Four cases are described in which livedo reticularis was associated with repeated cerebrovascular accidents, which eventually resulted in severe disability in two cases. Patients with severe ...disability had a history of many years, whereas two patients with little or moderate residual disability had a follow-up of 3 years each. CT scan revealed multifocal cerebral infarctions and cortical atrophy in all cases. Repeated cerebral angiograms, done in three cases, showed no signs of a vascular disease. There were no parameters that pointed to active immunological or inflammatory disorder. Neither clinical evidence of heart or large vessel disease was found. Observations suggest that a so-far unknown progressive cerebral vessel disease associated with livedo is the cause of a steady increase in multiple small cerebral infarctions. Because of the progressive character of the disease the search for effective therapy is needed.
In two patients with a traumatic carotid-cavernous fistula, permanent occlusion of the lesion was observed following cerebral angiography and confirmed by further angiography. A delay is therefore ...recommended between performing angiography and carrying out further treatment, which may carry some risk. Possibly the use of ionic contrast media, which irritate the vessels, compression of the carotid artery, which reduces flow through the fistula, and general anaesthesia, which may drop the blood pressure, initiate thrombosis in the cavernous sinus.
The problems in the radiological investigation of adults with the nephrotic syndrome are illustrated by three patients. In one it was due to spontaneous thrombosis of the cava, in the second there ...was renal vein thrombosis from self-administered overdose and the third patient had glomerulonephritis without renal vein thrombosis. In view of the therapeutic implications, radiological investigation of the renal veins is essential and should be carried out in every patient with the nephrotic syndrome.
Amongest nine cases of internal carotid artery thrombosis following blunt trauma, six showed a typical acute contrast termination several cm. beyond the carotid bifurcation. In the other cases, one ...was taken with an unusual projection, one had a high occlusion beyong the origin of the ophthalmic artery and the third showed a stenosis due to a mural thrombosis. Perforating carotid injuries should be examined angiographically because of the danger of late complications. Two functional occlusions were observed following acute vascular angulation. This type of occlusion is contrasted with the convex vascular margin in the internal carotid artery seen in atherosclerotic, embolic or "spontaneous" carotid occlusion.
A rare, extensive arterio-venous fistula with cardiac enlargement was found in an infant. Numerous branches from the internal and external carotid artery were disposed in a stellate manner to form a ...large central vessel, probably corresponding to the inferior sagittal sinus. The brain was grossly abnormal. The embryology, clinical features and diagnoses are discussed.
Ureteral rupture after blunt abdominal injury Stampfel, G; Joost, J
RöFo : Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebende Verfahren
141, Issue:
5
Journal Article
Peer reviewed
Two male and one female patients, between the ages of four and 25 years, involved in road traffic accidents, sustained isolated ruptures of the right proximal ureter in addition to severe injuries to ...the skull and extremities. The typical urographic finding of an absent ureter was seen only once. In one incomplete rupture of the ureter from a solitary kidney, the ureter filled with contrast and there was no dilatation of the renal pelvis and in another case, the appearance of the ureter was simulated by a peri-ureteric contrast leak. Ultrasound examinations following abdominal trauma should be directed at finding peri-renal fluid; this should be followed by an urogram in order to recognize ureteric rupture at an early stage, when there may be few symptoms.
In 6 patients with a trauma in wintersport we observed carotid artery injuries in the past 13 years. The diagnosis were two occlusions, one dissection, a bilateral stenosis, a traumatic aneurysm and ...a subclavian steal phenomenon. A spontaneous bilateral thrombosis of the carotid artery was seen during skiing. A carotid artery lesion should be diagnosed as soon as possible followed by an adequate therapy.
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