Left common carotid artery agenesis with bovine origin of the left internal carotid artery.

The absence of the left common carotid artery, with separate origins of the external carotid and internal carotid arteries from the aortic arc is a well-described but extremely rare congenital anomaly. We present a unique case of agenesis of left common carotid artery depicted at MR angiography where the left internal carotid artery had a bovine origin (from the brachiocephalic trunk) and the left external carotid artery arose from the aortic arc. In addition, it is important to diagnose this anatomical variant especially prior to interventional procedures, as it could hinder the catheterization of these arteries.

Embolization through the thyrocervical trunk: vascular anatomy, variants, and a case series.

Background And Purpose: The thyrocervical trunk (TCT) is the second ascending branch of the subclavian artery. It is considered a 'border territory' between interventional vascular radiology and interventional neuroradiology because it gives rise to branches both cervical and to the upper limbs. We describe the TCT branches anatomy, the most frequent variants, and expose eight endovascular procedures performed through the thyrocervical trunk.

Parachordal fistula--a case report and a short review.

Arteriovenous shunts of the neck and facial region rarely involve the external carotid artery and its branches. Most cases are considered to be iatrogenic or related to trauma but congenital shunts are rare. Parachordal arteriovenous fistulae are a group of embryologically derived arteriovenous shunts caused by defects involving the notochord, giving rise to cranial and paraspinal shunts.

Transvenous Onyx embolization of a subependymal deep arteriovenous malformation with a single drainage vein: technical note.

Cerebral arteriovenous malformations (AVMs) are uncommon. Treatment options include embolization, radiosurgery and surgery, separately or combined, the final goal being complete occlusion of the malformation. We describe the case of a symptomatic small subependymal AVM with a single deep drainage vein previously treated unsuccessfully by radiosurgery and transarterial embolization.

Identification of Risk Factors for the Occurrence of Cement Leakage During Percutaneous Vertebroplasty for Painful Osteoporotic or Malignant Vertebral Fracture.

Study Design: Retrospective study.

Objective: To identify fracture morphology-dependent risk factors for the occurrence of cement leakage during percutaneous vertebroplasty.

Summary Of Background Data: Extravertebral cement leakage is the most frequently reported complication and represents a major risk after vertebroplasty and balloon kyphoplasty.

Direct transforaminal Onyx embolization of intracranial dural arteriovenous fistulas: technical note and report of five cases.

Intracranial dural arteriovenous fistulas with retrograde leptomeningeal or cortical drainage are considered aggressive. Conventional treatment in these cases is possible surgically or with endovascular arterial injections of Onyx or cyanoacrylate, but there are still some cases where distal navigation is not possible due to tortuosity of the arterial feeders. We present five cases of direct transforaminal Onyx embolization where endovascular distal navigation could not be achieved.

Transvenous Onyx embolization of a subependymal deep arteriovenous malformation with a single drainage vein: technical note.

Cerebral arteriovenous malformations (AVMs) are uncommon. Treatment options include embolization, radiosurgery and surgery, separately or combined, the final goal being complete occlusion of the malformation. We describe the case of a symptomatic small subependymal AVM with a single deep drainage vein previously treated unsuccessfully by radiosurgery and transarterial embolization.

Intracranial perianeurysmal cyst: still a dilemma. A case report with endovascular management.

Intracranial perianeurysmal cysts constitute an extremely rare entity with very few cases reported in the literature. These cysts present an unknown mechanism of formation and clinical significance. Several theories based on isolated cases have been proposed, without drawing a clear conclusion.

Percutaneous onyx embolization of cervical paragangliomas.

Cervical paragangliomas are a group of vascular neoplasms arising from the extraadrenal neuroendocrine system. The present report describes a series of six cases of cervical paragangliomas successfully and safely embolized preoperatively by means of ethylene vinyl alcohol copolymer delivered by percutaneous needle punctures without the need for balloon protection. Although the results are promising, further studies are needed to confirm the superiority of this method versus other embolization techniques and embolic agents.

Biomechanical, histological and histomorphometric analyses of calcium phosphate cement compared to PMMA for vertebral augmentation in a validated animal model.

Introduction: Calcium phosphate cements (biocements) are alternative materials for use in vertebral augmentation procedures, and are a potential solution to problems associated with polymethylmethacrylate (PMMA) cements. The aim of this study is to demonstrate the utility of percutaneously injected biocements compared with PMMA in a validated animal model of osteoporosis.

Materials And Methods: Fortyseven augmentation procedures were performed on 11 osteoporotic sheep.

[Diagnosis and treatment of head and neck paragangliomas. Uses of angiography and interventional radiology].

The present article aims to describe the current role of interventional neuroradiology in the diagnosis and treatment of head and neck paragangliomas, based on our experience and a literature review. The cellular polymorphism of head and neck paragangliomas confers these tumors with their characteristics hypervascularization (angioarchitecture) with characteristic arteriographic signs and hemorrhage that justify presurgical embolization. The main indications of digital angiography in head and neck paragangliomas are to confirm diagnosis and identify functional involvement of the large cervical vessels, as well as their possible vascular replacement.

Percutaneous vertebroplasty: functional improvement in patients with osteoporotic compression fractures.

Study Design: Prospective, double-cohort study.

Objective: To evaluate conservative and percutaneous vertebroplasty (PV) management of osteoporotic vertebral fractures.

Summary Of Background Data: PV is an elective alternative to conservative management for the treatment of a painful osteoporotic vertebral fracture.

Endovascular Treatment of Cerebral AVM: Our Experience with Onyx.

We have been using Onyx, a non-adhesive liquid polymer, to treat cerebral AVMs endovascularly since 1999. During this time we have treated 45 consecutive, unselected patients. From the outset this product brought about a change in our approach to treating this type of lesion because of the different injection behaviour observed for this material compared with the adhesive Histoacryl that had been employed until then.

Predictors of outcomes of percutaneous vertebroplasty for osteoporotic vertebral fractures.

Study Design: Retrospective review of all percutaneous vertebroplasties performed in the authors' institution from November 1994 to June 2002. OBJECTIVE.: To determine the factors affecting the outcome of percutaneous vertebroplasty for the treatment of persistent painful osteoporotic fractures.

Effects of fibroblast growth factor and glial-derived neurotrophic factor on akinesia, F-DOPA uptake and dopamine cells in parkinsonian primates.

Parkinson's disease (PD) is a common neurodegenerative disorder that produces progressive disability despite symptomatic treatment. Several strategies, including stereotaxic brain lesions, deep brain stimulation, transplants of dopamine cells and administration of neurotrophic factors, have been proposed to improve efficacy and to counteract the progression of the disease. We here report the effects of repetitive intracerebral infusion of basic fibroblast growth factor (bFGF) and glial-derived neurotrophic factor, up to 1 year, in Cynomolgus monkeys with long standing asymmetric parkinsonism produced by unilateral intracarotid injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP).

Subthalamic lesion and paroxysmal tonic spasms.

Paroxysmal dyskinesia due to a subthalamic lesion is a rare finding. We describe a patient with paroxysmal tonic spasms due to a well-defined lesion in the subthalamic area. In this case, we confirm the nonepileptic nature of the episode and collect with detail the clinical features by means of a video-electroencephalographic recording.

[Arteriovenous malformations of the vein of Galen].

Vein of Galen arteriovenous malformations encompass a diverse group of vascular anomalies that share a common feature: dilatation of the vein of Galen. Although clinical presentations are highly variable, depending on age of presentation, signs and symptoms overlap between age groups. The association of heart failure and cranial bruit constitutes the most striking clinical presentation in neonates.

Vertebroplasty in the treatment of vertebral tumors: postprocedural outcome and quality of life.

The results of percutaneous vertebroplasty with polymethylmethacrylate (PMMA) of vertebral metastases were evaluated by a retrospective review of a consecutive series of 21 patients, with special reference to functional outcome. Patients complained of vertebral pain in all cases. Walking was impossible for 13 patients.

Percutaneous vertebroplasty: long-term clinical and radiological outcome.

We assessed radiographic and functional outcome in 13 patients with a minimum of 5 years follow-up from a prospectively monitored series of 17 patients who underwent percutaneous vertebroplasty (PPV). A visual analogue scale (VAS) and the short McGill questionnaire (MPQ) were used to assess average symptoms. The VAS showed significant improvement after treatment: the initial score was 9.

Moyamoya disease and sagittal sinus thrombosis in a child with Down's syndrome.

A girl with Down's syndrome, moyamoya disease and sagittal sinus thrombosis is described. She was diagnosed after acute neurological deterioration by MRI and angiography. Recombinant tissue plasminogen activator (r-TPA) was injected locally to recanalise the thrombus.

Nonhistological diagnosis of human cerebral tumors by 1H magnetic resonance spectroscopy and amino acid analysis.

We describe a multivariate analysis procedure to classify human cerebral tumors nonhistologically in vitro, combining the use of 1H magnetic resonance spectroscopy (MRS) with automatic amino acid analysis of biopsy extracts. Eighty-one biopsies were obtained surgically and classified histologically in eight classes: high-grade astrocytomas (class 1, n = 19), low-grade astrocytomas (class 2, n = 10), normal brain (class 3, n = 9), medulloblastomas (class 4, n = 4), meningiomas (class 5, n = 18), metastases (class 6, n = 8), neurinomas (class 7, n = 9), and oligodendrogliomas (class 8, n = 4). Perchloric acid extracts were prepared from every biopsy and analyzed by high resolution 1H MRS and automatic amino acid analysis by ionic exchange chromatography.

Percutaneous vertebroplasty: a special syringe for cement injection.

Percutaneous vertebroplasty is an effective treatment for many focal vertebral lesions. Methyl methacrylate is too viscous to be handled without difficulty in the conventional way because injection time is short. The operator is left with little time and must fumble with multiple syringes.