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Biomedical subjects

S Slaba

Publications and source records attributed to S Slaba.

43 records · Page 3Linked to original sources

[Hemostatic embolization of hepatocellular carcinoma complicated by hemoperitoneum. Apropos of 2 cases and review of the literature].

Rupture of hepatocellular carcinoma is a severe complication that occurs in about 10% of patients. It may occur as a terminal event in patients with advanced disease or it may be the first presentation in a healthy individual. Various treatment options have been proposed, which include conservative treatment, transarterial embolization and operative hemostasis or liver resection. We report intraperitoneal hemorrhage and hypovolemia in two patients with spontaneous rupture of an hepatocellular carcinoma treated successfully by transarterial hepatic embolization. On follow-up, these patients died 7 and 8 months after this treatment respectively.

Aged↗

[Pseudo-Takayasu in Behcet's disease].

Behcet's disease is a chronic multisystem vasculitis that is frequent in Lebanon. The great arteries involvement is rare. We report here an unusual case of subclavian artery occlusion (pseudo-Takayasu) with a literature review.

Adult↗

[An unusual cause of acute myelopathy: a dural arteriovenous fistula at the craniocervical junction].

BACKGROUND: Dural arteriovenous fistulas (DAVF) account for 10% to 15% of all intracranial arteriovenous malformations. Since the first case published by Woimant et al. in 1982, many type V DAVF, i.e. with spinal venous drainage, have been reported. Fistulas located at the craniocervical junction (CCJ) however, are exceptional and only 10 cases of CCJ fistulas associated with myelopathy have been described. CASE REPORT: The authors present a 36-year-old male patient without previous medical history, suffering from acute myelopathy. Cervical MRI showed multiple serpiginous flow-voids along the cord surface and cerebral angiography disclosed a dural fistula of the CCJ fed by the right posterior meningeal and occipital arteries. The venous drainage was directed caudally towards the perimedullary veins. Embolization through the occipital artery, using cyanoacrylate, was performed and resulted in complete cure of the malformation with rapid clinical recovery. DISCUSSION: The authors discuss the pathophysiology and clinical consequences of intracranial DAVF with myelopathy (named V, m+), that are usually identical to those of spinal dural fistulas and related to intramedullary venous hypertension. Early treatment is essential to reverse the patient's myelopathy. Embolization, if technically possible, is the preferred treatment and cyanoacrylate remains the best embolic agent. Following glue deposition, systemic high-dose steroids should be administered to prevent edema. CONCLUSION: In conclusion, this is the first case of DAVF of the foramen magnum causing myelopathy to be detected early and cured by glue embolization alone, with rapid and total clinical recovery.

Adult↗

Imaging of an exceptional tumor: myxoid chondrosarcoma of the jugular foramen.

We report on an unusual tumor of the jugular foramen in a 26-year-old male. The lesion showed moderate enhancement on CT scan and a higher signal intensity on T2-weighted MR images than on T1, with a massive enhancement after gadolinium. Tumor was entirely removed surgically and histology was consistent with a low-grade myxoid chondrosarcoma, an exceptional tumor in this location. The differential diagnosis includes paragangliomas, schwannomas, metastases and meningiomas. Radiological and histological features can also mimic chordomas. However, immunohistochemical analysis certifies the diagnosis.

Adult↗

[Digital substraction angiography using gadolinium as contrast medium for patients with renal failure. A study of 15 patients].

OBJECTIVES: To study the feasibility of IA-DSA for diagnostic or interventional purposes using gadolinium (Gd) as a contrast medium (CM) for patients with poor renal function. MATERIALS AND METHODS: This study is about 15 patients with renal insufficiency (creat. > 133 micromol/l) who needed IA-DSA for diagnostic or interventional purposes. Gd was used as a CM at a dose < or = 0.4 micromol/kg and a concentration > or = 75%. Serum creatinine level was evaluated before, at 24 h and 48 h after injection of Gd. An increase of creat. > or = 44 micromol/l was considered significant. Image quality was evaluated by two specialists. RESULTS: In 14/15 (93%) patients no significant elevation of the serum creat. level was noted. The images are of good to medium quality, the diagnostic or therapeutic purpose was however reached. Image quality depends on Gd concentration; the feasibility of the exam is limited by the quantity of Gd used and its dilution. The procedure is well tolerated without side effects. CONCLUSION: Gd allows arteriograms of adequate quality for diagnostic or therapeutic purposes without renal complications at doses used until now (0.4 micromol/kg). The procedure is easy to perform but only one region or organ can be studied in one procedure considering the relatively small volume of contrast allowed.

Adolescent↗

[Endocrinologic recovery after treatment of an intrasellar aneurysm].

OBJECTIVE: Cavernous intrasellar aneurysms are rare, but may be clinically mistaken for an hypophyseal tumor, thus the need for a preoperative diagnosis. CLINICAL PRESENTATION: We report on a 60-year-old woman suffering from retroorbital headache, diplopia and decreased visual acuity, along with hyperprolactinemia and both gonadotropic and thyreotropic deficencies. Computed tomography revealed a sellar mass with superior extension, but MR raised the possibility of a cavernous aneurysm, that was confirmed by arteriography, avoiding a disastrous transsphenoidal surgery. DISCUSSION: Intracavernous aneurysms are known having a benign course, but serious meningeal hemorrhage can occur in 1.4% of cases and carotid-cavernous fistulae in 8% of patients, warranting treatment. Medial development is rare and may be responsible for endocrinologic manifestations. Neurosurgical approach remains hazardous, and endovascular occlusion represents the method of choice. CONCLUSION: Intracavernous aneurysm must be taken into consideration in the differential diagnosis of pituitary masses because it has a completely different management.

Angiography↗

[Endovascular treatment of arteriovenous vertebro-vertebral fistula].

Vertebral arteriovenous fistulae are relatively rare, with limited experience in most centers. We report our experience in the treatment of a vertebral arteriovenous fistula treated by interventional method. A review of the literature is made and the etiology, presentation and treatment of this unusual lesion are discussed. The endovascular occlusion is now the treatment of choice of vertebral fistulae.

Adolescent↗