PURPOSE: To discuss the differences in angiographic findings between cases of spontaneous carotid cavernous fistula with and without the classical triad of symptoms (pulsating exophthalmos, bruit, and conjunctival chemosis). METHODS: With CT, MR, and angiography, we examined 12 cases of spontaneous carotid cavernous fistula, five of whom presented only with cranial nerve palsies. RESULTS: In the seven cases with the triad, the main venous drainage from the cavernous sinus was the superior ophthalmic vein. Only one or two veins drained the cavernous sinus, and cortical venous drainage was not present in any case. In contrast, all but one case with only cranial nerve palsies had at least three venous drainage routes from the cavernous sinus, including cortical venous drainage. CONCLUSION: For the diagnoses of spontaneous carotid cavernous fistula, it is important to know that some patients do not show the classical triad of symptoms. In such patients, early diagnosis and treatment are particularly important because cortical venous drainage and a consequent risk of hemorrhage are frequently present.

Adult↗

PubMedDate not supplied

Pathophysiologic assessment of stagnating arteries after removal of arteriovenous malformations.

PURPOSE: To assess the hemodynamics and pathophysiology of stagnating arteries after removal of arteriovenous malformations (AVMs). SUBJECTS: 50 patients with supratentorial pial AVMs underwent pre- and postoperative angiographic studies. RESULTS: The following characteristics were found to correlate with stagnating arteries: 1) advanced patient age, 2) large AVM size, 3) markedly dilated feeders, 4) early postoperative angiograms, and 5) delayed restoration of feeding artery diameter. CONCLUSIONS: The rate of blood flow in the former feeding arteries, expressed as v x pi x r2 (v = mean velocity, r = vessel radius), suddenly decreases after removal of AVMs. When dilatation persists postoperatively in these arteries the flow velocity decreases and stagnation takes place. Delayed postoperative restoration of feeding artery diameter may be caused by a decrease of elasticity due to long-standing hemodynamic stresses, and by increased postoperative vascular resistance of these arteries.

Adolescent↗

PubMedDate not supplied

Superselective embolization for severe traumatic epistaxis caused by fracture of the skull base.

Intractable epistaxis developed in a 13-year-old girl after she fell down a flight of stairs sustaining facial fractures and fracture of the skull base. Epistaxis was found to emanate from a right ascending pharyngeal artery, which the authors promptly and successfully embolized using polyvinyl alcohol particles and microfibrillar collagen.

Adolescent↗

PubMedDate not supplied

The antiproliferative effect of HGF on hepatoma cells involves induction of apoptosis with increase in intracellular polyamine concentration levels.

Hepatocyte growth factor (HGF) induced apoptosis and decreased the DNA synthesis in Hep G2 cells. In the HGF group interleukin-1 converting enzyme, ornithine decarboxylase (ODC) activity and intracellular polyamine concentrations were increased compared to those of the control group. Administration of the ODC inhibitor decreased polyamine concentration, and inhibited apoptotic changes in the cells. These changes were reversed by exogenous addition of polyamine. These findings suggest that one of the mechanisms by which HGF exerts its antiproliferative effect is induction of apoptosis and that increase in intracellular polyamine concentration may be one of the triggers of cell death.

Apoptosis↗