medicine.medical_specialty ,business.industry ,Dura mater ,Cauda equina ,Anatomy ,Sinuvertebral nerve ,Clinical anatomy ,Low back pain ,Spinal Artery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Lumbar ,medicine ,Orthopedics and Sports Medicine ,Surgery ,030212 general & internal medicine ,Neurosurgery ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Purpose Lumbar discogenic diffuse pain is still not understood. Authors describe the sinuvertebral nerve (SVN) as one possible cause. Body-donor studies are rare and controversial. Therefore, the aim was to revisit the origin, course and distribution in a body-donor study. Methods Six lumbar blocks (3 female, 3 male) aged between 59 and 94 years were dissected. After removal of the back muscles, lamina, dura mater and cauda equina, the anterior vertebral venous plexus, spinal artery and SVN were exposed and evaluated. Results 43 nerves out of 48 levels could be evaluated. The origin of the SVN was constituted by two roots: a somatic and a sympathetic branch arising from the rami communicantes. In 4/48 intervertebral canals studied (8.3%), we found two SVN at the same level. In 35/48 cases, one SVN was found. In 9/48 cases, no SVN was found. The SVN had a recurrent course below the inferior vertebral notch; in the vertebral canal it showed different patterns: ascending branch (31/43, 72.1%), common branch diverging into two branches (10/43, 23.3%), double ascending branch (1/43, 2.3%) finalizing two levels above and a descending branch (1/43, 2.3%). In 12/43 cases (27.9%) the SVN had ipsilateral connections with another SVN. The distribution ended in the middle of the vertebral body supplying adjacent structures. Conclusion A thorough understanding of the anatomy of the SVN might lead to significant benefits in therapy of discogenic low back pain. We suggest blocking the SVN at the level of the inferior vertebral notch of two adjacent segments. Level of evidence I Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding
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- 2021
10. Dissecting Aneurysm of the L1 Radiculomedullary Artery Associated with Subarachnoid Hemorrhage: A Case Report
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Francesco Zenga, Christian Cossandi, Diego Garbossa, Emanuela Crobeddu, Michele Lanotte, and Giulia Pilloni
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medicine.medical_specialty ,Weakness ,Subarachnoid hemorrhage ,Dissection (medical) ,Aneurysm, Ruptured ,Radiculomedullary artery ,Aneurysm ,Conservative treatment ,Dissection aneurysm ,medicine ,Humans ,business.industry ,Intracranial Aneurysm ,Arteries ,Subarachnoid Hemorrhage ,medicine.disease ,Spinal Artery ,Spine ,Cerebral Angiography ,Surgery ,Conservative strategy ,Aortic Dissection ,medicine.anatomical_structure ,Spinal angiography ,Neurology (clinical) ,medicine.symptom ,business ,Artery - Abstract
Background Both spinal artery aneurysm and spinal subarachnoid hemorrhage represent a very rare event. Methods We report a case of a ruptured dissecting aneurysm of the right L1 radiculomedullary artery associated with subarachnoid hemorrhage and severe motor weakness. Results An urgent decompressive hemilaminectomy was performed due to worsening in motor deficit. A subsequent spinal angiography showed a dissection of radiculomedullary artery of L1 on the right side, treated conservatively. Conclusion Nowadays, therapeutic strategies for this aneurysm remain controversial. Conservative strategy can represent a valid alternative.
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- 2021
11. Ruptured Isolated Aneurysm of a Coronal Branch of the Anterior Spinal Artery: Case Report and Discussion of Treatment Strategies
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Marcello D'Andrea, Vincenzo Antonelli, Alessandra Turrini, and Luigino Tosatto
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medicine.medical_specialty ,Rehabilitation ,Subarachnoid hemorrhage ,business.industry ,medicine.medical_treatment ,Anterior spinal artery ,Perioperative ,medicine.disease ,Spinal Artery ,Surgery ,Natural history ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,030220 oncology & carcinogenesis ,Coronal plane ,medicine.artery ,medicine ,cardiovascular diseases ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background Isolated spinal artery aneurysms are an extremely rare cause of subarachnoid hemorrhage. A limited number of case reports and case series have been reported in the literature. Treatment options include conservative management, surgical clipping/trapping, and endovascular procedures. Owing to the uncertain natural history of these lesions, there is no consensus about the optimal treatment. Case Description A 64-year-old man presented with subarachnoid hemorrhage from a ruptured anterior spinal artery aneurysm at the C1 level. Following initial conservative management, surgical treatment was proposed owing to an increase in lesion size at angiographic follow-up. A partially thrombosed aneurysm was found during surgery, suggesting that spontaneous resolution of the aneurysm was occurring. Despite initial worsening of neurological symptoms, the patient gradually recovered after rehabilitation. Conclusions Treatment decisions for spinal aneurysms should be made on a case-by-case basis, the goal being to offer the patient the best option, while avoiding exposure to unnecessary invasive procedures. As spontaneous resolution of a spinal artery aneurysm is unpredictable, our case highlights the importance of performing a perioperative vascular study if surgery is planned.
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- 2021
12. A Case of Subarachnoid Hemorrhage Due to Ruptured Lateral Spinal Artery Aneurysm
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Kenta Fujimoto, Ai Okamoto, Yoshitomo Uchiyama, Hiroyuki Hashimoto, and Hidetsugu Maekawa
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medicine.medical_specialty ,Subarachnoid hemorrhage ,Aneurysm ,business.industry ,medicine ,medicine.disease ,business ,Spinal Artery ,Surgery - Published
- 2021
13. Experience of surgical treatment of vertebral artery injuries
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Valentin V. Alekseev, Nikolay I. Glushkov, K. V. Sementsov, Vladimir F. Rylkov, Alexey A. Moiseev, Anastasia O. Votinova, Anatoliy V. Skorodumov, and Taras E. Koshelev
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Contrast angiography ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Vertebral artery ,Wound size ,Magnetic resonance imaging ,Spinal Artery ,City hospital ,medicine.artery ,Medicine ,Radiology ,business ,Surgical treatment - Abstract
The aim of the study was to analyze the results of spinal artery damage treatment of the injured. Materials and methods. An 2-year analysis of treating 7 patients with vertebral artery injuries admitted to the City Hospital (GB) No. 26 of St. Petersburg was carried out. The problems of diagnosing and treating these injuries have been identified. The solutions to these problems have been suggested. Two clinical cases of successful treatment of injured patients with spinal artery damage have been presented. Results. Theres a possibility of damaging vertebral arteries in neck injuries thus defining the need for introducing high-informative methods of inspection (a spiral computer tomography contrast angiography, a Magnetic Resonance Imaging) and low-invasive (X-ray endovascular) interventions in urgent surgery. The implementation of complex instrumental examinations, their nature, the number of them and urgency should be determined by a surgeon individually considering the recommendations of related specialists. Conclusions. Regardless of the wound size and the patients condition, examination and treatment of patients with neck injuries should be carried out in large hospitals with angiosurgeon and other narrow specialists in the panel of doctors with the 24-hour surveillance, as well as access to full examination and high-tech urgent operational interventions.
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- 2020
14. Detection of arteriography-negative anterior spinal artery branching via intercostobronchial trunk confirmed by CT during intercostobronchial trunk arteriography: A case report
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Yasuo Sakurai, Gen Yamada, Yoshihisa Kodama, and Koji Yamasaki
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lcsh:Medical physics. Medical radiology. Nuclear medicine ,medicine.medical_specialty ,medicine.medical_treatment ,lcsh:R895-920 ,Anterior spinal artery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Bronchial artery embolization ,Interventional Radiology ,Transarterial embolization ,medicine ,Radiology, Nuclear Medicine and imaging ,Embolization ,business.industry ,Spinal cord ischemia ,CT during arteriography ,Spinal Artery ,Trunk ,Radiology ,Complication ,business ,Bronchial artery ,030217 neurology & neurosurgery - Abstract
Spinal cord ischemia is an important complication of bronchial artery embolization for hemoptysis. It has been reported even though a spinal artery was not visualized on arteriography. We could show a 67-year-old man with repeated hemoptysis. His hemoptysis gradually worsened and diagnosed with severe hemoptysis, and transarterial embolization was planned to stop the hemoptysis. An anterior spinal artery arising from intercostobronchial trunk confirmed by computed tomography during arteriography even though it was not visualized on arteriography. Great care should be taken with transarterial embolization via intercostobronchial trunk, potentially branching the spinal artery, even though it was not visualized on arteriography alone.
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- 2020
15. Detection of the common origin of the radiculomedullary artery with the feeder of spinal dural arteriovenous fistula using slab maximum intensity projection image
- Author
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Jun Haruma, Tomohito Hishikawa, Masafumi Hiramatsu, Kenji Sugiu, Takao Yasuhara, Kazuhiko Nishi, Yu Takahashi, Satoshi Murai, Yoko Yamaoka, and Isao Date
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Male ,medicine.medical_specialty ,Contrast Media ,Arteriovenous fistula ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,Neuroradiology ,Aged, 80 and over ,Central Nervous System Vascular Malformations ,medicine.diagnostic_test ,business.industry ,Angiography, Digital Subtraction ,Digital subtraction angiography ,Middle Aged ,medicine.disease ,Spinal cord ,Magnetic Resonance Imaging ,Spinal Artery ,medicine.anatomical_structure ,Spinal Cord ,Rotational angiography ,Maximum intensity projection ,Female ,Neurology (clinical) ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Artery - Abstract
Endovascular therapy to the spinal dural arteriovenous fistula (SDAVF) with a common origin of the radiculomedullary artery and the feeder of the shunt has the risk of spinal cord infarction. This study aimed to retrospectively assess the detection rate of normal spinal arteries from the feeder of SDAVF. We retrospectively collected the angiographic and clinical data of SDAVFs. This study included 19 patients with 20 SDAVF lesions admitted to our department between January 2007 and December 2018. We assessed the detection rate of normal radiculomedullary artery branched from the feeder of SDAVF between the period using the image intensifier (II) and flat panel detector (FPD) and evaluated the treatment results. The detection rates of the radiculomedullary artery branched from the feeder of SDAVF were 10% (1/10 lesions) during the II period and 30% (3/10 lesions) during the FPD period. During the FPD period, all normal radiculomedullary arteries branched from the feeder were only detected on slab maximum intensity projection (MIP) images of rotational angiography, and we could not detect them in 2D or 3D digital subtraction angiography. All lesions that had a common origin of a normal radiculomedullary artery and the feeder were completely obliterated without complications. There was no recurrence during the follow-up period. The flat panel detector and slab MIP images seem to show the common origin of the normal radiculomedullary arteries from the feeder more accurately. With detailed analyses, SDAVF can be safety treated.
- Published
- 2020
16. Isolated Posterior Spinal Artery Aneurysm Presenting with Spontaneous Thrombosis After Subarachnoid Hemorrhage
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Takayuki Funatsu, Tomomi Ishikawa, Masato Murakami, Takaomi Taira, Kento Takebayashi, Tasuya Ishikawa, and Takakazu Kawamata
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medicine.medical_specialty ,Subarachnoid hemorrhage ,medicine.diagnostic_test ,business.industry ,Lumbar puncture ,medicine.disease ,Spinal cord ,Spinal Artery ,Posterior spinal artery ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Cerebrospinal fluid ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,medicine.artery ,Angiography ,medicine ,Surgery ,cardiovascular diseases ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery - Abstract
Background The cause of subarachnoid hemorrhage is more likely to be intracranial than spinal. Bleeding, although common with spinal arteriovenous malformations and spinal cord tumors, rarely occurs with ruptured isolated spinal artery aneurysms. Here, we report a case of isolated thoracic posterior spinal artery aneurysm presenting with thrombosis after subarachnoid hemorrhage. Case Description A 67-year-old woman presented with sudden-onset nausea and low back and right thigh pain that worsened with movement. Computed tomography (CT) and magnetic resonance imaging (MRI) scans of the head suggested a small subarachnoid hemorrhage in the high-convexity sulcus, and lumbar puncture showed bloody cerebrospinal fluid. There was no apparent intracranial aneurysm on CT angiography; however, spinal MRI showed a lesion on the right side of the spinal cord at Th10. Contrast-enhanced CT showed an enhancing lesion at this site on day 7 that was not present on day 15. Selective right Th10 intercostal artery angiography on day 22 showed no evidence of aneurysm. The lesion was suspected to be a thrombotic spinal artery aneurysm. Given the unclear natural history of this entity, surgery was performed on day 36. After right Th10 hemilaminectomy and opening the dura, the arachnoid and adhesions were found to be thickened. A fusiform-shaped thrombosed aneurysm continuous with the radiculopial artery was removed. The patient was discharged without neurologic deterioration. Conclusions Isolated spinal artery aneurysm is a rare cause of subarachnoid hemorrhage. It is expected that additional cases will clarify the natural history and indications for treatment.
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- 2020
17. Feasibility of Noninvasive Diagnosis of Spinal Vascular Diseases Using Time-Resolved Angiography With Stochastic Trajectories
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Xiao-Er Wei, Yuehua Li, Rui-Hua Qiao, Ming-Hua Li, and Wei-Bin Yu
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medicine.medical_specialty ,Anterior spinal artery ,Arteriovenous fistula ,spinal dural arteriovenous fistula ,time-resolved ,medicine.artery ,medicine ,Vein ,RC346-429 ,Original Research ,MR angiography ,medicine.diagnostic_test ,business.industry ,Vascular malformation ,Adamkiewicz artery ,medicine.disease ,Spinal cord ,Spinal Artery ,body regions ,medicine.anatomical_structure ,Neurology ,Angiography ,perimedullary arteriovenous fistula ,Neurology (clinical) ,Radiology ,Neurology. Diseases of the nervous system ,Differential diagnosis ,business - Abstract
Background and Purpose: To determine the feasibility of time-resolved angiography with stochastic trajectories (TWIST) in the diagnosis of spinal dural arteriovenous fistula (SDAVF) and perimedullary arteriovenous fistula (PAVF).Methods: A total of 11 negative patients with TWIST examination were retrospective analyzed and then 18 patients with suspected spinal vascular diseases underwent TWIST. For negative patients, Adamkiewicz artery (AKA), great anterior radiculomedullary vein (GARV) and anterior spinal artery (ASA) were retrospective analyzed. In patients, the results of TWIST were compared with those of DSA.Results: The displaying rates of the ASA, AKA and GARV in 11 negative patients were 100, 90.9, and 90.9%, respectively. The AKA and GARV were separated on TWIST. Of 18 patients, 11 and three were diagnosed with SDAVF and PAVF, respectively. The spinal cord vascular malformation diagnosed on TWIST was consistent with DSA with an excellent intermodality agreement (Kappa = 0.92, p < 0.001). The feeding artery and side of all 11 SDAVF patients were displayed on TWIST and the results were consistent with DSA. For PAVF patients, the feeding artery in two patients and the sides as displayed on TWIST were consistent with DSA.Conclusions: TWIST enables the differentiation of the spinal artery and vein and the differential diagnosis of SDAVF and PAVF.
- Published
- 2021
18. Naratriptan-Associated Spinal Artery Infarction
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Omar A. Danoun, Hassan Aboul Nour, and Daniel Miller
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Pharmacology ,medicine.medical_specialty ,Naratriptan ,business.industry ,Infarction ,Arteries ,General Medicine ,medicine.disease ,Spinal Artery ,Tryptamines ,Text mining ,Piperidines ,Internal medicine ,medicine ,Cardiology ,Humans ,Pharmacology (medical) ,business ,medicine.drug - Published
- 2021
19. Neurological manifestations of polyarteritis nodosa: a tour of the neuroaxis by case series
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Mauro Caffarelli, Tarik Tihan, Vinil Shah, Christine Anastasiou, Christopher F. Dowd, Sharon A. Chung, Cathra Halabi, Daniel L Cooke, Megan B. Richie, Ramin A. Morshed, Adib A. Abla, and Erika K Williams
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Adult ,Male ,medicine.medical_specialty ,Neurology ,Delayed Diagnosis ,Case Report ,Aneurysm, Ruptured ,Myelopathy ,Rare Diseases ,medicine ,Humans ,RC346-429 ,Case series ,Spinal artery aneurysm ,Thunderclap headaches ,Multidisciplinary ,Neurology & Neurosurgery ,Mononeuritis Multiplex ,Polyarteritis nodosa ,business.industry ,Headache ,Neurosciences ,Intracranial Aneurysm ,General Medicine ,Middle Aged ,medicine.disease ,Spinal cord ,Dermatology ,Spinal Artery ,Aneurysm ,Ruptured ,Brain Disorders ,medicine.anatomical_structure ,Good Health and Well Being ,Neurological ,Female ,Cognitive Sciences ,Neurology. Diseases of the nervous system ,Neurology (clinical) ,Neurosurgery ,Nervous System Diseases ,business ,Immunosuppressive Agents - Abstract
Background Heterogenous central nervous system (CNS) neurologic manifestations of polyarteritis nodosa (PAN) are underrecognized. We review three cases of patients with PAN that illustrate a range of nervous system pathology, including the classical mononeuritis multiplex as well as uncommon brain and spinal cord vascular manifestations. Case presentation Case 1 presented with mononeuritis multiplex and characteristic skin findings. Case 2 presented with thunderclap headache and myelopathy due to spinal artery aneurysm rupture. Both patients experienced disease remission upon treatment. Case 3 presented with headache and bulbar symptoms due to partially thrombosed intracranial aneurysms, followed by systemic manifestations related to visceral aneurysms. She demonstrated clinical improvement with treatment, was lost to follow-up, then clinically deteriorated and entered hospice care. Conclusions Although the peripheral manifestations of PAN are well-known, PAN association with CNS neurovascular disease is relatively underappreciated. Clinician awareness of the spectrum of neurologic disease is required to reduce diagnostic delay and promote prompt diagnosis and treatment with immunosuppressants.
- Published
- 2021
20. Intraspinal canal platform system for coil embolization of anterior spinal artery aneurysm associated with spinal cord arteriovenous malformation: a case report and literature review
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Yota Suzuki, Daishiro Abe, Tetsuyoshi Horiuchi, Daisuke Yamazaki, Yoshiki Hanaoka, Jun-ichi Koyama, Yu Fujii, Toshihiro Ogiwara, Takuya Nakamura, and Masahiro Agata
- Subjects
medicine.medical_specialty ,business.industry ,Anterior spinal artery ,Arteriovenous malformation ,General Medicine ,Rupture rate ,medicine.disease ,Spinal cord ,Spinal Artery ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,medicine.artery ,cardiovascular system ,medicine ,cardiovascular diseases ,Neurology (clinical) ,Endovascular treatment ,business ,030217 neurology & neurosurgery ,Coil embolization - Abstract
The prognosis for spinal artery aneurysms associated with spinal cord arteriovenous malformations (AVMs) is poor because of the high rupture rate of aneurysms. However, endovascular treatment remains technically difficult because the catheter system must be constructed via the small-caliber anterior spinal artery (ASA) or posterior spinal artery (PSA), which feeds functionally eloquent spinal cord. A 2.6F Carnelian HF-S microcatheter (Tokai Medical Products, Aichi, Japan) has been specifically designed to assist a 1.6F Carnelian MARVEL S microcatheter (Tokai Medical Products) as a small-profile 'platform catheter' close to the target lesion. Here we present a prenidal ASA aneurysm treated using a 2.6F Carnelian HF-S microcatheter as an intraspinal canal platform catheter and review related literature.A 50-year-old man presented with a subarachnoid haemorrhage due to cervical spinal cord AVM. Diagnostic vertebral angiography revealed the AVM supplied by the PSA originated from the right C2 segmental artery and ASA arising from the right V4 segment. Superselective angiography for each feeder was achieved through a 2.6F Carnelian HF-S microcatheter, and a prenidal ASA aneurysm was diagnosed, which was clinically consistent with haemorrhagic origin. A 1.6F Carnelian MARVEL S microcatheter was cannulated into the aneurysm through the 2.6F Carnelian HF-S microcatheter positioned at the ASA. The aneurysm coiling was successfully performed without system instability or periprocedural complications.Only a few cases have described endovascular treatment for spinal artery aneurysms. To date, no reports have been published regarding the use of an intraspinal canal platform catheter to treat spinal artery aneurysms. A 2.6F Carnelian HF-S microcatheter served as a useful intraspinal canal platform catheter for coil embolization of the ASA aneurysm. This system can provide excellent accessibility and controllability for endovascular treatment of spinal artery lesions.
- Published
- 2021
21. Anterior spinal artery aneurysm presenting with spinal subarachnoid hemorrhage in a case of polyarteritis nodosa
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Garrett Smith, Mehmet S. Albayram, and Brian L. Hoh
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medicine.medical_specialty ,Subarachnoid hemorrhage ,Anterior spinal artery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Pseudoaneurysm ,0302 clinical medicine ,Aneurysm ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,skin and connective tissue diseases ,integumentary system ,Polyarteritis nodosa ,business.industry ,Angiography, Digital Subtraction ,Middle Aged ,Subarachnoid Hemorrhage ,medicine.disease ,Spinal Artery ,Spine ,Polyarteritis Nodosa ,030220 oncology & carcinogenesis ,Female ,Radiology ,Artery of Adamkiewicz ,Tomography, X-Ray Computed ,business ,Bronchial artery - Abstract
Polyarteritis nodosa is characterized by presence of aneurysms in the renal, hepatic and mesenteric vasculature, and less often by vascular abnormalities in the intracranial compartment. Spinal subarachnoid hemorrhage is a rare phenomenon that can be associated with inflammatory vasculopathies such as polyarteritis nodosa, but the link between aneurysm formation and spinal subarachnoid hemorrhage in polyarteritis nodosa is unclear. We describe a case of a patient with polyarteritis nodosa and spinal subarachnoid hemorrhage following rupture of an aneurysm of the anterior spinal artery. Following operative washout and decompression of the subarachnoid hemorrhage, spinal digital subtraction angiography was performed and revealed intimal contour irregularities, stenotic changes, and multiple small aneurysms in renal, hepatic, and bronchial arteries and some proximal spinal arteries, and, most notably, a pseudoaneurysm of the anterior spinal artery supplied directly by the artery of Adamkiewicz. Polyarteritis nodosa was subsequently diagnosed in light of these findings. Though previous cases have noted spinal subarachnoid hemorrhage in of the context of polyarteritis nodosa, we found no previously documented case of a definitive aneurysm of the anterior spinal artery in a case of polyarteritis nodosa documented on angiography. This case highlights the potential importance of monitoring for aneurysms of the spinal vasculature in cases of polyarteritis nodosa and in screening for vasculitides in cases of spinal subarachnoid hemorrhage. Future studies are needed to describe patterns of the specific anatomic localization and incidence of spinal artery aneurysms in polyarteritis nodosa.
- Published
- 2019
22. Spinal cord watershed infarction: Novel findings on magnetic resonance imaging
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Garrett Smith, Mindy X. Wang, and Mehmet S. Albayram
- Subjects
medicine.medical_specialty ,Cord ,Computed Tomography Angiography ,Anterior spinal artery ,Ischemia ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,medicine.diagnostic_test ,Spinal Cord Ischemia ,Vascular disease ,business.industry ,Thrombosis ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Spinal cord ,Magnetic Resonance Imaging ,Spinal Artery ,Hyperintensity ,medicine.anatomical_structure ,Spinal Cord ,Infarction ,030220 oncology & carcinogenesis ,Cardiology ,Female ,business - Abstract
Spinal cord watershed ischemia is a rare phenomenon often associated with cardiac arrest, prolonged hypotension, and atherosclerotic disease. It can manifest as central necrosis with peripheral sparing in the transverse axis, and central lesion with rostral and caudal sparing in the longitudinal axis. Few reports provide detailed imaging findings of spinal cord watershed ischemia lesions. We present a patient who experienced watershed infarcts of the brain and spinal cord following prolonged hypotension due to blood loss after an aortic aneurysm repair. The patient experienced loss of neurologic function of the lower extremities and left arm that did not recover following spinal cord ischemia protocol. MRI revealed spinal cord watershed ischemia in both the longitudinal and axial planes with the point of maximal T2 signal hyperintensity in the central cord at T10-T11. Unique findings included zones of central maximal T2 signal hyperintensity with peripheral sparing, and moderate T2 intensity representing partial ischemia between regions of maximal T2 intensity unaffected peripheral regions. Thoracoabdominal computed tomography angiogram revealed extensive intraluminal thrombus and bilateral spinal artery occlusion from T8 to L2 and bilateral severe renal artery stenosis. T7 and L3 spinal arteries were patent. We suspect preexisting atherosclerotic disease played a significant role in the development of widespread watershed lesions following prolonged hypotension and resulted in a clinical and imaging presentation distinct from that seen with isolated anterior spinal artery occlusion. Our unique MRI findings portray a rarely documented pattern of spinal cord watershed ischemia and prompt questions about the role of anatomic idiosyncrasies and preexisting vascular disease in the development of spinal cord watershed ischemia.
- Published
- 2019
23. Role of antioxidant therapy in treatment of dorsopathy with vertebral artery syndrome
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Laboratory methods ,business.industry ,Anesthesia ,Medicine ,business ,Spinal Artery ,Neurological deficit - Abstract
Fifty patients with cervical dorsopathy with the spinal artery syndrome were studied using clinical scales (neurological deficit, psychoemotional disturbances) and laboratory methods (parameters of oxidant stress). The correlations between the oxidant stress and the dynamics of neurological syndromes and psychoemotional disturbances as well as the efficacy and safety of their treatment with antioxidants were determined.
- Published
- 2019
24. An isolated ruptured spinal aneurysm presents with a thalamic Infarct: case report
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Alexander Tenorio, Karl Meisel, Adib A. Abla, Matthew R Amans, and Brandon B. Holmes
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Male ,Abdominal pain ,medicine.medical_specialty ,Subarachnoid hemorrhage ,Case Report ,Aneurysm, Ruptured ,Neurodegenerative ,Cardiovascular ,lcsh:RC346-429 ,030218 nuclear medicine & medical imaging ,Posterior spinal artery ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Rare Diseases ,Clinical Research ,medicine.artery ,medicine ,Humans ,cardiovascular diseases ,Spinal Cord Injury ,lcsh:Neurology. Diseases of the nervous system ,Vertebral Artery ,Neurology & Neurosurgery ,business.industry ,Pain Research ,Neurosciences ,Thoracolumbar Region ,General Medicine ,Cerebral Infarction ,Subarachnoid Hemorrhage ,Middle Aged ,medicine.disease ,Spinal Artery ,Ruptured ,Surgery ,Thalamic infarct ,Spinal Cord ,Posterior spinal aneurysm ,Cognitive Sciences ,Neurology (clinical) ,Neurosurgery ,medicine.symptom ,Chronic Pain ,business ,Paraplegia ,030217 neurology & neurosurgery - Abstract
Background Isolated spinal artery aneurysms are extremely rare, and their pathogenesis, clinical presentation, and treatment strategies are poorly established. We report only the second case of a patient with an isolated posterior spinal aneurysm and concurrent left thalamic infarct and review the literature to help clarify treatment strategies of isolated spinal aneurysms. Case presentation A 49-year-old patient presented with acute onset walking difficulty followed by diaphoresis, back and abdominal pain, and paraplegia. Imaging was notable for a hemorrhagic spinal lesion with compression at T12 through L4 and an acute left thalamic infarct. Surgical exploration revealed an isolated posterior spinal artery aneurysm. The aneurysm was surgically resected and the patient had partial recovery six months post-operatively. Conclusions Isolated posterior spinal artery aneurysms of the thoracolumbar region are rare lesions that commonly present with abdominal pain, radiating back pain, and lower extremity weakness. Imaging may not provide a definitive diagnosis. The three primary treatment strategies are conservative management, endovascular treatment, or surgical resection. In patients with symptomatic cord compression, immediate surgical intervention is indicated to preserve neurologic function. In all other cases, the artery size, distal flow, morphology, and location may guide management.
- Published
- 2021
25. Neurovascular anatomy: Spine
- Author
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Lydia Gregg and Philippe Gailloud
- Subjects
business.industry ,Anterior spinal artery ,Anatomy ,Neurovascular bundle ,Spinal cord ,Spinal Artery ,030218 nuclear medicine & medical imaging ,Posterior spinal artery ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,medicine.anatomical_structure ,medicine.artery ,medicine ,Thecal sac ,business ,030217 neurology & neurosurgery ,Lumbosacral joint - Abstract
The arterial supply of the spinal cord is provided by the spinal branch of the cervical, thoracic, and lumbar intersegmental arteries. While supply is initially provided at each embryonic segment, only a few prominent anterior radiculomedullary arteries remain at the adult stage, including the arteries of the cervical and lumbosacral enlargements as well as a constant upper thoracic contributor. The spinal cord is surrounded by the vasocorona, an arterial network that includes several longitudinal anastomotic chains, notably the anterior and posterior spinal arteries, which respectively supply the central and peripheral components of the intrinsic vascularization. The intrinsic venous circulation is also divided into central and peripheral components. The perimedullary venous system includes several longitudinal anastomotic chains interconnected by the coronary plexus. The radiculomedullary veins loosely follow the spinal nerve roots on their way to the epidural plexus. Their point of passage through the thecal sac forms an important valve-like structure, the antireflux mechanism.
- Published
- 2021
26. Use of Fenestrated Stent-Grafts for Preservation of Spinal Artery Flow During Endovascular Repair of Thoracoabdominal Aortic Disease
- Author
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Anders Wanhainen, Kevin Mani, and Mario D'Oria
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Thoracoabdominal Aortic Aneurysms ,Aortic disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine ,Cardiac and Cardiovascular Systems ,cardiovascular diseases ,Kardiologi ,business.industry ,Neurologic complication ,Kirurgi ,Stent ,Spinal cord ischemia ,General Medicine ,medicine.disease ,Spinal Artery ,Surgery ,surgical procedures, operative ,Cardiology and Cardiovascular Medicine ,Fenestration ,business - Abstract
We illustrate the safety and feasibility of the application of fenestrated stent-grafts for the preservation of spinal artery flow during endovascular repair of thoracoabdominal aortic aneurysms (TAAA) in 2 patients deemed high-risk for spinal cord ischemia (SCI). In one case, an unstented fenestration was used in a 78-year-old male treated for distal stent-graft induced new entry tear. In the other case, a fenestration with a bridging stent-graft was used to revascularize a spinal artery in a 66-year-old female with Marfan disease and island patch aneurysm following open TAAA reconstruction. Both procedures were successful without any postoperative neurologic complication. The unstented fenestration led to a type III endoleak that required the relining of the aortic stent-graft 2 years later. The stented spinal fenestration was patent at a 5-year imaging follow-up.
- Published
- 2021
27. Retroperitoneal hemorrhage from an unrecognized puncture of the lumbar right segmental artery during lumbar chemical sympathectomy: diagnosis and management.
- Author
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Ho-Jin Shin, Yun-Mi Choi, Hye-Jin Kim, Sun-Jae Lee, Seok-Hyun Yoon, and Kyung-Hoon Kim
- Subjects
- *
LUMBAR vertebrae surgery , *HEMORRHAGE , *SYMPATHECTOMY , *FLUOROSCOPY , *ALLODYNIA , *TEMPERATURE effect - Abstract
Lumbar chemical sympathectomy has been performed using fluoroscopic guidance for needle positioning. An 84 year old woman with atherosclerosis obliterans was referred to the pain clinic for intractable cold allodynia of her right foot. A thermogram showed decreased temperature of both feet compared with temperatures above both ankles. The patient agreed to undergo lumbar chemical sympathectomy using fluoroscopy after being informed of the associated risks of nerve injury, hemorrhage, infection, transient back pain, and transient hypotension. During the procedure and three hours afterward, no abnormal signs or symptoms were found except an increase in right leg temperature. The patient was ambulatory after the procedure. However, one day after undergoing lumbar chemical sympathectomy, she visited our emergency department for abdominal discomfort and postural dizziness. Her blood pressure was 80/50 mmHg, and flank tenderness was noted. Retroperitoneal hemorrhage from the second right lumbar segmental artery was shown on computed tomography and angiography. Vital signs were stabilized immediately after embolization into the right lumbar segmental artery. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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28. Ruptured Isolated Spinal Artery Aneurysms.
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ROMERO, DIEGO GUTIERREZ, BATISTA, ANDRE LIMA, GENTRIC, JEAN CHRISTOPH, RAYMOND, JEAN, ROY, DANIEL, and WEILL, ALAIN
- Subjects
- *
ARTERIAL dissections , *ANEURYSMS , *SUBARACHNOID hemorrhage , *SPINAL nerve roots , *ARTERIOVENOUS malformation - Abstract
Isolated spinal artery aneurysms are exceedingly rare vascular lesions thought to be related to dissection of the arterial wall. We describe two cases presenting with spinal subarachnoid haemorrhage that underwent conservative management. In the first patient the radiculomedullary branch involved was feeding the anterior spinal artery at the level of D3 and thus, neither endovascular nor surgical approach was employed. Control angiography was performed at seven days and at three months, demonstrating complete resolution of the lesion. In our second case, neither the anterior spinal artery or the artery of Adamkiewicz could be identified during angiography, thus endovascular management was deemed contraindicated. Magnetic resonance imaging showed a stable lesion in the second patient. No rebleeding or other complications were seen. In comparison to intracranial aneurysms, spinal artery aneurysms tend to display a fusiform appearance and lack a clear neck in relation to the likely dissecting nature of the lesions. Due to the small number of cases reported, the natural history of these lesions is not well known making it difficult to establish the optimal treatment approach. Various management strategies may be supported, including surgical and endovascular treatment, but It would seem that a wait and see approach is also viable, with control angiogram and treatment decisions based on the evolution of the lesion. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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29. Spinal vessels: normal and abnormal findings on CT
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Sakai, O., Furuse, M., Nakashima, N., Ogawa, C., Shinozaki, T., Kikuno, M., Takahashi, Mutsumasa, editor, Korogi, Yukunori, editor, and Moseley, Ivan, editor
- Published
- 1995
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30. Subarachnoid Hemorrhage due to Ruptured Spinal Artery Aneurysm: A Diagnostic Challenge
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Vien Chi Le, Thang Huy Nguyen, Ngoc Hoang Nguyen, and Trung Quoc Nguyen
- Subjects
Abdominal pain ,medicine.medical_specialty ,Cord ,Subarachnoid hemorrhage ,medicine.diagnostic_test ,spinal aneurysm ,business.industry ,Magnetic resonance imaging ,Subarachnoid Hemorrhage ,medicine.disease ,Spinal cord ,Spinal Artery ,lcsh:RC346-429 ,nervous system diseases ,Aneurysm ,medicine.anatomical_structure ,Hematoma ,medicine ,radiculomedullary artery ,Neurology (clinical) ,Radiology ,cardiovascular diseases ,medicine.symptom ,business ,lcsh:Neurology. Diseases of the nervous system - Abstract
Subarachnoid hemorrhage (SAH) due to a solitary spinal aneurysm is extremely rare. Early diagnosis of spinal SAH is challenging, particularly when the spinal cord has not been compressed. We report a case of a 45-year-old male who presented with sudden onset of abdominal pain, followed by severe headache, vomiting, and generalized seizure. Three days after admission to the hospital, he developed progressive paraparesis. Magnetic resonance imaging (MRI) revealed spinal SAH with hematoma resulting in cord compression at the level of T9. Diagnostic spinal angiography identified a ruptured aneurysm of a radiculomedullary artery. In conclusion, rupture of a spinal aneurysm should be considered a possible cause of SAH in appropriate clinical settings, and clinicians must be aware of the possibility of cord compression.
- Published
- 2020
31. Incidental Finding of a Duplicated Vertebral Artery Followed by a Spinal Dural Arteriovenous Fistula on Spinal Angiography
- Author
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Danielle D Dang, Brian P Curry, Luke Mugge, and Michael Crimmins
- Subjects
Aortic arch ,medicine.medical_specialty ,Vertebral artery ,Neurosurgery ,Arteriovenous fistula ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,dual origin ,subclavian ,medicine.artery ,medicine ,dural arteriovenous fistula ,business.industry ,Vascular malformation ,General Engineering ,Neurosarcoidosis ,medicine.disease ,Spinal cord ,Spinal Artery ,Conus medullaris ,aorta ,medicine.anatomical_structure ,vertebral artery ,Radiology ,business ,030217 neurology & neurosurgery - Abstract
Duplicated origin of the vertebral artery (VA) is an extremely rare normal anatomic variant. While most often considered non-pathological, duplicated origin carries an increased risk of dissection. An association with vascular pathologies such as aneurysms, arteriovenous malformations, and AV fistulas has been suggested. The objective is to describe this unusual anatomic variant with is concomitant vascular pathology and review current literature. The authors report a case of incidentally-discovered duplicated origin of the left VA in patients with a spinal dural arteriovenous fistula (dAVF). A 61-year-old man with a history significant for sarcoidosis presented with progressive lower extremity weakness and paresthesias. MRI of the thoracic spine demonstrated significant confluent edema and patchy contrast enhancement in the caudal spinal cord and conus medullaris which did not appear related to the patient's neurosarcoidosis. A diagnostic spinal angiogram incidentally demonstrated that the left V1 segment had a duplicated origin, one branch arising from the aortic arch and the other branch arising from the left subclavian artery, with union at the C5 transverse foramen. This finding represented an incidental anomaly discovery was noted to be incidental and was not believed to be related to the patients underlying pathology. Subsequently, a dAVF was discovered, originating from the right T7 spinal artery. Location of this vascular malformation directly correlated with the patient's symptoms. The patient then underwent embolization of the spinal dAVF and recovered uneventfully. Duplicated origin of the VA is an extremely rare but well-described variant, most commonly involving the left VA. To our knowledge, this is the only reported spinal dAVF associated with duplicated origin of the left VA. An association with other pathological entities has been suggested, and thus this case adds to a growing body of cases characterizing these relationships.
- Published
- 2020
32. Cauda Equina and Filum Terminale Arteriovenous Fistulas: Anatomic and Radiographic Features
- Author
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Masaki Komiyama, Katsunari Namba, A. Higaki, Tomoya Ishiguro, Naoki Toma, and Yasunari Niimi
- Subjects
musculoskeletal diseases ,Male ,congenital, hereditary, and neonatal diseases and abnormalities ,Cauda Equina ,Anterior spinal artery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,medicine.diagnostic_test ,business.industry ,Cauda equina ,Anatomy ,Spinal cord ,Spinal Artery ,Magnetic Resonance Imaging ,Spine ,Conus medullaris ,medicine.anatomical_structure ,Spinal Cord ,Angiography ,Arteriovenous Fistula ,Neurology (clinical) ,Filum terminale ,business ,030217 neurology & neurosurgery ,Lumbosacral joint ,Magnetic Resonance Angiography - Abstract
Intradural AVF below the conus medullaris may develop either on the filum terminale or the cauda equina (lumbosacral and coccygeal radicular nerves). Although not a few filum terminale AVFs are found in the literature, only 3 detailed cauda equina AVFs have been reported. Here, we analyze the angiographic and MR imaging findings of our cauda equina and filum terminale AVF cases, supplemented with literature research to characterize the radiologic features of the 2 entities. On angiography, filum terminale AVFs were invariably supplied by the extension of the anterior spinal artery accompanied by a closely paralleling filum terminale vein. Cauda equina AVFs were fed by either a radicular or a spinal artery or both arteries, often with a characteristic wavy radicular-perimedullary draining vein. On thin-section axial MR imaging, the filum terminale AVF draining vein joined the spinal cord at the conus medullaris apex, but that of the cauda equina AVF joined above the conus medullaris apex.
- Published
- 2020
33. Spinal intraosseous arteriovenous fistulas with perimedullary drainage associated with vertebral compression fracture: illustrative case.
- Author
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Baba H, Kiyosue H, Ide S, Onishi K, Kubo T, and Tokuyama K
- Abstract
Background: Although osseous involvement is occasionally observed in spinal epidural arteriovenous fistulas (AVFs) or seen as a part of diseases of spinal arteriovenous metameric syndrome, purely intraosseous spinal AVFs are extremely rare. Their clinical and imaging characteristic features are not well known. The authors present a case of purely intraosseous AVFs associated with compression fracture., Observations: A 76-year-old man presented with back pain and progressive myelopathy. Computed tomography showed compression fracture of the T12 vertebral body and dilatation of perimedullary veins. Spinal angiography revealed an intraosseous AVF at the T12 spine level, which was fed by multiple feeders of ventral somatic branches and drained into the paravertebral and perimedullary veins. The intraosseous AVF was completely occluded by the combined techniques of transarterial and transvenous embolization with glue and a coil. The symptoms disappeared within 1 month after embolization., Lessons: Although extremely rare, spinal intraosseous AVFs can develop after compression fracture and cause congestive myelopathy. Combined transarterial and transvenous embolization is useful for the specific case of spinal intraosseous AVFs with both paravertebral and perimedullary drainage., Competing Interests: Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper., (© 2022 The authors.)
- Published
- 2022
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34. Clipping of Ruptured Aneurysm of Lateral Spinal Artery Associated with Anastomosis to Distal Posterior Inferior Cerebellar Artery: A Case Report
- Author
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Oliver Bozinov, Luca Regli, Zsolt Kulcsar, Menno R. Germans, University of Zurich, and Germans, Menno R
- Subjects
Male ,medicine.medical_specialty ,Subarachnoid hemorrhage ,medicine.medical_treatment ,610 Medicine & health ,Spinal vascular malformation ,Aneurysm, Ruptured ,Anastomosis ,030218 nuclear medicine & medical imaging ,10180 Clinic for Neurosurgery ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,10043 Clinic for Neuroradiology ,Cerebellum ,medicine.artery ,medicine ,Humans ,In patient ,cardiovascular diseases ,medicine.diagnostic_test ,business.industry ,Cerebral angiography ,Intracranial Aneurysm ,Arteries ,Clipping (medicine) ,Middle Aged ,Subarachnoid Hemorrhage ,medicine.disease ,Spinal Artery ,2746 Surgery ,Surgery ,2728 Neurology (clinical) ,Posterior inferior cerebellar artery ,Spinal Cord ,Arteriovenous Fistula ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background Arteries that anastomose with the posterior inferior cerebellar artery (PICA) can harbor aneurysms. Case Description We present a case of a patient who suffered a subarachnoid hemorrhage as a result from an aneurysm on the left lateral spinal artery (LSA) that anastomosed to the PICA. The aneurysm was treated surgically, and the flow between the LSA and PICA was disrupted. The activated anastomotic network created a new anastomosis between the LSA and PICA, which was seen at 6 months' follow-up. Conclusions Careful follow-up is warranted in patients who have an activated anastomotic network because they can potentially develop aneurysms on newly created anastomoses.
- Published
- 2018
35. Vertebral artery aneurysms and the risk of cord infarction following spinal artery coverage during flow diversion
- Author
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Vincent M. Tutino, Anish Kapadia, Patrick Nicholson, Alejandro Enriquez-Marulanda, Muhammad Waqas, Thomas R. Marotta, Kevin Phan, Mark R. Harrigan, Leonardo Renieri, Ivan Radovanovic, Timo Krings, Christoph J. Griessenauer, Anna Luisa Kühn, Caterina Michelozzi, Vitor Mendes Pereira, Elad I. Levy, Christophe Cognard, Adnan H. Siddiqui, Carmen Parra-Fariñas, Nicola Limbucci, Adam A Dmytriw, Paul M. Foreman, I-Hsiao Yang, Ajith J. Thomas, and Christopher S. Ogilvy
- Subjects
Male ,medicine.medical_specialty ,Vertebral artery ,Anterior spinal artery ,Infarction ,Neurosurgical Procedures ,Posterior spinal artery ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Postoperative Complications ,Risk Factors ,medicine.artery ,Thromboembolism ,Occlusion ,Medicine ,Humans ,Vertebral Artery ,Aged ,Retrospective Studies ,business.industry ,Endovascular Procedures ,Intracranial Aneurysm ,General Medicine ,Cerebral Infarction ,Middle Aged ,medicine.disease ,Spinal Artery ,Embolization, Therapeutic ,Surgery ,Posterior inferior cerebellar artery ,Treatment Outcome ,Spinal Cord ,030220 oncology & carcinogenesis ,Female ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
OBJECTIVECoverage of the anterior spinal artery (ASA) ostia is a source of considerable consternation regarding flow diversion (FD) in vertebral artery (VA) aneurysms due to cord supply. The authors sought to assess the association between coverage of the ASA, posterior spinal artery (PSA), or lateral spinal artery (LSA) ostia when placing flow diverters in distal VAs and clinical outcomes, with emphasis on cord infarction.METHODSA multicenter retrospective study of 7 institutions in which VA aneurysms were treated with FD between 2011 and 2019 was performed. The authors evaluated the risk of ASA and PSA/LSA occlusion, associated thromboembolic complication, complications overall, aneurysm occlusion status, and functional outcome.RESULTSSixty patients with 63 VA and posterior inferior cerebellar artery aneurysms treated with FD were identified. The median aneurysm diameter was 7 mm and fusiform type was the commonest morphology (42.9%). During a procedure, 1 (61.7%) or 2 (33.3%) flow diverters were placed. Complete occlusion was achieved in 71.9%. Symptomatic thromboembolic complications occurred in 7.4% of cases and intracranial hemorrhage in 10.0% of cases. The ASA and PSA/LSA were identified in 51 (80.9%) and 35 (55.6%) complications and covered by the flow diverter in 29 (56.9%) and 13 (37.1%) of the procedures, respectively. Patency after flow diverter coverage on last follow-up was 89.2% for ASA and 100% for PSA/LSA, not significantly different between covered and noncovered groups (p = 0.5 and p > 0.99, respectively). No complications arose from coverage.CONCLUSIONSFD aneurysm treatment in the posterior circulation with coverage of ASA or PSA/LSA was not associated with higher rates of occlusion of these branches or any instances of cord infarction.
- Published
- 2019
36. Spinal artery aneurysms: clinical presentation, radiological findings and outcome
- Author
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Leonardo Renieri, Peyman Shirani, Maksim Shapiro, Timo Krings, Eytan Raz, Giuseppe Lanzino, and Waleed Brinjikji
- Subjects
Adult ,medicine.medical_specialty ,Subarachnoid hemorrhage ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Back pain ,medicine ,Humans ,cardiovascular diseases ,Vertebral Artery ,Aged ,Retrospective Studies ,business.industry ,General Medicine ,Middle Aged ,Subarachnoid Hemorrhage ,medicine.disease ,Spinal cord ,Spinal Artery ,Surgery ,Dissection ,Treatment Outcome ,medicine.anatomical_structure ,Spinal Cord ,Female ,Neurology (clinical) ,medicine.symptom ,Presentation (obstetrics) ,business ,030217 neurology & neurosurgery ,Follow-Up Studies ,Artery - Abstract
Background and purposeSpinal arterial aneurysms are a rare cause of spinal subarachnoid hemorrhage (SAH). We performed a retrospective review of spinal arterial aneurysms not associated with spinal arteriovenus shunts from three institutions in order to better understand the clinical and imaging characteristics of these lesions.Materials and methodsWe performed a retrospective review of spinal arterial aneurysms managed at three North American institutions. For each patient, the following information was collected: demographic data, clinical presentation, comorbidities, imaging findings, and neurological status at the last follow-up. Treatment strategies and outcomes were reported.Results11 patients were included; 7 were women and median age was 60 years. The most common presentation was sudden back pain (81.8%). We found 3 aneurysms on the radiculomedullary artery and 8 along the radiculopial arteries. Of the 3 aneurysms on the radiculomedullary artery, 1 was treated conservatively, 1 was treated with coiling of the aneurysm and sacrifice of the radiculomedullary artery, and 1 was treated with surgical trapping. The 8 aneurysms on the radiculopial artery were treated endovascularly in 4 cases, surgically in 1 case, and conservatively in 3 cases. One surgically treated patient had a spinal subdural hematoma. There were no other complications. Mean clinical follow-up time was 20 months, and 87.5% of patients were functionally independent.ConclusionsSpinal arterial aneurysms are lesions which commonly present with sudden back pain and spinal SAH. Conservative, surgical, and endovascular treatment options are safe and effective. Long term outcomes in these patients are generally good.
- Published
- 2018
37. Surgical clipping of flow related giant unruptured anterior spinal artery aneurysm secondary to co-arctation of aorta: Management challenges and lessons learnt
- Author
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Anant Mehrotra, Kuntal Kanti Das, Raj Kumar, Pradeep Sharma, Jeena Joseph, and Awadhesh Kumar Jaiswal
- Subjects
medicine.medical_specialty ,Cord ,medicine.medical_treatment ,Anterior spinal artery ,lcsh:Surgery ,lcsh:RC346-429 ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine.artery ,medicine ,cardiovascular diseases ,lcsh:Neurology. Diseases of the nervous system ,Aorta ,medicine.diagnostic_test ,business.industry ,lcsh:RD1-811 ,Clipping (medicine) ,Pulmonary edema ,medicine.disease ,Spinal Artery ,Surgery ,Angiography ,cardiovascular system ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery - Abstract
Background: Anterior spinal artery aneurysms (ASAA) are extremely rare. While these aneurysms are very well known to cause spinal subarachnoid haemorrhage/hematomyelia secondary to sudden rupture, presentation with chronic myelopathy remains extremely rare. Case report: A 50-year-old gentleman presented with chronic upper thoracic myelopathy for 1 year. MRI of the dorsal spine revealed an intradural T2 hypointense mass with prominent vessels at T1 level. During intra-arterial angiography, accidental diagnosis of a co-existent co-arctation of the aorta was made. The intradural spinal mass turned out to be a giant, partially thrombosed ASA aneurysm on angiography. This patient underwent surgical clipping of the aneurysm utilizing a posterolateral approach. The patient experienced a stormy early postoperative period due to acute renal failure and pulmonary edema that settled down by the time of discharge. Conclusion: ASAA remains an extremely rare cause of compressive myelopathy. Its association with co-arctation of aorta increases treatment related mortality. Posterolateral approach provides a good exposure of the aneurysm for surgical clipping with minimal retraction of the cord. Keywords: Unruptured, Clipping, Thoracic spine, Spinal artery, Co-arctation
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- 2017
38. Spinal ventral epidural arteriovenous fistulas of the lumbar spine: angioarchitecture and endovascular treatment.
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Kiyosue, Hiro, Tanoue, Shuichi, Okahara, Mika, Hori, Yuzo, Kashiwagi, Junji, and Mori, Hiromu
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THERAPEUTIC embolization , *ANGIOGRAPHY , *ARTERIOVENOUS fistula , *MEDICAL information storage & retrieval systems , *LUMBAR vertebrae , *MAGNETIC resonance imaging , *MEDLINE , *ONLINE information services , *SYSTEMATIC reviews , *ANATOMY - Abstract
Introduction: Spinal ventral epidural arteriovenous fistulas (EDAVFs) are relatively rare spinal vascular lesions. We investigated the angioarchitecture of spinal ventral EDAVFs and show the results of endovascular treatment. Methods: We reviewed six consecutive patients (four males and two females; mean age, 67.3 years) with spinal ventral EDAVFs treated at our institutions from May 2011 to October 2012. All patients presented with progressive myelopathy. The findings of angiography, including 3D/2D reformatted images, treatments, and outcomes, were investigated. A literature review focused on the angioarchitecture and treatment of spinal ventral EDAVFs is also presented. Results: The EDAVFs were located in the ventral epidural space at the L1-L5 levels. All EDAVFs were supplied by the dorsal somatic branches from multiple segmental arteries. The ventral somatic branches and the radiculomeningeal arteries also supplied the AVFs in two patients. The AVFs drained via an epidural venous pouch into the perimedullary vein in four patients and into both the perimedullary vein and paravertebral veins in two patients. Four cases without paravertebral drainage were treated by transarterial embolization with diluted glue, and two cases with perimedullary and paravertebral drainages were treated by transvenous embolization alone or in combination with transarterial embolization. An angiographic cure was obtained in all patients. Clinical symptoms resolved in two patients, markedly improved in three patients, and minimally improved in one patient. Conclusion: In our limited experience, spinal ventral EDAVFs were primarily fed by somatic branches. EDAVFs can be successfully treated by endovascular techniques selected based on the drainage type of the AVF. [ABSTRACT FROM AUTHOR]
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- 2013
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39. Aneurysm of the lateral spinal artery: A case report
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Morigaki, Ryoma, Satomi, Junichiro, Shikata, Eiji, and Nagahiro, Shinji
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- 2012
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40. The Role of the Primitive Lateral Basilovertebral Anastomosis of Padget in Variations of the Vertebrobasilar Arterial System
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Lydia Gregg and Philippe Gailloud
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0301 basic medicine ,Dorsum ,Histology ,business.industry ,Anatomy ,Anastomosis ,Spinal Artery ,nervous system diseases ,Radicular artery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Medicine ,Trigeminal artery ,030101 anatomy & morphology ,business ,030217 neurology & neurosurgery ,Ecology, Evolution, Behavior and Systematics ,Biotechnology ,Artery - Abstract
Purpose: The primitive lateral basilovertebral anastomosis (PLBA) is an embryonic longitudinal anastomotic channel that transiently interconnects the developing branches of the vertebrobasilar system. This study reviews the anatomy of the PLBA and describes several variants associated with its partial persistence. Methods: Four types of vertebrobasilar anomalies linked to the PLBA are illustrated by 13 angiographic observations. Results: The angiographic appearances of (i) typical and atypical persistent trigeminal artery variants, (ii) common trunks of origin for one, two or three cerebellar arteries, (iii) aberrant origins of the cerebellar arteries, and (iv) vertebrobasilar duplications are described. The PLBA is the cranial continuation of the ascending ramus of the dorsal radicular branch of the proatlantal artery (i.e., the radicular artery of C1) and represents the cranial equivalent of the posterior-lateral spinal artery. Conclusion: Several previously ill-defined or misunderstood variations of the vertebrobasilar system can be explained by partial persistence of the PLBA. This article is protected by copyright. All rights reserved.
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- 2017
41. Isolated posterior spinal artery aneurysm.
- Author
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Koçak, A., Ateş, Ö., Çayli, S. Rüştü, and Saraç, K.
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ANEURYSMS , *VASCULAR diseases , *INTRACRANIAL aneurysms , *CEREBROVASCULAR disease , *BLOOD vessels , *BRAIN diseases - Abstract
Isolated aneurysms of the posterior spinal artery (not associated with arteriovenous malformations) are exceptionally rare. Three cases have been reported in the literature to date. We report a case of an isolated posterior spinal artery aneurysm causing acute subarachnoidal haemorrhage. Spinal artery aneurysms are contrasted with the more common intracranial aneurysms in terms of presentation and pathogenesis. [ABSTRACT FROM AUTHOR]
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- 2006
- Full Text
- View/download PDF
42. Benefits and Limitations of Indocyanine Green Fluorescent Image-Guided Surgery for Spinal Intramedullary Tumors
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Toshihiro Takami, Kentaro Naito, Nobuyuki Shimokawa, Toru Yamagata, and Kenji Ohata
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Adult ,Indocyanine Green ,Male ,Hemangioma, Cavernous, Central Nervous System ,Pathology ,medicine.medical_specialty ,Adolescent ,Anterior spinal artery ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Hemangioblastoma ,Humans ,Medicine ,Spinal Cord Neoplasms ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Astrocytic Tumor ,Astrocytoma ,Middle Aged ,Ependymal tumor ,Spinal cord ,medicine.disease ,Spinal Artery ,Cerebral Angiography ,medicine.anatomical_structure ,Image-guided surgery ,Surgery, Computer-Assisted ,030220 oncology & carcinogenesis ,Female ,Surgery ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery - Abstract
Background Intraoperative image guidance using near-infrared indocyanine green videoangiography (ICG-VA) has been used to provide real-time angiographic images during vascular or brain tumor surgery, and it is also being used for spine surgery. Objective To further investigate the benefits and limitations of ICG-VA image-guided surgery for spinal intramedullary tumors through retrospective study. Methods ICG-VA was used in 48 cases that were treated surgically over the past 5 yr. The pathological diagnoses of the tumors included astrocytic tumor, ependymal tumor, cavernous malformation, and hemangioblastoma. Results Localization of normal spinal arteries and veins on the dorsal surface of the spinal cord helped the surgeons determine the length or point of myelotomy. Well-demarcated tumor stain was recognized in limited cases of anaplastic or highly vascularized tumors, whereas the location of cavernous malformation was recognized as an avascular area on the dorsal surface of the spinal cord. Feeding arteries and tumor stain were well differentiated from draining veins in dorsal hemangioblastomas, but not in intramedullary deep-seated or ventral tumors. The preservation of small perforating branches of the anterior spinal artery after successful resection of the tumor could be well visualized. Conclusion ICG-VA can provide real-time information about vascular flow dynamics during the surgery of spinal intramedullary tumors, and it may help surgeons localize the normal circulation of the spinal cord, as well as the feeding arteries and draining veins, especially in highly vascular tumors. However, the benefits of intraoperative ICG-VA might be limited for intramedullary deep-seated or ventral tumors.
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- 2017
43. Spinal Cord Ischemia Secondary to Epidural Metastasis from Small Cell Lung Carcinoma
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Kenji Shimizu, Takahiro Hatta, Yasushi Makino, Satoshi Mikami, Hirotoshi Yasui, Naoya Ozawa, Nami Makino, Satoshi Baba, and Mayu Fukushima
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Male ,Lung Neoplasms ,Palliative care ,Spinal Cord Neoplasm ,03 medical and health sciences ,Fatal Outcome ,0302 clinical medicine ,medicine ,Back pain ,Paralysis ,Humans ,Spinal Cord Neoplasms ,Lung cancer ,Spinal Cord Ischemia ,business.industry ,Combination chemotherapy ,Articles ,General Medicine ,Middle Aged ,medicine.disease ,Collateral circulation ,Small Cell Lung Carcinoma ,Spinal Artery ,030220 oncology & carcinogenesis ,Anesthesia ,Cervical Vertebrae ,Epidural Neoplasms ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Patient: Male, 56 Final Diagnosis: Small cell lung carcinoma Symptoms: Back pain • paralysis Medication: — Clinical Procedure: MRI Specialty: Pulmonology Objective: Unusual clinical course Background: Spinal cord ischemia is an uncommon event that is mainly caused by dissociation of the ascending aorta as a complication after aortic surgery. Spinal arteries can develop collateral circulation; therefore, the frequency of spinal infarction is about 1% of that in the brain. Few cases of spinal cord ischemia developing in the course of lung cancer have been reported. Case Report: We presented the case of a 56-year-old man with small cell lung carcinoma, cT4N2M1a (stage IV). He was treated with irradiation and 2 courses of platinum and etoposide combination chemotherapy. He complained of back pain followed by quadriplegia and sensory disturbance after cessation of chemotherapy. With a diagnosis of spinal cord metastasis, steroids were administered. However, diaphragmatic paralysis appeared a few hours later. He was started on palliative care and died after 6 days. Autopsy showed epidural metastasis and spinal ischemia at the C5 level. Conclusions: Epidural metastasis can compress the spinal artery and cause circulatory disorders. Spinal cord ischemia should be considered in patients with rapid paralysis in the course of lung cancer.
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- 2017
44. Anterior spinal artery aneurysm in aortic stenosis of different etiology: Report of three cases
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Rajendra V. Phadke, Vivek Singh, Suprava Naik, and Sanjeev Bhoi
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Computed Tomography Angiography ,Anterior spinal artery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Vertebral Artery ,Computed tomography angiography ,Aorta ,medicine.diagnostic_test ,business.industry ,Arteriovenous malformation ,Aortic Valve Stenosis ,General Medicine ,Middle Aged ,medicine.disease ,Spinal cord ,Magnetic Resonance Imaging ,Spinal Artery ,Surgery ,Stenosis ,medicine.anatomical_structure ,Neuroimaging of Vascular Diseases ,cardiovascular system ,Female ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery - Abstract
Isolated aneurysms of spinal arteries are rare. Spinal artery aneurysms are commonly found in association with spinal cord arteriovenous malformation and coarctation of aorta and rarely with aortic arch interruption and Klippel-Trenaunay syndrome. Spinal angiograms are the gold standard for diagnosing these spinal artery aneurysms but with the advances in computed tomography technology these aneurysms can also be very well demonstrated in computed tomography angiograms. We describe three cases of anterior spinal artery aneurysm, those are flow related aneurysms, associated with coarctation of aorta and with Takayasu arteritis.
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- 2017
45. Spontaneous spinal subarachnoid haemorrhage and subdural haematoma upon customary bowing: a case report
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Ji Hyun Hong
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,Lumbar puncture ,business.industry ,Subdural haematoma ,Arteriovenous malformation ,General Medicine ,medicine.disease ,Spinal Artery ,nervous system diseases ,Surgery ,body regions ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,030220 oncology & carcinogenesis ,medicine ,Coagulopathy ,Subarachnoid haemorrhage ,cardiovascular diseases ,Neurology (clinical) ,business ,Vasculitis ,030217 neurology & neurosurgery - Abstract
Spinal subarachnoid haemorrhage is a rare clinical condition, and a spinal subarachnoid haemorrhage associated with subdural haematoma is extremely infrequent. Iatrogenic causes such as trauma and lumbar puncture, coagulopathy, arteriovenous malformation, spinal artery aneurysm, vasculitis or neoplasm are known predisposing factors. Minor effort or trauma can be a cause of spontaneous spinal subarachnoid haemorrhage. Herein, we report a rare case of spontaneous spinal subarachnoid haemorrhage and subdural haematoma that occurred when the patient engaged in a kneeling bow on the floor.
- Published
- 2020
46. Cervicomedullary Region Spinal Artery Aneurysms: Report of Seven Cases with Review of Etiology and Management Strategies
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John E Wanebo, Andrew F. Ducruet, Peter Nakaji, Brandon D. Liebelt, and Robert F. Spetzler
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medicine.medical_specialty ,business.industry ,medicine ,Etiology ,business ,Spinal Artery ,Surgery - Published
- 2019
47. A Patient with Upper Cervical Spinal Cord Infarction Presenting with the Sudden Onset of Severe Occipital Headache Followed by Occipital Neuralgia
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Yuji Uchida, Shigeru Fukutake, Hisashi Ito, Tetsumasa Kamei, Ai Seki, Terunori Sano, Hiroshi Kitahara, and Sanae Odake
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medicine.medical_specialty ,business.industry ,Vertebral artery ,Dissection (medical) ,medicine.disease ,Spinal Artery ,Surgery ,Occipital neuralgia ,Occipital headache ,medicine.artery ,medicine ,Right posterior ,Neuralgia ,Spinal cord infarction ,business - Abstract
A 78-year-old man suddenly developed a severe occipital headache, followed by right greater occipital neuralgia (ON). Brain MR imaging revealed a spinal cord infarction in the territory of the right posterior spinal artery (PSA) at the C2 level without vertebral artery (VA) dissection. Even without VA dissection, upper cervical PSA syndrome could cause severe occipital headache. Furthermore, ipsilateral ON could follow it. The present case suggests that severe occipital headache and ON can occur in a patient with upper cervical PSA syndrome without VA dissection.
- Published
- 2019
48. Robot-assisted ligation of bronchial artery could be an alternative to embolization
- Author
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Omar Matthieu Sarsam, Jean-Marc Baste, Christophe Peillon, and Bruno Pochulu
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Adult ,Pulmonary and Respiratory Medicine ,Hemoptysis ,medicine.medical_specialty ,medicine.medical_treatment ,Bronchial Arteries ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,medicine.artery ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Embolization ,Pathological ,medicine.diagnostic_test ,business.industry ,Angiography ,General Medicine ,Embolization, Therapeutic ,Spinal Artery ,Surgery ,medicine.anatomical_structure ,Descending aorta ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,Bronchial artery ,Ligation ,business ,Artery - Abstract
A 37-year-old patient presented with a self-limiting episode of moderate haemoptysis. Contrast-enhanced chest computed tomography showed a tortuous and dilated right bronchial artery arising from the descending aorta at the level of T6. Therapeutic angiography was attempted, but in the presence of spinal artery arising from the bronchial artery in question, selective embolization was contraindicated due to risk of spinal cord ischaemia. After a multidisciplinary meeting, it was decided to attempt surgery to ligate this pathological artery. We performed minimally invasive robot-assisted ligation of this pathological artery. The postoperative course was uneventful with good clinical and radiological outcome at 3-month follow-up. A minimally invasive approach provides a real alternative to embolization and could be a therapeutic option.
- Published
- 2017
49. Distortion and retraction injury at the hair-pin portion of the radiculomedullary artery during endovascular therapy for arteriovenous fistulas of the filum terminale
- Author
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Yasunari Niimi, Shinsuke Sato, and Bikei Ryu
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,lcsh:Surgery ,Injury ,Endovascular therapy ,lcsh:RC346-429 ,Radiculomedullary artery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Embolization ,lcsh:Neurology. Diseases of the nervous system ,Endovascular ,business.industry ,Filum terminale ,Distortion ,lcsh:RD1-811 ,Standard technique ,Spinal Artery ,Surgery ,Shunt (medical) ,Catheter ,medicine.anatomical_structure ,Anterior spinal artery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Artery - Abstract
Background Filum terminale arteriovenous fistulas (FTAVFs) are rare spinal arteriovenous shunt. Transarterial embolization via the radiculomedullary artery (RMA)–anterior spinal artery (ASA) axis is generally accepted as a standard technique. However, embolization via the RMA–ASA axis, which involves long distances and tortuous running, is technically challenging. Case description We report a 25-year-old man with multiple FTAVFs supplied from the Th9 RMA–ASA axis. Retraction injury and distortion of the hair-pin portion of the RMA occurred due to microcatheter withdrawal after n-butyl-2-cyanoacrylate injection from the RMA–ASA axis. We attempted to repair the RMA distortion by microcatheter manipulation without worsening the neurological condition. Conclusions Transarterial embolization via the RMA–ASA axis is associated with risk of vessel injury during catheter withdrawal through the involved long distance and its tortuous course.
- Published
- 2021
50. Spontaneous healing of retroperitoneal hematoma following injury to a lateral branch of the lumbar spinal artery after percutaneous endoscopic discectomy: A case report
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Jong Won Lee, Jin Woo Hur, Jeong Gyun Kim, Hyun Koo Lee, Jong Joo Rhee, and Yeo Song Kim
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Lumbar artery ,medicine.medical_specialty ,Abdominal pain ,Percutaneous ,lcsh:Surgery ,lcsh:RC346-429 ,Percutaneous transforaminal endoscopic lumbardiscectomy (PELD) ,030218 nuclear medicine & medical imaging ,Pseudoaneurysm ,03 medical and health sciences ,0302 clinical medicine ,Hematoma ,Lumbar ,medicine ,Outpatient clinic ,lcsh:Neurology. Diseases of the nervous system ,medicine.diagnostic_test ,business.industry ,lcsh:RD1-811 ,medicine.disease ,Spinal Artery ,Surgery ,Retroperitoneal hematoma ,Angiography ,Neurology (clinical) ,medicine.symptom ,Kambin’s triangle (KT) ,business ,030217 neurology & neurosurgery - Abstract
Purpose The minimally invasive percutaneous endoscopic discectomy (PED) was developed in the 20th century. Recently, the interest in minimally invasive surgery and the number of PEDs has increased. The incidence of postoperative retroperitoneal hematoma following percutaneous endoscopic discectomy was reported at 0.1 ~ 1%. We report a case of spontaneous healing of retroperitoneal hematoma following injury to a lateral branch of the lumbar spinal artery after percutaneous endoscopic discectomy. Methods A 58-year-old male underwent percutaneous endoscopic resection of the L4-5 disc via a transforaminal approach. After 2 h, he complained of rigid abdominal pain with hypotension. Abdominal computerized tomography (CT) revealed large hematoma (1300 mL) on the right retroperitoneum. A small pseudoaneurysm was detected at a lateral muscular branch of the 4th lumbar spinal artery on angiography without contrast leakage, with no additional treatment of this lesion. Results We performed conservative treatment at an intensive care unit. Two weeks later (POD 14 days), the patient was discharged with the hematoma almost well absorbed and small despite with bruise dorsally, without other complications. The abdominal CT obtained from the outpatient department (OPD) showed absorption of retroperitoneal hematoma without any signs of pseudo-aneurysm. Conclusions We report a case of retroperitoneal hematoma following injury to a lateral branch of spinal artery during percutaneous transforaminal endoscopic lumbar discectomy (PELD). Bleeding occurs external to the cannulation site, and is therefore, difficult to detect it, warranting extra precaution during surgery.
- Published
- 2020
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