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Radiological measurements of dimensions of acutely ruptured internal carotid artery aneurysm: a comparative study between computed tomographic angiography and digital subtraction angiography  [cached]
George Wong,Simon C.H. Yu,Wai Sang Poon
Clinics and Practice , 2012, DOI: 10.4081/cp.2012.e75
Abstract: After aneurysmal subarachnoid hemorrhage, most center practices treatment modality selection based on size and geometry in computed tomographic angiography. However, the validity as compared to digital subtraction angiography (DSA) is not well studied. Twenty patients with ruptured internal carotid artery aneurysm were identified in a two-year period. Mean difference in measurements from 3D computed tomographic angiography (3D-CTA) and 3D-DSA were less than 1 mm and 3D-DSA measurement did not alter the decision to proceed for endovascular embolization. With modern multislice computed tomography technology, good quality 3D-CTA alone would be sufficient to make size and geometry assessment for treatment selection for patients with ruptured internal carotid artery aneurysm.
Posterior-draining dural carotid cavernous fistulae: a possible cause of computed tomographic angiography negative isolated third nerve palsy  [cached]
George Wong,Simon Chun Ho Yu,Wai Sang Poon
Clinics and Practice , 2011, DOI: 10.4081/cp.2011.e110
Abstract: Computed tomographic angiography (CTA) is a well-established non-invasive investigation for this neurological presentation to exclude intracranial aneurysms. However, dural arteriovenous fistulae with anterograde venous drainage only can be missed by CTA. Here we reported two patients with painful complete third nerve palsy and dural carotid cavernous fistulae with anterograde venous drainage only missed by CTA. The natural history and management option are discussed. In patients with persistent symptoms or without vasculopathic risk factors, magnetic resonance angiography (MRA) or digital subtraction angiography (DSA) should be considered to exclude the diagnosis.
Retropharyngeal internal carotid artery: case report  [cached]
Figueiredo, Ricardo Rodrigues,Azevedo, Andreia Aparecida de
International Archives of Otorhinolaryngology , 2009,
Abstract: Introduction: Variations to the course of carotid arteries may lead to abnormal pharyngeal protrusions, to which the otorhinolaryngologist should always attentive. Objective: To report a case of abnormal pharyngeal protrusion due to vascular anomaly in the course of the internal carotid artery, with literature review. Case Report: A 73- year-old woman complained of globus pharyngeus and intermittent dysphonia. A pulsating convexity was observed at the right part of the oropharynx, associated to laryngoscopic signals of pharyngo-laryngeal reflux. The pharyngeal computed tomography scan showed an abnormal tortuous internal carotid in the retropharyngeal space. The patient was sent to the vascular surgeon, who, after a normal blood flow finding at the Doppler, opted for an expectation conduct. The pharyngeal symptoms improved with the antireflux treatment. Final Comments: Internal carotid vascular anomalies must always be recalled in the pharyngeal wall convexity differential diagnosis.
Trifurcation of the right common carotid artery  [cached]
Chitra R
Indian Journal of Plastic Surgery , 2008,
Abstract: Variations in the position of the bifurcation of the common carotid artery and the origin or branching pattern of the external carotid artery are well known and documented. Here, we report the trifurcation of the right common carotid artery in a male cadaver aged about 55 years. The right common carotid artery was found to divide into the external and internal carotids and the occipital artery. High division of bilateral common carotid arteries and a lateral position of the right external carotid artery at its origin were also observed in the same cadaver. There were two ascending pharyngeal arteries on the right side - one from the occipital artery and another from the internal carotid artery. The intraarterial approach is one of the most important routes for the administration of anticancer drugs for head and neck cancers. A profound knowledge of the anatomical characteristics and variations of the carotid artery such as its branching pattern and its position is essential to avoid complications with catheter insertion.
Primary pharyngeal tuberculosis  [cached]
Gupta K,Yadav S.P.S,Sarita,Manchanda M
Lung India , 2005,
Abstract: Pharynx is not a common site for clinical manifestation of tuberculosis. Primary tuberculosis of pharyngeal wall is uncommon. Usually its symptoms mimic malignancy causing delay in diagnosis. We report a case of primary pharyngeal tuberculosis in a 60 years old male.
Position and Blood Supply of the Carotid Body in a Kenyan Population
Muthoka,Johnstone M; Hassanali,Jameela; Mandela,Pamella; Ogeng'o,Julius A; Malek,Adel A;
International Journal of Morphology , 2011, DOI: 10.4067/S0717-95022011000100010
Abstract: position and source of blood supply to the human carotid body displays population variations. these data are important during surgical procedures and diagnostic imaging in the neck but are only scarcely reported and altogether missing for the kenyan population. the aim of this study was to describe the position and blood supply of the carotid body in a kenyan population. a descriptive cross-sectional study at the department of human anatomy, university of nairobi, was designed. 136 common carotid arteries and their bifurcations were exposed by gross dissection. the carotid body was identified as a small oval structure embedded in the blood vessel adventitia. position and source of blood supply were photographed. data are presented by tables and macrographs. 138 carotid bodies were identified. commonest position was carotid bifurcation (75.4%) followed by external carotid artery (10.2%), internal carotid artery (7.2%) and ascending pharyngeal artery (7.2%). sources of arterial blood supply included the carotid bifurcation (51.4%), ascending pharyngeal (21.0%), external carotid (17.4%) and internal carotid (10.2%) arteries. position and blood supply of the carotid body in the kenyan population displays a different profile of variations from those described in other populations. neck surgeons should be aware of these to avoid inadvertent injury.
Acute Traumatic Intracranial Carotid Aneurysm
Yurt A,Memis A
Journal of Neurological Sciences , 2004,
Abstract: We report a case of a traumatic aneurysm of the intracranial carotid artery. The necessity to suspect a vascular traumatic lesion when an unusual subarachnoid hemorrhage or hyperdense lesion is seen on the computed tomographic scan in case of trauma . In this case , neurological examination results, x-ray, computed tomographic scans, pre- and postembolization cerebral angiograms , and follow up data were included.
Manifesto for a Dangerous Sociology
Cisneros, César
Athenea Digital , 2008,
Abstract: Based on my experience as a Mexican sociologist, I argue for the practice of a "Dangerous Sociology". I examine the process of sociological observation to show the need for such a practice. Some dimensions of this "Dangerous Sociology" are defined.
Continuous Vagus Nerve Monitoring during Carotid Endarterectomy  [PDF]
Tamaki Tomonori, Kubota Minoru, Node Yoji, Morita Akio
Open Journal of Modern Neurosurgery (OJMN) , 2017, DOI: 10.4236/ojmn.2017.71001
Abstract: Backgrounds: Injury to the vagus nerve or one of its branches during carotid endarterectomy can result in vocal fold paralysis but the exact mechanism of injury responsible for vocal fold paralysis after carotid endarterectomy is unclear. Aims: This study was performed to identify potential predictors of vagus nerve injury and obtain feedback by application of intraoperative continuous vagus nerve monitoring. Materials and Methods: Seventy-four patients undergoing carotid endarterectomy were enrolled. A new vagus nerve electrode was designed for less invasive continuous vagus nerve stimulation and monitoring of the vocal fold electromyogram without disturbing the surgical procedure. The device was rectangular (13 mm × 9 mm), with two small round electrodes set on a flexible silicon plate and tube. The electrode was fully implantable during carotid endarterectomy and was positioned at the most distal site of the vagus nerve by suturing to the connective tissue without nerve dissection. All patients underwent laryngoscopy to assess postoperative vocal fold and pharyngeal wall palsy at one week after carotid endarterectomy. Results: Sudden loss of the vocal fold electromyogram was noted in two patients (during plaque removal and during arterial wall suture in one each). In these two patients, incomplete vocal fold and pharyngeal palsy was confirmed by laryngoscopy. The cause of vagus nerve injury may have been traction at the time of distal internal carotid artery manipulation. The vocal fold electromyogram remained normal during the operation in the other 72 patients. However laryngoscopy revealed postoperative vocal fold and pharyngeal palsy in six patients. These findings suggested that delayed vagus nerve injury can occur after carotid endarterectomy. Conclusion: The continuous vagus nerve monitoring may be worthwhile for elucidating the mechanism of vagus nerve injury related to carotid endarterectomy.
The Current Role of Carotid Duplex Ultrasonography in the Management of Carotid Atherosclerosis: Foundations and Advances  [PDF]
Kelly R. Byrnes,Charles B. Ross
International Journal of Vascular Medicine , 2012, DOI: 10.1155/2012/187872
Abstract: The management of atherosclerotic carotid occlusive disease for stroke prevention has entered a time of dramatic change. Improvements in medical management have begun to challenge traditional interventional approaches to asymptomatic carotid stenosis. Simultaneously, carotid artery stenting (CAS) has emerged as an alternative to carotid endarterectomy (CE). Finally, multiple factors beyond degree of stenosis and symptom status now mitigate clinical decision making. These factors include brain perfusion, plaque morphology, and patency of intracranial collaterals (circle of Willis). With all of these changes, it seems prudent to review the role of carotid duplex ultrasonography in the management of atherosclerotic carotid occlusive disease for stroke prevention. Carotid duplex ultrasonography (CDU) for initial and serial imaging of the carotid bifurcation remains an essential component in the management of carotid bifurcation disease. However, correlative axial imaging modalities (computer tomographic angiography (CTA) and contrast-enhanced magnetic resonance angiography (CE-MRA)) increasingly aid in the assessment of individual stroke risk and are important in treatment decisions. The purpose of this paper is twofold: (1) to discuss foundations and advances in CDU and (2) to evaluate the current role of CDU, in light of other imaging modalities, in the clinical management of carotid atherosclerosis. 1. Introduction Carotid atherosclerosis is one of several etiological factors for stroke, an important health problem with a high burden of disease in the western world and in developing countries. Of all strokes, an estimated 88% are ischemic in nature [1–5]. Less than 20% of these are caused by atheroma in the carotid bifurcation [6–8]. While the percentage of strokes attributed to carotid disease is relatively low, the overall social and economic burden is high. It is, therefore, important to identify and manage carotid atherosclerosis with the aim of stroke prevention. The mortality rate for stroke in the United States has declined by nearly 70% since 1950 [9]. In December 2010, the Center for Disease Control and Prevention announced stroke was the fourth leading cause of death in the United States (down from its third place ranking which it held for decades) [10]. The identification of major risk factors through population-based studies [1, 11, 12] and randomized controlled trials (RCTs) of symptomatic [13–15] and asymptomatic [16, 17] patients has led to effective public health and clinic-based control strategies. These strategies include combining
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