• Title/Summary/Keyword: Carotid dissection

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Treatment of Internal Carotid Artery Dissections with Endovascular Stent Placement: Report of Two Cases

  • Deok Hee Lee;Seung Ho Hur;Hyeon Gak Kim;Seung Mun Jung;Dae Sik Ryu;Man Soo Park
    • Korean Journal of Radiology
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    • v.2 no.1
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    • pp.52-56
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    • 2001
  • Extracranial carotid artery dissection may manifest as arterial stenosis or occlusion, or as dissecting aneurysm formation. Anticoagulation and/or antiplatelet therapy is the first-line treatment, but because it is effective and less invasive than other procedures, endovascular treatment of carotid artery dissection has recently attracted interest. We encountered two consecutive cases of trauma-related extracranial internal carotid artery dissection, one in the suprabulbar portion and one in the subpetrosal portion. We managed the patient with suprabulbar dissection using a self-expandable metallic stent and managed the patient with subpetrosal dissection using a balloon-expandable metallic stent. In both patients the dissecting aneurysm disappeared, and at follow-up improved luminal patency was observed.

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Carotid Artery Disease in Duplex Sonography: 3 Cases (이중초음파에서 관찰된 목동맥 질환: 3례)

  • Han, Minho;Choi, Junghye;Seo, Gang Sik;Nam, Hyo Suk
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.1
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    • pp.114-118
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    • 2019
  • Duplex sonography has been used to non-invasively diagnose carotid artery disease and to follow up patients with this disease. In carotid artery disease, carotid mobile thrombus and dissection are rarely detected by duplex sonography in patients with cerebrovascular events. In particular, carotid dissection occurs when a small tear forms in the tunica intima and makes 2 lumens in the carotid artery, including true and false lumens. This study reports 3 rare cases of carotid mobile thrombus, spontaneous carotid dissection, and carotid dissection in Takayasu arteritis.

A Case of Carotid Artery Resection and Replacement (경동맥 절제술 및 치환술 1례)

  • Kim, Dea-Sik;Oh, Cheon-Hwan
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.202-206
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    • 1999
  • A carotid artery resection and replacement including neck dissection are used as a method of treatment for head and neck cancer with infiltration into the carotid artery. The recent development of imaging technique makes it easy to estimate the detailed anatomical relationship between the tumor infiltration into the carotid artery, it's resection and replacement are indicated at radical neck dissection. To detect any possibility of cerebral ischemia at the time of ligation of carotid artery, a temporary occlusion test of internal carotid artery with a ballon catheter (balloon occlusion test) is performed. Recently, we performed a carotid artery resection and replacement using an artificial vessel Gore-Tex) in a case of neck cancer with infiltration into the carotid artery.

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The Unusual Origin of the Sternocleidomastoid Artery from the Lingual Artery

  • Kim, Tae-Hong;Chung, Seung-Eun;Hwang, Yong-Soon;Park, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.44-46
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    • 2012
  • The sternocleidomastoid (SCM) artery supplying blood to the SCM muscle has different origins according to its anatomical segment. The authors performed cadaveric neck dissection to review the surgical anatomy of neurovascular structures surrounding the carotid artery in the neck. During the dissection, an unusual finding was cited in which the SCM artery supplying the middle part of the SCM muscle originated from the lingual artery (LA); it was also noted that it crossed over the hypoglossal nerve (HN). There have been extremely rare reports citing the SCM artery originated from the LA. Though the elevation of the HN over the internal carotid artery was relatively high, the vascular loop crossing over the HN was very close to the carotid bifurcation. Special anatomical consideration is required to avoid the injury of the HN during carotid artery surgery.

Surgery for Advanced Nodal Metastasis in Thyroid Cancer (갑상선암에서 진행된 림프절 전이에 대한 수술적 치료)

  • Park, Min Woo;Rho, Young Soo
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.117-122
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    • 2018
  • Metastases to regional cervical lymph nodes occur frequently in patients with thyroid cancer. The appropriate management of regional lymph node is important to achieve good disease control and to classify risk stratification for adjuvant radioactive iodine. However, there are some occasions that neck dissection is difficult and embarrassing in thyroid cancer. Especially, extensive or unusual nodal metastases bring challenges and makes neck dissection more difficult. Carotid artery management is one of the most difficult procedure in neck dissection. The management of patients who have persistent or recurrent cervical metastasis involving the carotid artery has been controversial and treatment dilemma to the surgeon. Metastasis of well differentiated thyroid cancer to the retropharyngeal lymph nodes is rare but occasionally encountered. The complete surgical excision is usually recommended for retropharyngeal lymph node metastasis of well differentiated thyroid cancer. An extensive mediastinal dissection in advanced differentiated thyroid carcinoma is occasionally required. This paper will review recent reports of management of advanced nodal metastasis of thyroid cancer and share the author's personal experience.

Bilateral thyrolinguofacial trunk: unusual and rare branching pattern of external carotid artery

  • Baxla, Monica;Kumari, Chiman;Kaler, Saroj
    • Anatomy and Cell Biology
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    • v.51 no.4
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    • pp.302-304
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    • 2018
  • Prior knowledge of arterial supply to the head and neck is of substantial importance for well-planned surgeries involving the concerned region. We are reporting an unusual and rare variation in the branching pattern of external carotid artery in a 60-year-old female cadaver. A common trunk known as thyrolinguofacial trunk, originating from the anterior surface of the external carotid artery (right and left) giving of superior thyroid artery and a linguofacial trunk during a routine neck dissection. The linguofacial trunk then divided into a lingual and a facial artery. Vascular abnormalities are usually detected either on the dissection table or by the radiologists during imaging or accidently during surgeries leading to serious consequences.

Spontaneous Recanalization from Traumatic Internal Carotid Artery Occlusion

  • Kim, Young-Sung;Yoon, Seung-Hwan;Kim, Eun-Young;Park, Hyeon-Seon
    • Journal of Korean Neurosurgical Society
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    • v.42 no.2
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    • pp.125-128
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    • 2007
  • The incidence of spontaneous recanalization after traumatic internal carotid artery occlusion is very rare. We have experienced a case of spontaneous recanalization after a traumatic internal carotid artery occlusion. A 5-year-old boy developed contra-lateral hemiparesis and dysphasia after a blunt injury on the head and neck. He had a complete left internal carotid artery occlusion which was diagnosed through angiography. We treated the patient with an anti platelet agent and rehabilitation. Six months later, he regained motor power of right extremities, language ability, and revisualization of internal carotid artery on the follow-up magnetic angiography. We confirmed a recanalization of injured internal carotid artery on the conventional cerebral angiography which was performed one year later. We suggest conservative treatment with serial angiographic studies as a possible option of traumatic internal carotid artery occlusion even though there is hemodynamic instability.

Concurrent Ruptured Pseudoaneurysm of the Internal Carotid Artery and Cerebral Infarction as an Initial Manifestation of Polycythemia Vera

  • Choi, Kyu-Sun;Kim, Jae-Min;Ryu, Je-Il;Oh, Young-Ha
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.137-140
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    • 2015
  • The most common neurologic manifestations of polycythemia vera (PV) are cerebral infarction and transient ischemic attacks, while cerebral hemorrhage or intracranial dissection has been rarely associated with PV. Here we report the first case of a 59-year-old patient with intracranial supraclinoid internal carotid artery (ICA) dissection causing cerebral infarction and concomitant subarachnoid hemorrhage due to pseudoaneurysm rupture as clinical onset of PV. This case report discusses the possible mechanism and treatment of this extremely rare condition.

Spontaneous intracranial internal carotid artery dissection in a child with psoriasis (소아에서 건선과 함께 진단된 자발성 두개강 내 내경 동맥 박리 1례)

  • Kim, Young Ok;Son, Young Jun;Woo, Young Jong;Yun, Sook Jung
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.1044-1047
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    • 2009
  • A 13-year-old girl with psoriasis of the elbow, trunk, and face suddenly developed a severe headache followed by left hemiparesis and facial palsy. Brain magnetic resonance imaging showed an acute infarction of the right temporofrontal lobe and basal ganglia on the T2- and diffusion-weighted images. Cerebral angiography showed pre-occlusive irregular scalloped stenosis (99%) in the proximal M1 segment of the right middle cerebral artery and a web-like stenosis at the supraclinoid portion of the right internal carotid artery (ICA) suggestive of a spontaneous intracranial ICA dissection. The patient was administered a low dose of dipyridamole, and a rehabilitation program was initiated. Headache, left motor weakness, and facial droop improved within a week. However, mild left facial palsy and reduced fine motor function of the left hand were still present after 3 weeks. We report a rare case of spontaneous intracranial ICA dissection in a child with psoriasis.

dissecting aortic aneurysm (DeBakey Type III) -Report of two cases- (박리성 대동맥류(DeBakey Type III)의 외과적 치험 -2예보고-)

  • 문경훈
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.443-448
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    • 1986
  • Aortic dissection is a serious disease that mortality does not approach to zero despite of medical and surgical improvement. Recently two cases of aortic dissection were treated with good results by the two other methods. Case 1 [57-Y-0-Male]; Chief complaint was chest pain radiating to the back. Preoperatively he was controlled by Minipress, dichlotride, & sodium nitroprusside. Aortography showed DeBakey Type III aortic dissection extending from just below the Lt. subclavian artery to the proximal portion of the origin of the renal artery. Through the midline long incision Flow reversal & Thrombo-exclusion method was used, and bypass course was proximal anastomosis at the ascending aorta - through the Rt. thoracic cavity - midportion of the diaphragm - posterior to the liver, stomach, & pancreas - distal anastomosis at the abdominal aorta proximal to its bifurcation. Bypass graft was preclotted 20 mm Dacron Woven Graft, and the aortic arch between the Lt. subclavian artery & Lt. common carotid artery was divided and meticulously sutured. Control aortogram which was done at 4th postoperative month revealed obstruction of the false lumen by thrombosis, and complications were not noticed. Case 2 [53-Y-0-Male]; Chief complaint was chest pain radiating to the abdomen. DeBakey Type III aortic dissection which was similar to the case 1 was detected by the aortography, and involvement of the Lt. subclavian & common carotid arteries was suspicious. Through the Lt. posterolateral thoracotomy the Ringed Intraluminal Sutureless Graft, No. 22 mm, was inserted from just below the Lt. common carotid artery to the midportion of the descending thoracic aorta under total circulation arrest using a F-F bypass, and the Lt. subclavian artery was ligated. Postoperatively hospital course was uneventful with antihypertensive drugs, and any specific complications were not noticed.

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