The purpose of this section is to show cases — unusual, instructive, different cases. Cases illustrating the full capabilities of cerebral angiography and embolization.
Diagnostic Angiography
- Angiographic Appearance of Encephalitis
- Encephalotrigeminal Angiomatosis (Sturge-Weber Syndrome)
- CNS Vasculitis
- Differential Diagnosis of Skull Base Lesion — author Eytan Raz, M.D.
- Cavernous Thrombophlebitis — angiographic diagnosis!
- Dissection with false lumen
- Angiography after Burr Hole for EVD — another score for the angiogram
- Trigeminal Neuralgia Due to Lateral Pontine Vein Compression of CN V, in setting of Petrosal Vein Dural Fistula
- Bow Hunter’s Syndrome — Positional Vertebrobasilar Insufficiency
- Carotid Dissections with Lower Cranial Nerve Dysfunction
- Carotid Web — a Rare Cause of Embolic Stroke
- Bihemispheric PICA stroke with lateral spinal artery PICA reconstitution
- Vasa Vasorum
- Supreme Intercostal (Thoracic Aorta) Origin of Right Vertebral Artery
- Ventral Ophthalmic Artery
- Anterior Cerebral Artery Dolichoectasia
- Pure Arterial Malformation
- Diploic Veins
- Ultrasound-Guided Femoral Artery Pseudoaneurysm Compression
- Thrombosed DVA (Developmental Venous Anomaly)
- Foramen Cecum Vein
- Basilar Pseudoaneurysm / healed dissection / pure arterial malformation — what is it?
- Venous Sinus Thrombosis and Cortical Drainage Adaptation — How to Form a Complete Flow Picture
- Good Angiographic Technique — Basilar Terminus Fenestration
- Intraprocedural Embolus Recognition
- Intraprocedural Embolus and Iatrogenic Dissection
- Thalamic Hypertensive Hemorrhage — DYNA Spot Sign
- Basal Ganglia Hypertensive Hemorrhage — DYNA Spot Sign
- Ischemic Optic Neuropathy DYNA CT
- Temporomandibular Joint AVM — World’s Only Example
- Charcot-Bouchard Aneurysms of Unusual Size? I Don’t Think They Exist
- Intracranial Arterial Dissection — Diagnosis and Treatment Challenges
- Venous Sinus Thrombosis – CT / Angio Correlation
- Myxoma — Multiple Fusiform Intracranial Aneurysms
- Diagnostic Dilemma 1
- Moya Moya Fusions Progressive Occlusion
Venous Cerebrovascular
- Postoperative Venous Infarction
- Venous Pulsatile Tinnitus — talk page
- Sigmoid Sinus Fenestration in Venous Pulsatile Tinnitus
- Isolated Cortical Venous Thrombosis
- Pulsatile Tinnitus Venous Sinus Stenosis and Stenting
- Pulsatile Tinnitus Venous Sinus Stenosis and Stenting Case 2 — including normalization of overall cerebral venous drainage
- Pulsatile Tinnitus Venous Sinus Stenosis — Imaging Spectrum
- Pulsatile Tinnitus Intracranial Hypertension Venous Stenting
- Pulsatile Tinnitus Intracranial Hypertension Venous Stenosis Despite VP Shunt Placement
- Pulsatile Tinnius Venous Sinus Diverticulum Stenting
- Cervical Jugular Compression C1 Lateral Mass Resection and Styloidectomy
- Thrombosis Vein of Galen / Straight Sinus — Direct tPA Administration — Magic
- Extremely Unsual DVA and Venous Drainage Anomalies
- “Venous Malformation” Receiving Cortical Venous Drainage
- Massive Venous Sinus Thrombosis — Thrombectomy and Direct tPA Infusion
- Mastoiditis Venous Sinus Thrombosis Late IH Complication
- Venous Sinus Stenting, Threatened Labbe Occlusion Rescue
Spinal Vascular
- Anterior Spinal Artery Identification — common origin segmental artery variant — BANANA Bites
- Spinal Stroke — Segmental Artery Atherosclerosis
- Spinal AVM — Recurrence and Excellent DYNA CTs
- Spinal Stroke — Reperfusion Hyperemia Flat Panel / Cone Beam Imaging
- Thoracic Schwannoma — Anatomy Correlation — Flat Panel / Cone Beam Imaging
Dural Fistula
- Embolization of Spinal Dural Fistula — protecting the nearby Adamkiewicz
- Embolization of Spinal Dural Fistula at Same Level as Anterior Spinal Artery Supply
- Spinal Dural Fistula (several cases, including a combined surgical-endovascular case)
- Dural fistula adjacent to Adamkiewicz — “DANGEROUS ANASTOMOSIS”
- Spinal Pial Fistula Disguised as a Dural Fistula
- Missed Spinal Dural Fistula — 4th Angiogram Is The Charm — With Review of Technique
- Cervical Spinal Dural Fistula — Superb Cone Beam Imaging
- Thoracic Fistula — Classic Case — Great Cone Beam Images — Scepter C — Returning Veins to Cord
- Spinal Dural Fistula Cone Beam Posterior Spinal Artery Identification
- Spinal Dural Fistula Embolization Adjacent to Anterior and Posterior Spinal Arteries
- Missed Spinal Dural Fistula — MRI To The Rescue?
- Post-Treatment Venous Thrombosis — MRI Findings
Epidural Fistula
Spinal Shunts
- Spinal Epidural AVM Presenting with Epidural Hematoma
- Spinal Pial Fistula Disguised as a Dural Fistula
- Spinal Epidural AVM Embolization — Extreme Importance of Prospective Anterior Spinal Artery Identification
- Parkes Weber Paraspinal Fistula Embolization — another example of ASA identification
- Multiple Spinal Shunts — Pial Epidural Dural — Images Only
Spinal Aneurysm
- Spinal Arterial Aneurysm
- Missed Spinal Arterial Aneurysm
- Pre-embolization identification of the anterior spinal artery
- Radiculopial Artery Aneurysm Resection (surgical case, companion to Spinal Arterial Aneurysm)
- Lateral Spinal Artery Aneurysm
- Epidural Cervical Hematoma with Pseudoaneurysm — nBCA embolization
- Thoracic Radiculomedullary Aneurysm — headache and SAH presentation
Spinal Tumor Embolization
- Spinal Hemangioblastoma Preoperative Embolization — Posterior Spinal Arterial Network
- Spinal Hemangioblastoma Standalone Embolization
- Spinal Hemangioma Embolization adjacent to Anterior Spinal Artery Supply
- Posterior Spinal Artery / Radiculopial Test Occlusion and Sacrifice — Technique and Advanced Imaging
- Hemangioma Embolization Benefits of Cone Beam CT
Miscellaneous
- Spinal Epidural Hematoma
- Anterior Spinal Artery Reconstitution of the PICA, with Associated Aneurysm
- Anterior Spinal Artery Duplication
- Batson’s Venous Plexus in Retroperitoneal Fibrosis
- Lateral Spinal Artery Thrombectomy
- ACDF Intraoperative Vertebral Artery Injury and Repair
- Thyrocervical trunk direct fistula, likely post-traumatic
Brain Aneurysm
- ACOM dual A1-A2 Pipeline
- Blister Aneurysm Pipeline Embolization
- Tiny (1 x 0.8 mm) Ruptured Aneurysm Coiling
- Another Tiny Ruptured ACOM Aneurysm Coiling
- In Tribute — EZ Does It: Neuroform EZ Stent-Supported Aneurysm Coiling
- Radial Access Left Paraophthalmic Aneurysm Pipeline Embolization
- Radial Access Small Paraophthalmic Aneurysm Pipeline — Small Aneurysms Need Short Pipelines
- Left SCA Aneurysm Left Radial Approach
- Recurrent Post-Clip PCOM Presenting with CNIII Palsy, Strategic Pipeline Treatment, Radial Attempt with Femoral Conversion
- Ulnar Access ACOM Aneurysm Coiling with Balloon Protection
- Delayed Post-clipping Aneurysm Re-rupture, with Subsequent Coil and Pipeline Embolization
- Delayed Post-Coiling Aneurysm Re-rupture and Re-Treatment
- Flow Diversion by Clipping (Basilar Tip Aneurysm)
- Basilar Perforator Aneurysm Clipping
- Basilar Perforator Ruptured Pseudoaneurysm — Delayed Diagnosis and Pipeline
- Terson Syndrome
- Brachial FMD ACOM Aneurysm Coiling
- Stent-retriever Vasospasm Angioplasty
- AICA Aneurysm — Primitive Lateral Basivertebral Anastomosis of Padget
- Dual Catheter Aneurysm Coiling
- Real Balloon Remodeling
- Vessel Wall Imaging Ruptured Aneurysm
- Subcallosal Artery and ACOM Aneurysms
- Pipeline of Residual Ruptured Aneurysm — Beautiful DYNA and stereo images
- Comaneci Device for Distal Vasospasm
- Basilar Pseudoaneurysm / healed dissection / pure arterial malformation — what is it?
- Missed ACOM Aneurysm
- SAH Angioplasty with Old Carotid Occlusion — a Lucky Break — Part 1
- WEB — Super Complex Ruptured ACOM — Double WEB Double ACOMs Double Fenestration and ICA occlusion — 2WEB8 treatment
- Superior Hypophyseal Pipeline Shield Embolization
- Ruptured M2 Pseudoaneurysm Pipeline Shield Embolization
- “Blister” Dorsal Wall Pseudoaneurysm Embolization — BANANA BITES Video
- Plug and Pipe / MCA Pipe Subacute Rupture
- PICA Pipeline Excellent Anatomy
- Basilar Pipeline Innumerable Congenital Variations — Hyostapedial, Ventral Ophthalmic
- Vertebral Artery Intradural Fusiform Aneurysm Lateral Medullary Perforators — Flow Diversion
- Vertebral Artery Intradural Fusiform Aneurysm Pipeline Shield Metal Coverage and Pore Size Analysis
- Subcallosal Artery Threatened Occlusion During Coiling of ACOM Aneurysm — Great Recovery!
- Large Paraophthalmic Aneurysm Insufficient Pipeline Coverage and Re-Treatment
- Growth and Rupture of Vertebral Pseudoaneurysm with vertebral-PICA Pipeline
- Trauma ICA Dorsal Wall Pseudoaneurysm Pipeline
- Vertebral Pseudoaneurysm Unruptured Pipeline Metal Coverage Pore Size Calculator
- Perimesencephalic Hemorrhage — AVM and Basilar Perforator Aneurysm — Who Done It?
- ACOM Pipe — Small A1 is Way Better Than None
- “Failed” Pipe — Multiple Teaching Points
- ACOM A1-A1 Variation and Brilinta Resistance — FUSION Images
Vertebral Augmentation (Kyphoplasty, etc)
- Kyphoplasty: Redefining Vertebra Plana — The Very Collapsed Bone, Not So Collapsed In Reality
- Kyphoplasty: Paying Attention to Fracture Lines
- Loose Pedicle Screw: Percutaneous Vertebral Augmentation of Loose Pedicle Screw After Spinal Fusion
- Sacroplasty, CT-guided
- Loose Pedicle Screw — another case
- Another great no so plana plana case — with great reduction and improved cord status
- Refracture of well-cemented level
Dural Fistulas
Sigmoid
- Sigmoid Sinus Dural Fistula with Direct Cortical Venous Drainage (Cognard IIb)
- Sigmoid Sinus Dural Fistula with Direct Cortical Venous Drainage and Extensive Venous Infarction (Cognard IIb)
- Sigmoid Sinus Dural Fistula with Venous Infarction and Scepter SC assisted nBCA embolization
- Cerebellar Hemorrhage due to Sigmoid Dural Fistula — very rare
- Sigmoid Fistula Superselective Transvenous Embolization 1
- Sigmoid Fistula Superselective Transvenous Embolization 2
- Sigmoid Fistula Superselective Transvenous Embolization 3
- Sigmoid Fistula Complex Superselective Transvenous Embolization 4
- Sigmoid Fistula Superselective Transvenous Embolization 5
- Superselective Embolization Trapped High Grade Sigmoid Sinus Fistula
- Sigmoid Fistula and Extensive Venous Thrombosis — images only
- Sinus Sacrifice Strategic Features and Price of Waiting
Cavernous
- Cavernous Sinus Dural Fistula with Meningohypophyseal Trunk (MHT) nBCA embolization
- Direct Transorbital Puncture Cavernous Sinus Dural Fistula Embolization 1
- Direct Transorbital Puncture Cavernous Sinus Dural Fistula Embolization 2
- Cavernous Sinus Shunted Pouch Superselective Transvenous Achilles Heel Embolization
- Another Cavernous Sinus Shunted Pouch Superselective Embolization — now via Hypoplastic AND Occluded Inferior Petrosal Sinus
- Cavernous Sinus Transvenous Occlusion Angiogiographic Aspects
Ethmoidal
- Ethmoidal Dural Fistula middle meningeal – anterior meningeal approach embolization
- Ethmoidal Dural Fistula Trans-ophthalmic nBCA Embolization and Amazing Globe Images
- Ethmoidal Dural Fistula Trans-Ophthalmic nBCA Embolization Case 2
- Ethmoidal Dural Fistula Transvenous Embolization
Tentorial
- Dural Venous Channel — Tentorium Cerebelli Fistula 1
- Dural Venous Channel — Tentorium Cerebelli Fistula 2 — with Cerebelar Congestion and other Dural Venous Channels
- Dural Venous Channel — Tentorium Cerebelli with Prominent PICA supply — NOT Brain AVM
- Dural Venous Channel — Tentorium Cerebelli with Vermian Hemorrhage
- Dural Venous Channel — Tentorium Cerebelli Fistula Next to Labbe
- Tentorial — Hybrid Double Angle and Scepter Mini Embolization
- Brain AVM – Tentorial Dural AVF — Common Vein — Complex Case Cone Beam CT Analysis and Treatment
- Small arterial supply large venous infarct fistula
Condylar
- Posterior Condylar Dural Fistula
- Superselective Transvenous Embolization of Complex Jugular Bulb (Condylar) Fistula
- Posterior Fossa Subarachnoid Hemorrhage Hypoglossal Canal Dural Fistula
- Jugular Bulb Superselective Embolization — important anatomy concepts
Other
- Direct Occipital Dural Fistula Embolization (Cognard IV)
- Dural Venous Channel — Small Parasagittal Fistula Big Venous Hemorrhage
- Dural Venous Channel — Posterior Temporal High Grade Fistula
- Sphenoparietal Sinus Cognard IV Borden III fistula — ANAGLYPH page
- Falcotentorial Fistula Angiogram and Gamma Knife Radiosurgery
- Direct Right Carotid-Cavernous Fistula Embolizaton
- C1 Dural Fistula Combined Surgical Case
- Dural Venous Channel — Parasagittal Convexity High Grade Fistula
- Direct CC Fistula Superlative Cavernous Sinus Anatomy and PED-Shield-Coil embo
- Torcular Super-High Grade Fistula Superselective Embolization
- Petrous Apex Fistula Surgical Occlusion
- Innumerable Sinus Fistulas Superselective Transvenous Cure Images Only
Brain AVM
- Tectal Plate Ruptured AVM Embolization Cure
- Symptomatic Deep Venous Varix Embolization
- Lenticulostriate Pseudoaneurysm nBCA Torpedo / Sandwich Technique Embolization
- Brain AVM – Tentorial Dural AVF — Common Vein — Complex Case Cone Beam CT Analysis and Treatment
Preoperative Tumor Embolization
- Petroclival Meningioma Embolization (including MHT access)
- Petroclival Meningioma Embolization (ILT and MHT access)
- Petroclival Meningioma Major ILT Embolization
- Sphenoid Wing and Petroclival Meningioma Embolization (MHT, accessory meningeal artery access)
- Foramen Magnum Preoperative Meningioma Embolization
- Foramen Magnum Preoperative Meningioma Embolization 2 with Particles and nBCA
- Preoperative Orbital Tumor Embolization
- Preoperative Posterior Fossa Hemangiopericytoma Embolization
- Transnasal Resection of Meningioma following Preoperative Embolization — endoscope views included
- Spinal Hemangioblastoma Standalone Embolization
- JNA Preoperative Embolization
- Ophthalmic Artery Meningioma Embolization
- Convexity Embolization Dural Venous Channel Recognition
- BANANA BITES: Sphenoid Wing Menigioma Embo Venous and Arterial Points
- Petroclival Meningioma One Stop Pedicle Shop Embo Clival Anastomoses
- Hemangiopericytoma Pial and Dural Embo
- Foramen Magnum Meningioma — Cone Beam CT Fusion — Presurgical Planning Gem
- Petroclival Meningioma Multiple Cone Beam Fusions PCOM Supply Preop MHT Embolizations AND Standalone Embo Shrinkage
Subdural / MMA Embolization
- Subdural Embolization Accessory Meningeal Artery Supply
- Subdural Embolization — Occipital Artery Dural Supply
- nBCA embolization of meningolacrimal variant MMA
- Subdural Embolization Occult Ophthalmic Artery Anastomosis
- Multiple Orbital Anastomoses nBCA Technique Points
- Recurrent Meningeal Artery Collateral Embolization via Intradural Anastomoses
- Post-craniotomy Subdural Contralateral MMA Reconstitution and nBCA Embo
- Bilateral Recurrent Meningeal Arteries Subdural Embolization Outcome Difference Collateral Pattern
- Post Remote Pterional Craniotomy MMA Embolization via Collaterals + Follow Up
- Occult Orbital Anastomosis — Useful Points
Stroke
- Carotid Web — a Rare Cause of Embolic Stroke
- Artery of Percheron Occlusion with Perfusion Imaging and Thrombectomy
- Stroke — CT vs. CT perfusion case 1
- Stroke — something for (almost) everyone
- Distal MCA (M4 segment) mechanical thrombectomy
- Bihemispheric PICA stroke with lateral spinal artery PICA reconstitution
- Septic Emboli with Bilateral ICA Occlusion and Thrombectomy
- Left Radial Access Left Vertebral Artery Intracranial Stenting
- Failure of Leptomeningeal Collaterals in Delayed Thrombectomy
- Right ICA thrombectomy with a dominant A1 segment — thrombectomy still helps
- Acute Intracranial Stenting for M1 thrombectomy and re-occlusion
- Acute Stroke Intracranial Stenting Case 2
- Acute Intracranial Stenting with Ophthalmic DYNA
- Balloon Assisted Tracking Technique for Large Catheter Distal Access
- Intra-Arterial tPA in 2018
- Lateral Spinal Artery Thrombectomy
- Persistent Stapedial Artery ICA Reconstitution in Acute Ischemic Stroke
- M3 Sofia 5 Aspiration Thrombectomy and Cool Venous Variants
- Basilar Thrombectomy via Posterior Communicating Artery
- Intracranial Stenting Cavernous Segment
- Distal Thromboaspiration Utilizing 027 catheter
- Distal Thromboaspiration with 027 microcatheter case 2
- M3 Aspiration — 1 mm target vessel, 1.5mm Sofia 5
- MR Perfusion, MRI, and MRA in hyperacute stroke — followed by distal aspiration thrombectomy
- Unstable Cervical Carotid Plaque Causing Repeat M1 Occlusions
- An even more critical top of basilar occlusion
- HYPOdense Basilar Sign / Basilar Aspiration Angioplasty / SCA Stent-triever angioplasty
- Seizure Perfusion
- Azygous ACA Embolus and Thrombectomy
- Bilateral ACA and left MCA occlusions — perfusion and anatomy guide intervention
- Carotid Revascularization — Balloon Guide Protection Strategy and Perfusion Use in Intervention
- Wedge Microcatheter Intracranial Angioplasty
- ACA A2 segment Balloon-Mounted Stenting
- Intracranial Dissection — an_In-Depth Study
- “Large M4” Zoom Thrombectomy — see what that means…
- Zoom Beveled Tip Stuck at Bifurcation– Worth It? M3 case
- “Kissing Sofias” Vertebral Thrombectomy for Wallenberg Syndrome
- Duplicated Vert Dissection — Anatomy Knowledge Solves Mystery
- Basilar Stenting — Nice Collaterals and Extra Credit Question
- 027 Aspiration Thrombectomy — Marksman and Sofia — with Beautiful Extra Anatomy
- Intracranial Multifocal MCA Dissection — Diagnostic and Therapeutic Challenges, Value of Cone Beam CT
- SAMMPRIS Intracranial Stenting — Many Learning Points and Great Pituitary!
- PCOM Route M2 Atherosclerotic Occlusion Revascularization — Old ICA Occlusion
- Delayed / Subacute MCA Revascularization and Stenting
- Emergent Nonagenerian Intracranial Stenting
- Double Solitaire Double Strength M2 Thrombectomy
- Carotid web M1 and A2 thrombectomy
- PCA Impostor Vessels – CAUTION!! during thrombectomy
- Delayed / Subacute intracranial ICA Revascularization and Stenting
- Delayed A2 Intracranial Revascularization and Stenting
- Delayed M2 Intracranial Revascularization and Stenting Onyx Resolute 1
- Delayed M2 Intracranial Revascularization and Stenting Onyx Resolute 2
- Delayed Supraclinoid Carotid ICAD Revascularization Onyx Resolute
- Re-stenting of M2 Segment Stent Occlusion
- SAMMPRIS Case Supraclinoid Stenting Snowplow Effect Ophthalmic and Superior Hypophyseal Occlusions
- Intracranial Angioplasty Failure Rescue Stenting
- Pediatric Intracranial Dissection
- M3 Aspiration Colossus/Zoom
- Vertebral Artery Intracranial Stenting — Fantastic Collaterals
- Bilateral PCA Occlusions and ICAD
- Perfusion point — M1 and A2 Occlusions
- Central Retinal Artery Occlusion – CRAO — Cone Beam CT Timing
- Post Resection
- Carotid T — Drivers of Outcome — Perforator and Other Injury
Trauma
- The Nonhappening Epidural Hematoma — Post-traumatic Dural Fistula
- Post-traumatic dural fistula with parenchymal, subarachnoid hemorrhage (companion case of The Nonhappening Epidural Hematoma)
- Post-traumatic fistulas
- Another Post-Traumatic Middle Meningeal Artery Fistula
- Post-Traumatic Recurrent Meningeal Artery Fistula
- Epidural Hematoma and Middle Meningeal Artery Fistula
- Direct CC Fistula Cavernous Sinus Onyx Embolization
- Pseudoaneurysm intracranial ICA — carotid cave and sphenoid sinus — Coils and Pipeline Shield
- Acute Interhemispheric Subdural and Delayed Parenchymal Hematomas from Anterior Cerebral Artery Injury
- Direct Cavernous Carotid Fistula — Multiple Lucky Sinus Compartments
Gamma Knife
Miscellaneous
- Takayasu Arteritis Left Subclavian Angioplasty
- Brain Metal Emboli
- Seizure Perfusion
- Descending Palatine Artery Pseudoaneurysm — post LeFort Osteotomy
- Ear AVM
Locked-in Syndrome: Atheromatous Basilar Occlusion
- Orbital AVM Preoperative Embolization
- Orbital AVM Preoperative Embolization 2 — Direct Puncture and Transophthalmic
- Scalp AVM Superselective Preoperative Embolization
- Radial Access
- Left Paraophthalmic Aneurysm Pipeline Embolization
- Direct Right Carotid-Cavernous Fistula Embolizaton
- Left Radial Access Left Vertebral Artery Intracranial Stenting
- Small Paraophthalmic Aneurysm Pipeline — Small Aneurysms Need Short Pipelines
- Left SCA Aneurysm Left Radial Approach
- Recurrent Post-Clip PCOM Presenting with CNIII Palsy, Strategic Pipeline Treatment, Radial Attempt with Femoral Conversion
- Ulnar Access ACOM Aneurysm Coiling with Balloon Protection
- ACOM Pipeline Embolization
- Aberrant Right Subclavian Access to Right CCA and Right Vert
- Carotid Stent
- Brachial FMD ACOM Aneurysm Coiling
- Ultrasound-Guided Femoral Artery Pseudoaneurysm Compression
- Situs Inversus Right Radial Catheterization
