Dural arteriovenous fistulas (DAVFs) are abnormal connections between branches of the intracranial arteries and dural veins or sinuses. Advancements in the technique of endovascular embolization has made it the treatment of choice for DAVFs. The goal of treatment is to completely occlude the fistula orifice while maintaining the normal cerebral venous drainage. Depending on the site of the DAVF, endovascular treatment has its own challenges to the performing physician. In this case report, we will discuss complex anterior cranial fossa DAVFs, treatment approaches, and complications of the treatment.
Background: A single coronary artery (SCA) is a rare anomaly encountered using conventional coronary angiography. A right coronary artery (RCA) originating from a left anterior descending artery (LAD) is a rare subtype of SCA. Only a few cases are described in published literature.
Case presentation: We described this anomaly in a 55-year-old male who presented with angina pectoris. The anomalous RCA was suspected by conventional coronary angiogram and was confirmed by computed tomography (CT) coronary angiography. Using CT, we demonstrated the course of the abnormal vessel and its relation to the main vessel. We also detected the presence of plaque, which caused luminal stenosis of the proximal LAD, which may cause global ischaemia.
Conclusion: We concluded that although conventional coronary angiography is an important diagnostic method, new non-invasive methods such as CT coronary angiography can be a better screening tool to detect and characterise coronary anomalies.
Electronic Supplementary Materials
Supplementary Material 1: Coronary angiogram demonstrates anomalous RCA originating from LAD.
Supplementary Material 2: CTA coronary shows anomalous RCA originates from the mid-portion of LAD.
Dural arteriovenous fistulas (DAVFs) are abnormal connections between branches of the intracranial arteries and dural veins or sinuses. Advancements in the technique of endovascular embolization has made it the treatment of choice for DAVFs. The goal of treatment is to completely occlude the fistula orifice while maintaining the normal cerebral venous drainage. Depending on the site of the DAVF, endovascular treatment has its own challenges to the performing physician. In this case report, we will discuss complex anterior cranial fossa DAVFs, treatment approaches, and complications of the treatment.
Duplication of the internal auditory canal is a rare entity. It can be unilateral or bilateral involvement and usually found during an investigation of sensorineural hearing loss or facial nerve palsy. We report this image finding in a child with Down syndrome with bilateral profound sensorineural hearing loss. There was no facial nerve palsy. We highlight the rarity of this image finding and the importance of imaging for detection of middle and inner ear abnormality in a case of congenital sensorineural hearing loss as it helps in decision making for the suitable treatment.
Keywords: Duplicate IAC; Bilateral Duplicate IAC; sensorineural hearing loss; Down syndrome
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