Murat Firat

Cerebral infarct associated with factor V Leiden mutation in a boy with hemophilia A

An 11‐year‐old boy with mild hemophilia A was admitted to our hospital because of focal convulsions. Magnetic resonance imaging showed an old occipital infarct. Protein C, S, antithrombin III, anticardiolipin antibodies and fibrinogen were normal. Heterozygosity for factor V Leiden mutation was detected. We suggest that factor V Leiden mutation should be studied in hemophiliacs with thrombosis. Am. J. Hematol. 56:189–190, 1997.

Unusual appearance of intracranial fibromuscular dysplasia : A case report

Fibromuscular dysplasia (FMD) of intracranial arteries is seen rarely and usually limited to the intrapetrosal internal carotid artery or carotid siphon. The authors report a case with recurrent subarachnoid hemorrhage diagnosed angiographically as FMD with extensive involvement of intracranial arteries. Angiography showed large fusiform dilata tions and multiple aneurysms along the left intracranial internal carotid artery into its major branches, middle cerebral and posterior communicating arteries, and tip of the basilar and posterior cerebral arteries. Such an angiographic appearance has not been previously reported. Radiologic findings are demonstrated and possible pathophysiologic mechanisms are discussed.

Bilateral cavernous carotid artery aneurysms in a 4-year-old child: endovascular treatment with mechanically detachable coils

Abstract We present a 4-year-old child who suffered bilateral third nerve palsies secondary to bilateral giant saccular cavernous carotid artery aneurysms. Endovascular treatment was performed by means of direct endosaccular aneurysm occlusion on the right side and parent vessel occlusion on the left, using mechanically detachable coils. No complication occurred during or after the procedure. The bilateral third nerve palsies resolved over 3 months. Follow-up angiography at 1 year is presented.

Guglielmi detachable coil treatment of a partially thrombosed giant basilar artery aneurysm in a child

Abstract We report a partially thrombosed giant of the aneurysm basilar artery with prominent mass effect, diagnosed in an 11 year-old child who presented with neurological deficits due to brain stem compression. After the patent portion of the aneurysm was embolised with Guglielmi detachable coils, remarkable clinical improvement occurred. Angiography demonstrated complete occlusion of the aneurysm and MRI revealed dramatic shrinkage of the aneurysm at 6-month and 1-year follow-up.

Arteriovenous fistula: a cause of torticollis

Torticollis is a symptom that may represent a wide spectrum of disorders ranging from a simple etiology to a life-threatening pathology. Pediatricians have to suspect central nervous system abnormalities whenever faced with torticollis. The authors report an arteriovenous fistula at the craniocervical junction in a patient presenting with torticollis.

Retrieval of an embolization coil from the internal carotid artery using the amplatz microsnare retrieval system

An unusual case of unintentional release of an embolization coil into the proximal internal carotid artery is reported. The coil migrated and lodged distally in the petrous portion of the internal carotid artery during initial removal attempts using a regular nitinol loop snare. The coil was retrieved with the Amplatz Nitinol Microsnare system.

Placement of Mechanically Detachable Spiral Coils in the Endovascular Treatment of Intracranial Aneurysms. Work in Progress

PURPOSE To determine the usefulness of mechanically detachable spiral tungsten coils (MDSs) in the endovascular, endosaccular occlusion of intracranial aneurysms. MATERIALS AND METHODS Anterior communicating artery aneurysms shown at angiography in two patients and a basilar tip aneurysm shown in one patient were treated with MDSs. RESULTS In the basilar artery aneurysm, eight coils were delivered. Two additional coils were placed at 3 months because of filling of the residual aneurysm neck. Angiography at 1 year showed no recanalization. The smaller aneurysm in the anterior communicating artery was totally occluded by a single coil. Angiography at 6 months showed no recanalization. The other aneurysm was occluded by two coils, with a small amount of residual filling. A third coil was withdrawn before detachment. The patient had aspiration pneumonia and electrolyte imbalance, but he was in stable condition 3 weeks later and was discharged. CONCLUSION The pliable, soft, retrievable MDS system provides instantaneous release of a spiral coil.