Localized or diffuse reduction in blood flow through the vertebrobasilar arterial system, which supplies the BRAIN STEM; CEREBELLUM; OCCIPITAL LOBE; medial TEMPORAL LOBE; and THALAMUS. Characteristic clinical features include SYNCOPE; lightheadedness; visual disturbances; and VERTIGO. BRAIN STEM INFARCTIONS or other BRAIN INFARCTION may be associated.
The first branch of the SUBCLAVIAN ARTERY with distribution to muscles of the NECK; VERTEBRAE; SPINAL CORD; CEREBELLUM; and interior of the CEREBRUM.
A clinically significant reduction in blood supply to the BRAIN STEM and CEREBELLUM (i.e., VERTEBROBASILAR INSUFFICIENCY) resulting from reversal of blood flow through the VERTEBRAL ARTERY from occlusion or stenosis of the proximal subclavian or brachiocephalic artery. Common symptoms include VERTIGO; SYNCOPE; and INTERMITTENT CLAUDICATION of the involved upper extremity. Subclavian steal may also occur in asymptomatic individuals. (From J Cardiovasc Surg 1994;35(1):11-4; Acta Neurol Scand 1994;90(3):174-8)
Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb.
The artery formed by the union of the right and left vertebral arteries; it runs from the lower to the upper border of the pons, where it bifurcates into the two posterior cerebral arteries.
An illusion of movement, either of the external world revolving around the individual or of the individual revolving in space. Vertigo may be associated with disorders of the inner ear (EAR, INNER); VESTIBULAR NERVE; BRAINSTEM; or CEREBRAL CORTEX. Lesions in the TEMPORAL LOBE and PARIETAL LOBE may be associated with FOCAL SEIZURES that may feature vertigo as an ictal manifestation. (From Adams et al., Principles of Neurology, 6th ed, pp300-1)
Radiography of the vascular system of the brain after injection of a contrast medium.
Pathological processes which result in the partial or complete obstruction of ARTERIES. They are characterized by greatly reduced or absence of blood flow through these vessels. They are also known as arterial insufficiency.
Conditions in which the production of adrenal CORTICOSTEROIDS falls below the requirement of the body. Adrenal insufficiency can be caused by defects in the ADRENAL GLANDS, the PITUITARY GLAND, or the HYPOTHALAMUS.
Conditions in which the KIDNEYS perform below the normal level in the ability to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal insufficiency can be classified by the degree of kidney damage (as measured by the level of PROTEINURIA) and reduction in GLOMERULAR FILTRATION RATE.
Impaired venous blood flow or venous return (venous stasis), usually caused by inadequate venous valves. Venous insufficiency often occurs in the legs, and is associated with EDEMA and sometimes with VENOUS STASIS ULCERS at the ankle.
Abnormal outpouching in the wall of intracranial blood vessels. Most common are the saccular (berry) aneurysms located at branch points in CIRCLE OF WILLIS at the base of the brain. Vessel rupture results in SUBARACHNOID HEMORRHAGE or INTRACRANIAL HEMORRHAGES. Giant aneurysms (>2.5 cm in diameter) may compress adjacent structures, including the OCULOMOTOR NERVE. (From Adams et al., Principles of Neurology, 6th ed, p841)
A malabsorption condition resulting from greater than 10% reduction in the secretion of pancreatic digestive enzymes (LIPASE; PROTEASES; and AMYLASE) by the EXOCRINE PANCREAS into the DUODENUM. This condition is often associated with CYSTIC FIBROSIS and with chronic PANCREATITIS.
Splitting of the vessel wall in the VERTEBRAL ARTERY. Interstitial hemorrhage into the media of the vessel wall can lead to occlusion of the vertebral artery, aneurysm formation, or THROMBOEMBOLISM. Vertebral artery dissection is often associated with TRAUMA and injuries to the head-neck region but can occur spontaneously.
Failure of the PLACENTA to deliver an adequate supply of nutrients and OXYGEN to the FETUS.
Non-invasive method of vascular imaging and determination of internal anatomy without injection of contrast media or radiation exposure. The technique is used especially in CEREBRAL ANGIOGRAPHY as well as for studies of other vascular structures.
A method of delineating blood vessels by subtracting a tissue background image from an image of tissue plus intravascular contrast material that attenuates the X-ray photons. The background image is determined from a digitized image taken a few moments before injection of the contrast material. The resulting angiogram is a high-contrast image of the vessel. This subtraction technique allows extraction of a high-intensity signal from the superimposed background information. The image is thus the result of the differential absorption of X-rays by different tissues.
NECROSIS induced by ISCHEMIA in the POSTERIOR CEREBRAL ARTERY distribution system which supplies portions of the BRAIN STEM; the THALAMUS; TEMPORAL LOBE, and OCCIPITAL LOBE. Depending on the size and location of infarction, clinical features include OLFACTION DISORDERS and visual problems (AGNOSIA; ALEXIA; HEMIANOPSIA).
Brief reversible episodes of focal, nonconvulsive ischemic dysfunction of the brain having a duration of less than 24 hours, and usually less than one hour, caused by transient thrombotic or embolic blood vessel occlusion or stenosis. Events may be classified by arterial distribution, temporal pattern, or etiology (e.g., embolic vs. thrombotic). (From Adams et al., Principles of Neurology, 6th ed, pp814-6)
Vascular diseases characterized by thickening and hardening of the walls of ARTERIES inside the SKULL. There are three subtypes: (1) atherosclerosis with fatty deposits in the ARTERIAL INTIMA; (2) Monckeberg's sclerosis with calcium deposits in the media and (3) arteriolosclerosis involving the small caliber arteries. Clinical signs include HEADACHE; CONFUSION; transient blindness (AMAUROSIS FUGAX); speech impairment; and HEMIPARESIS.
The dense rock-like part of temporal bone that contains the INNER EAR. Petrous bone is located at the base of the skull. Sometimes it is combined with the MASTOID PROCESS and called petromastoid part of temporal bone.
A syndrome characterized by recurrent episodes of excruciating pain lasting several seconds or longer in the sensory distribution of the TRIGEMINAL NERVE. Pain may be initiated by stimulation of trigger points on the face, lips, or gums or by movement of facial muscles or chewing. Associated conditions include MULTIPLE SCLEROSIS, vascular anomalies, ANEURYSMS, and neoplasms. (Adams et al., Principles of Neurology, 6th ed, p187)
Use of reflected ultrasound in the diagnosis of intracranial pathologic processes.

Bilateral vertebral artery occlusion following cervical spine trauma--case report. (1/331)

A 41-year-old female presented with a rare case of bilateral vertebral artery occlusion following C5-6 cervical spine subluxation after a fall of 30 feet. Digital subtraction angiography showed occlusion of the bilateral vertebral arteries. Unlocking of the facet joint, posterior wiring with iliac crest grafting, and anterior fusion were performed. The patient died on the 3rd day after the operation. This type of injury has a grim prognosis with less than a third of the patients achieving a good outcome.  (+info)

Direct surgery of basilar trunk and vertebrobasilar junction aneurysms via the combined transpetrosal approach. (2/331)

Surgical access to aneurysms of the basilar trunk and vertebrobasilar junction is hampered by their direct proximity of these lesions to highly vulnerable neural structures like the brain stem and cranial nerves, as well by the bony structure of the petrous bone blocking the direct surgical approach to these aneurysms. Only recently lateral approaches directed through parts of the petrous bone have been reported for surgery of basilar trunk and vertebrobasilar junction aneurysms like the anterior transpetrosal, the retrolabyrinthine transsigmoid, as well as the combined supra-infratentorial posterior transpetrosal approach. As experience in the use of this approach is limited in the neurosurgical literature we present our surgical experiences in 11 patients with basilar trunk and vertebrobasilar junction aneurysms, operated on using the supra-infratentorial posterior transpetrosal approach. In 10 patients, including one patient with a giant partially thrombosed basilar trunk aneurysm, direct clipping of the aneurysm via the transpetrosal route was possible. In one patient with a giant vertebrobasilar junction aneurysm, the completely calcified aneurysm sac was resected after occlusion of the vertebral artery. Of the whole series, one patient died and in three patients postoperative accentuation of preexisting cranial nerve deficits occurred. Except transient cerebrospinal fluid leak in two patients, the postoperative course was uneventful in the remaining patients. Postoperative angiography demonstrated complete aneurysm clipping in ten patients and relief of preoperative brain stem compression in the patient with the giant vertebrobasilar junction aneurysm. It is concluded, that the supra-infratentorial posterior transpetrosal approach allows excellent access to the basilar artery trunk and vertebrobasilar junction and can be considered the approach of choice to selected aneurysms located in this area.  (+info)

Cerebrovascular reserve before and after vertebral artery angioplasty. (3/331)

The selection of patients with severe vertebrobasilar artery stenosis for angioplasty is based mainly on clinical experience rather than on controlled data. We present a patient with severe vertebral artery stenosis in whom we could document the positive effect of angioplasty on posterior circulation hemodynamics by using transcranial Doppler sonography.  (+info)

Persistent primitive hypoglossal artery associated with cerebral aneurysm and cervical internal carotid artery stenosis--case report. (4/331)

A 71-year-old female had vertigo attacks once or twice a day secondary to vertebrobasilar insufficiency. Left carotid angiography revealed persistent primitive hypoglossal artery (PPHA) associated with a large internal carotid artery (ICA) aneurysm and severe stenosis of the ICA. The bilateral vertebral arteries were hypoplastic. The basilar artery was opacified via the PPHA but not via vertebral arteries. Clipping of the aneurysm was performed first because the risk of rupture of the aneurysm was not negligible. One month after clipping, carotid endarterectomy using a T-shaped shunt system was successfully performed. The postoperative course was uneventful and the vertebrobasilar ischemic attacks did not recur. Left carotid angiography demonstrated complete obliteration of the aneurysm and disappearance of the carotid artery stenosis. Low ICA flow (70 ml/min) and low stump pressure of the PPHA (25 mmHg) strongly suggested low perfusion of the posterior circulation. Carotid endarterectomy may be essential for augmentation of the posterior circulation in patients with PPHA associated with ICA stenosis.  (+info)

Preliminary experience using contrast-enhanced MR angiography to assess vertebral artery structure for the follow-up of suspected dissection. (5/331)

BACKGROUND AND PURPOSE: Important advances have been made recently in MR angiography with the use of contrast medium injection, which has proved valuable for the imaging of vertebral arteries (VAs) obtained during short scanning times. Our purpose was to assess the feasability of contrast-enhanced fast 3D MR angiography for imaging VAs and to evaluate the long-term follow-up of VA dissections. METHODS: Sixteen consecutive patients with 18 angiographically documented VA dissections (seven occlusive dissections and 11 stenotic dissections, including two each with a pseudoaneurysm) were followed up using both contrast-enhanced 3D MR angiography and cervical T1-weighted MR imaging at a median delay of 22 months. Ten patients underwent MR imaging at the acute phase as well, and nine underwent early follow-up angiography at a median delay of 3 months. MR angiographic findings were determined by consensus, focussing on image quality, presence of residual stenosis, luminal irregularities, and occlusion. RESULTS: Of the 32 VAs, a segment of the artery was not assessable on contrast-enhanced MR angiography in each of four small VAs. A central signal void artifact of cervical arteries was seen in one patient and motion artifacts were seen in two, but images could be interpreted. A venous enhancement was detected in 10 of 16 examinations, but this did not prevent image analysis. Ten of 11 stenotic dissections returned to normal, whereas one stenotic dissection progressed to occlusion. Two pseudoaneurysms detected by initial angiography resolved spontaneously; one was revealed only by delayed MR angiography, and one was detected on an early MR angiogram and proved resolved on a late MR angiogram. Of the seven initially occluded VAs, five reopened, with a hairline residual lumen in each of three. CONCLUSION: This preliminary experience showed that contrast-enhanced MR angiography is a promising tool for imaging VAs; it allows the assessment of VA dissection changes over time. Most lesions tended to heal spontaneously, but persisting occlusion or pseudoaneurysm could be detected during the late course.  (+info)

Treatment of posterior circulation ischemia with extracranial percutaneous balloon angioplasty and stent placement. (6/331)

BACKGROUND AND PURPOSE: Vertebrobasilar territory ischemia (VBI) leads to disabling neurological symptoms and poses a risk for stroke by an embolic or flow-related mechanism. We present our clinical experience in the endovascular treatment of patients with symptomatic VBI from severe atherosclerosis or dissection of the vertebral and subclavian arteries that was unresponsive to medical therapy. METHODS: Twenty-one patients (9 female, 12 male) with a mean age of 65.7 years (range 47 to 81 years) underwent treatment with percutaneous endovascular balloon angioplasty and stent placement. Sixteen patients (76.2%) had evidence of contralateral involvement, and 9 (42.8%) demonstrated severe anterior-circulation atherosclerosis. Nine patients had a previous infarct in the occipital lobe, cerebellum, or pons before treatment. Follow-up was available for all patients. RESULTS: Balloon angioplasty with intravascular stent placement was performed in 13 vertebral artery lesions (10 at the origin, 3 in the cervical segment) and in 8 subclavian lesions. The prestenting stenosis was 75% (50% to 100%) and was reduced to 4.5% (0% to 20%) after stenting. Six of the patients with proximal subclavian stenosis demonstrated angiographic evidence of subclavian steal, which resolved in all cases after treatment. All patients showed improvement in symptoms after the procedure except for 1 who developed a hemispheric stroke after thrombotic occlusion of an untreated cavernous carotid artery stenosis (rate of major stroke and mortality=4.8%). One patient (4.8%) had a periprocedural transient ischemic attack (TIA), and none had minor stroke. At long-term follow-up (mean=20.7+/-3.6 months) of the surviving 20 patients, 12 (57.1%) remained symptom-free, 4 (19%) had at most 1 TIA over a 3-month period, 2 (9.5%) had at most 1 TIA per month, and 2 (9.5%) had persistent symptoms. There were no clinically evident infarcts during the follow-up period. CONCLUSIONS: Endovascular treatment using balloon angioplasty with intravascular stent placement for symptomatic stenotic lesions resulting in VBI that is unresponsive to medical therapy appears to be of benefit in this high-risk subset of patients with poor collateral flow.  (+info)

Intracranial deployment of coronary stents for symptomatic atherosclerotic disease. (7/331)

Intracranial percutaneous transluminal balloon angioplasty (PTA) has been used as a technique of last resort in the treatment of intracranial atherosclerotic disease when medical and surgical alternatives have failed or cannot be applied. The major risks associated with PTA include intracranial vessel rupture and abrupt vessel dissection causing occlusion. Angioplasty techniques in the extracranial circulation have been improved by the development of safe stent technology in combination with potent antiplatelet agents. We report three successful cases of symptomatic intracranial atherosclerotic disease in middle-aged adults treated by endovascular PTA followed by deployment of coronary stents.  (+info)

Bow hunter's stroke associated with atlantooccipital assimilation--case report. (8/331)

A 39-year-old male presented with bow hunter's stroke manifesting as repeated vertebrobasilar ischemic attacks induced by head rotation 45 degrees to the left. Three-dimensional computed tomography angiography clearly showed the occluded right vertebral artery (VA) between the axis and atlas. Single photon emission computed tomography study showed diffuse hypoperfusion of the brain stem and bilateral cerebellar hemispheres, suggesting hemodynamic compromise of these regions. He refused surgery and was treated conservatively. The most likely mechanism is that the affected VA was fixed by the ossification of the atlantooccipital membrane, vascular groove, and transverse foramen of the atlas, and therefore became elongated and compressed by head-turning.  (+info)

Vertebrobasilar insufficiency (VBI) is a medical condition characterized by inadequate blood flow to the vertebral and basilar arteries, which supply oxygenated blood to the brainstem and cerebellum. These arteries arise from the subclavian arteries and merge to form the basilar artery, which supplies critical structures in the posterior circulation of the brain.

VBI is often caused by atherosclerosis, or the buildup of plaque in the arterial walls, leading to narrowing (stenosis) or occlusion of these vessels. Other causes include embolism, arterial dissection, and vasculitis. The decreased blood flow can result in various neurological symptoms, such as dizziness, vertigo, imbalance, difficulty swallowing, slurred speech, visual disturbances, and even transient ischemic attacks (TIAs) or strokes.

Diagnosis of VBI typically involves a combination of clinical evaluation, imaging studies like MRA or CTA, and sometimes cerebral angiography to assess the extent and location of vascular narrowing or occlusion. Treatment options may include lifestyle modifications, medications to manage risk factors (such as hypertension, diabetes, or high cholesterol), antiplatelet therapy, or surgical interventions like endarterectomy or stenting in severe cases.

The vertebral artery is a major blood vessel that supplies oxygenated blood to the brain and upper spinal cord. It arises from the subclavian artery, then ascends through the transverse processes of several cervical vertebrae before entering the skull through the foramen magnum. Inside the skull, it joins with the opposite vertebral artery to form the basilar artery, which supplies blood to the brainstem and cerebellum. The vertebral artery also gives off several important branches that supply blood to various regions of the brainstem and upper spinal cord.

Subclavian Steal Syndrome is a medical condition that occurs when there is a narrowing or blockage (stenosis) in the subclavian artery, usually at or near its origin from the aorta. This stenosis causes reduced blood flow to the ipsilateral upper extremity. The decreased blood supply to the arm leads to reversal of flow in the vertebral artery, which normally supplies blood to the brain and neck structures. As a result, the brain may receive insufficient blood flow, causing symptoms such as dizziness, lightheadedness, syncope (fainting), or transient ischemic attacks (TIAs or "mini-strokes").

The syndrome is called 'subclavian steal' because the vertebral artery essentially "steals" blood from the circle of Willis (the network of arteries at the base of the brain) to compensate for the reduced flow in the subclavian artery. The condition most commonly affects the left subclavian artery, but it can also occur on the right side or both sides.

Subclavian Steal Syndrome is typically diagnosed through a combination of physical examination, medical history, and imaging tests such as Doppler ultrasound, CT angiography (CTA), or magnetic resonance angiography (MRA). Treatment options include surgical bypass, endovascular stenting, or medication to manage symptoms and reduce the risk of stroke.

The subclavian artery is a major blood vessel that supplies the upper limb and important structures in the neck and head. It arises from the brachiocephalic trunk (in the case of the right subclavian artery) or directly from the aortic arch (in the case of the left subclavian artery).

The subclavian artery has several branches, including:

1. The vertebral artery, which supplies blood to the brainstem and cerebellum.
2. The internal thoracic artery (also known as the mammary artery), which supplies blood to the chest wall, breast, and anterior mediastinum.
3. The thyrocervical trunk, which gives rise to several branches that supply the neck, including the inferior thyroid artery, the suprascapular artery, and the transverse cervical artery.
4. The costocervical trunk, which supplies blood to the neck and upper back, including the posterior chest wall and the lower neck muscles.

The subclavian artery is a critical vessel in maintaining adequate blood flow to the upper limb, and any blockage or damage to this vessel can lead to significant morbidity, including arm pain, numbness, weakness, or even loss of function.

The basilar artery is a major blood vessel that supplies oxygenated blood to the brainstem and cerebellum. It is formed by the union of two vertebral arteries at the lower part of the brainstem, near the junction of the medulla oblongata and pons.

The basilar artery runs upward through the center of the brainstem and divides into two posterior cerebral arteries at the upper part of the brainstem, near the midbrain. The basilar artery gives off several branches that supply blood to various parts of the brainstem, including the pons, medulla oblongata, and midbrain, as well as to the cerebellum.

The basilar artery is an important part of the circle of Willis, a network of arteries at the base of the brain that ensures continuous blood flow to the brain even if one of the arteries becomes blocked or narrowed.

Vertigo is a specific type of dizziness characterized by the sensation that you or your surroundings are spinning or moving, even when you're perfectly still. It's often caused by issues with the inner ear or the balance-sensing systems of the body. Vertigo can be brought on by various conditions, such as benign paroxysmal positional vertigo (BPPV), labyrinthitis, vestibular neuritis, Meniere's disease, and migraines. In some cases, vertigo may also result from head or neck injuries, brain disorders like stroke or tumors, or certain medications. Treatment for vertigo depends on the underlying cause and can include specific exercises, medication, or surgery in severe cases.

Cerebral angiography is a medical procedure that involves taking X-ray images of the blood vessels in the brain after injecting a contrast dye into them. This procedure helps doctors to diagnose and treat various conditions affecting the blood vessels in the brain, such as aneurysms, arteriovenous malformations, and stenosis (narrowing of the blood vessels).

During the procedure, a catheter is inserted into an artery in the leg and threaded through the body to the blood vessels in the neck or brain. The contrast dye is then injected through the catheter, and X-ray images are taken to visualize the blood flow through the brain's blood vessels.

Cerebral angiography provides detailed images of the blood vessels in the brain, allowing doctors to identify any abnormalities or blockages that may be causing symptoms or increasing the risk of stroke. Based on the results of the cerebral angiography, doctors can develop a treatment plan to address these issues and prevent further complications.

Arterial occlusive diseases are medical conditions characterized by the blockage or narrowing of the arteries, which can lead to a reduction in blood flow to various parts of the body. This reduction in blood flow can cause tissue damage and may result in serious complications such as tissue death (gangrene), organ dysfunction, or even death.

The most common cause of arterial occlusive diseases is atherosclerosis, which is the buildup of plaque made up of fat, cholesterol, calcium, and other substances in the inner lining of the artery walls. Over time, this plaque can harden and narrow the arteries, restricting blood flow. Other causes of arterial occlusive diseases include blood clots, emboli (tiny particles that travel through the bloodstream and lodge in smaller vessels), inflammation, trauma, and certain inherited conditions.

Symptoms of arterial occlusive diseases depend on the location and severity of the blockage. Common symptoms include:

* Pain, cramping, or fatigue in the affected limb, often triggered by exercise and relieved by rest (claudication)
* Numbness, tingling, or weakness in the affected limb
* Coldness or discoloration of the skin in the affected area
* Slow-healing sores or wounds on the toes, feet, or legs
* Erectile dysfunction in men

Treatment for arterial occlusive diseases may include lifestyle changes such as quitting smoking, exercising regularly, and eating a healthy diet. Medications to lower cholesterol, control blood pressure, prevent blood clots, or manage pain may also be prescribed. In severe cases, surgical procedures such as angioplasty, stenting, or bypass surgery may be necessary to restore blood flow.

Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of certain hormones, primarily cortisol and aldosterone. Cortisol helps regulate metabolism, respond to stress, and suppress inflammation, while aldosterone helps regulate sodium and potassium levels in the body to maintain blood pressure.

Primary adrenal insufficiency, also known as Addison's disease, occurs when there is damage to the adrenal glands themselves, often due to autoimmune disorders, infections, or certain medications. Secondary adrenal insufficiency occurs when the pituitary gland fails to produce enough adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce cortisol.

Symptoms of adrenal insufficiency may include fatigue, weakness, weight loss, decreased appetite, nausea, vomiting, diarrhea, abdominal pain, low blood pressure, dizziness, and darkening of the skin. Treatment typically involves replacing the missing hormones with medications taken orally or by injection.

Renal insufficiency, also known as kidney failure, is a medical condition in which the kidneys are unable to properly filter waste products and excess fluids from the blood. This results in a buildup of these substances in the body, which can cause a variety of symptoms such as weakness, shortness of breath, and fluid retention. Renal insufficiency can be acute, meaning it comes on suddenly, or chronic, meaning it develops over time. It is typically diagnosed through blood tests, urine tests, and imaging studies. Treatment may include medications to control symptoms, dietary changes, and in severe cases, dialysis or a kidney transplant.

Venous insufficiency is a medical condition that occurs when the veins, particularly in the legs, have difficulty returning blood back to the heart due to impaired valve function or obstruction in the vein. This results in blood pooling in the veins, leading to symptoms such as varicose veins, swelling, skin changes, and ulcers. Prolonged venous insufficiency can cause chronic pain and affect the quality of life if left untreated.

An intracranial aneurysm is a localized, blood-filled dilation or bulging in the wall of a cerebral artery within the skull (intracranial). These aneurysms typically occur at weak points in the arterial walls, often at branching points where the vessel divides into smaller branches. Over time, the repeated pressure from blood flow can cause the vessel wall to weaken and balloon out, forming a sac-like structure. Intracranial aneurysms can vary in size, ranging from a few millimeters to several centimeters in diameter.

There are three main types of intracranial aneurysms:

1. Saccular (berry) aneurysm: This is the most common type, characterized by a round or oval shape with a narrow neck and a bulging sac. They usually develop at branching points in the arteries due to congenital weaknesses in the vessel wall.
2. Fusiform aneurysm: These aneurysms have a dilated segment along the length of the artery, forming a cigar-shaped or spindle-like structure. They are often caused by atherosclerosis and can affect any part of the cerebral arteries.
3. Dissecting aneurysm: This type occurs when there is a tear in the inner lining (intima) of the artery, allowing blood to flow between the layers of the vessel wall. It can lead to narrowing or complete blockage of the affected artery and may cause subarachnoid hemorrhage if it ruptures.

Intracranial aneurysms can be asymptomatic and discovered incidentally during imaging studies for other conditions. However, when they grow larger or rupture, they can lead to severe complications such as subarachnoid hemorrhage, stroke, or even death. Treatment options include surgical clipping, endovascular coiling, or flow diversion techniques to prevent further growth and potential rupture of the aneurysm.

Exocrine pancreatic insufficiency (EPI) is a condition characterized by the reduced ability to digest and absorb nutrients due to a lack of digestive enzymes produced by the exocrine glands in the pancreas. These enzymes, including lipases, amylases, and proteases, are necessary for breaking down fats, carbohydrates, and proteins in food during the digestion process.

When EPI occurs, undigested food passes through the gastrointestinal tract, leading to malabsorption of nutrients, which can result in various symptoms such as abdominal pain, bloating, diarrhea, weight loss, and steatorrhea (fatty stools). EPI is often associated with chronic pancreatitis, cystic fibrosis, pancreatic cancer, or other conditions that damage the exocrine glands in the pancreas.

EPI can be diagnosed through various tests, including fecal elastase testing, fecal fat quantification, and imaging studies to assess the structure and function of the pancreas. Treatment typically involves replacing the missing enzymes with oral supplements taken with meals and snacks to improve digestion and absorption of nutrients. In addition, dietary modifications and management of underlying conditions are essential for optimal outcomes.

Vertebral artery dissection is a medical condition that involves a tear in the inner lining (the tunica intima) of the vertebral artery, one of the major blood vessels supplying oxygenated blood to the brain. This tear allows blood to enter the vessel wall, creating a false lumen and leading to narrowing or blockage of the true lumen. The dissection can occur spontaneously or following trauma to the neck, and it can result in decreased blood flow to the brainstem and cerebellum, potentially causing symptoms such as headache, neck pain, dizziness, vertigo, double vision, difficulty swallowing, slurred speech, and weakness or numbness on one side of the body. Vertebral artery dissection is a serious condition that requires prompt medical attention and management to prevent potential complications such as stroke.

Placental insufficiency is a condition in which the placenta does not provide adequate nutrients and oxygen to the developing fetus. This can occur due to various reasons, such as poor placental development, damage to the placenta, or problems with the blood flow to the placenta. As a result, the fetus may receive less oxygen and nutrients than it needs for proper growth and development, which can lead to a range of complications, including low birth weight, preterm birth, and developmental delays.

The medical definition of placental insufficiency is: "a condition in which the placenta fails to provide adequate support to the developing fetus, resulting in impaired fetal growth and development." This condition can be diagnosed through various tests, such as ultrasound, fetal monitoring, and blood tests, and may require close monitoring and management throughout pregnancy to ensure the best possible outcomes for both the mother and the baby.

Magnetic Resonance Angiography (MRA) is a non-invasive medical imaging technique that uses magnetic fields and radio waves to create detailed images of the blood vessels or arteries within the body. It is a type of Magnetic Resonance Imaging (MRI) that focuses specifically on the circulatory system.

MRA can be used to diagnose and evaluate various conditions related to the blood vessels, such as aneurysms, stenosis (narrowing of the vessel), or the presence of plaques or tumors. It can also be used to plan for surgeries or other treatments related to the vascular system. The procedure does not use radiation and is generally considered safe, although people with certain implants like pacemakers may not be able to have an MRA due to safety concerns.

Digital subtraction angiography (DSA) is a medical imaging technique used to visualize the blood vessels and blood flow within the body. It combines the use of X-ray technology with digital image processing to produce detailed images of the vascular system.

In DSA, a contrast agent is injected into the patient's bloodstream through a catheter, which is typically inserted into an artery in the leg and guided to the area of interest using fluoroscopy. As the contrast agent flows through the blood vessels, X-ray images are taken at multiple time points.

The digital subtraction process involves taking a baseline image without contrast and then subtracting it from subsequent images taken with contrast. This allows for the removal of background structures and noise, resulting in clearer images of the blood vessels. DSA can be used to diagnose and evaluate various vascular conditions, such as aneurysms, stenosis, and tumors, and can also guide interventional procedures such as angioplasty and stenting.

Posterior cerebral artery (PCA) infarction refers to the death of brain tissue in the region of the brain supplied by the posterior cerebral artery due to insufficient blood supply. The PCA supplies blood to the occipital lobe (responsible for vision), parts of the temporal lobe, and other structures in the brain.

PCA infarction can result from various conditions that cause a blockage or reduction of blood flow in the PCA, such as embolism (a clot or debris traveling from another part of the body), thrombosis (a blood clot forming within the artery), or dissection (tearing of the artery wall). Symptoms of PCA infarction may include visual loss or disturbances, memory problems, language impairment, and other neurological deficits, depending on the extent and location of the infarction.

A Transient Ischemic Attack (TIA), also known as a "mini-stroke," is a temporary period of symptoms similar to those you'd get if you were having a stroke. A TIA doesn't cause permanent damage and is often caused by a temporary decrease in blood supply to part of your brain, which may last as little as five minutes.

Like an ischemic stroke, a TIA occurs when a clot or debris blocks blood flow to part of your nervous system. However, unlike a stroke, a TIA doesn't leave lasting damage because the blockage is temporary.

Symptoms of a TIA can include sudden onset of weakness, numbness or paralysis in your face, arm or leg, typically on one side of your body. You could also experience slurred or garbled speech, or difficulty understanding others. Other symptoms can include blindness in one or both eyes, dizziness, or a severe headache with no known cause.

Even though TIAs usually last only a few minutes, they are a serious condition and should not be ignored. If you suspect you or someone else is experiencing a TIA, seek immediate medical attention. TIAs can be a warning sign that a full-blown stroke is imminent.

Intracranial arteriosclerosis is a medical condition characterized by the thickening and hardening of the walls of the intracranial arteries, which are the blood vessels that supply blood to the brain. This process is caused by the buildup of plaque, made up of fat, cholesterol, and other substances, within the walls of the arteries.

Intracranial arteriosclerosis can lead to a narrowing or blockage of the affected arteries, reducing blood flow to the brain. This can result in various neurological symptoms, such as headaches, dizziness, seizures, and transient ischemic attacks (TIAs) or strokes.

The condition is more common in older adults, particularly those with a history of hypertension, diabetes, smoking, and high cholesterol levels. Intracranial arteriosclerosis can be diagnosed through imaging tests such as magnetic resonance angiography (MRA) or computed tomographic angiography (CTA). Treatment typically involves managing risk factors and may include medications to control blood pressure, cholesterol levels, and prevent blood clots. In severe cases, surgical procedures such as angioplasty and stenting may be necessary to open up the affected arteries.

The petrous bone is a part of the temporal bone, one of the 22 bones in the human skull. It is a thick and irregularly shaped bone located at the base of the skull and forms part of the ear and the cranial cavity. The petrous bone contains the cochlea, vestibule, and semicircular canals of the inner ear, which are responsible for hearing and balance. It also helps protect the brain from injury by forming part of the bony structure surrounding the brain.

The term "petrous" comes from the Latin word "petrosus," meaning "stony" or "rock-like," which describes the hard and dense nature of this bone. The petrous bone is one of the densest bones in the human body, making it highly resistant to fractures and other forms of damage.

In medical terminology, the term "petrous" may also be used to describe any structure that resembles a rock or is hard and dense, such as the petrous apex, which refers to the portion of the petrous bone that points towards the sphenoid bone.

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which is one of the largest nerves in the head. It carries sensations from the face to the brain.

Medically, trigeminal neuralgia is defined as a neuropathic disorder characterized by episodes of intense, stabbing, electric shock-like pain in the areas of the face supplied by the trigeminal nerve (the ophthalmic, maxillary, and mandibular divisions). The pain can be triggered by simple activities such as talking, eating, brushing teeth, or even touching the face lightly.

The condition is more common in women over 50, but it can occur at any age and in either gender. While the exact cause of trigeminal neuralgia is not always known, it can sometimes be related to pressure on the trigeminal nerve from a nearby blood vessel or other causes such as multiple sclerosis. Treatment typically involves medications, surgery, or a combination of both.

Echoencephalography (EEG) is a type of neurosonology technique that uses ultrasound to assess the structures of the brain and detect any abnormalities. It is also known as brain ultrasound or transcranial Doppler ultrasound. This non-invasive procedure involves placing a small ultrasound probe on the skull, which emits sound waves that travel through the skull and bounce back (echo) when they reach the brain tissue. The resulting echoes are then analyzed to create images of the brain's structures, including the ventricles, cerebral arteries, and other blood vessels.

EEG is often used in infants and young children, as their skulls are still thin enough to allow for clear ultrasound imaging. It can help diagnose conditions such as hydrocephalus (fluid buildup in the brain), intracranial hemorrhage (bleeding in the brain), stroke, and other neurological disorders. EEG is a safe and painless procedure that does not require any radiation or contrast agents, making it an attractive alternative to other imaging techniques such as CT or MRI scans. However, its use is limited in older children and adults due to the thickening of the skull bones, which can make it difficult to obtain clear images.

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