La Radiologia medica
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La Radiologia medica · Apr 1997
Review[Spontaneous carotid-cavernous fistula: correlations between clinical findings and venous drainage].
We reviewed retrospectively 6 cases of spontaneous carotid cavernous fistulas to discuss the differences in clinical findings depending on venous patterns. Orbit US was performed in all patients but one and all patients were examined with CT and intraarterial digital subtraction angiography (DSA). Orbit US, performed in 5 patients with ocular signs, showed dilation of the ophthalmic veins, in 3 cases bilaterally. ⋯ In the patient presenting III, IV and VI nerve palsy, the venous drainage was direct from the cavernous sinus to pericarotid plexus, pterygoid plexus and inferior petrosal sinus; in this case there were no ocular signs. The clinical findings of spontaneous cavernous fistulas are caused by the arterial supply and, especially, by the venous drainage of the fistula; for the early diagnosis and treatment it is important to know that some patients do not exhibit the classic triad of symptoms, characterized by pulsating exophthalmos, bruit and conjunctival chemosis. Our experience has confirmed that spontaneous carotid cavernous fistulas may be characterized by atypical clinical findings, such as ocular signs contralateral to the fistula side or palsies of cranial nerves only.
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La Radiologia medica · Oct 1996
Review[Criteria for utilization and indications for use of permanent and short- and medium term temporary endocaval filters. Personal experience and review of the literature].
Screening and prophylaxis of the population at risk is the most correct approach to thromboembolic disease. Caval filters play a major role in the prevention of pulmonary embolism, but their use remains widely controversial, even if they are an alternative or additional method to medical therapy and not antithetical to it. July, 1990, to September, 1995, seventy-seven permanent vena cava filters (59 LGM, 13 Filcard and 5 titanium-Greenfield), 22 short-duration temporary vena cava filters (11 LGT, 6 Filcard, 3 Filcard-Emanuelli and 2 Lysofilter) and 10 mid-duration temporary vena cava filters (Tempofilter) were inserted in 109 patients (55 men and 54 women) aged 17-88 years. ⋯ An axillary hemorrhage was observed in the site of previous surgery, during fibrinolysis with a Lysofilter, as well as the incomplete opening of a titanium-Greenfield filter and of two permanent LGM filters, partly trapped within endocaval thrombi. No further consequences to the patients due to permanent filters were observed, nor any case of symptomatic pulmonary thromboembolism, in patients with permanent or temporary filters. With reference to the relative literature and to their own experience, the Authors propose a detailed and rational synthesis of the diagnostic-instrumental approach protocol to thromboembolic disease.