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Book: Venous disorders of the central nervous system

Willinsky, Robert A.

(Neuroimaging clinics of North America ; 13,1)

2003

Author's details	Robert A. Willinsky, guest ed
Series title	Neuroimaging clinics of North America ; 13,1
Collection
Language	English
Size	XI, 156 S. : zahlr. Ill.
Publisher	Saunders
Publishing place	Philadelphia u.a.
Publishing country	United States
Document type	Book
HBZ-ID	HT013660076
Database	Catalogue ZB MED Medicine, Health

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Se 1309 -13,1-	verfügbar in Königswinter	Königswinter

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Article ; Online: Periventricular nodular heterotopia associated with a "transmantle band sign" in patients with epilepsy.

Hainc, Nicolin / Alcaide-Leon, Paula / Willinsky, Robert A / Krings, Timo / Nicholson, Patrick

Epilepsia

2023 Volume 64, Issue 6, Page(s) 1605–1611

Abstract: Objective: Previous studies using advanced magnetic resonance imaging (MRI) techniques have documented abnormal transmantle bands connecting ectopic nodules to overlying cortex in patients with periventricular nodular heterotopia (PNH). We describe a ... ...

Abstract	Objective: Previous studies using advanced magnetic resonance imaging (MRI) techniques have documented abnormal transmantle bands connecting ectopic nodules to overlying cortex in patients with periventricular nodular heterotopia (PNH). We describe a similar finding using conventional MRI techniques. Methods: Patients were identified by means of a full-text search of radiological reports. All scanning was performed using conventional sequences at 3 Tesla (3T). Scans were reviewed by three neuroradiologists, and we characterized imaging features based on type of PNH and cortical irregularities associated with the transmantle band. Results: A total 57 PNH patients were reviewed, of whom 41 demonstrated a "transmantle band" connecting the nodule to the overlying cortex. One or more periventricular heterotopic nodules was present in all 41 patients-this was bilateral in 29 of 41 (71%) and unilateral in the remaining 29%. In many cases there was more than one such band, and in some cases this band was nodular. In 19 of the cases, the cortex to which the band connected was abnormal, showing thinning in 4 cases, thickening in 5 cases, and polymicrogyria in another 10. Significance: The transmantle band can be seen frequently in both unilateral and bilateral cases of PNH and can be visualized with conventional 3T MRI sequences. The band highlights the underlying neuronal migration issues at play in the pathogenesis of this disorder, but its underlying role in the complex, patient-specific epileptogenic networks in this cohort has yet to be determined and warrants further investigation.
MeSH term(s)	Humans ; Periventricular Nodular Heterotopia/complications ; Periventricular Nodular Heterotopia/diagnostic imaging ; Epilepsy/etiology ; Epilepsy/complications ; Cerebral Cortex ; Magnetic Resonance Imaging/methods
Language	English
Publishing date	2023-04-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.17604
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Article ; Online: The presence of pachymeningeal hyperintensity on non-contrast flair imaging in patients with spontaneous intracranial hypotension.

O'Cearbhaill, Roisin M / Haughey, Aoife M / Willinsky, Robert A / Farb, Richard I / Nicholson, Patrick J

Neuroradiology

2023 Volume 65, Issue 5, Page(s) 893–898

Abstract: Purpose: Traditionally, in the work-up of patients for spontaneous intracranial hypotension, T1 post-contrast imaging is performed in order to assess for pachymeningeal enhancement. The aim of this study is to assess whether pachymeningeal ... ...

Abstract	Purpose: Traditionally, in the work-up of patients for spontaneous intracranial hypotension, T1 post-contrast imaging is performed in order to assess for pachymeningeal enhancement. The aim of this study is to assess whether pachymeningeal hyperintensity can be identified on a non-contrast FLAIR sequence in these patients as a surrogate sign for pachymeningeal enhancement. Methods: The patient cohort was identified from a prospectively maintained database of patients with a clinical diagnosis of intracranial hypotension. Patients who had both a post-contrast T1 sequence brain as well as non-contrast FLAR sequence of the brain were reviewed. Imaging was retrospectively reviewed by three independent neuroradiologists. Each study was assessed for the presence or absence of pachymeningeal hyperintensity on the FLAIR sequence. Results: From January 2010 to July 2022, 177 patients were diagnosed with spontaneous intracranial hypotension. In total, 121 were excluded as post-contrast imaging was not performed during their work-up. Twenty-four were excluded as the FLAIR sequence was performed after administration of contrast. Six were excluded as there was no pachymeningeal thickening present on T1 post-contrast imaging, although there were other signs of intracranial hypotension. The study group therefore consisted of 26 patients. Pachymeningeal thickening was correctly identified on the non-contrast FLAIR sequence in all patients (100%). Conclusion: Where present, diffuse pachymeningeal hyperintensity can be accurately identified on a non-contrast FLAIR sequence in patients with spontaneous intracranial hypotension. This potentially obviates the need for gadolinium base contrast agents in the work-up of these patients.
MeSH term(s)	Humans ; Intracranial Hypotension/diagnostic imaging ; Retrospective Studies ; Magnetic Resonance Imaging/methods ; Brain ; Contrast Media
Chemical Substances	Contrast Media
Language	English
Publishing date	2023-02-13
Publishing country	Germany
Document type	Journal Article
ZDB-ID	123305-1
ISSN	1432-1920 ; 0028-3940
ISSN (online)	1432-1920
ISSN	0028-3940
DOI	10.1007/s00234-023-03128-7
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Article: Intradural spinal varix: the "doughnut" sign on

Huynh, Thien J / Willinsky, Robert A

BJR case reports

2016 Volume 3, Issue 1, Page(s) 20160078

Abstract: Intradural spinal varices are rare lesions, with only three cases being previously reported in the literature. Previously described patients underwent MRI for non-specific low back pain and radiculopathy and were found to have an intradural lesion ... ...

Abstract	Intradural spinal varices are rare lesions, with only three cases being previously reported in the literature. Previously described patients underwent MRI for non-specific low back pain and radiculopathy and were found to have an intradural lesion adjacent to the cauda equina, mimicking a nerve sheath tumour or ependymoma. Consideration of an intradural varix in the differential diagnosis of an intradural extramedullary spinal lesion is necessary to guide appropriate management. We report a case of an intradural spinal varix diagnosed with first-pass arterial and blood pool phase gadolinium-enhanced auto-triggered elliptic centric-ordered MR angiography. Digital subtraction angiography confirmed that there was no shunt but failed to demonstrate the varix. We reviewed the existing literature to look for common clinical and imaging features.
Language	English
Publishing date	2016-09-22
Publishing country	England
Document type	Case Reports
ISSN	2055-7159
ISSN	2055-7159
DOI	10.1259/bjrcr.20160078
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Article ; Online: Aneurysmal wall enhancement and perianeurysmal edema after endovascular treatment of unruptured cerebral aneurysms.

Su, I-Chang / Willinsky, Robert A / Fanning, Noel F / Agid, Ronit

Neuroradiology

2014 Volume 56, Issue 6, Page(s) 487–495

Abstract: Introduction: Perianeurysmal edema and aneurysm wall enhancement are previously described phenomenon after coil embolization attributed to inflammatory reaction. We aimed to demonstrate the prevalence and natural course of these phenomena in unruptured ... ...

Abstract	Introduction: Perianeurysmal edema and aneurysm wall enhancement are previously described phenomenon after coil embolization attributed to inflammatory reaction. We aimed to demonstrate the prevalence and natural course of these phenomena in unruptured aneurysms after endovascular treatment and to identify factors that contributed to their development. Methods: We performed a retrospective analysis of consecutively treated unruptured aneurysms between January 2000 and December 2011. The presence and evolution of wall enhancement and perianeurysmal edema on MRI after endovascular treatment were analyzed. Variable factors were compared among aneurysms with and without edema. Results: One hundred thirty-two unruptured aneurysms in 124 patients underwent endovascular treatment. Eighty-five (64.4 %) aneurysms had wall enhancement, and 9 (6.8 %) aneurysms had perianeurysmal brain edema. Wall enhancement tends to persist for years with two patterns identified. Larger aneurysms and brain-embedded aneurysms were significantly associated with wall enhancement. In all edema cases, the aneurysms were embedded within the brain and had wall enhancement. Progressive thickening of wall enhancement was significantly associated with edema. Edema can be symptomatic when in eloquent brain and stabilizes or resolves over the years. Conclusions: Our study demonstrates the prevalence and some appreciation of the natural history of aneurysmal wall enhancement and perianeurysmal brain edema following endovascular treatment of unruptured aneurysms. Aneurysmal wall enhancement is a common phenomenon while perianeurysmal edema is rare. These phenomena are likely related to the presence of inflammatory reaction near the aneurysmal wall. Both phenomena are usually asymptomatic and self-limited, and prophylactic treatment is not recommended.
MeSH term(s)	Brain Edema/diagnosis ; Brain Edema/etiology ; Endovascular Procedures ; Female ; Humans ; Intracranial Aneurysm/surgery ; Magnetic Resonance Angiography/methods ; Male ; Postoperative Complications/diagnosis ; Postoperative Complications/etiology ; Retrospective Studies
Language	English
Publishing date	2014-03-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	123305-1
ISSN	1432-1920 ; 0028-3940
ISSN (online)	1432-1920
ISSN	0028-3940
DOI	10.1007/s00234-014-1355-x
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Article: VESSEL ARTERY DISSECTION AND PSEUDOANEURYSMS: ENDOVASCULAR APPROACHES

Willinsky, Robert A.

Seminars in Neurosurgery

2000 Volume 11, Issue 01, Page(s) 59–70

Abstract: Intracranial dissections are frequently recognized as a cause of stroke and subarachnoid hemorrhage. The posterior circulation is the most common location for these dissections. The purpose of this article is to focus on the presentation and management ... ...

Abstract	Intracranial dissections are frequently recognized as a cause of stroke and subarachnoid hemorrhage. The posterior circulation is the most common location for these dissections. The purpose of this article is to focus on the presentation and management of vertebral artery and posterior cerebral artery dissections. For patients presenting with stroke anticoagulation is the first line of treatment. For those presenting with a bleed proximal occlusion using endovascular techniques is the treatment of choice. Vertebral artery dissections (VADs) can be treated with either balloons or coils, and early angiographic follow-up is needed to reassess the status of the diseased segment. Trapping by endovascular techniques may be needed in a limited number of these VADs. Posterior cerebral artery dissections presenting with a bleed are best treated using Guglielmi detachable coils to achieve the shortest segment of occlusion.
Keywords	Dissecting aneurysm ; vertebral artery ; posterior cerebral artery ; endovascular therapy
Language	English
Publishing date	2000-01-01
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2060538-9
ISSN	1526-4572 ; 1526-8012
ISSN (online)	1526-4572
ISSN	1526-8012
DOI	10.1055/s-2000-11558
Database	Thieme publisher's database

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Article ; Online: Factors determining the success of endovascular treatments among patients with spinal dural arteriovenous fistulas.

Su, I-Chang / terBrugge, Karel G / Willinsky, Robert A / Krings, Timo

Neuroradiology

2013 Volume 55, Issue 11, Page(s) 1389–1395

Abstract: Introduction: Despite improvements of embolization agents and techniques, endovascular treatment of spinal dural arteriovenous fistula (SDAVF) is still limited by inconsistent success. The aim of embolization is to occlude initial portion of the ... ...

Abstract	Introduction: Despite improvements of embolization agents and techniques, endovascular treatment of spinal dural arteriovenous fistula (SDAVF) is still limited by inconsistent success. The aim of embolization is to occlude initial portion of the draining vein by liquid embolic materials. This study investigates factors that contribute to the success of embolization treatments among SDAVF patients. Methods: We performed a retrospective analysis on consecutive SDAVF patients who received N-butyl cyanoacrylate (NBCA) glue embolization between January 1992 and June 2012. Univariable and multivariable logistic regression analyses were performed to calculate the probability of successful draining vein occlusion for variable procedure-related factors. Results: We attempted endovascular approach as the first intention treatment in 66 out of 90 consecutive patients. Among them, a total of 43 NBCA glue injections were performed in 40 patients. Successful embolization was achieved in 24 patients (60 %). In multivariable analyses, antegrade flow during microcatheter test injection (OR 13.2, 95 % CI 1.7 to 105.4) and use of glue concentration ≥ 30 % (OR 0.1, 95 % CI 0.01 to 0.8) were detected as significant positive and negative predictors of successful venous penetration, respectively. With persistent antegrade flow, the success rates using a glue mixture of more than 30 % dropped significantly from 85.0 to 42.9 % (p = 0.049). If contrast stagnated during microcatheter injections, success rates were low regardless of glue concentrations. Conclusions: Presence of antegrade flow toward the draining vein and injection of NBCA glue less than 30 % are associated with higher chance of draining vein penetration and, therefore, successful endovascular SDAVF obliteration.
MeSH term(s)	Age Distribution ; Central Nervous System Vascular Malformations/diagnostic imaging ; Central Nervous System Vascular Malformations/epidemiology ; Central Nervous System Vascular Malformations/therapy ; Embolization, Therapeutic/statistics & numerical data ; Enbucrilate/therapeutic use ; Endovascular Procedures/statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Ontario/epidemiology ; Prevalence ; Radiography ; Retrospective Studies ; Risk Factors ; Sex Distribution ; Spinal Cord Diseases/diagnostic imaging ; Spinal Cord Diseases/epidemiology ; Spinal Cord Diseases/therapy ; Tissue Adhesives/therapeutic use ; Treatment Outcome
Chemical Substances	Tissue Adhesives ; Enbucrilate (F8CEP82QNP)
Language	English
Publishing date	2013-10-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	123305-1
ISSN	1432-1920 ; 0028-3940
ISSN (online)	1432-1920
ISSN	0028-3940
DOI	10.1007/s00234-013-1285-z
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Article ; Online: Aggressive intracranial dural arteriovenous fistula presenting with cerebrospinal fluid rhinorrhea: case report.

Willems, Peter W A / Willinsky, Robert A / Segev, Yoram / Agid, Ronit

Neurosurgery

2009 Volume 65, Issue 6, Page(s) E1208–9; discussion E1209

Abstract: Objective: This is the first report of an aggressive dural arteriovenous fistula presenting with rhinorrhea. It demonstrates the importance of recognizing increased intracranial pressure, and its underlying cause, as the predisposing factor to a ... ...

Abstract	Objective: This is the first report of an aggressive dural arteriovenous fistula presenting with rhinorrhea. It demonstrates the importance of recognizing increased intracranial pressure, and its underlying cause, as the predisposing factor to a spontaneous cerebrospinal fluid leak because this carries implications for management. Clinical presentation: Ten years after minor trauma and directly after an intercontinental flight, a 43-year-old woman presented with rhinorrhea. Right-sided pulsatile tinnitus had been present for the past 9 years. Imaging demonstrated an intracranial dural arteriovenous fistula of the right transverse sinus with cortical venous reflux. Magnetic resonance imaging findings indicated long-standing increased intracranial pressure. Intervention: The fistula was treated by endovascular means, using both transvenous and transarterial approaches, which led to immediate relief of the tinnitus and resolution of the rhinorrhea within 4 days. Conclusion: A dural arteriovenous fistula should be included in the differential diagnosis of underlying causes of increased intracranial pressure when examining a patient with a cerebrospinal fluid leak. Treatment of the fistula should precede attempts to treat the rhinorrhea, especially if the fistula has cortical venous reflux.
MeSH term(s)	Adult ; Angiography, Digital Subtraction/methods ; Central Nervous System Vascular Malformations/complications ; Central Nervous System Vascular Malformations/diagnosis ; Central Nervous System Vascular Malformations/surgery ; Cerebrospinal Fluid Rhinorrhea/complications ; Cerebrospinal Fluid Rhinorrhea/diagnosis ; Cerebrospinal Fluid Rhinorrhea/surgery ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Microsurgery/methods ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2009-12
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/01.NEU.0000356975.63780.33
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Article ; Online: Symptomatic enlargement of an occluded giant carotido-ophthalmic aneurysm after endovascular treatment: the vasa vasorum theory.

Dehdashti, Amir R / Thines, Laurent / Willinsky, Robert A / Tymianski, Michael

Acta neurochirurgica

2009 Volume 151, Issue 9, Page(s) 1153–1158

Abstract: We describe a patient with a symptomatic left giant carotido-ophthalmic aneurysm who initially underwent coil embolization with subtotal obliteration. The patient's symptoms were initially stable, but 1 year later, she presented with a rapidly ... ...

Abstract	We describe a patient with a symptomatic left giant carotido-ophthalmic aneurysm who initially underwent coil embolization with subtotal obliteration. The patient's symptoms were initially stable, but 1 year later, she presented with a rapidly progressive contralateral visual deficit. Although angiogram showed a stable neck remnant, MR confirmed aneurysm growth and showed a new peripheral hematoma in the wall of the thrombosed aneurysm. Surgical exploration was undertaken, and even after trapping and intra-aneurysmal thrombectomy, constant bleeding was observed from the wall of the thrombosed aneurysm consistent with the vasa vasorum. Bleeding stopped after cauterization and partial resection of the aneurysm dome, and the aneurysm was clipped. The patient's recent visual deficit markedly improved, and the angiogram did not reveal any residue. Giant aneurysms may continue to grow due to a hypertrophic vasa vasorum and subadventitial hemorrhages. Surgery should be considered if complete thrombosis of the aneurysm does not alleviate patient's symptoms.
MeSH term(s)	Carotid Artery, Internal/diagnostic imaging ; Carotid Artery, Internal/pathology ; Carotid Artery, Internal/surgery ; Carotid Artery, Internal, Dissection/diagnostic imaging ; Carotid Artery, Internal, Dissection/pathology ; Carotid Artery, Internal, Dissection/therapy ; Cerebral Angiography ; Disease Progression ; Embolization, Therapeutic/adverse effects ; Female ; Hematoma/diagnostic imaging ; Hematoma/pathology ; Hematoma/therapy ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/pathology ; Intracranial Aneurysm/therapy ; Middle Aged ; Ophthalmic Artery/diagnostic imaging ; Ophthalmic Artery/pathology ; Ophthalmic Artery/physiopathology ; Postoperative Complications/etiology ; Postoperative Complications/pathology ; Postoperative Complications/physiopathology ; Reoperation ; Secondary Prevention ; Surgical Instruments ; Treatment Outcome ; Vasa Vasorum/pathology ; Vasa Vasorum/physiopathology ; Vision, Low/etiology ; Vision, Low/physiopathology ; Vision, Low/therapy
Language	English
Publishing date	2009-09
Publishing country	Austria
Document type	Case Reports ; Journal Article
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-009-0270-0
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Article: Persistant anterior falcine sinus: demonstration by CT angiography.

Matouk, Charles C / Mandell, Daniel M / Krings, Timo / Willinsky, Robert A / Ter Brugge, Karel G

The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques

2011 Volume 38, Issue 5, Page(s) 760–761

MeSH term(s)	Aged ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Cerebral Angiography/methods ; Cranial Sinuses/diagnostic imaging ; Cranial Sinuses/drug effects ; Cranial Sinuses/pathology ; Humans ; Lymphoma, B-Cell/drug therapy ; Lymphoma, B-Cell/pathology ; Male
Language	English
Publishing date	2011-03-28
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	197622-9
ISSN	0317-1671
ISSN	0317-1671
DOI	10.1017/s0317167100054159
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