Introduction Headache is a frequent but neglected side effect of angiography, and the criteria for angiography related headache have been based on only a few studies. Methods One-hundred and thirty nine patients who underwent cerebral angiography and 30 controls who underwent peripheral angiography participated in this prospective, non-randomized, case-control study. Participants were instructed to tell the angiography staff in case a headache developed and were questioned about their headache just after, 24 hours after, and one week after angiography. Results In the cerebral angiography group 42 patients (30.2%) had procedural headache compared to three of the controls (10%). Two different types of headache related to angiography were observed: one during angiography, which was related to contrast injection, and the other occuring within 24 hours. Both headaches were more frequent in patients with a history of primary headache, but were distinctly different from the premorbid headache. Headache characteristics are described in detail. Discussion Both types of headache related to angiography did not match the ICHD-3beta criteria for angiography headache, but were similar to headaches reported in studies that were not included in the current criteria. The timing and characteristics of these headaches are discussed in the light of our and previous reports. We suggest that the present ICHD-3 beta criteria are inadequate in properly defining angiography headache and should be revised in the light of the present literature.

Tc-99m MAA SPECT has a predictive value in terms of response to radioembolization, PFS, and OS. Dosimetry based on Tc-99m MAA SPECT images can be used in the selection of patients and, in particular, to adaptation of treatment plan in selected patients.

No abstract

Bu çalışmada, varis şikayeti olan hastalarda Doppler US ile alt ekstremite de tespit edilen kronik venöz yetmezliğinin paternlerinin ve klinik öneminin ortaya konması amaçlanmıştır. Yöntemler: Venöz yetmezlik semptomu olan 2006 hasta çalışmaya dahil edilmiştir.Doppler US inceleme yapılan toplam 3938 alt ekstremite venöz sistemi incelenmiştir. Araştırmada yüzeyel ve derin venöz yetmezlik kombinasyonu gösteren dört patern klasifiye edilmiştir. Sonuçlar: İnceleme yapılan 2006 hastanın, 966'sında ya tek venöz yetmezlik seviyesi (790, %82) ya da yetmezlik kombinasyonu (176, %18) saptanmıştır. Yüzeyel venöz yetmezlik, %57,6 Vena Safena Manga (VSM), %25,5 safenofemoral bileşke (SFB), %9,1 Vena Safena Parva (VSP), %2,4 Giacomini Veni, %1,8 safenopopliteal bileşke (SPB) seviyesinde karşımıza çıkmıştır. Yetmezlik gösteren hastalar arasında %51 oranında çoklu seviye yetmezlik kombinasyonları saptanmıştır. Bu kombinasyonlar dört patern olarak açıklanmıştır. Patern 1: SFB ile VSM (%97,9), VSM'nın dallarının (%7,1) ve perforan venlerin (%20,8) birlikteliği. Patern 2: Derin venöz yetmezliğin, SFB (%63,6), VSM (%76,4), ve VSP (%16,4) ile kombinasyonu. Patern 3: SPB yetmezliğinin VSP (%95,5) ile birlikteliği. Patern 4: Giacomini Ven yetmekliğinin VSM (%67,9) ve VSP (%75) ile kombinasyonu. Tartışma: Kronik venöz yetmezlik dört patern olarak karşımıza çıkabilir. Sonuçlarımız özellikle SFB ile VSM ve derin venöz sistem ile VSM yetmezlik birlikteliğinin çok sık olduğunu ortaya koymaktadır.

AIM:To understand the late anatomical results of surgically treated intracranial aneurysms (IA's) and to investigate the incidence of recurrent, de novo aneurysms, the natural history of residual aneurysms, and the morphological changes in temporarily clipped vascular segments. MATErIAL and METHods:A total of 117 patients underwent screening with digital subtraction angiography (DSA) or computed tomographic angiography (CTA) in a range of 3 -13 years. Late angiographies were evaluated in terms of recurrence, change in known residua, the presence of de novo aneurysms and the morphological changes in temporarily clipped vessels. We also analysed the cumulative data including previously published results. rEsuLTs:In the long-term DSA, three residual aneurysms were observed to be enlarged while four remnants showed no morphological change. In one patient, spontaneous obliteration was seen. No recurrent aneurysm was detected. One de novo aneurysm was observed. We did not find any morphological change in 71 temporarily clipped vascular segments. CoNCLusIoN:Our data demonstrates that completely occluded aneurysms could remain stable even years later. Most of the small neck residues appeared to remain unchanged or even be thrombosed but they should be carefully followed. The incidence of de novo aneurysms might be expected to be lower.

Giant hepatic hemangioma treatment with transcatheter arterial embolisation and transcatheter arterial chemoembolisation; Comparative results

Variations of the branches of the external carotid artery have been well documented in the available literature. However, variation of the occipital artery arising from the internal carotid artery is extremely rare case. A 42-year-old man patient who suffered from subarachnoid hemorrhage with suspicious vascular anomalies was found to have this variation on the right side by angiography during selective catheterisation of main carotid artery for vascular mapping. Our literature searches revealed that there was rare case such variations. We think that this variation should contribute to literature and should be kept in mind during surgical, radiological and diagnostic procedures.

ÖZETAmaç: Çalışmamızda kemoterapiden fayda görmeyen, rezeke edilemeyen karaciğer kanserlerinde yttrium-90 (Y-90) resin mikrosfer radyoembolizasyon terapisinin etkinliğinin ortaya konması amaçlanmıştır.Yöntemler: Çalışmaya radyoembolizasyon tedavisi uygulanan, rezeke edilemeyen primer veya gastrointestinal sistemden metastatik 55 hasta dahil edilmiştir. Üç hasta ön değerlendirme anjiografisi sonrasında çalışma dışı bı-rakılmıştır. Kalan 52 hastanın 13'ü (%23.6) hepatosellü-ler karsinoma, 39'u (%76.4) metastatik karaciğer kanseri hastasıdır. Elli iki hasta radyoembolizan tedavi görmüştür. Her hastaya verilen tedavi, Solid Tümörlerde Tedaviye Yanıt Kritirleri'ne (RECIST) göre değerlendirilmiş ve tüm sürvi olasılığı Kaplan-Meier metoduna ile grafik olarak gösterilmiştir.Bulgular: Y-90 tedavisi sonrası 47 hasta takip edilebilmiştir. Hastaların %57'sinde klinik fayda yanıtı alınmış, %43'ünde hastalık progresyon göstermiştir. Hastaların medyan hepatik progresyonsuz survi süresi 3.4 ay (%95 confidence interval (ci): 1.4-5.3), tüm sürvi süresi 11.3 (%95 confidence interval (ci): 8.7-14.03) olarak saptanmıştır.Sonuç: Bu çalışma Y-90 resin mikrosfer radyoembolizan tedavinin rezeke edilemeyen karaciğer kanseri hastalarında etkin olduğunu ortaya koymaktadır.Anahtar kelimeler: Yttrium-90, radyoembolizasyon, anjiografi, karaciğer kanseri ABSTRACT Objective: To determine the effects of yttrium-90 (Y-90) resin microsphere radioembolization therapy on patients with unresectable liver cancer who do not benefit from chemotherapy. Methods:Fifty-five patients underwent radioembolization therapy included in the study whose had unresectable primary or metastatic liver cancer originating from the gastrointestinal tract. Three were excluded from the study after pre-evaluation angiography. Thirteen (23.6%) of the remaining 52 patients had hepatocellular carcinoma and 39 (76.4%) had metastatic liver cancer. Fifty-two patients underwent Y-90 radioembolization treatment. Each patient's response to the administered treatment was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST) and the overall probability of survival was displayed graphically by the Kaplan-Meier method.Results: After Y-90 therapy, 47 patients were follow-up. While 57% of the patients responded to treatment as clinical benefit, the disease progressed in 43%. The median hepatic progression-free survival time of the patients was 3.4 months (95% confidence interval (ci):1.4-5.3) and the overall survival time was 11.3 months (95%, CI:8.7-14.03). Conclusion:This study emphasizes that Y-90 resin microsphere radioembolization treatment is effective in patients with unresectable liver cancer.