Teaching point: Extradigital glomus tumor should be considered in the differential diagnosis of a highly vascular solid lesion that is painful on palpation.
Teaching point: Extradigital glomus tumor should be considered in the differential diagnosis of a highly vascular solid lesion that is painful on palpation.
Teaching point: Tracheal diverticulosis is a rare and benign disorder, characterized by single or multiple tracheal wall outpouchings, either congenital or acquired, usually diagnosed incidentally on chest high‑resolution computed tomography, and in general remaining asymptomatic.
Teaching point: Neurogenic pulmonary edema is a rare complication of cerebral trauma and should be considered in trauma patients presenting with pulmonary edema when no other cause is found.
Teaching point: The clues to the correct diagnosis of heterotopic ossification of the indirect head of the rectus femoris are its location above the acetabular rim and its (inverted) comma‑like morphology.
Teaching point: In an elderly patient with a history of atypical, intermittent medial thigh pain presenting with signs of intestinal obstruction, entrapment of bowel loops in an obturator hernia should be included in the differential diagnosis and should be further elaborated by computed tomography (CT).
Background and purpose: Cerebral vasospasm (CV) following aneurysmal subarachnoid hemorrhage (aSAH) may lead to morbidity and mortality. Endovascular mechanical angioplasty may be performed if symptomatic CV is refractory to noninvasive medical management. Compliant and noncompliant balloons and manually adjustable mesh may be used in this indication. We describe our initial experience with the Comaneci (Rapid Medical, Yokneam, Israel) in cerebral vasospasm treatment following aSAH. Methods: All patients included in the prospective observational SAVEBRAIN PWI (NCT05276934 on clinicaltrial.gov) study who underwent cerebral angioplasty using the Comaneci device for the treatment of medically refractory and symptomatic CV after aSAH were identified. Patient demographic information, procedural details, and outcomes were obtained from electronic medical records. Results: Between February 2022 and June 2023, seven consecutive patients underwent CV treatment with the Comaneci. Angioplasty of 37 arterial segments (supraclinoid internal carotid artery, A1, A2, and A3 segments of the anterior cerebral artery and M1 and M2 segments of the middle cerebral artery) was attempted, and 35/37 (95%) were performed. The vessel diameter improved significantly following angioplasty (+64%), while brain hypoperfusion decreased (-45% of the mean T Max). There was no long-term clinical complication, and 6% per-procedural complications occurred. Conclusions: The Comaneci is effective in the treatment of cerebral vasospasm following aSAH, bringing a new device in the armamentarium of the neurointerventionalist to perform intracranial angioplasty.
Teaching point: Melorheostosis is a rare sclerosing bone dysplasia, characterized by sclerosis at the periosteal and/or endosteal side of the cortex, causing undulating thickening of the bony contour resembling "dripping candle wax."
The authors define corrected dates of three remarkable events of early history of radiology in Berlin, which have been wrongly reported in the literature. Compiled evidence from contemporary newspaper publications demonstrates that Röntgen delivered his lecture to kaiser William II on 12 January 1896. Paul Spies gave a lecture on Röntgen rays to the Reichstag on 13 February 1896. The first publicly taken X-ray in Berlin was obtained on 20 January 1896.
Teaching point: Extrapelvic endometriosis involving pudendal and sciatic nerve may be a cause of lower limb pain.
Hepatic artery aneurysms (HAAs) are rare vascular malformations that can arise from atherosclerosis, trauma, or iatrogenic injury. HAAs can be symptomatic and lead to serious complications. We present the case of a patient with painless jaundice caused by obstruction of the distal common bile duct by a HAA on a replaced right hepatic artery. This was further complicated with cholangitis. After endovascular stenting of the aneurysm, cholestasis decreased. Learning point: Hepatic artery aneurysms can cause common bile duct obstruction resulting in cholestasis.