Cerebral venous angioma associated with varix

A rare case of cerebral varix associated with a venous angioma is reported. Findings on dynamic computed tomography were highly characteristic and closely correlated to those on angiography. To our knowledge, such a combination of cerebral vascular anomalies has been reported only once previously.     

Oxygen parameters of arterial and mixed venous blood, - new and old

A complete pH and blood gas analysis of arterial and mixed venous blood may comprise more than forty different quantities. We have selected sixteen, including patient temperature. The arterial oxygen tension group includes the oxygen tension, fraction of oxygen in inspired air, and fraction of mixed venous blood in the arterial (total physiological veno-arterial shunting). The haemoglobin oxygen capacity group includes effective haemoglobin concentration and fractions of carboxy- and methaemoglobin. The haemoglobin oxygen affinity group includes half-saturation tension and estimated 2,3-diphosphoglycerate concentration of erythrocytes. In a neonatal care unit fraction of fetal haemoglobin need to be included. The arterial oxygen extractivity is measured as the oxygen extraction tension, which indicates the degree of compensation among the oxygen tension, capacity, and affinity. The mixed venous group includes mixed venous oxygen tension, and, when measured, cardiac output, and oxygen consumption rate. The acid-base status includes blood pH, arterial carbon dioxide tension, and extracellular base excess. Other quantities such as haemoglobin oxygen saturation, respiratory index, total oxygen concentration (oxygen content), oxygen extraction fraction, oxygen delivery, and several others, seem to be redundant.     

The surgeon and venous and mixed venous/arterial ulcers

The treatment of leg ulcers encompasses several techniques: mechanical and surgical debridement under local anaesthetic, the excision of the ulcerous base followed by pinch skin or mesh grafting. Varicose vein surgery is based on stripping methods or ligation of the perforators with the aim of relieving the venous overload. These methods are evolving with the use of endoscopic techniques (endovenous laser, radio frequency technique).     

Diluted venous blood appears arterial: implications for central venous cannulation

IMPLICATIONS: There is always a danger of arterial puncture during central venous access. One can usually identify an inadvertent arterial puncture when the aspirated blood is bright red. This sign is removed if one were to put saline in the aspirating syringe, as dusky venous blood turns bright red on dilution.     

Oxygen and acid-base parameters of arterial and mixed venous blood, relevant versus redundant

A complete pH and blood gas analysis of arterial and mixed venous blood may comprise more than forty different quantities. We have selected sixteen, including patient temperature. The arterial oxygen tension group includes the oxygen tension, fraction of oxygen in inspired air, and fraction of mixed venous blood in the arterial (total physiological veno-arterial shunting). The haemoglobin oxygen capacity group includes effective haemoglobin concentration and fractions of carboxy- and methaemoglobin. The haemoglobin oxygen affinity group includes half-saturation tension and estimated 2, 3-diphosphoglycerate concentration of erythrocytes. In a neonatal care unit fraction of fetal haemoglobin needs to be included. The arterial oxygen extractivity is measured as the oxygen extraction tension, which indicates the degree of compensation among the oxygen tension, capacity, and affinity. The mixed venous group includes mixed venous oxygen tension, and, when measured, cardiac output, and oxygen consumption rate. The acid-base status includes blood pH, arterial carbon dioxide tension, and extracellular base excess. Other quantities such as haemoglobin oxygen saturation, respiratory index, total oxygen concentration (oxygen content), oxygen extraction fraction, oxygen delivery, and several others, provide no essential additional clinical information and are therefore redundant.     

Gas exchange as monitored in mixed venous and arterial blood during experimental cardiopulmonary resuscitation

Nineteen anaesthetized piglets were investigated. After catheterization and a stabilization period, ventricular fibrillation was induced with a transthoracic DC shock, after which a 10-min period of cardiopulmonary resuscitation (CPR) took place. CPR included manual chest compression and mechanical ventilation with pure oxygen. After 1 min of CPR, an infusion of alkaline buffer was begun and completed within 5 min. A total of 50 mmol of either sodium bicarbonate (n = 6) or tris buffer mixture (n = 7) were given. These two groups were compared with a third control group (n = 6) receiving the same volume of normal saline. After 8 min of CPR all animals were given 0.5 mg adrenaline i.v., and after 10 min DC shocks were used to revert the heart back to normal sinus rhythm. Our results demonstrate that blood flow and not ventilation is the limiting factor for the efficient disposal of CO2 during CPR. This also applied when the demand for CO2 transport was increased by administration of sodium bicarbonate. The respiratory exchange ratio increased 1.9-fold, indicating that the transport of carbon dioxide was less affected than that of oxygen. The estimated alveolo-arterial oxygen tension difference, shunt, and overall ventilation/perfusion ratio increased, creating an inverse hyperbolic relationship between arterial PCO2 and PO2. The difference between mixed venous and arterial PCO2 correlated well to the mixed venous PCO2, implying more efficient pulmonary elimination of PCO2 when the mixed venous PCO2 was high. Pulmonary gas exchange during CPR appears to be independent of alkaline buffer therapy in the form of sodium bicarbonate or tris buffer mixture.(ABSTRACT TRUNCATED AT 250 WORDS)     

Cerebellar hemorrhage associated with capillary telangiectasia and venous angioma: A case report

We report a case of recurrent cerebellar hemorrhage from a capillary telangiectasia associated with a venous angioma. Based on the findings in this case and a review of the literature, we conclude that the hemorrhage was from the telangiectasia and not from the associated venous angioma. The association between capillary telangiectasias and cavernous malformations and the established association of the latter with venous angiomas are reviewed. This case illustrates the complex interrelationship between these histologically distinct malformations and its influence on their potential to hemorrhage.     

Management of mixed arterial and venous leg ulcers

BACKGROUND: The aim was to assess healing in patients with mixed arterial and venous leg ulcers after protocol-driven treatment in a specialist leg ulcer clinic. METHODS: The study included consecutive patients referred with leg ulceration and venous reflux over 6 years. Legs without arterial disease (ankle : brachial pressure index (ABPI) above 0.85) were treated with multilayer compression bandaging and patients with severe disease (ABPI 0.5 or less) were considered for immediate revascularization. Those with moderate arterial compromise (ABPI above 0.5 up to 0.85) were initially managed with supervised modified compression and considered for revascularization if their ulcer did not heal. Healing rates were determined using life-table analysis. RESULTS: Of 2011 ulcerated legs, 1416 (70.4 per cent) had venous reflux. Of these 1416, 193 (13.6 per cent) had moderate and 31 (2.2 per cent) had severe arterial disease. Healing rates by 36 weeks were 87, 68 and 53 per cent for legs with insignificant, moderate and severe arterial disease respectively (P < 0.001). Seventeen legs with moderate and 15 with severe arterial disease were revascularized. Of these, ulcers healed in four legs with moderate and seven with severe disease within 36 weeks of revascularization (P = 0.270). Combined 30-day mortality for revascularization was 6.5 per cent. CONCLUSION: A protocol including supervised modified compression and selective revascularization achieved good healing rates for mixed arterial and venous leg ulceration.     

Excision of cavernous angioma with preservation of coexisting venous angioma. Case report

The case of a patient presenting with dysphasic seizures due to a cavernous angioma coexisting with a venous malformation is reported. The cavernous angioma was resected with preservation of the venous malformation, as confirmed by postoperative studies. The patient was seizure-free following surgery.     

Case of venous angioma with chronic encapsulated hematoma

We would like to report a rare case of a venous angioma with a chronic encapsulated hematoma, in a 31-year-old woman who was admitted to our hospital in November, 2005. Her neurological examination was noted to be normal. A CT was performed which showed an isodense mass in the left cerebellar hemisphere. This finding was confirmed on MR imaging, which showed a hyperintense mass on T1-weighted imaging, and a hypo to isointense area on T2-weighted images. T1-weighted images with Gd-DTPA enhancement revealed a dilated vein and, as a result, an angiogram was obtained. The venous phase demonstrated medullary veins converging on a central vein, which is usually known as a caput medusae. Follow up T1-weighted images with Gd-DTPA enhancement showed peripheral ring enhancement and expansion of the capsulated hematoma. Total removal of the hematoma and its capsule was performed in July, 2006. The hematoma was seen both inside and outside the tough capsule. A histological examination revealed that the capsule consisted of an outer collagenous layer and an inner granulated layer with deposits of hemosiderin. The hemorrhage rate of a venous angioma has been reported as between 0.22-0.61% per year. We thought that the initial small hemorrhage from the venous angioma resulted in the development of an encapsulated hematoma, and the total hematoma had expanded not only inside due to the hemorrhage of the capsule, but also outside because of the venous angioma.     

Developmental venous anomalies (DVA): The so-called venous angioma

Summary Following a review of the literature it is possible to demonstrate the normality of the so called venous angiomas. They should be named Developmental Venous Anomaly (DVA). They illustrate in their two extreme types (superfical and deep) the hemodynamic equilibrium of the transcortical venous drainage in the periependymal zones. Venous ectasias and varices which can be encountered, associated with DVA constitute an acquired feature in relation to a venous outlet obstacle.The sinus pericranii represents an extracerebral DVA, but also corresponds to a normal variation. As any extreme anatomical variant, each DVA corresponds to a weak situation which may express itself clinically; only rare situations justify a radical treatment.     

Orbital lymphangioma and its association with intracranial venous angioma

Orbital lymphangioma is an uncommon, benign cystic lesion, generally manifest in childhood. It usually presents with a slowly progressive proptosis, displacement of the globe, ptosis and restriction of eye movements. Occasionally, focal lesions may remain asymptomatic. Spontaneous intraorbital haemorrhage may cause acute proptosis, compressive optic neuropathy and loss of vision. An 8-year-old girl presented with progressive left proptosis and a unilateral soft tissue mass at the supraorbital frontal region. Multiple intracranial venous angiomas were seen on MRI. Surgical decompression of the optic nerve was performed because of progressive decrease in visual acuity. We review the relevant literature; rarity of the orbital lymphangioma and its association with non-contiguous intracranial vascular anomalies were emphasized.     

Brain stem hemorrhage associated with venous angioma: report of two cases

The incidence of hemorrhage associated with venous angioma has been considered to be rare. We here report two cases of brain stem venous angioma which also showed brain stem hemorrhage. Case 1; a 15-year-old female had experienced weakness in the left upper extremity 8 months prior to admission. She developed dysfunction of the left cranial nerves, and magnetic resonance imaging (MRI) showed a huge enlarging hematoma in the pons. Cerebral angiography showed venous angioma penetrating through the pons. Evacuation of the hematoma was performed through the fourth ventricle and many small vessels were found in the hematoma. Although all symptoms were partially resolved after the operation, a re-hemorrhage occurred 1 month after the operation. Case 2; a 50-year-old man had suddenly developed headache and vertigo several days prior to admission. Computed tomography (CT) and MRI showed a small hematoma in the lesion with venous angioma adjacent to the hematoma. All symptoms gradually resolved with conservative therapy.     

Parasitic lumbar arterial blood supply in renal angiomyolipoma

A young woman with azotemia was found to have an angiomyolipoma which had parasitic blood supply from a lumbar artery. Parasitic lumbar arterial blood supply has previously been considered a strong indication of malignancy. Since this benign lesionhad not invaded the adjacent retroperitoneal structures, the phenomenon tends to confirm the postulate that parasitic blood supply to a lesion may occur through hypertrophy of small anastomotic channels normally present between adjacent vessels but not normally seen in angiography.     

The arterial blood supply of the ascending colon

The arterial blood supply of the ascending colon was studied by means of the injection technique in 10 post-mortem samples taken from children. In 9 of the 10 cases a complete marginal artery was found. It was supplied by the ileocolic artery in the region of the cecum and by the right colic artery near the right colic flexure. Accessory arteries supplying the ascending colon were infrequent. The narrow calibre of the marginal artery, together with the absence of accessory arteries, may result in a deficient blood supply to the middle part of the ascending colon. In contrast to the marginal arteries, the intramural vessels exhibited a uniform pattern of distribution.     

经肺动脉与支气管动脉血管造影的CTA观察原发肺癌的血供

目的用支气管动脉(BA)和肺动脉(PA)造影CTA观察肺癌血供情况。方法前瞻性观察6例支气管肺癌患者,分别行体循环动脉和肺动脉数字减影血管造影(DSA)后,留置BA导管与PA导管行CTBA与CTPA,观察BA与PA对肺癌的血供。结果CTPA上,无体动脉与左心强化的图像上肿瘤未见强化,有体动脉或左心强化的图像上见肿瘤边缘强化,CT强化值为10.0~45.6 Hu。CTBA上肿瘤部分明显强化,CT强化值为150.3~320.7 Hu,可见杂乱无章的肿瘤血管影,3例见纵隔淋巴结强化。结论本组病例观察表明原发性肺癌由BA为主的多发体循环动脉供血,未发现PA参与供血。     

Operated case of cerebral venous angioma with early venous filling on cerebral angiography--case report

A 34-year-old woman had a generalized convulsion of sudden onset on April 30, 1985. The next day, she suffered a reattack of generalized convulsion. She was admitted to Kokura Memorial Hospital on May 13, 1985, and was found to have intracerebral hemorrhage on CT-scan then, underwent surgical procedure. Based on cerebral angiographic findings and histological examination, the diagnosis of cerebral venous angioma was done. Cerebral venous angioma is a relatively rare vascular malformation. Its characteristic angiographic findings are a normal arterial phase and a local network of small vein that converged centrally into a single large vein. However, this present case of venous angioma in the left frontal lobe with hematoma showed not only characteristically enlarged medurally vein, but also early venous filling. The literature of operated venous angioma with early venous filling of the brain are reviewed and discussed.