• Title/Summary/Keyword: Conventional angiography

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A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia

  • Seung, Won-Bae;Kim, Dae-Yong;Park, Yong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.291-293
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    • 2015
  • Anterior communicating artery (ACoA) aneurysms sometimes present with visual symptoms when they rupture or directly compress the optic nerve. Giant or large ACoA aneurysms producing bitemporal hemianopsia are extremely rare. Here we present an unusual case of bitemporal hemianopsia caused by a large intracranial aneurysm of the ACoA. A 41-year-old woman was admitted to our neurosurgical department with a sudden-onset bursting headache and visual impairment. On admission, her vision was decreased to finger counting at 30 cm in the left eye and 50 cm in the right eye, and a severe bitemporal hemianopsia was demonstrated on visual field testing. A brain computed tomography scan revealed a subarachnoid hemorrhage at the basal cistern, and conventional cerebral catheter angiography of the left internal carotid artery demonstrated an $18{\times}8mm$ dumbbell-shaped aneurysm at the ACoA. Microscopic aneurysmal clipping was performed. An ACoA aneurysm can produce visual field defects by compressing the optic chiasm or nerves. We emphasize that it is important to diagnose an aneurysm through cerebrovascular study to prevent confusing it with pituitary apoplexy.

A Case of Ruptured Peripheral Aneurysm of the Anterior Inferior Cerebellar Artery Associated with an Arteriovenous Malformation : A Less Invasive Image-Guided Transcortical Approach

  • Lee, Seung-Hwan;Koh, Jun-Seok;Bang, Jae-Seung;Kim, Gook-Ki
    • Journal of Korean Neurosurgical Society
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    • v.46 no.6
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    • pp.577-580
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    • 2009
  • A 47-year-old man presented with a subarachnoid hemorrhage (SAH) and right cerebellar hematoma was referred for evaluation. Cerebral angiography revealed a distal anterior inferior cerebellar artery (AICA) aneurysm associated with an arteriovenous malformation (AVM). Successful obliteration and complete removal of the aneurysm and AVM were obtained using transcortical approach under the guidance of neuronavigation system. The association of a peripheral AICA aneurysm and a cerebellar AVM by the same artery is unique. The reported cases of conventional surgery for this disease complex are not common and their results are variable. Less invasive surgery using image-guided neuronavigation system would be helpful and feasible for a peripheral aneurysm combining an AVM of the posterior fossa in selective cases

Contralateral Cerebral Infarction after Stent Placement in Carotid Artery : An Unexpected Complication

  • Park, Seong-Ho;Lee, Chang-Young
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.159-162
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    • 2008
  • Stenting is a useful alternative treatment modality in carotid artery stenosis patients who are too high-risk to undergo carotid endarterectomy (CEA). We report a case of contralateral cerebral infarction after stenting for extracranial carotid stenosis. A 78-year-old woman was admitted to the hospital with left-sided weakness. Based on magnetic resonance imaging (MRI) of the brain and conventional angiography, she was diagnosed with an acute watershed infarct of the right hemisphere secondary to severe carotid stenosis. Stenting was performed for treatment of the right carotid artery stenosis after a one-week cerebral angiogram was completed. Thirty minutes after stent placement, the patient exhibited a generalized seizure. Four hours later, brain MRI revealed left hemispheric cerebral infarction. Complex aorta-like arch elongation, tortuosity, calcification, and acute angulation at the origin of the supra-aortic arteries may increase the risk of procedural complications. In our case, we suggest that difficult carotid artery catheterization, with aggressive maneuvering during stenting, likely injured the tortuous, atherosclerotic aortic arch, and led to infarction of the contralateral cerebral hemisphere by thromboemboli formed on the wall of the atherosclerotic aorta.

A case of tacrolimus-induced encephalopathy after kidney transplantation

  • Kim, Myoung-Uk;Kim, Sae-Yoon;Son, Su-Min;Park, Yong-Hoon
    • Clinical and Experimental Pediatrics
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    • v.54 no.1
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    • pp.40-44
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    • 2011
  • We present a case of tacrolimus-induced encephalopathy after successful kidney transplantation. An 11-year-old girl presented with sudden onset of neurologic symptoms, hypertension, and psychiatric symptoms, with normal kidney function, after kidney transplantation. The symptoms improved after cessation of tacrolimus. Magnetic resonance imaging (MRI) showed acute infarction of the middle cerebral artery (MCA) territory in the right frontal lobe. Three days later, she had normal mental function and maintained normal blood pressure with left hemiparesis. Follow-up MRI was performed on D19, showing new infarct lesions at both cerebral hemispheres. Ten days later, MRI showed further improvement, but brain single photon emission computed tomography (SPECT) showed mild reduction of uptake in both the anterior cingulate gyrus and the left thalamus. One month after onset of symptoms, angiography showed complete resolution of stenosis. However, presenting as a mild fine motor disability of both hands and mild dysarthria, what had been atrophy at both centrum semiovale at 4 months now showed progression to encephalomalacia. There are two points of interest in this case. First, encephalopathy occurred after administration of tacrolimus and improved after discontinuation of the drug. Second, the development of right-side hemiplegia could not be explained by conventional MRI; but through diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) of white matter tract, visualization was possible.

Structure design of Csl-Se Detector using Monte Carlo Simulation (몬테카를로 시뮬레이션을 통한 Csl-Se 검출기의 구조 설계)

  • Park, Ji-Koon;Kang, Sang-Sik;Choi, Jang-Young;Lee, Hung-Won;Nam, Sang-Hee
    • Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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    • 2002.11a
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    • pp.420-423
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    • 2002
  • In recent years, there has been keen interest in developing f1at panel detectors for all modalities of radiology, including gerneral radiology, fluoroscopy(angiography and cardiology), electronic portal imaging, and mammography. In this paper, we report the new hybrid x-ray detector consisted of CsI(Tl) photoemission layer and a-Se photoconductor layer to resolve conventional x-ray detector such as the direct detector using a-Se and the indirect detector using CsI(Tl)/a-Si. To design the structure of CsI(Tl)/a-Se detector, the penetrated energy spectrum and absorption fraction was estimated using MCNP 4C code. Experimental results showed that the absorption fraction of $500{\mu}m-Se$ film and $150{\mu}m-CsI\left(Tl \right)/a-Se\left( 30{\mu}m \right)$ film is 70% at 70 kVp. The absorption energy is 90% at $350{\mu}m-CsI(Tl)$.

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Segmentation of Arterial Vascular Anatomy around the Stomach based on the Region Growing Based Method

  • Kang, Jiwoo;Kim, Doyoung;Lee, Sanghoon
    • Journal of International Society for Simulation Surgery
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    • v.1 no.2
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    • pp.75-79
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    • 2014
  • Purpose The region growing has a critical problem that it often extract vessels with unexpected objects such as a bone which has a similar intensity characteristics to the vessel. We propose the new method to extract arterial vascular anatomy around the stomach from the CTA volume without the post-processing. Materials and Methods Our method, which is also based on the region growing, requires the two seed points from the use. I automatically extracts perigastric arteries using the adaptive region growing method and it does not need any post-processing. Results The three region growing based methods are used to extract perigastric arteries - the conventional region growings with restrict and loose thresholds each and the proposed method. The 3D visualization from the result of our method shows our method extracted the all required arteries for gastric surgery. Conclusion By extracting perigastric arteries using the proposed method, over-segmentation problem that unexpected anatomical objects such as a rib or backbone are also segmented does not occurs anymore. The proposed method does not need to sensitively determine the thresholds of the similarity function. By visualizing the result, the preoperative simulation of arterial vascular anatomy around the stomach can be possible.

A Case of Systemic Lupus Erythematosus Presenting with Amaurosis Fugax without Antiphospholipid Antibodies Syndrome (항인지질항체증후군을 동반하지 않은 일과성 단안 실명으로 발현된 전신성 홍반성 루푸스 1 예)

  • Kim, Jung-Hyun;Hah, Jung-Sang;Park, Mee-Young;Lee, Se-Jin;Lee, Jun
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.113-117
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    • 2006
  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that may affect many organ systems including the nervous system. The immune response in patients with SLE can cause inflammation and other damage that can cause significant injury to the arteries and tissues. A 48-year-old woman was admitted to the hospital because of transient monocular blindness. Magnetic resonance imaging and conventional angiography showed severe stenosis of the distal intracranial internal carotid artery. The patient was diagnosed as having SLE but the antiphospholipid antibodies were negative. Amaurosis fugax has not been previously reported as an initial manifestation of SLE in Korea. We report a patient with a retinal transient ischemic attack as the first manifestation of SLE.

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Experimental Evaluation of Scattered X-Ray Spectra due to X-Ray Therapeutic and Diagnosis Equipment for Eye Lens Dosimetry of Medical Staff

  • Kowatari, Munehiko;Nagamoto, Keisuke;Nakagami, Koich;Tanimura, Yoshihiko;Moritake, Takashi;Kunugita, Naoki
    • Journal of Radiation Protection and Research
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    • v.47 no.1
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    • pp.39-49
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    • 2022
  • Background: For proper monitoring of the eye lens dose, an appropriate calibration factor of a dosimeter and information about the mean energies of X-rays are indispensable. The scattered X-ray energy spectra should be well characterized in medical practices where eye lenses of medical staffs might be high. Materials and Methods: Scattered X-ray energy spectra were experimentally derived for three different types of X-ray diagnostic and therapeutic equipment, i.e., the computed tomography (CT) scan, the angiography and the fluoroscopy. A commercially available CdZnTe (CZT) spectrometer with a lead collimator was employed for the measurement of scattered X-rays, which was performed in the usual manner. Results and Discussion: From the obtained energy spectra, the mean energies of the scattered X-rays lied between 40 and 60 keV. This also agreed with that obtained by the conventional half value layer method. Conclusion: The scattered X-rays to which medical workers may be exposed in the region around the eyes were characterized by means of spectrometry. The obtained mean energies of the scattered X-rays were found to match the flat region of the dosimeter response.

Case Report on Stenosis of Anterior Cerebral Artery with Cerebral Infarction by Medical Therapy (뇌경색 환자의 전대뇌동맥협착에 대한 치험1례)

  • Lee, Hyun-Ju;Kim, Min-Su;Hwang, Kyu-Dong
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.54-61
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    • 2009
  • Arteriosclerosis is a pathologic term that contains hardening of arterial wall, loss of arterial elasticity and stenosis of artery. To diagnose this disease, conventional angiography, MRA, transcranial doppler ultrasonography are commonly used. And it causes various clinical phases by a region of the disease. In oriental medicine, arteriosclerosis is classified into congested fluids(痰飮), blood stasis(瘀血), stagnation of Gi(氣滯) and treated by Herb-Med, acupuncture, cupping, moxibustion, and the like. The purpose of this study was to investigate the effect of oriental medical therapy on cerebral arteriosclerosis. A patient with cerebrovascular disease admitted due to dizziness, mild dysarthria, tinnitus, anxiety disorder and his Brain MRA showed severe arteriosclerosis in right anterior cerebral artery(ACA) and middle cerebral artery(MCA). Every day, we administered to patient Herb Med and Herb pills. Also, acupuncture, moxibustion were done, too. As a result of the treatment, the patient's follow up Brain MRA showed improved state of ACA stenosis.

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Design of MRI Spectrometer Using 1 Giga-FLOPS DSP (1-GFLOPS DSP를 이용한 자기공명영상 스펙트로미터 설계)

  • 김휴정;고광혁;이상철;정민영;장경섭;이동훈;이흥규;안창범
    • Investigative Magnetic Resonance Imaging
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    • v.7 no.1
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    • pp.12-21
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    • 2003
  • Purpose : In order to overcome limitations in the existing conventional spectrometer, a new spectrometer with advanced functionalities is designed and implemented. Materials and Methods : We designed a spectrometer using the TMS320C6701 DSP capable of 1 giga floating point operations per second (GFLOPS). The spectrometer can generate continuously varying complicate gradient waveforms by real-time calculation, and select image plane interactively. The designed spectrometer is composed of two parts: one is DSP-based digital control part, and the other is analog part generating gradient and RF waveforms, and performing demodulation of the received RF signal. Each recover board can measure 4 channel FID signals simultaneously for parallel imaging, and provides fast reconstruction using the high speed DSP. Results : The developed spectrometer was installed on a 1.5 Tesla whole body MRI system, and performance was tested by various methods. The accurate phase control required in digital modulation and demodulation was tested, and multi-channel acquisition was examined with phase-array coil imaging. Superior image quality is obtained by the developed spectrometer compared to existing commercial spectrometer especially in the fast spin echo images. Conclusion : Interactive control of the selection planes and real-time generation of gradient waveforms are important functions required for advanced imaging such as spiral scan cardiac imaging. Multi-channel acquisition is also highly demanding for parallel imaging. In this paper a spectrometer having such functionalities is designed and developed using the TMS320C6701 DSP having 1 GFLOPS computational power. Accurate phase control was achieved by the digital modulation and demodulation techniques. Superior image qualities are obtained by the developed spectrometer for various imaging techniques including FSE, GE, and angiography compared to those obtained by the existing commercial spectrometer.

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