• Title/Summary/Keyword: Magnetic resonance angiography

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A Case Report of Pontine Infarction as an Initial Manifestation of Systemic Lupus Erythematosus: Diagnostic Clues from MRI and Digital Subtraction Angiography (전신성 홍반성 루푸스의 초기 증상으로 나타난 교뇌경색의 증례 보고: 자기공명영상 및 디지털감산 혈관조영술에서의 진단 단서)

  • Mi Sun Chung;Jun Soo Byun;Younghee Yim
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1281-1286
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    • 2021
  • Brainstem infarction due to vertebrobasilar insufficiency is a rare initial presentation of systemic lupus erythematosus (SLE) patients and small-vessel dissection as the direct cause of infarction has not been reported. We report the case of a 20-year-old female with acute infarction on the right side of the pons due to a small artery (pontine perforator) dissection, identified on digital subtraction angiography and high-resolution vessel wall MRI (vwMRI). She was diagnosed with SLE based on the presence of neurologic disorders and relevant laboratory findings. The pontine perforator-dissecting aneurysm had occluded and the right distal vertebral artery had resolved on subsequent vwMRI. She had a modified Rankin Scale (mRS) score of 1 at discharge with mild symptom improvement, and exhibited no further aggravation of symptoms at 3 or 12 months, maintaining an mRS score of 1.

Angiographically Occult Vascular Malformation of the Cauda Equina Presenting Massive Spinal Subdural and Subarachnoid Hematoma

  • Kim, Ji-Hyun;Lee, Sun-Ho;Kim, Eun-Sang;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.373-376
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    • 2011
  • We report a case of a non traumatic spinal subdural hematoma or subarachnoid hematoma manifesting as lumbago, leg pain and bladder dysfunction that showed angiographically occult vascular malformation (AOVM). Although the spinal angiogram did not reveal any vascular abnormality, the follow-up magnetic resonance image showed AOVM. Complete surgical removal was performed due to the aggravated bladder dysfunction. This case highlights the need to consider bleeding due to spinal AOVM, even when angiography is negative.

Meningeal Solitary Fibrous Tumor

  • Lee, Jong-Myong
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.232-234
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    • 2005
  • We report a rare case of a patient with meningeal solitary fibrous tumor. A 60-year-old woman presented with right leg monoparesis. Brain magnetic resonance imaging demonstrates a well enhancing huge mass, located in left parietal lobe. Cerebral angiography demonstrating increased vascularity in area of the tumor, which had feeder vessels extending from the internal carotid artery and external carotid artery. A presumptive diagnosis of meningioma or hemangiopericytoma was considered. At surgery, the consistency was firm and had destroyed the dura and skull. A gross total resection was performed. Immunohistochemically, tumor was strongly, and widely, positive for CD34 and vimentin. There was no staining for epithelial membrane antigen(EMA), S-100 protein, cytokeratin, and glial fibrillary acidic protein (GFAP). Differential diagnosis of intracranial solitary fibrous tumor includes fibroblastic meningioma, meningeal hemangiopericytoma, neurofibroma, and schwannoma.

Downbeat Nystagmus Associated With Brainstem Compression by Vertebral Artery

  • Moon, Ki-Hyoung;Lee, Sang-Ahm;Ahn, Jae-Sung;Kwun, Byung-Duk
    • Journal of Korean Neurosurgical Society
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    • v.41 no.3
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    • pp.190-192
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    • 2007
  • Rarely, downbeat nystagmus can occur due to compression of the lower brainstem by the ectatic vertebral artery and be resolved by microvascular decompression. We present a case of a 67-year-old man with downbeat nystagmus associated with brainstem compression by ectatic vertebral artery. He presented with oscillopsia and vertigo. When he turned his head upward, his symptoms were aggravated and a gait disturbance occurred. Magnetic resonance imaging and computed tomographic angiography demonstrated compression of the medulla oblongata by the left ectatic vertebral artery and other medical causes of downbeat nystagmus were ruled out. Retromastoid craniotomy was performed and after lifting the vertebral artery off the medulla, a trough-shaped indentation in the lower brainstem was identified. The ectatic vertebral artery was repositioned and a Teflon was inserted between the brainstem and the ectatic vertebral artery. Postoperatively, downbeat nystagmus had disappeared.

Sphenoid Ridge Meningioma Presenting as Acute Cerebral Infarction

  • Ko, Jun Kyeung;Cha, Seung Heon;Choi, Chang Hwa
    • Journal of Korean Neurosurgical Society
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    • v.55 no.2
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    • pp.99-102
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    • 2014
  • A previously healthy 52-year-old man presented to the emergency room with acute onset left hemiparesis and dysarthria. Brain computed tomography and magnetic resonance examinations revealed acute cerebral infarction in the right middle cerebral artery territory and a sphenoid ridge meningioma encasing the right carotid artery terminus. Cerebral angiography demonstrated complete occlusion of the right proximal M1 portion. A computed tomography perfusion study showed a wide area of perfusion-diffusion mismatch. Over the ensuing 48 hours, left sided weakness deteriorated despite medical treatment. Emergency extracranial-intracranial bypass was performed using a double-barrel technique, leaving the tumor as it was, and subsequently his neurological function was improved dramatically. We present a rare case of sphenoid ridge meningioma causing acute cerebral infarction as a result of middle cerebral artery compression.

Isolated Congenital Left Ventricular Diverticulum in Adults

  • Jung, Joon Chul;Oh, Hong Chul;Kim, Kyung-Hwan
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.355-358
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    • 2015
  • Isolated congenital left ventricular diverticulum is a rare cardiac malformation. Here, we report the case of a 33-year-old woman who had suffered from recurrent transient ischemic attacks for 6 years. Preoperative cardiac magnetic resonance imaging and computed tomography angiography revealed a diverticulum near the apex. The diverticulum was successfully obliterated by cardiopulmonary bypass. We suggest that isolated congenital left ventricular diverticulum can be easily corrected with a low surgical risk by patch repair and plication techniques.

Time-Phased Implementation of a Large-Scale PACS at Samsung Medical Center

  • Ro, Duk-Woo;Choi, Hyung-Sik;Lim, Jae-Hoon;Kim, Won-Ki
    • Proceedings of the KOSOMBE Conference
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    • v.1994 no.12
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    • pp.26-27
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    • 1994
  • The first step implementation of a hospital-wide Picture Archiving Communications System (PACS) at a newly built hospital Samsung Medical Center (SMC), is described. Current clinical operation encompasses the fiber optics delivery of direct-interfaced magnetic resonance imager (LRI), X-ray computed tomography (CT). digital subtraction angiography (DSA) and computed radiography (CR) digital images via high performance file server to the departments of radiology, neurosurgery, orthopedics surgery, neurology, emergency room and the surgical intensive care unit.

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An Unusual Case of a Thrombosed Giant Distal PICA Aneurysm Simulating a Large Cavernous Angioma

  • Lim, Dong-Ho;Jung, Shin;Jung, Tae-Young;Kim, Tae-Sun
    • Journal of Korean Neurosurgical Society
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    • v.43 no.3
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    • pp.155-158
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    • 2008
  • A 64-year-old woman was referred to our hospital with a one-month history of progressive headache. Magnetic resonance imaging (MRI) showed a hemorrhagic mass adjacent to the left inferior cerebellar hemisphere associated with a peripheral rim of signal void. Angiography demonstrated an avascular mass and the provisional diagnosis was a large cavernous angioma in the cerebellum. Intraoperative findings revealed a thrombosed giant aneurysm of the left distal posterior inferior cerebellar artery (PICA). We report an unusual case of a completely thrombosed giant aneurysm simulating a large cavernous angioma in the cerebellum. The cerebellar cisternal location of the mass may be a clue for the pre-operative diagnosis of an aneurysm.

Aneurysm at the Origin of the Accessory Middle Cerebral Artery - A Case Report - (부중대뇌동맥 기시부의 동맥류 - 증례보고 -)

  • Ahn, Jung Yong;Joo, Jin Yang
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.832-835
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    • 2000
  • A case of unruptured cerebral aneurysm at the junction of accessory middle cerebral artery and the distal portion of the $A_1$ segment of the anterior cerebral artery is reported. To the authors' knowledge, this is the first reported case of cerebral aneurysm developed at the junction of accessory middle cerebral artery, demonstrated on magnetic resonance angiography(MRA). The accessory middle cerebral artery is a rare vascular variant of middle cerebral artery. Furthermore, it is extremely rare for an aneurysm to be developed at the origin of the accessory middle cerebral artery. The development of the accessory middle cerebral artery is very important in surgery of cerebral aneurysm and collateral circulation of cerebral infarction. Review of the literature regarding the genesis and anatomical variation of the accessory middle cerebral artery is also presented.

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삼차원 조영증강 자기공명혈관조영술을 이용한 내경동맥 협착에 대한 평가: 디지털감산혈관조영술과의 비교

  • 한동복;최충곤;박지강;이정현;이호규
    • Proceedings of the KSMRM Conference
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    • 2001.11a
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    • pp.139-139
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    • 2001
  • 목적: 경동맥 분지부에서 내경동맥 협착에 대한 평가에 있어서 삼차원 조영증강 자기공명혈관조영술의 정확도를 알아보고자 하였다. 대상 및 방법: 삼차원 조영증강 자기공명혈관조영술(3D Contrast-enhanced MRA)과 디지털감산혈관 조영술(Digital Subtraction Angiography, DSA)을 모두 시행한 35명의 환자, 68예의 내경동맥을 분석하였다. 내경동맥 협착의 측정은 North American Symptomatic Carotid Endarterectom Trial (NASCET) 기준을 이용하였다. 두 가지 검사에서 협착 정도를 경도(mild:0-29%), 중등도(moderate:30-69%), 심한 협착(severe:70-99%), 완전 폐색(occlusion:100%)등 네 그룹으로 나누었다. 두 명의 관찰자(A,B)가 DSA에서 측정한 협착 정도를 기준으로 3D Contrast-enhanced MRA에서 측정한 협착 정도를 비교하여 두 검사 방법간에 판정 일치율과 차이점을 분석하였다.

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