• Investigative Magnetic Resonance Imaging
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• v.18 no.4
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• pp.290-302
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• 2014

Purpose : Susceptibility-weighted magnetic resonance (MR) sequence is three-dimensional (3D), spoiled gradient-echo pulse sequences that provide a high sensitivity for the detection of blood degradation products, calcifications, and iron deposits. This pictorial review is aimed at illustrating and discussing its main clinical applications. Materials and Methods: SWI is based on high-resolution, 3D, fully velocity-compensated gradient-echo sequences using both magnitude and phase images. To enhance the visibility of the venous structures, the magnitude images are multiplied with a phase mask generated from the filtered phase data, which are displayed at best after post-processing of the 3D dataset with the minimal intensity projection algorithm. A total of 200 patients underwent MR examinations that included SWI on a 3 tesla MR imager were enrolled. Results: SWI is very useful in detecting multiple brain disorders. Among the 200 patients, 80 showed developmental venous anomaly, 22 showed cavernous malformation, 12 showed calcifications in various conditions, 21 showed cerebrovascular accident with susceptibility vessel sign or microbleeds, 52 showed brain tumors, 2 showed diffuse axonal injury, 3 showed arteriovenous malformation, 5 showed dural arteriovenous fistula, 1 showed moyamoya disease, and 2 showed Parkinson's disease. Conclusion: SWI is useful in detecting occult low flow vascular lesions, calcification and microbleed and characterising diverse brain disorders.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.781-785
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• 2001

Cervicomedullary junction arteriovenous malformation(AVM) is extremely rare. The authors present a case of a cervicomedullary junction AVM in a 31-year-old woman presenting with recurrent intraventricular hemorrhage (IVH). Magnetic resonance imaging revealed the AVM(of a size of approximately $2{\times}2.5{\times}4cm$) extending from a lower medulla to C2-3 level. Vertebral angiography demonstrated a tightly coiled vascular mass with multiple feeders (radiculomedullary arteries) and irregular-shaped aneurysm at distal part of feeder originating at right C-1 level. The patient underwent superselective embolization of upper nidus and the aneurysm. The pertinent literature is reviewed, and diagnostic and therapeutic implications are discussed.

• The Korean Journal of Nuclear Medicine
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• v.34 no.5
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• pp.426-432
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• 2000

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1030-1036
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• 2000

Objective : The aim of this study was to retrospectively analyze the safety and effect of Linac based Photon Knife Radiosugery System(PKRS) for treatment of cerebral arteriovenous malformation. Patients and Methods : The authors analyzed the clinical method and results of ten patients who were followed up more than two years, among the 18 patients who had radiosurgery on arteriovenous malformation from June, 1992, to Dec. 1997, with Linac based Photon knife radiosurgery system(PKRS) which was developed in our hospital. Results : The average age of the patients was 30.4(with the range of 13-49), and the sex was seven males and three females. For the initial clinical symptoms, there were five patients with headache, three with seizure, one with hemiparesis, and one with vomiting. Before the radiosurgery, computed tomography, MRI, and cerebral angiogram were done. For the location of arteriovenous malformation, it was found on six patients of cerebral hemisphere, two of thalamus, one of brainstem, and one of corpus callosum. Regarding the size of nidus, there were seven patients of smaller than 3cm, and three patients of larger than 3cm. Computed tomography, MRI, and cerebral angiogram were done periodically for sixth months, first year, and second year after the radiosurgery of PKRS for the completeness of obliteration. Six cases showed complete obliteration, and four partial obliterations were observed among ten cases, and interestingly, six cases of complete obliteration were observed among seven cases of small AVM of smaller than 3cm(the rate of complete obliteration : 85.7%). All patients tolerated the treatment and no significant complication were seen. Conclusion : In this study, linac based radiosurgery using PKRS onto arteriovenous malformation showed excellent effects, therefore authors believe that it is an ideal method for small sized or deep seated AVM.

• Archives of Craniofacial Surgery
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• v.10 no.1
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• pp.44-48
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• 2009

Purpose: The treatment of arteriovenous malformation (AVM) of the face remains a difficult challenge in plastic surgery. Incomplete resection resulting in uncontrolled bleeding, postoperative enlargement of the remaining malformation, and a poor functional and cosmetic result could be the problems confronted by the surgeons. Methods: A 37 year-old male with large arteriovenous malformation in face treated with preoperative superselective transarterial embolization and free flap transfer. The size of the defect was $13{\times}9cm$. Sclerotheraphy without resection were performed several times but the results were unsatisfactory. Resection was performed the next day of embolization. We were able to repair with the thoracodorsal artery perforator free flap. And facial muscle reconstruction performed by simultaneous muscle and nerve transfer. Results: During the follow-up period 8 months the patient regained an acceptable cosmetic appearance. And he has shown no reexpansion of the malformation. Conclusion: The thoracodorsal artery perforator free flap could be a good choice for the reconstruction for massive defects of the face. A huge arteriovenous malformation could be safely removed and successfully reconstructed by the complete embolization, wide excision and coverage with a well vascularized tissue.

• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1067-1072
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• 2003

Purpose : Non-accidental intracranial hemorrhage in children is not low in incidence and results in high mortality and serious sequelae. So, the authors have researched the distribution of sex and age, causes, symptoms and signs, hemorrhagic types, mortality rate and sequelae of the patients hospitalized with non-accidental intracranial hemorrhage at Hallym University Sacred Heart Hospital. Methods : The medical records of twenty patients, aged 15 or younger, and excluding neonatal patients, were analyzed retrospectively. The patients in this study were admitted with non-accidental intracranial hemorrhage from January 1999 to June 2002. Results : Of the twenty cases, the ratio of male to female was 1 : 0.8. The patients aged one or less and between 11 and 15 were discovered to be the most frequent cases. Shaken baby syndrome and arteriovenous malformation were found to be the most frequent causes. Seizure was most frequently found to be a symptom and a sign. Hemorrhagic type was classified into subdural hemorrhage eight, intracerebral hemorrhage five. There were three mortal cases. Twelve surviving patients, excluding five not-followed ones, were reclassified into six cases of complete recovery and six of sequalae. Conclusion : Non-accidental intracranial hemorrhage in children is not low in incidence, with a high mortality rate and a high incidence of serious sequelae after survival. Consequently, early diagnosis and appropriate treatment are required. In addition, appropriate rehabilitation after treatment is needed because the high survival rate due to advanced medical treatment results in an increasing number of neurologic sequelae.

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.1018-1023
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• 2021

A meandering pulmonary vein (MPV) is a rare pulmonary vascular anomaly characterized by an abnormal course of the pulmonary vein draining into the left atrium. We report the case of a 55-year-old female who was diagnosed with a right MPV on pulmonary angiography. Enhanced chest CT revealed a vascular structure with an abnormal course that drained into the right superior pulmonary vein in the right upper lobe, which resembled a pulmonary arteriovenous malformation (AVM). Pulmonary angiography performed to discriminate between an MPV and pulmonary AVM showed no feeding artery, normal parenchymal staining, and drainage to the left atrium via the culprit vessel. Thus, the patient was diagnosed with MPV. When an MPV is difficult to differentiate from other vascular anomalies on enhanced chest CT, pulmonary angiography can be helpful. By recognizing the angiographic findings of an MPV, unnecessary treatment can be prevented.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.1-9
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• 2001

Purpose : To establish the role of stereotactic radiosurgery (SRS) for the treatment of patients with angiographically occult vascular malformation (AOVM). Materials and Methods : Eleven patients (12 lesions) with AOVM were treated with linear accelerator-based SRS between February 1995 and December 1999. A magnetic resonance imaging of each patients showed well-circumscribed vascular lesion with reticulated core of heterogeneous signal intensity and peripheral rim of low signal intensity. SRS were peformed with the median peripheral dose of 16 Gy (range 13~25). A single isocenter was used with median collimator size of 14 mm (range 8~20) diameter. Results : With a median follow-up period of 42 months (range 12~56), rebleeding occurred in 3 AOVMS at 5, 6 and 12 months after SRS but no further bleeding did. Two patients experienced radiation-induced necrosis associated with permanent neurologic deficit and one patient showed transient edema of increased 72 signal intensity. Conclusion : SRS may be effective for the prevention of rebleeding in AOVM located in surgically inaccessible region of the brain. Careful consideration should be needed in the decision of case selection and dose prescription because the incidence of radiation-induced complications is too high to be accepted.

• Korean Journal of Head & Neck Oncology
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• v.12 no.2
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• pp.224-229
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• 1996

Head and neck arteriovenous malformation usually forms huge mass, cause profuse bleeding or potenially compromise the airway. This bleeding is vulnerable to be uncontrollable and life­threatening. Sometimes it has a high mortality. Although surgical resection is possible in some cases, the morbidity such as a defects of soft tissue is very high and its reconstruction is very difficult. The authors report an 11 year old female patient in whom occlusion of arteriovenous malformation with glue after transcutaneous embolization made a satisfactory results. At the beginning, she was transferred for massive oral bleeding. The bleeding was persistent and it was not possible to remove the packing in spite of many times of embolizations through feeding arteries. The massive bleeding trom the left upper alveolar mucosa compromised the airway and tracheotomy was done. Whenever the hypovolemic shock was occurred in a short time, blood transfusion and cardiopulmonary resucitation were done. To embolize the vascular mass of arteriovenous malformation, as a final trial before operation, the spinal needle was administered through the left upper gingiva under the fluoroscopy. The glue was injected on the target. The bleeding was stopped and we have noticed the absence of nidus on follow-up angiography after 3 weeks. We experienced that some cases of arteriovenous malformation in head & neck revealing the bleeding could be treated with transcutaneous embolization instead of surgical resection.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.726-732
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• 2020

Neurofibromatosis type 1 (NF1) is a common autosomal-dominant disorder. Vasculopathies associated with NF1 are rare and can cause aneurysms, stenoses, and arteriovenous malformations. Aneurysms may rupture spontaneously, which could be fatal. Spontaneous mesenteric hemorrhage due to rupture of an inferior mesenteric artery aneurysm associated with NF1 has rarely been reported. Herein, we report a case of spontaneous rupture of a fusiform aneurysm in the superior rectal artery in a 56-year-old woman with NF1 who was successfully treated with transcatheter arterial embolization.