No abstract

The authors report on a patient presenting with subarachnoid hemorrhage that was caused by a rupture of an spinal combined arteriovenous malformation at cervicothoracic junction. The patient was a 30-year-old female, who had exhibited an abrupt onset of severe low neck and occipital pain with radiation into shoulders and vomiting. Neurological examination revealed severe meningism without motor or sensory deficit. Digital subtraction angiography did not demonstrate any intracranial source of bleeding, whereas spinal angiography revealed a spinal arteriovenous malformation at cervicothoracic junction. Endovascular treatment of the malformation was considered for this patient. Occipital and neck pain with radiation into schoulders and severe meningism are clues pointing to a spinal origin of the haemorrhage.

AIM: Intracranial aneurysm rupture is followed by high mortality and morbidity. In order to understand the aneurysm's natural course, it is necessary to recognize the predisposing factors for the rupture. ResULTs:The ratio between the width of the aneurysm neck and diameter of the carrying blood vessel -artery in ruptured aneurysms (OR) was 1.58±0.61, and in unruptured aneurysms 1.14±0.52 (p<0.01). Aspect ratio of ruptured aneurysm was 1.89 ± 0.59, and in unruptured 1:33 ± 0.17. The angle of inclination of ruptured aneurysms was 139.22 ± 21.53, while in unruptured aneurysms it was 101.73 ± 21.26. CoNCLUsIoN:Based on the results of our research, a predictive model of morphometric characteristics of the vessel bearing the aneurysm to rupture can be identified: an irregular shape of the aneurysm, AR> 1.6, OR> 1.5 and inclination angle >135 deg. soNUÇ: Araştırmamızın sonuçları temelinde rüptüre olacak anevrizmayı taşıyan damarın morfometrik özelliklerinin prediktif bir modeli tanımlanabilir: Anevrizmada düzensiz şekil, aspekt oranı >1,6, OR >1,5 ve inklinasyon açısı >135 derece.

AIm: Glioblastoma multiforme in the motor area is the surgical challenge because of the need for more radical resection in order to extend the life of the patient, and the risk that radicalism could lead to additional neurological deficit. results: Distance of the central sulcus in relation to the coronary suture, measured by magnetic resonance imaging (MRI) was 18.38 mm ± 9.564 mm. The volume of electricity required for a motor response was mean 8.79 ± 1.484 mA, with increasing distance from the coronary suture the amperage required to explicit motor responses decreased. The difference (mm) between the distance from the coronary suture measured using MRI and distances measured electrostimulation smaller and power consumption was less (F = 13.285, p <0.01). COnClusIOn:The method of cortical cerebral cortex electrostimulation is simple and safe method and a binding protocol to the patient safe operation glioblastoma multiforme localized in the motor area of the brain. BulGulAr: Manyetik rezonans görüntülemesine göre koronal sütür ile santral sulkus arasındaki uzaklık ortalama 18.38 mm ± 9.564 mm. bulundu. Motor cevabı oluşturmak için gerekli olan akımın ortalaması 8.79 ± 1.484 mA bulundu. Koronal sütüre olan uzaklık arttıkça ortaya çıkan motor cevap azaldı. Manyetik rezonans görüntülemesine göre ve elektrostimülasyona göre yapılan ölçümlerin (mm) farklılığı analiz edildiğinde; uzaklık elektrostimülasyonda daha azdı (F = 13.285, p <0.01).sOnuÇ: Motor alana yerleşmiş glioblastome multiforme olgularında serebral kortikal elektrostimülasyon basit ve güvenilir bir yöntemdir.

The results of this study are consistent with current publications review and clearly recognize the advantages and disadvantages of diagnostic neuroradiological procedures, with DSA of brain blood vessels as a binding preoperative diagnostic procedure in cases in who it is not possible to clearly visualize the supporting blood vessel and neck of the aneurysm by using the findings of CTA, MRA and MSCTA.