INTRODUCTION: Torcular dural sinus malformations (tDSMs) are rare vascular pathologies with various anatomoclinical pictures and prognosis. We analyzed our case series and corroborated the complexity of this rare unit by a review of literature. CASE SERIES: From 2003 to 2018, we treated four tDSMs patients. The evolution of three postnatally diagnosed cases of similar angioarchitecture contrasted with a fourth antenatally diagnosed case with significant torcular thrombosis. All patients were examined by computed tomography, magnetic resonance imaging, CT angiography, and MRI angiography. Three patients underwent digital subtraction angiography with embolization of feeders. Unusual pathological images were depicted. CONCLUSIONS: Early diagnosis along with embolization of feeders and lake could improve the outcome for tDSM patients with dural arteriovenous shunts. Ventriculoperitoneal shunt implantation before endovascular treatment led to significant worsening of both clinical presentation and MRI picture. For patients who persist with hydrocephalus despite the endovascular approach, we suggest endoscopic third ventriculostomy as a first-line treatment option. Antenatally diagnosed patients with thrombosed lakes constitute a prognostically better group of patients. Spontaneous thrombosis and remodelation of the lake can, however, still leave neurological sequelae, as observed in our patient.
- MeSH
- cévní malformace centrálního nervového systému * diagnostické zobrazování chirurgie MeSH
- dítě MeSH
- dura mater MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mozková angiografie MeSH
- novorozenec MeSH
- sinus cavernosus * MeSH
- sinus durae matris * abnormality diagnostické zobrazování MeSH
- těhotenství MeSH
- terapeutická embolizace * MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
High-flow priapism is a rare condition mainly caused by perineal trauma. Laceration of cavernosal artery results in a formation of arterial-lacunar fistula with unregulated blood flow causing prolonged erection. We present a case of a 25-year-old man with high-flow priapism and concurrent erectile dysfunction treated with repeated selective embolisation with only a partial effect. When no further embolisation was possible, we assumed on conservative management even through the fistula was still present. Spontaneous detumescence occurred 9 months, and erectile function has fully restored 24 months after the injury. To the best of our knowledge, spontaneous detumescence with full restoration of erection even through the persistent arterial-lacunar fistula has not been reported previously. Therefore, we propose conservative approach after embolisation to be an option.
- MeSH
- arterie MeSH
- dospělí MeSH
- erekce penisu MeSH
- erektilní dysfunkce etiologie terapie MeSH
- lidé MeSH
- penis krevní zásobení MeSH
- píštěle MeSH
- priapismus komplikace terapie MeSH
- regionální krevní průtok MeSH
- terapeutická embolizace MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
K embolizaci patologického kapilárního řečiště 17 dětí s kapilárním typem muskulokutánní formy arteriovenózní malformace a 6 dětí s juvenilním angiofíbromem nosohltanu použili autoři sférické částice syntetického hydrogelu z poly(2.hydroxyethyl methakrylátu). Velikost částice v průměru byla 0,5 mm. Embolizace kapilárního řečiště byla úspěšná. Kapiláry byly zcela vyplněny sférickým biokompatibilnim materiálem, který uzavíral cévy zvětšením svého objemu a omezoval tak podstatným způsobem nebezpečí krváceni. V okolní zdravé tkáni nedošlo k žádným projevům toxického, edematózního či zánětlivého charakteru. K nevýhodám embolizačního materiálu patří ulpívavost partikulí v katétru a z toho plynoucí nebezpečí embolizace do jiné než cílové cévní struktury.
For embolization of a pathological capillary circulation in 17 children with the capillary type of the musculocutaneous arteriovenous malformation and 6 children with juvenile angiofibroma of the nasopharynx th^ authors used spherical particles of synthetic hydrogel fi-om poly(2-hydroxyethyl methacrylate). The particle size was 0.5 mm on average. Embolization of the capillary circulation was successful. The capillaries were completely filled with spherical biocompatible material which closed the vessels by increasing its volume and thus prevented dangerous haemorrhage. In the siunrounding healthy tissue no manifestations of toxic, oedematous or inflammatory processes developed. The disadvantages of embolization material include the adherence of the material in the catheter and the ensuing danger of embolization in another vessel than the target vessel.
- MeSH
- cholangiografie metody MeSH
- cholangitida MeSH
- cholestáza MeSH
- intrahepatální cholestáza mortalita MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- kongresy MeSH
