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https://www.readbyqxmd.com/read/29326418/a-case-of-right-sided-direct-carotid-cavernous-fistula-a-diagnostic-challenge
#1
Htun Latt, Kyaw Kyaw, Htwe Htwe Yin, Deepak Kapoor, Sammy San Myint Aung, Raheel Islam
BACKGROUND Carotid cavernous fistulas (CCFs) are rare potentially sight-threatening abnormal connections between carotid artery and cavernous sinus. CASE REPORT We report a case of CCF in an 83-year-old female, who presented with swollen and painful right eye. The patient was initially treated with empiric antibiotics for suspected peri-orbital cellulitis, as noted clinically and in computed tomography (CT) orbits. However, lack of clinical improvement, physical finding of orbital bruit/thrill, and enlarged superior ophthalmic vein in magnetic resonance (MR) orbits suggest alternate diagnoses...
January 12, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29304556/diagnosis-treatment-and-outcome-of-arterioureteral-fistula-the-urologist-s-perspective
#2
Hendrik Heers, Christopher Netsch, Konrad Wilhelm, Armin Secker, Florian Kurtz, Philipp Spachmann, Simon Viniol, Rainer Hofmann, Axel Hegele
Introduction Arterioureteral fistula (AUF) is a rare but potentially life-threatening disease which primarily arises as a long-term complication in oncological patients who have permanent ureteric stenting. The incidence is rising. The objective of this study was to outline the risk factors for, management and outcome of AUF in a large individual case series. Patients and methods 26 AUF cases in 24 patients from six German tertiary referral centres occurring between 2008 and 2016 were identified retrospectively and entered into a dedicated database using patient notes and out-patient visits...
January 5, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29288227/endobronchial-metastasis-of-mixed-mullerian-tumour-of-the-uterus
#3
Vadsala Baskaran, Laura Pugh, Robert James Berg, John Anderson
Endobronchial metastasis occurs in only 2%-5% of non-pulmonary cancers. Here we report on an 84-year-old woman who presented with breathlessness and light-headedness while on holiday in Australia, 2 years post-treatment for endometrial cancer. Initial CT pulmonary angiogram identified a soft tissue mass in the left hemithorax. A chest radiograph performed after repatriation was consistent with a large left pleural effusion, but bedside ultrasound showed a lobulated mass involving the left hemidiaphragm. A pleural procedure in the traditional 'triangle of safety' would have resulted in inadvertent puncture of the underlying mass...
December 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29281095/proximal-and-distal-occlusion-of-complex-cerebral-aneurysms-implications-of-flow-modeling-by-fluid-structure-interaction-analysis
#4
Jasper H G Helthuis, Sindhoor Bhat, Tristan P C van Doormaal, Ramarathnam Krishna Kumar, Albert van der Zwan
BACKGROUND: In complex cerebral aneurysms, adequate treatment by complete occlusion is not always possible. Partial occlusion by either proximal or distal occlusion is an alternative. However, the hemodynamic consequences of these partial occlusion options are often not easily predictable. OBJECTIVE: To assess the feasibility of fluid-structure interaction (FSI) analysis to investigate the hemodynamic changes after partial occlusion in cerebral aneurysms. METHODS: Two patients were analyzed...
December 21, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29273536/variability-of-stroke-patients-meeting-endovascular-stroke-trial-criteria-in-a-non-clinical-trial-setting
#5
Jennifer E Fugate, Waleed Brinjikji, Harry Cloft, David F Kallmes, Alejandro A Rabinstein
BACKGROUND: Five randomized trials proving the efficacy and safety of mechanical embolectomy for ischemic stroke within 8hours used differing radiological methods to select patients. We aimed to evaluate the proportion of patients in clinical practice that would meet radiological criteria for inclusion in these trials. METHODS: Retrospective study of ischemic stroke patients at a large academic medical center who were considered for endovascular stroke therapy based on confirmed intracranial large vessel occlusion from April 2010-November 2014...
December 19, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29262389/-pontine-hemorrhage-suspected-due-to-dural-arteriovenous-fistula-at-the-craniocervical-junction-a-case-report
#6
Shou Nishii, Tomohiro Araki, Kazuhide Hamada, Yotaro Kitano, Yoichi Miura, Kenji Kanamaru
Dural arteriovenous fistulas occurring at the craniocervical junction(CCJd-AVF)are uncommon; however, they demonstrate a wide range of clinical presentations. We describe the case of a patient with pontine hemorrhage suspected due to CCJd-AVF. A 68-year-old man presented to our hospital with a sudden onset of left hemiparesis. Cranial computed tomography(CT)revealed pontine and subarachnoid hemorrhage. Magnetic resonance imaging, as well as MR, CT, and left vertebral angiograms were performed and showed a CCJd-AVF in addition to a varix coincident with the hematoma cavities...
December 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29262388/-ruptured-dissecting-aneurysm-of-the-fenestrated-vertebral-artery-a-case-report
#7
Kenta Takahara, Toshiyuki Amano, Yuichiro Tsurusaki, Noriyuki Koga, Kei Murao, Shoji Arihiro, Shinya Yamaguchi, Sei Haga
Fenestration of a vertebral artery(VA)is a rare anomaly that has occasionally been associated with the formation of saccular aneurysms, whereas dissection of a limb of the fenestrated artery is an extremely rare occurrence. We report the case of a ruptured dissecting aneurysm of a fenestrated VA. A 56-year-old man presented with acute-onset headache followed by respiratory failure. Computed tomography(CT)revealed diffuse subarachnoid hemorrhage, and CT angiography(CTA)demonstrated fenestration of the left VA and a fusiform aneurysm of the dorsolateral limb of the fenestrated VA...
December 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29248657/comprehensive-cardiac-ct-with-myocardial-perfusion-imaging-versus-functional-testing-in-suspected-coronary-artery-disease-the-multicenter-randomized-crescent-ii-trial
#8
Marisa Lubbers, Adriaan Coenen, Marcel Kofflard, Tobias Bruning, Bas Kietselaer, Tjebbe Galema, Marc Kock, Andre Niezen, Marco Das, Marco van Gent, Ewout-Jan van den Bos, Leon van Woerkens, Paul Musters, Suze Kooij, Fay Nous, Ricardo Budde, Miriam Hunink, Koen Nieman
OBJECTIVES: This study sought to assess the effectiveness, efficiency, and safety of a tiered, comprehensive cardiac computed tomography (CT) protocol in comparison with functional testing. BACKGROUND: Although CT angiography accurately rules out coronary artery disease (CAD), incorporation of CT myocardial perfusion imaging as part of a tiered diagnostic approach could improve the clinical value and efficiency of cardiac CT in the diagnostic work-up of patients with angina pectoris...
December 8, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29238621/burkholderia-aortic-aneurysm-a-case-report-and-review-of-the-literature
#9
Sreelakshmi Panginikkod, Aishwarya Ramachandran, Pratyusha Bollimunta, Roshanak Habibi, Roshan Kumar Arjal, Venu Gopalakrishnan
Melioidosis is a frequently fatal infection caused by the Gram-negative bacillus Burkholderia pseudomallei endemic to Southeast Asia and Northern Australia. It is a rare imported pathogen in the United States and is a potential bioterror agent. We report the case of an 82-year-old previously healthy man who presented with 2 weeks of fever and epigastric pain after he returned from the Philippines. A diagnosis of nondissecting mycotic aneurysm in the descending thoracic aorta was made with the help of CT angiogram and positive blood cultures...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29234734/endovascular-aneurysm-sealing-for-management-of-aortic-occlusive-disease
#10
Ahmed Elbasty, Michael Crawford, Darren Morrow
Introduction: Endovascular management of aortic occlusive disease is an alternative to open surgery. This case describes the use of a Nellix graft to treat infrarenal aortic stenosis, outwith the graft indication for use. Case report: A 71 year old man with multiple comorbidities, presented with bilateral buttock claudication. A computed tomography angiogram (CTA) showed significant infrarenal aortic stenosis. Under local anaesthetic, using a percutaneous approach, Nellix grafts were inserted...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29227856/gastroduodenal-artery-aneurysm-post-traumatic-pancreatic-pseudocyst-drainage-an-interesting-case
#11
Mohammad Zarin, Sajid Ali, Abdul Majid, ZakaUllah Jan
BACKGROUND AND AIM: Pseudoaneurysms of the gastroduodenal artery (GDA) are rare and mostly associated with pancreatitis. However, they can occur as a possible complication following gastric or pancreatic surgery and thus prior recognition and prompt treatment is mandatory (Lee et al., 2009 [1]). We report a case of a ruptured GDA aneurysm in a patient who underwent roux-en-y-cystojejunostomy for traumatic pancreatic pseudocyst and this has rarely been reported in the literature. Our patient presented with melena one month post operatively...
December 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29226460/ct-pulmonary-angiogram-for-assessing-the-treatment-outcome-of-acute-pulmonary-embolism
#12
Hai-Ting Zhou, Wen-Ying Yan, De-Li Zhao, Hong-Wei Liang, Guo-Kun Wang, Zai-Sheng Ling, Jin-Ling Zhang
OBJECTIVE: To discuss the value of CT pulmonary angiogram (CTPA) for assessing the treatment outcome of acute pulmonary embolism (APE). MATERIALS AND METHODS: CT pulmonary angiogram data and other clinical data were collected for 28 cases diagnosed as APE and analyzed retrospectively. The number and positions of emboli in the pulmonary artery, pulmonary artery obstruction index, right ventricular/left ventricular diameter ratio, main pulmonary artery/ascending aorta diameter ratio and blood oxygen saturation, and pulmonary arterial pressure were compared before and after treatment...
December 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/29222218/fat-embolism-a-rare-cause-of-perioperative-renal-transplant-dysfunction
#13
Jemima Scott, Neil Collin, Richard Baker, Rommel Ravanan
Fat embolism is a recognised complication of bony injury and orthopaedic surgery, commonly involving the long bones and pelvis. We report on the case of a 68-year-old renal transplant recipient who developed acute kidney injury following surgical stabilisation of metastatic carcinoma of the acetabulum and replacement of the proximal femur. A CT renal angiogram demonstrated a large fat embolus in the inferior vena cava (IVC) and left iliac veins below the level of IVC filter, with impaired renal perfusion. The risks of open or endovascular lipothrombectomy were felt to outweigh the potential benefits...
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29217342/cinematic-rendering-of-cardiac-ct-volumetric-data-principles-and-initial-observations
#14
Steven P Rowe, Pamela T Johnson, Elliot K Fishman
BACKGROUND: Cinematic rendering (CR) a new method of 3D computed tomography (CT) volumetric visualization that produces photorealistic images. As with traditional 3D visualization methods, CR may prove to be of value in providing important information when evaluating regions of complex anatomy such as the heart. METHODS: The gated, IV contrast-enhanced chest CT angiogram data from three recent patients were evaluated with CR. Image comparision demonstrates the difference between CR and traditional volume rendering (VR), owing to a more complex lighting model that enhances surface detail and produces realistic shadows to add depth to 3D visualizations...
December 2, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29203309/spontaneous-acute-arterial-subdural-haematoma
#15
Michael J Mulcahy, Joga Chaganti, Ashraf Dower, Darweesh Al-Khawaja
BACKGROUND: Spontaneous acute arterial subdural haematoma (SDH) is a rare entity caused by haemorrhage from a cortical perisylvian artery without a known precipitant. CASE DESCRIPTION: A 53 year old man presented with a two day history of acute onset headache and dysphasia. He had a generalised seizure on arrival to hospital. There was no history of trauma. A CT demonstrated an acute left sided SDH. A CT angiogram and a digital subtraction angiogram demonstrated active contrast extravasation into the SDH...
December 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29196284/complete-heart-block-as-the-presenting-feature-in-subarachnoid-haemorrhage
#16
Joshua Pepper, Ciara Fenton, Howard Brydon
Cardiac manifestations of subarachnoid haemorrhage (SAH) are well-documented phenomena that can complicate the treatment of this devastating condition. Here, we present a case of SAH presenting as complete heart block on initial assessment, an extremely rare event.A 53-year-old woman presented with a witnessed fall, sustaining a mild head injury. She denied any symptoms of SAH. Initial ECG revealed complete heart block, for which the patient was accepted under the cardiology team. For completion, a CT head scan was requested, this demonstrated significant SAH blood load in an aneurysmal rather than traumatic pattern...
November 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29181217/traumatic-haemorrhagic-cervical-lymphadenopathy-with-underlying-infectious-mononucleosis
#17
George Rahmani, Sarah Power
A 16-year-old male presented to the Emergency Department with a painful 3 × 3 cm left-sided neck swelling six hours following blunt trauma to the neck from a heavy swinging door. A CT angiogram was performed which revealed a large haemorrhagic lymph node as well as generalised cervical lymphadenopathy. The patient was eventually diagnosed with infectious mononucleosis. This case report describes a rare case of traumatic haemorrhagic cervical lymphadenopathy with an underlying diagnosis of infectious mononucleosis...
2017: Case Reports in Radiology
https://www.readbyqxmd.com/read/29177789/carotid-near-occlusion-frequently-has-high-peak-systolic-velocity-on-doppler-ultrasound
#18
Simon R Khangure, Hadas Benhabib, Matylda Machnowska, Allan J Fox, Christer Grönlund, Wendy Herod, Robert Maggisano, Anders Sjöberg, Per Wester, Seyed-Parsa Hojjat, Julia Hopyan, Richard I Aviv, Elias Johansson
PURPOSE: Carotid near-occlusion is a tight atherosclerotic stenosis of the internal carotid artery (ICA) resulting in decrease in diameter of the vessel lumen distal to the stenosis. Near-occlusions can be classified as with or without full collapse, and may have high peak systolic velocity (PSV) across the stenosis, mimicking conventional > 50% carotid artery stenosis. We aimed to determine how frequently near-occlusions have high PSV in the stenosis and determine how accurately carotid Doppler ultrasound can distinguish high-velocity near-occlusion from conventional stenosis...
November 25, 2017: Neuroradiology
https://www.readbyqxmd.com/read/29173798/portable-ct-pulmonary-angiogram-in-an-infant-on-veno-arterial-extracorporeal-membrane-oxygenation-in-the-pediatric-intensive-care-unit
#19
REVIEW
Simon S Ho, Meral M Patel, Renee M Mansour, Atul Vats, Nikhil K Chanani, Bradley S Rostad
PURPOSE: Computed tomography (CT) has been shown to change management in children on extracorporeal membrane oxygenation (ECMO). Although techniques have been described to transport these critically ill patients to the CT suite in the radiology department, transport out of the intensive care setting is not without risk, and using portable CT is a practical alternative. However, obtaining a CT pulmonary angiogram (CTPA) in a patient on veno-arterial (VA) ECMO presents unique challenges due to bypass of the cardiopulmonary system, which may lead to suboptimal opacification of the pulmonary arteries...
October 31, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29167966/planning-prostate-artery-embolisation-is-it-essential-to-perform-a-pre-procedural-cta
#20
Drew Maclean, Ben Maher, Mark Harris, Jonathan Dyer, Sachin Modi, Nigel Hacking, Timothy Bryant
PURPOSE: A highly variable prostatic artery origin coupled with frequent anastomoses to adjacent organs makes prostate artery embolisation a challenging procedure. Despite CT angiography facilitating procedural planning, it is not performed in all centres. Therefore, we explored the utility of prostatic CT angiography by assessing its capacity to identify the prostatic arteries and highlight troublesome anastomoses. MATERIALS AND METHODS: A retrospective review of patients undergoing prostate artery embolisation for symptoms of benign prostatic obstruction between June 2012 and October 2016 was conducted, with analysis of the pre-procedural CT angiography...
November 22, 2017: Cardiovascular and Interventional Radiology
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