#neuroir

[radiologyreview]

Vein of Galen

Arteriovenous fistula (AVF) between deep choroidal arteries and embryonic median prosencephalic vein of Markowski (MPV)

High flow through MPV prevents formation of Vein of Galen → VGAM is misnomer

[radiologyreview]

Supply by PICA, AICA, SCA

[radiologyreview]

Brain perfusion

It is hypothesized that tissue at risk of infarction will have decreased CBF, normal or elevated CBV secondary to activation of cerebral autoregulatory mechanisms, and elevated MTT, while infarcted tissue will have decreased CBF and CBV with elevated MTT

[radiologyreview]

Spetzler Martin avm

http://radiopaedia.org/articles/spetzler-martin-avm-grading-system

[radiologyreview]

Cerebral Angiogram - vasospasm

Vasospasm does not usually affect bifurcations, atherosclerotic disease does.

[radiologyreview]

Angiogam

[radiologyreview]

Avm repair

Do not embolize (radiation instead) if:

There is a vessel supplying the AVM but continuing distally to supply the brain as well. (?Empassante vessel)

AVM is located in the dominant lobe regional to motor cortex (brocas and wenickes)

[radiologyreview]

Double flush

When bringing up berenstein catheter double flush it below the arch ...less risk of clot propagation

[radiologyreview]

Enpassant - vessel that supplies avm on way to supplying normal brain

[radiologyreview]

Vertebroplasty

Anterior third of vertebral body

Acrylic glue (cement) mixed with tantalum for radiopacity

Osteopenia - 7mL

metastasis - 1.5-3mL

Cement may cause hypotension

Complications:  spinal cord compression from leak, radiculopathy from NF leak, PE from paravertebral vein leak, osteomyelitis, allergic response.

Source = The Requisites, Vascular and Interventional Radiology, Kaufman and Lee

[radiologyreview]

Spinal Cord supply

Anterior spinal artery at T4-5 (from intercostal or bronchial arteries)

Artery of Adamkiewicz (hairpin turn and a midline course) at level of T6-12 originates from the left intercostal 75% of the time.

Source = The Requisites, Vascular and Interventional Radiology, Kaufman and Lee

[radiologyreview]

Venous sampling for hyperparathyroidism

Samples from multiple levels in the brachiocephalic, IJV, and SVC are obtained to lateralize adenoma. Ratio of 2:1 compared to peripheral vein is diagnostic

Source = The Requisites, Vascular and Interventional Radiology, Kaufman and Lee