The catheter method of angiography has become more popular in the past few years, as it provides the following advantages over the method of injecting the contrast medium by means of a simple needle: 1. The contrast medium may be injected into a vessel at any level desired. 2. Risk of extravascular injection of the contrast medium is minimised. 3. The patient may be placed in any position required. 4. The catheter may be left in situ without risk while the films are being developed, thus facilitating re-examination if necessary. Until recently, however, the use of the catheter method was restricted because of the lack of a suitable flexible thin-walled catheter which could be

https://informahealthcare.com/doi/pdf/10.1080/02841850802133386

Catheter replacement of the needle in percutaneous arteriography; a new technique.

V ASCULAR malformations of the central nervous system have been known for at least three hundred years (Olivecrona and Ladenheim '57), hu t are still surrounded by considerable confusion and associated with a complex classification. Detailed morphologic studies of large numbers of cases are rare. Reviews of the many classifications can be found in the works of Evans and Courville '39, Noran '45, Olivecrona and Ladenheim '57, and Rayno r and Kingman '65. While the relationship of vascular malformations to vascular neoplasms is still less than completely clear (Raynor and Kingman '65), it seems relatively certain tha t arteriovenous malformations are true developmental malformations and not neoplasms (Wolf and Brock '35, Noran '45, Manuelidis '50, Olivecrona and Ladenheim '57, Zttlch '57, Russell and Rubinstein '59, Bailey '61, Kaplan et al. '61, McCormick and Nofzinger '66). Ztilch '57 states tha t the distinction between vascular malformations and vascular neoplasms is difficult, and distinguishes between the two groups on the basis of the autonomous growth seen in the la t ter group. However , as Russell and Rubinstein '59 and others have noted, "in common with the t rue neoplasms, it is clear tha t some [malformations] at least are not static bu t grow and inflict progressive destruct ion on the adjacent bra in ." Noran '45 considered tha t the presence of brain parenchyma between the vessels of the angioma was of "pa ramoun t impor tance" in concluding tha t it is a malformat ion ra ther than a vascular neoplasm. Clearly, however, this does not hold for all malformations, most notably the cavernous angiomas. In spite of these difficulties, one considers the malformations to be distinct from the t rue

The Pathology of Vascular (“Arteriovenous”) Malformations

Summary Ischaemic stroke results from acute arterial occlusion leading to focal hypoperfusion. Thrombolysis is the only proven treatment. Advanced neuroimaging techniques allow a detailed assessment of the cerebral circulation in patients with acute stroke, and provide information about the status of collateral vessels and collateral blood flow, which could attenuate the effects of arterial occlusion. Imaging of the brain and vessels has shown that collateral flow can sustain brain tissue for hours after the occlusion of major arteries to the brain, and the augmentation or maintenance of collateral flow is therefore a potential therapeutic target. Several interventions that might augment collateral blood flow are being investigated.

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Collateral blood vessels in acute ischaemic stroke: a potential therapeutic target

Focal cerebral ischemia was induced by occlusion of the middle cerebral artery in rats. The volumetric assessment of infarcted tissue, 2 days following occlusion, was calculated from the examination of eight preselected coronal sections. Five differing rat strains were examined. A small and variable infarcted volume was seen in Wistar-Kyoto rats; Sprague-Dawley rats had a relatively large, but still variable, infarcted volume. Of the normotensive rat strains, the most reproducible volume of infarcted tissue was seen in Fischer-344 rats; also the absolute value of the infarcted volume did not vary from one series to another in this strain. Chronic arterial hypertension, studied in both normal and stroke-prone spontaneously hypertensive rats, was associated with significantly larger infarction volumes. Age does not change the volume of necrosis: Fischer-344 rats were studied at 3, 9, and 20 months of age, and no significant differences were noted between these ages. Experimental diabetes was induced by the ...

https://journals.sagepub.com/doi/pdf/10.1038/jcbfm.1988.86

The quantification of cerebral infarction following focal ischemia in the rat: influence of strain, arterial pressure, blood glucose concentration, and age.

✓ The microvascular anatomy of the posterior part of the circle of Willis, important in surgery of pituitary tumors and basilar aneurysms, was defined in 50 cadaver brains. Significant findings were as follows: 1) Anomalies of the posterior half of the circle of Willis were found in 46% of cases. 2) Hypoplastic P-1 (posterior cerebral segment) and posterior communicating segments gave origin to the same number and size of perforating arteries, having the same termination as normal-sized segments. Thus hypoplastic segments should be handled with care and divided to aid in exposure of the basilar bifurcation only after careful consideration. 3) An average of four perforating branches arose from P-1; most from the superior and posterior surfaces. No branches arose from the anterior surface of the basilar bifurcation. The most proximal P-1 branch originated 2 to 3 mm distal to the basilar bifurcation. It was most commonly a thalamoperforating artery. The largest P-1 branch was usually a thalamoperforating or ...

Microsurgical anatomy of the upper basilar artery and the posterior circle of Willis

Introduction The present study was undertaken in order to determine the anatomical structures of the circle of Willis, 27 with the purpose of learning its normal configuration, the frequency of deficient or incomplete circles, and, if possible, how these findings can be correlated with the clinical problems of vascular disease, such as infarcts, aneurysms, and vascular anomalies. There are many problems in vascular disease of the brain which make desirable an intimate knowledge of variants in the anatomy of the circle of Willis. The state of the circle becomes important in determining the adequacy of the brain circulation in operations for cerebral aneurysm and in ligation of the carotid artery. The possibility of bypassing or shunting effects in occlusion of one of the cerebral vessels and the adequacy of recovery or lack of recovery after vascular occlusion might be explained in part by variations in the anatomy of the circle

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=neurpsych&articleId=652878&pdfFileName=archneurpsyc_81_4_002.pdf

Anatomical studies of the circle of Willis in normal brain.

ADHESIVE arachnoiditis following spinal anesthesia is a well-recognized entity and has been well documented by Kennedy and associates,* Yaskin and Alpers, 3 and Thorsen. 4 The reason for its development is not clear, and it has been variously attributed to the effects of the anesthetic, to impurities, and to associated infection. It is possible that the cause is not the same in all instances, but experience with a fatal case of extensive, severe adhesive arachnoiditis raised the possibility that a hitherto not widely recognized pathogenic agent may have played an inciting role. The agent in question was a commercially available detergent cleaning material, Alconox, which had been used in the preparation of the anesthetic equipment. It is possible that the Alconox alone or the synergistic action of a surface-active agent and the anesthetic may have been responsible for the arachnoiditis. REPORT OF A CASE History. —S. F., a 54-year-old married

Role of intrathecal detergents in pathogenesis of adhesive arachnoiditis.

CEREBRAL angiography can be performed by open surgical procedure, with direct injection of the common carotid artery, or by percutaneous needle puncture of the carotid artery. The open technic is time consuming, is a surgical procedure and leaves an unsightly scar. The percutaneous method also has disadvantages, such as the possibility of the injection of opaque medium into the perivascular tissues and the danger of manipulating the head while the needle is in the artery. One of us (D. C. D.) thought these disadvantages of the percutaneous technic could be overcome and devised the following modification: With the patient on a fluoroscopic table, and after the usual preparation for a minor surgical procedure, the common carotid artery is palpated, and the point of maximum pulsation is found. With the use of local anesthesia, percutaneous puncture of the artery is performed. We have been using a 3 inch, 17 gage Huber

Richard M. Paddison

Papers

Anatomical studies of the circle of Willis in normal brain.

Role of intrathecal detergents in pathogenesis of adhesive arachnoiditis.

An improved technic for percutaneous cerebral angiography; a preliminary report.