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At least 1,261 records · Page 70Linked to original sources
PubMed1996

Dural arteriovenous fistula of the posterior fossa developing after surgical occlusion of the sigmoid sinus. Report of five cases.

In this article, the authors present five cases of dural arteriovenous fistula (AVF) that developed in the transverse-sigmoid sinus 2 to 6 years after sacrifice of the sigmoid sinus because of tumor involvement. The original tumor was meningioma in two patients and neurinoma, glomus jugulare tumor, and ameloblastoma in one patient each. The involved sigmoid sinus was resected along with the tumor and ligated at the normal edge; all that remained of the sigmoid sinus was a small stump on the retrosigmoid portion. Serial angiography performed before and after tumor surgery revealed no abnormal arteriovenous communications or dural AVF in any of the cases. Although many reports have suggested that sinus thrombosis is a precipitating factor in the pathogenesis of dural AVFs, this has been difficult to verify because of the small number of cases in which serial angiography was performed before the development of a dural AVF. In all of the cases presented in this article, surgical resection of a dural AVF and histological examination were performed. Subintimal fibrous thickening was marked, and the sinus wall was found to contain many dural vessels. Organized thrombosis with neovascularization was seen in only two patients. These cases demonstrate that subintimal fibrous thickening a hypertrophied sinus wall secondary to increased intrasinus pressure or sinus thrombosis occurring after sinus occlusion can provoke the development of a dural AVF within the course of a lifetime. Maintenance of intrasinus blood flow may be very important to prevent this late postoperative complication.

Arteriovenous Fistula↗
PubMed2003

Abnormal sagittal sinus blood flow in term infants following a perinatal hypoxic ischaemic insult.

Ultrasound is a useful tool for the study of the superior sagittal sinus in neonates. The normal patterns of blood flow have been established, and the technique has been used to diagnose sagittal sinus thrombosis. This report describes the sonographic diagnosis of abnormally sluggish or absent sagittal sinus flow in two term infants. The first was a 2,320-g female infant with postnatal hypoxia. The second was a 5,000-g male infant who developed hypoxic ischaemic encephalopathy after delivery complicated by shoulder dystocia. In both cases the normal pattern of blood flow in the superior sagittal sinus was re-established on follow-up ultrasonography.

Asphyxia Neonatorum↗
PubMed1991

[Imaging of cerebral flow dynamics using MR angiography and selective pre-saturation: initial experiences].

MR angiography with selective pre-saturation was applied in 5 normal volunteers, 22 patients with cerebrovascular disease, 3 patients with arteriovenous malformations (AVM) and one patient with thrombosis of the superior sagittal sinus. The results were compared with Doppler ultrasound and conventional angiography. MR angiography reliably demonstrated the direction of blood flow and the presence or absence of collateral flow in the circle of Willis. Collateral flow via leptomeningeal vessels and the ophthalmic artery could not be demonstrated. In the patient with superior sagittal sinus thrombosis, the absence of flow was well seen. MR angiography was able to demonstrate the major supplying arteries in the patients with AVMs. MR angiography is a valid noninvasive means to demonstrate direction of flow and blood supply of the major intracranial arteries.

Cerebral Angiography↗
PubMed1999

[The neuroradiological findings in Behçet's disease].

PURPOSE: We present the typical neuroradiological findings in three patients with neuro-Behçet in comparison with a review of neuroradiological and histopathological findings described in the literature. MATERIAL AND METHODS: In three male patients aged 32-57 years with Behçet's disease and neurological symptoms cranial CT and MRI studies were carried out. Findings were monitored over a period of 6-18 months. Additionally, cerebral and renal DSA were performed in two patients. RESULTS: In two patients we found acute inflammatory lesions located in the brainstem and the periventricular white matter, some of which were associated with an acute inflammatory disruption of the blood-brain barrier. Lesions decreased in size under treatment, but complete resolution was not consistently noted. In the third patient we found a thrombosis of the superior sagittal sinus but no other intracranial abnormalities. CONCLUSIONS: Our findings agree with those described in the literature as being typical of Behçet's disease. Inflammatory lesions most commonly occur in the brain stem, followed by the basal ganglia and the cortex and white matter of both the cerebrum and cerebellum. In contrast to venous sinus thrombosis, brainstem atrophy and cortical or cerebellar lesions, white matter lesions have little diagnostic value, irrespective of their location. The definitive diagnosis of Behçet's disease is made on the basis of clinical criteria.

Adult↗
PubMedDate not supplied

Cerebral venous thrombosis occurring during an ectopic pregnancy and complicated by intracranial hypertension.

Thrombosis of the cerebral dural sinuses and veins has been described since the early 19th century. Clinically the process is characterised by diverse symptomatology and physical findings and in spite of advances in diagnostic radiological techniques it remains an under-recognised condition. It has been most commonly associated with sepsis, trauma, pregnancy, the puerperium and many other hypercoagulable states. We describe an apparently unique case of sagittal sinus thrombosis occurring during an ectopic pregnancy. This was subsequently complicated by intracranial hypertension in spite of clinical improvement and magnetic resonance imaging (MRI) evidence suggesting a return of venous patency. The clinical presentation, radiological features and management is discussed.

Adult↗
PubMed1989

Isolated sphenoiditis: a diagnostic problem.

A case of primary isolated sphenoiditis that developed cavernous sinus thrombosis is presented. It is difficult to diagnose and patients are often not seen initially by an ENT surgeon, making it more important for other branches of medicine to be aware of this condition. We discuss isolated sphenoiditis with particular reference to the diagnosis, management and complications of this condition.

Cavernous Sinus↗
PubMed1998

MR imaging and CT of orbital infections and complications in acute rhinosinusitis.

The acute onset of orbital and periorbital inflammation presents the clinician with a diagnostic and therapeutic dilemma, the consequence of which may be very serious. The progression from the initial stage of cellulitis to orbital abscess, cavernous sinus thrombosis, brain abscess, meningitis, or visual loss may be quite rapid at times. CT, ultrasonography, and MR imaging play an important role in clinical management of these patients. Indeed, it is the information obtained through orbital imaging that directs the clinician to use the correct therapeutic modality.

Abscess↗
PubMed1998

[A case of dural arteriovenous fistula accompanied by sinus occlusion. A serial study with CT scan].

A dural arteriovenous fistula (AVF) of the posterior fossa was found in a 58-year-old businessman suffering from a month's history of dementia. Bilateral transverse sinus thrombosis was also found and his symptom was attributed to venous congestion caused by the sinus occlusion. He had received partial resection of the right trigeminal neurinoma two years before, and the operation was thought to have caused the sinus occlusion. Dural AVF of the posterior fossa usually causes tinnitus or headache, whereas dementia seen in present case is relatively rare. In the present case, serial study of cranial CT scan demonstrated evolution of dural AVF after sinus occlusion. Venous congestion was thought to re-open the physiological micro-AVF to cause the dural AVF.

Arteriovenous Fistula↗
PubMed2005

First-line investigation of acute intracerebral hemorrhage using dynamic magnetic resonance angiography.

PURPOSE: To report the initial experience of magnetic resonance (MR) digital subtraction angiography (MR-DSA) in the dynamic assessment of the cerebral circulation in acute non-traumatic intracerebral hemorrhage (ICH). MATERIAL AND METHODS: Twelve patients with acute ICH were investigated within 6 days of the ictus using a dynamic contrast-enhanced 2-D MR angiogram that produces subtracted images with a temporal resolution of 1-2 frame/s. The MR-DSA examinations were assessed for evidence of an intracranial vascular abnormality and were compared with (i) the routine MR sequences, (ii) non-dynamic time-of-flight MR angiography, and (iii) catheter angiogram performed during the same admission. RESULTS: All 12 MR-DSA examinations were considered to be technically satisfactory. MR-DSA detected an intracranial vascular abnormality in 7 patients (3 arteriovenous malformations, 2 aneurysms, 1 dural arteriovenous fistula, and 1 venous thrombosis). All abnormalities were confirmed by catheter angiography with the exception of one patient with venous sinus thrombosis found on MR imaging that did not undergo catheter angiography. All four arteriovenous shunts were detected by MR-DSA by virtue of early venous filling. CONCLUSION: MR-DSA can be performed satisfactorily in the setting of acute ICH and provides an alternative method to catheter angiography for identifying shunting vascular abnormalities such as arteriovenous malformations and fistulae, as well as large aneurysms and venous occlusions. MR-DSA is a contrast-medium-based technique that does not suffer from the T1 shortening effects of acute hemorrhage that can obscure abnormalities on conventional flow-based non-dynamic techniques.

Adult↗
PubMed1998

Cerebral venous thrombosis in pregnancy: the role of protein S deficiency.

We report a 20 year-old, 28 week-pregnant woman, who developed superior sagittal sinus thrombosis, associated with a decreased free protein S level. Her father, who had been a stroke victim, had also significantly lower level of protein S. In very rare cases, a congenital or acquired protein S deficiency leads to cerebral venous thrombosis. The detection of such abnormalities has major practical consequences for the long-term management of patients to prevent further thrombotic episodes.

Adult↗
PubMed2006

Paediatric cerebral venous thrombosis.

Cerebral venous thrombosis (CVT) in children is a multifactorial serious disease. It is being increasingly diagnosed, mainly because of more sensitive diagnostic procedures and increasing clinical awareness. The clinical manifestations can be life-threatening and cause long-term neurological deficits. Thromboembolism in children is a multifactorial disorder in which both genetic and acquired risk factors play a role. CVT occurs in various clinical settings, including infection, dehydration, renal failure, trauma, cancer and haematological disorder with multiple risk factors. Clinical manifestations of CSVT are nonspecific and may be subtle. Most of the clinical scenarios occur at all ages and the clinician should consider this diagnosis in a wide range of acute neurological presentations in childhood. CVT can have an extremely variable clinical presentation, mode of onset, imaging appearance and outcome. Its prognosis remains largely unpredictable. Diffusion and perfusion MRI may play a role in detecting venous congestion and CT or MR venography are now the methods of choice for investigation of cerebral venous thrombosis. The options for treatment of infants and children include standard or low molecular weight heparin for 7-10 days followed by oral anticoagulants for 3-6 months. Specific treatment with anticoagulation is controversial in children, but has been established as appropriate therapy in adults. Anticoagulant treatment with heparin is probably safe and beneficial for children with sinus thrombosis, even those with intracranial haemorrhages.

Age Factors↗
PubMed1993

Dural arteriovenous fistula: a cause of hypoperfusion-induced intellectual impairment.

A 76-year-old, right-handed man developed posttraumatic dural arteriovenous fistula (DAVF) involving the superior sagittal sinus. He developed slow but progressive intellectual deterioration and gait disturbance after a minimal head trauma. Cerebral angiography demonstrated a DAVF of the superior sagittal sinus with sinus thrombosis supplied by branches of the bilateral external carotid arteries, and a DAVF of the right sigmoid sinus supplied by the right occipital artery. Selective embolization was carried out. He showed marked improvement on neuropsychological testing, especially on test items which are supposed to tap functions of the right cerebral hemisphere which showed an improved cerebral blood flow. We concluded that the intellectual impairment of our patient was caused by cerebral hypoperfusion, especially of the right cerebral hemisphere.

Aged↗