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S Maimon

Publications and source records attributed to S Maimon.

11 recordsLinked to original sources
PubMed2006

Endovascular treatment of isolated dissecting aneurysm of the posterior inferior cerebellar artery.

BACKGROUND AND PURPOSE: Isolated dissecting aneurysms of the posterior inferior cerebellar artery (PICA) carry a high risk of rebleeding with an associated increased mortality rate. Although rare, they present a therapeutic challenge. Surgical treatment carries a significant risk of neurologic complications, predominantly lower cranial nerve deficits because of the close relationship of the aneurysm with the brain stem and cranial nerves. The purpose of this article is to show that endovascular treatment of dissecting aneurysms of the PICA can be effective and can allow the patient to avoid the complications associated with surgery. METHODS: Six patients (age range, 28-70 years) with dissecting aneurysms of the PICA were treated at our center by endovascular occlusion with Guglielmi detachable coils or glue and followed for up to 30 months. Inclusion of patients in the study was based on careful angiographic assessment of the vascular anatomy and collateral supply of the posterior fossa. When on the basis of the anatomy, potential lack of sufficient collaterals was suggested, a test occlusion was performed to determine the feasibility of an endovascular approach. Four additional cases, which have been described in the literature, were included in the analysis of results. RESULTS: In all patients, the aneurysm was successfully occluded with no apparent procedure-related complications. Follow-up studies showed stable and complete occlusion of the aneurysm in all patients with no long-term neurologic deficits. CONCLUSIONS: Endovascular treatment by aneurysm and parent artery occlusion is a relatively safe and reliable alternative to surgery for isolated dissecting aneurysms of the PICA.

Adult↗
PubMed2001

Spinal dural arteriovenous fistulae--a diagnostic challenge.

BACKGROUND: Spinal dural arteriovenous fistulae comprise the majority of spinal vascular malformations. The most common clinical presentation is that of progressive myeloradiculopathy, probably related to venous hypertension, which may lead to permanent disability and even death. OBJECTIVE: To report our clinical experience with spinal dural arteriovenous fistulae. METHODS: Nine patients with spinal dural AVF were managed at our center during a one year period (1998-1999). The patients, eight men and one woman ranging in age from 46 to 75 years, presented with initially fluctuating and eventually permanent and progressive paraparesis, sensory disturbances and sphincter dysfunction. The neurological signs generally began symmetrically and progressed from the distal to proximal limb regions. The duration of symptoms before diagnosis ranged from 6 to 36 months during which the patients underwent an extensive but fruitless work-up and even unnecessary operations due to misdiagnosis. All patients finally underwent magnetic resonance imaging and spinal angiography, which demonstrated the pathological vascular fistula. Interruption of the AVF was achieved by embolization or by surgical resection. RESULTS: Following treatment, six patients experienced improvement of gait and sphincter control, and the severe neurological deficits stabilized in the other three patients with long duration of illness. There was no further deterioration in any of the treated patients. CONCLUSIONS: The history, neurological findings and radiological changes on MRI scan should alert clinicians to the possibility of spinal dural AVF, leading to diagnostic spinal angiography. Early diagnosis and treatment may significantly improve outcome and prevent permanent disability and even mortality.

Aged↗
PubMed2000

Osteomyelitis of the ribs in the antibiotic era.

A total of 106 cases of rib osteomyelitis were reviewed, including 2 cases described in detail. Mycobacterial and bacterial infections accounted for 47 cases each. Fungal rib osteomyelitis occurred in 11 cases and 1 case was caused by Entamoeba histolytica. Most cases occurred in children and young adults. The mean duration of symptoms before diagnosis was 16, 26 and 32 weeks for bacterial, mycobacterial and fungal rib osteomyelitis, respectively. Common clinical signs were fever (73%), soft tissue mass (64%) and chest pain (60%). Route of infection was defined in 85 cases: 62% from contiguous spread and 38% via haematogenous route of infection. Eighty-nine percent had a favourable outcome after antimicrobial therapy with or without surgery. In conclusion, rib osteomyelitis is a rare infection of various aetiologies. The majority of cases occur in children and young adults and its diagnosis is usually delayed for several weeks.

Adult↗
PubMed2000

Treatment of spontaneous carotid-cavernous fistula in Ehlers-Danlos syndrome by transvenous occlusion with Guglielmi detachable coils. Case report and review of the literature.

The authors report on a young woman with Ehlers-Danlos syndrome (EDS) Type IV in whom a spontaneous direct carotid-cavernous fistula (CCF) was treated by transvenous occlusion with regular and fiber-coated Guglielmi detachable coils. To the authors' knowledge, this is the first time this approach has been used in a patient with EDS. The different treatment options are discussed, and the literature on endovascular treatment of direct CCFs in EDS is reviewed.

Adult↗
PubMed1997

Acute stroke after coronary angiography associated with protruding mobile thoracic aortic atheromas.

We describe two patients who developed acute embolic stroke immediately after coronary catheterization for unstable angina. Transesophageal echocardiography (TEE) and spiral CT of the chest revealed protruding floating atheromas within the aortic arch. These cases of stroke immediately after coronary catheterization suggest that protruding floating atheromas of the thoracic aorta place patients at risk for stroke. TEE or CT might predict a risk of stroke in such patients.

Acute Disease↗
PubMed1996

[Extensive postpartum, bilateral ovarian vein thrombosis].

A 29-year-old woman with extensive pelvic thrombophelebitis complicating postpartum, ovarian vein thrombosis is described. The phlebitic process involved both ovaries, extending upwards to the inferior vena cava above the level of the renal veins and downwards to the ileo-femoral system, obstructing the venous drainage of the lower limbs. Extensive postpartum thrombophlebitis is now rarely encountered, since its early clinical diagnosis using CT and US techniques allows early treatment, obviates this complication. Postpartum bedside alertness, aided by modern imaging techniques, may prevent serious, life-threatening complications.

Adult↗
PubMed1994

[Pulmonary sequestration detected by ultrasound].

Pulmonary sequestration is part of the spectrum of bronchopulmonary foregut anomaly. It is a rare type of congenital malformation in which a mass of pulmonary tissue is separate from the normal lung and receives its arterial supply directly from the systemic circulation. Angiographic demonstration of a systemic artery leading to the sequestrated lung has usually been used to diagnose this condition. In the past 10 years cases of this rare anomaly have been detected and diagnosed by ultrasonography in the pre- and postnatal period. We describe a very rare case of intraabdominal, extralobar pulmonary sequestration detected in the antenatal period. Ultrasonography showed a hyperechoic subdiaphragmatic mass above the left kidney, near the aorta. In the mass were 2 echo-free vascular structures. 2 arterial branches originating from the abdominal aorta which traversed the subdiaphragmatic mass. The near-diaphragmatic location of many pulmonary sequestrations provides an excellent acoustic window for sonographic detection. MRI can help in the diagnosis when ultrasonographic findings are equivocal. Ultrasound and MRI will soon replace aortic angiography in the diagnosis of this condition in the pre- and postnatal period, pulmonary sequestration should be included in the differential diagnosis of upper abdominal masses identified by ultrasonography.

Aorta, Abdominal↗
PubMed1993

[Endoscopic drainage of pancreatic pseudocyst: endoscopic cysto-enterostomy].

Pancreatic pseudocysts occur in 20% of cases of chronic pancreatitis. Spontaneous resolution is seen in about 9% of the cases, but most cysts persist and frequently cause complications, such as compression of adjacent organs or infection. Endoscopic cysto-enterostomy has recently been reported as a new nonsurgical invasive approach. We present a 40-year-old alcoholic man with a large pancreatic pseudocyst compressing the distal choledochus and pancreatic duct, who was treated successfully by endoscopic cysto-duodenostomy.

Adult↗