[MR arterio- and venography: strategies for using 2D and 3D inflow procedures].
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Angiography↗
Biomedical subjects
L Solymosi
Publications and source records attributed to L Solymosi.
[Concomitant vertebral trauma in patients with craniocerebral injuries. 34 consecutive patients over 3 years].
Between February 1986 and January 1989, a total of 430 inpatients with the diagnosis of a head injury were prospectively registered and analysed for the association of a spinal trauma. Of these patients, 92% (n = 396) suffered a primary coma and 8% (n = 34) a secondary coma. On admission the ratio of coma, somnolence, and mild clouding was 6:1:3. In 8% (n = 34) the head injury was combined with a lesion of the spinal column. The cervical spine was affected in two-thirds of the cases (21/34). The clinical outcome was subdivided into three categories: dead (n = 10), paraplegic (n = 12), and 12 other patients. At least 4 patients were disabled at the end of the observation period (hospitalized or receiving home care). It is discussed how to avoid overlooking associated spinal fractures in patients with head trauma and multiple injuries that all require emergency treatment.
Adolescent↗
An intravascular technique to occlude the middle cerebral artery in baboons.
A technique is described for occlusion of the middle cerebral artery in the baboon by an intravascular approach. A torque catheter is introduced under fluroscopic control into the internal carotid artery by transfemoral catheterization. In conjunction with a guide wire an infusion microcatheter with increasing stiffness from the distal tip to the proximal shaft is positioned in the proximal part of the middle cerebral artery via the introducer system. N-Butyl-2-cyanoacrylate-monomers are injected into the microcatheter for permanent occlusion of the middle cerebral artery. The procedure was successfully completed in 21 out of 24 baboons. In 3 baboons the occlusion could not be achieved since the torque catheter could not pass proximal extreme tortuosities of possibly arterisclerotic internal carotid arteries. Infarcts in the 21 animals were confirmed by computerized tomography and/or autopsies in all animals.
Animals↗
[MR tomography, CT and angiography of vascular malformations of the central nervous system].
The findings on MR tomography in 31 vascular malformations of the central nervous system are described; 26 of these had angiography and 24 were examined by CT. There were 19 A-V angiomas, 7 cavernomas and 5 large aneurysms. MRT provided a correct diagnosis in 29 out of 31 cases, angiography succeeded in 19 out of 26 cases and CT in 20 of 24. MRT was superior to CT and angiography. Nevertheless, it cannot replace arteriography, since this is the only method for demonstrating the vascular supply of angiomas and small aneurysms can be demonstrated only by arteriography.
Angiography↗
[MR tomography following craniocerebral trauma: comparison with computed tomography, electroencephalography and neurologic status].
56 patients with head and brain trauma and in coma were studied prospectively by means of MRT, CT, EEG and neurological examination. All patients had initial CT and EEG admission. MRT showed that in our patients morphological return to normal was the exception. Patients with head and brain injuries should be examined by MRT during the course of their illness. The use of special sequences, such as gradient-echo sequences for the diagnosis of haemorrhagic contusions, is indicated. CT should be retained for evaluating bone injury and cerebral damage during the acute stage.
Adult↗
An unusual congenital arteriovenous fistula of the vertebral artery and its embolization by a detachable balloon catheter.
This report concerns a 4-year-old boy with a pulsating tumor on the left side of the neck. Angiography revealed a congenital arteriovenous fistula of the vertebral artery at C2 level being fed by a left ascending cervical artery. The shunting vessel was cut off by a detachable balloon catheter via the vertebral artery so that the physiological blood supply could be restored.
Child, Preschool↗
[Preoperative diagnosis: the Wada test with SPECT control for localizing brain function in therapy-refractory epilepsy].
Extensive diagnostic measures are necessary to clarify the indication for surgery in patients suffering from epilepsy that is refractory to treatment. Within the overall framework of neuropsychological diagnosis we conducted the Wada test, injecting 200 mg (or 3 mg/kg body weight) of sodium amytal on different days, in each case into the left or right internal carotid artery. This results in a 3-5 minute anaesthesia of the relevant hemisphere. By means of a neuropsychological short test it is possible to determine the performance of the non-blocked hemisphere. The extent of the blocking is also determined by simultaneous i.v. injection of HM-PAO (hexamethyl propylene amine oxime) labelled with 99m Tc, the uptake of which by various cerebral regions is visualised via SPECT. The Wada test supplies information on the lateralisation of cognitive functions (speech, memory etc.) whereas the SPECT examination enables additional determinations not only of processes that must be characterised as diaschisis, but also on the extent of blocking of a hemisphere. The results supply clues to expected postoperative cognitive deficits and thus enable a differentiated assessment of the indication for surgery. This is discussed on the basis of two clinical cases.
Adult↗
Diagnosis of neurinoma in the region of the jugular foramen--a case report.
Neurinomas in the region of the jugular foramen are extremely rare, are difficult to diagnose before surgery, and have seldom been described in the literature. The typical jugular foramen syndromes (Collet-Sicard syndrome, Vernet's paralysis) may be caused by many various disorders. The diagnostic problems are illustrated using one of our cases as an example. The differential diagnosis was made before surgery using currently available radiologic techniques. The tentative diagnosis "neurinoma of the hypoglossal nerve" was confirmed intraoperatively and histologically.
Cerebral Angiography↗
Comparison of the effects of infusion with hydroxyethyl starch and low molecular weight dextran on cerebral blood flow and hemorheology in normal baboons.
Cerebral blood flow (CBF) and hemorheological parameters, such as hematocrit, plasma viscosity, and erythrocyte aggregation, were measured before and up to 7 h after 60-min infusions with 10% hydroxyethyl starch (HES), or 0.9% NaCl solution and 10% low molecular weight dextran (LMWD) in a total of 12 normal baboons. Infusion of HES increased CBF up to 48% from the resting level, and decreased hematocrit without an increase in plasma viscosity. Infusion of LMWD decreased hematocrit with an increase in CBF of up to 9.6%, but increased plasma viscosity at the same time. The disaggregating effect for erythrocytes was rather more obvious with LMWD than with HES but without significant difference between them. These data show different rheological effects with infusions of HES and LMWD on the physiological conditions of normal baboons.
Animals↗
[Dural angiomas].
The management of arteriovenous malformations confined exclusively to the dura and its duplications (DAVMs) is a challenge. The problems of diagnosis and the possible methods of treatment are discussed on the basis of 23 personal cases. Selective and superselective angiography for the detection of any multipedicular supply from separate arterial systems has proved essential before rational treatment can be instituted. Usually it is not possible to cure DAVMs by embolization alone: the approach now used for the main feeders arising from branches of the internal carotid and vertebral arteries is inadequate. However, it is usually possible to reduce the volume of the shunt flow and the pressure in the draining sinuses. Frequently the success is only temporary and a combined surgical and intravascular procedure is later necessary. In isolated cases, inoperable DAVMs can be transformed to operable ones by first performing embolization.
Cerebral Angiography↗
[Foramina parietalia permagna].
We report a patient who presented with the foramina parietalia permagna feature. This harmless malformation of the skull has already been described long ago but is rare and fairly unknown. Therefore, it may present problems concerning differential diagnosis. To our knowledge our case is the first to be illustrated and analyzed by cerebral computed tomography.
Female↗
'Open angioplasty' in carotid artery obstructions.
A new method has been introduced for the treatment of highly located or long-segment stenoses or obstructions of the internal carotid artery not accessible by conventional carotid-endarterectomy. Following conventional carotid-endarterectomy a balloon catheter is passed through the incised carotid artery as far as the stenosis and then inflated several times. Possibly dislodged plaque material can be washed out by the retrograde blood stream. The results in 30 cases, with angiopraphic, Doppler sonographic and neurologic follow-up examinations, are reported. It was possible to achieve a distinct additional cerebral blood supply through the recanalized internal carotid artery by this method, without a severe complication rate.
Carotid Arteries↗
A new neuroradiologic method for therapy of spinal epidural hematomas.
A simple method was described with which spinal epidural hematomas in the cervical region can be rapidly decompressed when appropriate facilities for emergency surgery are not available.
Adult↗
A case of spinal paraganglioma.
The neuroradiologic finding of a paraganglioma in the vertebral canal is described here for the first time. These tumors occur more frequently than was previously presumed. Similarities with paragangliomas in the craniocervical region are apparent on angiograms. We consider angiography to be indicated when, in association with a spinal tumor, urinary biogenic amine levels are elevated. When necessary, embolization can be performed after angiography.
Angiography↗
[Intracranial venous angiomas].
Until now there have only been 13 reports of clinically diagnosed intracranial venous angiomas, which have been operatively demonstrated and histologically examined. We have seen 2 further cases, both of which received operative treatment. Although this condition is pathologically commoner as arteriovenous angioma, it is rarely clinically diagnosed. The diagnostic value of the computer tomogram is stressed and the findings from 2 young patients are compared with the literature. The angiogram from these angiomas's show considerable differences depending on the method used. This could explain some of difficulties in histological diagnosis.
Adolescent↗
Immediate postangiographic intraarterial treatment of cerebral vasospasm after subarachnoid hemorrhage with nimodipine. Report on 3 cases.
Three cases of symptomatic vasospasm after spontaneous subarachnoid hemorrhage are reported. Vasospasm occurred preoperatively in two instances and postoperatively in another. All three cases received an intraarterial perfusion with 0.2 mg nimodipine (BAY e 9736) per hour for 90 minutes. Resolution of the spasms was demonstrated by angiography. As there were no side effects attributable to this form of treatment, new possibilities for neuroradiological intervention may arise in selected cases.
Adult↗
[Revascularization of extensively stenosed or nearly occluded carotid arteries].
Various therapeutical procedures in patients with extensive and/or distal stenoses of the internal carotid artery (ICA) are discussed. Possible complications are pointed out, such as cerebral embolism during percutaneous intraluminal angioplasty or symptomatic occlusion of the stenotic segment after extracranial-intracranial arterial bypass operation involving haemodynamic changes. In suitable cases, a combined method of endarterectomy and angioplasty is recommended, and the results of 8 cases treated by this method are reported with a distinct post-operative increase of the ICA blood flow. Follow-up remained without recurrent ischaemic attacks.
Aged↗
[Posterobasal meningiomas. Neuroradiologic diagnosis and its relation to clinical and operative findings].
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Cerebral Angiography↗