No abstract available.
*Cerebral Angiography ; Cerebral Arteries/*abnormalities ; Female ; Humans ; Intracranial Aneurysm/*radiography

Primitive trigeminal artery (PTA) and primitive otic artery (POA) is a very rare entity in adult life. We present a case of PTA and POA associated with a giant unruptured cavernous aneurysm in a 54-year-old woman. The PTA and the POA arose from the sac of the aneurysm directly, which greatly complicated endovascular therapy management.
*Cerebral Angiography ; Cerebral Arteries/*abnormalities ; Diagnosis, Differential ; Embolization, Therapeutic ; Female ; Humans ; Intracranial Aneurysm/*radiography/therapy ; Middle Aged

Adult ; Carotid Artery Diseases ; pathology ; Carotid Artery, Internal ; pathology ; Cerebral Arteries ; abnormalities ; Humans ; Magnetic Resonance Imaging ; Male

Cerebral amyloid angiopathy (CAA) is a disorder characterized by amyloid deposition in the walls of leptomeningeal and cortical arteries, arterioles, and less often capillaries and veins of the central nervous system. CAA occurs mostly as a sporadic condition in the elderly, its incidence associating with advancing age. All sporadic CAA cases are due to deposition of amyloid-beta, originating from proteolytic cleavage of the Amyloid Precursor Protein. Hereditary forms of CAA are generally familial (and therefore rare in the general population), more severe and earlier in onset. CAA-related lobar intracerebral hemorrhage is the most well-studied clinical condition associated with brain amyloid deposition. Despite ever increasing understanding of CAA pathogenesis and availability of reliable clinical and diagnostic tools, preventive and therapeutic options remain very limited. Further research efforts are required in order to identify biological targets for novel CAA treatment strategies. We present a systematic review of existing evidence regarding the epidemiology, genetics, pathogenesis, diagnosis and clinical management of CAA.
Aged ; Amyloid ; Arteries ; Arterioles ; Brain ; Capillaries ; Central Nervous System ; Cerebral Amyloid Angiopathy ; Cerebral Hemorrhage ; Congenital Abnormalities ; Dementia ; Ear ; Humans ; Incidence ; Plaque, Amyloid ; Veins

BACKGROUND AND OBJECTIVES: Carotid artery stenting has evolved as a potential alternative to carotid endarterectomy in patients (pts) with significant carotid artery stenosis. We evaluated the feasibility and long-term outcome of carotid artery stenting in selected pts at high surgical risk. MATERIALS AND METHODS: Between May, 1996 and September 1998 we performed carotid artery stenting at 35 lesions in 25 pts. There were 23 males and 2 fe-males. Mean age was 63.2+/-6.6 (range 54 - 77). Eight four percent (21/25) of the pts had significant coronary artery disease. Sixty four percent (16/25) of the pts had significant peripheral artery lesions. Sixty percent (15/25) of the pts had neurologic symptoms or non-disabling stroke. We used Wallstent in 32 lesions and Palmaz stent in 3 lesions. Carotid stenting was undertaken in 33 internal carotid, 1 common carotid and 1 external carotid lesions. Bil-ateral carotid stenting was undertaken in forty percent (10/25) of the pts. RESULTS: Carotid stenting was successful in all lesions. One patient died due to massive cerebral hemorrhage 3 days after carotid stenting, who had und-erwent stenting as a rescue procedure for failed endarterectomy. One major stroke developed during procedure with partial recovery. For the combined endpoint of strokes and death within 30 days of procedure, the incidence was 8% and 5.7% in terms of pts and procedures, respectively. On follow-up (12+/-7 months), we found neither neurologic complications nor death. Angiographic and/or duplex sonography which were performed at 5.5 month in all (18) eligible pts with 24 lesions revealed no evidence of stent deformity or restenosis ( 50% of diameter stenosis). Mean angiographic stenosis was 20% on follow-up angiography. CONCLUSION: Carotid artery stenting can be performed with high success and low complication rate in pts with significant carotid artery stenosis especially at high surgical risk. Follow-up clinical outcome of average 12 month was good with low restenosis rate.
Angiography ; Arteries ; Carotid Arteries* ; Carotid Stenosis* ; Cerebral Hemorrhage ; Congenital Abnormalities ; Constriction, Pathologic ; Coronary Artery Disease ; Endarterectomy ; Endarterectomy, Carotid ; Follow-Up Studies* ; Humans ; Incidence ; Male ; Neurologic Manifestations ; Stents* ; Stroke

INTRODUCTIONNourishment for the brain, a highly vascular organ, is derived from a unique structure called the 'circle of Willis', which is formed by the terminal branches of the internal carotid arteries (ICAs) and basilar arteries (BAs). The circle of Willis forms an anastomotic link between the carotid and vertebrobasilar systems in the arterial supply of the brain, while the BA forms an important component of the brain's posterior circulation and supplies its many vital parts.

METHODSA study was performed on 20 brain specimens used for routine dissections at the Anatomy Department, Kasturba Medical College, in order to examine the morphology of BAs in the brain.

RESULTSIn most specimens, the position of the termination of BA was normal, although variations were present in the mode of termination. In one specimen, the BA terminated by dividing into two superior cerebellar arteries. The posterior cerebral arteries (PCAs) arose from ICAs on both sides in this specimen, and a communicating branch was present between the terminal point of the BA and PCA on the left. In another specimen, unilateral variation was seen, with the PCA arising from the ICA on the right and a posterior communicating artery arising from the PCA, connecting it with the BA. The anatomy on the left side was normal.

CONCLUSIONWe highlight the morphological aspects of the BA, the knowledge of which would help neurosurgeons safely diagnose, as well as plan and execute vascular bypass and shunting procedures for the treatment of stenosis, aneurysms and arteriovenous malformations in the posterior cranial fossa.

Basilar Artery ; abnormalities ; anatomy & histology ; Brain ; anatomy & histology ; blood supply ; Cadaver ; Carotid Arteries ; pathology ; Carotid Artery, Internal ; anatomy & histology ; Circle of Willis ; anatomy & histology ; Humans ; Posterior Cerebral Artery ; anatomy & histology

OBJECTIVETo explore the clinical screening and value of vertebral artery ultrasound, Transcranial doppler (TCD), Magnetic resonance angiography (MRA) and Computed tomography angiography (CTA) in the diagnosis of cerebral arteriosclerosis combined with vertebral artery abnormalies according to vertebral artery digital subtraction angiography (DSA).

METHODSFrom January 2006 to September 2010, 186 patients with cerebral arteriosclerosis were retrospectively analyzed. Among the patients, 133 cases were males and 53 cases were females,ranged from 30 to 84 years (with a mean of 63.8 years). All the patients were estimated by DSA; 172 cases were estimated vertebral artery ultrasound and TCD; 53 cases were estimated by MRA; 25 cases were estimated by CTA. The positive results by DSA were seen as case group, while the negative results were seen as control group. The sensitivity, specificity and concordance rate among four groups were calculated.

RESULTSThe abnormality rate of vertebral artery with DSA, vertebral artery ultrasound, TCD, MRA and CTA separately was 50.00% (93/186), 30.81% (53/172), 49.42% (85/172),15.10% (8/53) and 40.00% (10/25). According to DSA standard, the sensitivity of vertebral artery ultrasound in diagnosing was 50.57%, the specificity was 89.41%, and concordance rate was 69.77%; while the sensitivity of TCD was 68.48%, the specificity was 72.50%, and concordance rate was 70.35%; the sensitivity of MRA was 21.43%, specificity was 92.00%, and concordance rate was 54.72%; the sensitivity of CTA was 63.64%,the specificity was 78.57%, and concordance rate was 72.00%.

CONCLUSIONThe reasonable and combined application of vertebral artery ultrasound, TCD, MRA and CTA is helpful for diagnosing cerebral arteriosclerosis combined with vertebral artery abnormalies. For the patients with cerebrovascular disease, cervical massage technique should be paid highly attention, which may cause vertebral artery injury and other complications.

Adult ; Aged ; Aged, 80 and over ; Angiography, Digital Subtraction ; Arteriosclerosis ; diagnosis ; Cerebral Arteries ; diagnostic imaging ; Cerebrovascular Disorders ; diagnosis ; diagnostic imaging ; Female ; Humans ; Intracranial Arteriosclerosis ; diagnosis ; diagnostic imaging ; Male ; Middle Aged ; Ultrasonography ; Vertebral Artery ; abnormalities ; diagnostic imaging