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  • 1
    ISSN: 1432-1920
    Keywords: Key words Ultrasonography transcranial Doppler ; aneurysm intracranial ; haemodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated the haemodynamics in the parent artery of 17 small (〈 9 mm) and 17 large (L 9.5 mm) saccular aneurysms by transcranial colour-coded Doppler sonography (TCCD) and related the findings to digital subtraction angiography (DSA). We measured flow velocity within the parent artery and, by positioning the Doppler gate within the colour flow image close to the ostium of the aneurysm, obtained a superselective Doppler spectral waveform. The parameters measured included the time-averaged maximal velocity (TAMX), peak systolic, and end-diastolic velocity and pulsatility index (PI). The values were compared to the contralateral side and between small and large aneurysms. DSA was analysed for parent artery stenosis. Mean systolic velocities in the parent arteries of large aneurysms were significantly higher than in the contralateral normal artery (1.08 ± 0.23 vs 0.80 ± 0.23 m/s; P = 0.0003) and higher than in the parent artery of small aneurysms (0.89 ± 0.18 m/s; P = 0.01). Increased systolic velocity accounted for a higher PI in the parent artery of large aneurysms (mean 1.48 ± 0.42) than on the other side (0.87 ± 0.12; P = 0.0001) and in the parent artery of small aneurysms (0.85 ± 0.14; P = 0.0001). PI proximal to seven thrombosed large aneurysms was higher (mean 1.85 ± 0.38) than close to unthrombosed large aneurysms (1.23 ± 0.22; P = 0.0005). Increased PI and systolic velocities could not be shown within branches of 5 large aneurysms and were reversible in the parent artery of four patients examined again after occlusion of the aneurysm. Systolic velocities and PI did not differ significantly (P = 0.41 and P = 0.25, respectively) in ruptured and unruptured aneurysms. Stenosis of the parent artery was not shown by DSA in any case.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1920
    Keywords: Key words Craniometaphyseal dysplasia ; Skeletal dysplasia ; Basilar invagination ; Magnetic resonance imaging ; Posterior cranial fossa
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Craniometaphyseal dysplasia (CMD) is a very rare disorder of bone remodelling characterised by sclerosis of the skull base, vault and facial bones and metaphyseal splaying of tubular bones. The recessive form appears to be more severe than the dominant. Cranial nerve deficits have been reported in infancy and early childhood in a few patients, but the long-term history of recessive CMD is not well documented. We report cerebellomedullary compression in a girl with recessive CMD recognised at 14 years because of progressive truncal ataxia. MRI revealed backward angulation of the thickened clivus, narrowing of the foramen magnum and upward deviation of the cerebellum by a markedly thickened occipital squama, tonsillar herniation and obliteration of the infratentorial cerebrospinal fluid spaces. Posterior cranial fossa decompression resulted in marked improvement of the ataxia. Compression of posterior cranial fossa structures has to be considered in the natural history and management of CMD.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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  • 3
    ISSN: 1432-1920
    Keywords: Craniometaphyseal dysplasia ; Skeletal dysplasia ; Basilar invagination ; Magnetic resonance imaging ; Posterior cranial fossa
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Craniometaphyseal dysplasia (CMD) is a very rare disorder of bone remodelling characterised by sclerosis of the skull base, vault and facial bones and metaphyseal splaying of tubular bones. The recessive form appears to be more severe than the dominant. Cranial nerve deficits have been reported in infancy and early childhood in a few patients, but the long-term history of recessive CMD is not well documented. We report cerebellomedullary compression in a girl with recessive CMD recognised at 14 years because of progressive truncal ataxia. MRI revealed backward angulation of the thickened clivus, narrowing of the foramen magnum and upward deviation of the cerebellum by a markedly thickened occipital squama, tonsillar herniation and obliteration of the infratentorial cerebrospinal fluid spaces. Posterior cranial fossa decompression resulted in marked improvement of the ataxia. Compression of posterior cranial fossa structures has to be considered in the natural history and management of CMD.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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