✓ A case of subarachnoid hemorrhage (SAH) complicating cerebral arterial ectasia is reported. While ischemia and cranial nerve palsies are commonly associated with this condition, review of the literature reveals that SAH is exceedingly rare. The pathogenesis, radiographic findings, and clinical complications of cerebral arterial ectasia are discussed.
Steven J. Goldstein and Phillip A. Tibbs
Steven J. Goldstein
✓ A 31-year-old woman developed a sudden onset of vertebrobasilar ischemia while exercising. Cerebral arteriography revealed a dissecting hematoma of the cervical portion of the dominant vertebral artery. Both the neurological deficits and the intramural hematoma of vertebral artery resolved with conservative therapy alone.
Steven J. Goldstein, Charles Lee, A. Byron Young and George J. Guidry
✓ The authors describe the radiographic findings in a patient with Klippel-Trenaunay syndrome who also had aplasia of the left internal carotid artery and a very unusual malformation of the circle of Willis. This constellation of clinical and radiographic findings is unique and has not been previously reported in the medical literature.
Huina Zhang, Frank La Marca, Scott J. Hollister, Steven A. Goldstein and Chia-Ying Lin
The goal in this study was to develop a convenient, less-invasive animal model to monitor progression of intervertebral disc (IVD) degeneration for future testing of new treatments for disc degeneration.
Level 5/6 and 7/8 IVDs of rat caudal spine were stabbed laterally with 18- or 21-gauge hypodermic needles to a depth of 5 mm from the subcutaneous surface with the aid of fluoroscopy. In vivo MR imaging studies were performed at 4, 8, and 12 weeks postsurgery to monitor progression of IVD degeneration. Histological analysis including H & E and safranin O staining, and immunohistochemical studies of collagen type II and bone morphogenetic protein receptor type II (BMPRII) were assessed at 12 weeks postsurgery.
The 18- and 21-gauge needle–stabbed discs illustrated decreases in both the T2 density and MR imaging index starting at 4 weeks, with no evidence of spontaneous recovery by 12 weeks. Histological staining demonstrated a decreased nucleus pulposus (NP) area, and the NP–anulus fibrosus border became unclear during the progression of disc degeneration. Similar patterns of degenerative signs were also shown in both safranin O– and collagen type II–stained sections. The BMPRII immunohistochemical analysis of stabbed discs demonstrated an increase in BMPRII expression in the remaining NP cells and became stronger in anulus fibrosus with the severity of disc degeneration.
After introducing an 18- or 21-gauge needle into the NP area of discs in the rat tail, the stabbed disc showed signs of degeneration in terms of MR imaging and histological outcome measurements. Changes in BMPRII expression in this animal model provide an insight for the effectiveness of delivering BMPs into the region responsible for chondrogenesis for disc repair. This convenient, less-invasive, reproducible, and cost-effective model may be a useful choice for testing novel treatments for disc degeneration.