scholarly journals Relative Hypodense Vertebral Artery Sign on Computerized Tomography in Atherosclerotic Near Occlusion

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Muhammad Faraz Raghib ◽  
Slaven Pikija

A 52-year-old white male presented with an acute onset of slurred speech along with hypoesthesia in the entire left arm. The acute computed tomography (CT) showed relative hypodensity in the intracranial segment of left vertebral artery (VA) that was not present in historical images, pointing to the possible lack of flow. The site of occlusion was confirmed by magnetic resonance imaging (MRI) that showed susceptibility effect in the affected artery. By means of historical native CT comparison the site of VA thrombosis was correctly predicted. Local atherosclerotic thrombosis of the VA could be relatively hypodense on native CT and still have positive susceptibility weighted imaging (SWI) sign.

2021 ◽  
pp. 135245852199965
Author(s):  
Kedar R Mahajan ◽  
Moein Amin ◽  
Matthew Poturalski ◽  
Jonathan Lee ◽  
Danielle Herman ◽  
...  

Objective: Describe magnetic resonance imaging (MRI) susceptibility changes in progressive multifocal leukoencephalopathy (PML) and identify neuropathological correlates. Methods: PML cases and matched controls with primary central nervous system lymphoma (PCNSL) were retrospectively identified. MRI brain at 3 T and 7 T were reviewed. MRI-pathology correlations in fixed brain autopsy tissue were conducted in three subjects with confirmed PML. Results: With PML ( n = 26 total, n = 5 multiple sclerosis natalizumab-associated), juxtacortical changes on susceptibility-weighted imaging (SWI) or gradient echo (GRE) sequences were noted in 3/3 cases on 7 T MRI and 14/22 cases (63.6%) on 1.5 T or 8/22 (36.4%) 3 T MRI. Similar findings were only noted in 3/25 (12.0%) of PCNSL patients (odds ratio (OR) 12.83, 95% confidence interval (CI), 2.9–56.7, p < 0.001) on 1.5 or 3 T MRI. On susceptibility sequences available prior to diagnosis of PML, 7 (87.5%) had changes present on average 2.7 ± 1.8 months (mean ± SD) prior to diagnosis. Postmortem 7 T MRI showed SWI changes corresponded to areas of increased iron density along the gray–white matter (GM-WM) junction predominantly in macrophages. Conclusion: Susceptibility changes in PML along the GM-WM junction can precede noticeable fluid-attenuated inversion recovery (FLAIR) changes and correlates with iron accumulation in macrophages.


2020 ◽  
Vol 4 (4) ◽  
pp. 626-627
Author(s):  
Boris Ryabtsev ◽  
Matthew Slane

Case Presentation: A 53-year-old male presented to the emergency department with acute onset of bilateral hearing loss as well as vertigo and severe vomiting. The Head Impulse– Nystagmus–Test of Skew exam was indicative of a central neurologic process. Computed tomography angiogram of the head and neck revealed near-total bilateral vertebral artery occlusions in the second and third segments. The patient was admitted for further evaluation; subsequent magnetic resonance imaging revealed multiple areas of infarction in the cerebellar hemispheres, medulla, and occipital lobes. Discussion: This case describes a unique presentation of a posterior stroke. Common symptoms include vertigo, loss of balance, and vomiting. However, bilateral hearing loss as a prominent symptom is uncommon. Imaging revealed a rare finding of bilateral vertebral artery occlusion.


2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Amit Mahore ◽  
Raghvendra Ramdasi ◽  
Sandip Mavani ◽  
Vithal Rangarajan ◽  
Manoj Patil ◽  
...  

A 52-year-old female presented with frequent episodes of falls without loss of consciousness. These episodes lasted for brief period followed by full neurological recovery. Magnetic resonance imaging (MRI) of the brain showed foramen magnum meningioma encasing left vertebral artery. The patient had dramatic improvement after excision of the tumor.


2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Ferry Dharsono ◽  
Andrew Thompson ◽  
Jolandi van Heerden ◽  
Andrew Cheung

Hyperglycaemia with hemichorea (HGHC) is an unusual clinical entity that can be associated with corpus striatum hyperintensity on T1-weighted (T1W) magnetic resonance imaging (MRI) sequences. We report the utility of the susceptibility weighted image (SWI) sequence and the filtered phase SWI sequence in the imaging assessment of HGHC.


2015 ◽  
Vol 5 (2) ◽  
pp. 67-69
Author(s):  
Arpit Sharma ◽  
Jyoti Dabholkar ◽  
Jaini Lodha ◽  
Nitish Virmani

ABSTRACT Cavernous hemangioma is a rare tumor of the adult larynx. These hemangiomas are confined to the larynx and generally asymptomatic. We present a rare case of a huge cavernous hemangioma in a 22-year-old patient who presented with stridor and a huge swelling in the neck, of acute onset. Detailed evaluation including 70° Hopkins laryngoscopy, contrastenhanced computed tomography (CT) scan and magnetic resonance imaging (MRI) revealed a vascular malformation with both intra- and extralaryngeal components. The typical findings of hemangioma with its management are highlighted in this article. Postoperatively, patient's voice improved and the stridor was relieved. How to cite this article Lodha J, Sharma A, Dabholkar J, Virmani N. Unusual Presentation of Laryngeal Cavernous Hemangioma. Int J Phonosurg Laryngol 2015;5(2):67-69.


2015 ◽  
Vol 22 (1) ◽  
pp. 62-66 ◽  
Author(s):  
Yasuhiro Kawabata ◽  
Tetsuya Tsukahara ◽  
Shunichi Fukuda ◽  
Satoru Kawarazaki ◽  
Tomokazu Aoki

Background Double origin of the posterior inferior cerebellar artery (DOPICA) has been rarely reported in the literature, with a reported incidence of 1.45%. In contrast, a high concurrence rate of DOPICA and vertebral artery dissecting aneurysm has been reported. Clinical presentation A 61-year old woman presented with vomiting and diplopia with preceding headache. Magnetic resonance imaging (MRI) showed fresh infarction of the left lateral medulla and a vertebral artery dissecting aneurysm of the left vertebral artery. The next day, she exhibited transient loss of consciousness and worsening of headache, and MRI depicted subarachnoid hemorrhage. Four-vessel digital subtraction angiography showed a posterior inferior cerebellar artery (PICA) arising both intracranially and extracranially from the left vertebral artery. Although the dissecting lesion involved the V3 and V4 portion, it did not involve an extracranially originating PICA. Internal trapping of the V3 and V4 portion was chosen as the extracranial channel was expected to supply the PICA territory. This procedure was safely performed. Conclusion Early endovascular intervention should be considered in the treatment of dissecting aneurysm of vertebral artery associated with DOPICA for patients with relatively long lesions even in unruptured cases.


Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 127
Author(s):  
Laszlo Szalontai ◽  
Zsofia Jokkel ◽  
Tamas Horvath ◽  
Marton Piroska ◽  
Bianka Forgo ◽  
...  

Background and Objectives: The asymmetrical vertebral artery (VA) flow and diameter are common findings, which can result in an asymmetrical blood flow in the basilar artery (BA), leading to bending of the artery over time. This study investigated whether the variation of the different vertebrobasilar morphological indices that influence flow characteristics might be inherited. Materials and Methods: We analyzed 200 cerebral magnetic resonance imaging (MRI) scans of healthy Caucasian twins (100 pairs) who underwent time-of-flight MRI. From the scans, we reconstructed the 3D mesh of the posterior circulation from the start of the V4 segment to the basilar tip and subsequently analyzed the morphology of the vertebrobasilar system. The phenotypic covariances of the different morphological parameters were decomposed into heritability (A), shared (C), and unshared (E) environmental effects. Results: 39% of the twins had left dominant VA, while 32.5% had right dominant. In addition, 28.5% were classified as equal. The vertebral artery V4 segment diameter, curvature, and tortuosity were mainly influenced by shared (C) and unshared (E) environmental factors. A moderate heritability was found for the BA length (A: 63%; 95% CI: 45.7–75.2%; E: 37%; 95% CI: 24.8–54.3%) and volume (A: 60.1%; 95% CI: 42.4–73.2%; E: 39.9%; 95% CI: 26.8–57.6%), while the torsion of both arteries showed no heritability and were only influenced by the unshared environment. Conclusions: The length and volume of the BA show a moderate genetical influence. However, most of the measured morphological indices were influenced by shared and unshared factors, which highlight the role of the ever-changing hemodynamic influences shaping the geometry of the vertebrobasilar system.


2021 ◽  
Vol 20 (3) ◽  
pp. 324-329
Author(s):  
Bünyamin Güney ◽  
◽  
İbrahim Önder Yeniçeri ◽  
Emrah Doğan ◽  
Neşat Çullu ◽  
...  

Objective. The aim of this study is to evaluate the magnetic resonance imaging (MRI) findings of central neural system (CNS) superficial siderosis cases and the diagnostic contribution of the susceptibility-weighted imaging (SWI) sequence to conventional imaging. Method. TSE T2-weighted and SWI-MRI of 26 patients diagnosed as CNS-superficial siderosis (CNS-SS) were retrospectively evaluated with 3-Tesla MRI. The localization and type of involvement of SS were reviewed. Results. The CNS-SS were divided into two categories as central amyloid angiopathy-SS (CAA-SS) and non central amyloid angiopathy-SS (non-CAA-SS). In non-CAA cases, the involvement was typical (classic) in 5 cases and atypical in 9 cases. In 12 of these cases (85.7%), SS findings were observed on both turbo spine echo (TSE) T2 images and SWI imaging, while in 2 cases (14.3%) SS was detected only on SWI images. In 7 of the CAA-SS cases, involvement was focal type SS (58.33%), while 5 cases had diffuse type SS (41.67%) involvement. In the vast majority of cases (n = 10) of this type of SS, involvement was detected only in SWI images, while siderosis was not detected in TSE T2 images. In addition, occult cerebral vascular malformation accompanying SS, which can be observed only in the SWI sequence, was found in a total of 4 cases. In the cross-matching statistical analysis performed between CAA-SS and non-CAA-SS groups and subgroups, SWI was found to be significantly superior to T2 in detecting SS in the CAA-SS group (p:0,007). Conclusions. SWI imaging was superior in detecting SS and detecting cerebral occult vascular malformation in CAA-SS cases. Although the detectability of SS by SWI was high in other groups, no statistically significant difference was found. Under these circumstances, we think that it will be beneficial to add SWI imaging to the routine imaging protocol in cases with suspected CNS-SS.


2017 ◽  
pp. 8
Author(s):  
Mariusz Wachowski

Tło. Zakrzepica zatok żylnych (dural venous sinus thrombosis – DVST) stanowi istotny i trudny problem diagnostyczny ze względu na mało specyfi czny obraz kliniczny oraz zróżnicowaną dynamikę objawów. Celem niniejszego opisu przypadku jest uzasadnieniemożliwości wykorzystania sekwencji zależnej od podatności magnetycznej (susceptibility-weighted imaging – SWI) w skutecznym rozpoznawaniu DVST oraz w różnicowaniu jej potencjalnych powikłań. Opis przypadku. 38-letnia pacjentka została przyjęta do kliniki neurologii z powodu silnego bólu głowy z następczą utratą przytomności. Przy przyjęciu wykonano przeglądową tomografi ę komputerową (TK) głowy. Uzyskane obrazy oceniono jako prawidłowe. W 6. dobie hospitalizacji ze względu na nagłe pogorszenie stanu klinicznego oraz podwyższone wartości D-dimerów przeprowadzono jednofazowe badanie metodą rezonansu magnetycznego (magnetic resonance imaging – MRI). Stwierdzono poszerzenie zatoki strzałkowej górnej oraz obecność skrzepliny na odcinku około 55 mm. Ponadto w sekwencji FLAIR oraz T2-zależnej stwierdzonoobszary patologiczne w zakręcie zaśrodkowym. W związku z podejrzeniem wystąpienia zawału żylnego przeprowadzono sekwencję SWI, co pozwoliło na jego wykluczenie. Ustalono rozpoznanie przekrwienia żylnego. Wnioski. Analiza obrazu w sekwencji SWI pozwoliła na jednoznaczne wykluczenie udaru krwotocznego i umożliwiła kontynuowanie terapii przeciwzakrzepowej.


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