Publications by authors named "Konstantinos Kouskouras"

24 Publications

  • Page 1 of 1

Bolus Intravenous Procainamide in Patients with Frequent Ventricular Ectopics during Cardiac Magnetic Resonance Scanning: A Way to Ensure High Quality Imaging.

Diagnostics (Basel) 2021 Jan 27;11(2). Epub 2021 Jan 27.

First Department of Cardiology, AHEPA Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece.

Acquiring high-quality cardiac magnetic resonance (CMR) images in patients with frequent ventricular arrhythmias remains a challenge. We examined the safety and efficacy of procainamide when administered on the scanner table prior to CMR scanning to suppress ventricular ectopy and acquire high-quality images. Fifty consecutive patients (age 53.0 [42.0-58.0]; 52% female, left ventricular ejection fraction 55 ± 9%) were scanned in a 1.5 T scanner using a standard cardiac protocol. Procainamide was administered at intermittent intravenous bolus doses of 50 mg every minute until suppression of the ectopics or a maximum dose of 10 mg/kg. The average dose of procainamide was 567 ± 197 mg. Procainamide successfully suppressed premature ventricular contractions (PVCs) in 82% of patients, resulting in high-quality images. The baseline blood pressure (BP) was mildly reduced (mean change systolic BP -12 ± 9 mmHg; diastolic BP -4 ± 9 mmHg), while the baseline heart rate (HR) remained relatively unchanged (mean HR change -1 ± 6 bpm). None of the patients developed proarrhythmic changes. Bolus intravenous administration of procainamide prior to CMR scanning is a safe and effective alternative approach for suppressing PVCs and acquiring high-quality images in patients with frequent PVCs and normal or only mildly reduced systolic function.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/diagnostics11020178DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911068PMC
January 2021

Off-label intravenous thrombolysis for early recurrent brain embolism associated with aortic arch thrombus.

Neurol Res Pract 2021 Jan 16;3(1). Epub 2021 Jan 16.

Second Department of Neurology, Aristotle University of Thessaloniki, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Thessaloniki, Greece.

Safety data of intravenous thrombolysis (IVT) in presence of aortic arch thrombus is scant. Furthermore, IVT is debatable in patients with prior recent stroke. We present a 51-year-old woman with recurrent major infarction 5 days after a minor left MCA territory stroke. She had a floating aortic arch thrombus and she was treated safely and effectively with off-label IVT. Patients with small infarct volumes and mild/no residual neurological deficits after an initial stroke might be considered for IVT in case of early recurrence. IVT may be reasonable in a context of acute severely disabling stroke associated with aortic arch thrombus.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s42466-021-00103-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7811222PMC
January 2021

A case of pulmonary arteriovenous malformation in the setting of Rendu Osler Weber syndrome.

Radiol Case Rep 2021 Mar 18;16(3):483-486. Epub 2020 Dec 18.

Department of Cardiology, AHEPA University Hospital of Thessaloniki, Greece.

Rendu Osler Weber syndrome is a rare disorder, in which arteriovenous malformations are a hallmark feature. We describe the case of a 77-year-old female patient who presented with dyspnea, recurrent epistaxis, and signs of right ventricular heart failure, along with hypoxia and severe anemia. Several imaging modalities facilitated diagnostic workup. The computed tomography revealed an area of pulmonary arteriovenous malformation. Visceral involvement, along with clinical criteria and medical history, established the diagnosis of Rendu Osler Weber syndrome. The patient was scheduled for embolization of the PAVM soon after the diagnosis. Proper imaging, guided by clinical suspicion can be extremely helpful in diagnosing and treating this rare entity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.radcr.2020.12.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753088PMC
March 2021

When Both the Right Ventricle and the Pulmonary Artery "Light Up": A Case of Takayasu Arteritis.

Heart Lung Circ 2021 Apr 13;30(4):e63-e64. Epub 2020 Nov 13.

First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.hlc.2020.10.015DOI Listing
April 2021

Calcification of coronary arteries and aortic valve and circulating a-klotho levels in patients with chronic kidney disease.

J Thorac Dis 2020 Mar;12(3):431-437

Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Background: Evidence suggests that the anti-aging protein a-Klotho is a central modulator of mineral homeostasis. Circulating a-Klotho exerts endocrine activity and has been implicated in the process of vascular calcification, which is accelerated in patients with chronic kidney disease (CKD) and portends an unfavorable overall prognosis. However, the role of a-Klotho in this process remains unclear. The purpose of this study was to investigate the possible interaction between a-Klotho and the calcification of the aortic valve and coronary arteries in patients with CKD.

Methods: In this study we enrolled a total of 60 adult patients with CKD. Group 1 included 30 participants with CKD stage V and group 2 included 30 participants with CKD stage III.

Results: Participants in group 1 had lower levels of circulating a-Klotho compared to group 2 (390; 280-590 . 722; 501-897 pg/mL; P=0.001), were of younger age (55.5; 45-63 . 69; 62-74 years; P<0.001), had lower body mass index (25.6; 23.8-27.5 . 28.2; 25.7-31.1 kg/m; P=0.036), higher serum phosphate (4.75; 4-5.6 . 3.35; 2.9-3.8 mg/dL; P<0.001), higher calcium-phosphate product (41; 35.1-49.2 . 31.5; 28.6-35 mg/dL; P<0.001), and higher parathyroid hormone (PTH) levels (28.4; 15-44.6 . 7.05; 4.3-10.2 pmol /L; P<0.001).

Conclusions: No statistically significant difference was found between the two groups in terms of coronary arteries and aortic valve calcification. Calcitonin, PTH and phosphate were identified as predictors for circulating a-Klotho levels whereas, only hyperlipidemia was identified as predictor for coronary artery calcification. In conclusion, circulating a-Klotho is found to decrease with worsening CKD severity but no correlation was found between the levels of a-Klotho and severity of coronary arteries and aortic valve calcification.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/jtd.2020.01.49DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139066PMC
March 2020

Darier-Roussy sarcoidosis in a 53-year-old patient.

Postgrad Med J 2020 Apr 9;96(1134):233. Epub 2019 Oct 9.

First Propedeutic Department of Internal Medicine, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/postgradmedj-2019-137134DOI Listing
April 2020

Extracranial internal carotid artery occlusive dissection - multimodality presentation in a case series.

Vasa 2019 May 12;48(3):244-250. Epub 2018 Dec 12.

2 1st Department of Neurology, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloniki, Greece.

Carotid dissection is a rare disease, mainly affecting young and middle-aged patients potentially ending up in stroke. Multimodality imaging plays an essential role, both in terms of prompt and accurate diagnosis and follow-up of this entity. We herein present a case series of patients with internal carotid artery dissection and compare the various imaging findings of ultrasonography, multidetector computed tomography angiography and magnetic resonance angiography, with a purpose to illustrate the value of multimodality imaging in the diagnosis of carotid dissection. Ultrasound represents the first-line imaging modality for the evaluation of a suspected carotid pathology. Digital subtraction angiography is considered the gold standard method for evaluation of carotid luminal abnormalities and is currently reserved for those patients selected for endovascular surgery. Nevertheless, the widespread availability of modern cross-sectional techniques such as multi-detector computed tomography angiography and magnetic resonance angiography has made angiography marginalised. Computed tomography and magnetic resonance angiography offered accurate delineation of vascular lumen and providing valuable information for the vascular wall composition. Careful interpretation of imaging findings on various imaging modalities can lead to early and accurate diagnosis of carotid dissection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1024/0301-1526/a000768DOI Listing
May 2019

A comparative study of color Doppler imaging and contrast-enhanced ultrasound for the detection of ulceration in patients with carotid atherosclerotic disease.

Eur Radiol 2019 Apr 22;29(4):2137-2145. Epub 2018 Oct 22.

Department of Radiology, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Objectives: To evaluate the diagnostic accuracy of color Doppler imaging (CDI) and contrast-enhanced ultrasound (CEUS) for diagnosing carotid ulceration, having multi-detector computed tomography angiography (MDCTA) as the reference method.

Methods: Patients with carotid disease referred for ultrasound (US), either due to the occurrence of neurovascular symptoms or for screening purposes, were included in this study if at least one plaque causing moderate (50-69%) or severe (70-99%) internal carotid artery stenosis was detected. Carotid US with CDI technique, CEUS, and MDCTA were performed in all patients, investigating the presence of ulceration. The agreement between modalities was evaluated using kappa statistics.

Results: The study population included 54 patients (median age 62 years, inter-quartile range 16.2) and 66 carotid arteries. The mean degree of stenosis was 68.5% (SD 12.2%) while 47.1% of plaques were symptomatic. MDCTA characterized 28.8% of plaques as smooth, 45.5% irregular, and 24.3% ulcerated. Flow reversal was detected with CDI in 65.5% of ulcerations, while swirling of the microbubbles and neovessels adjacent to the ulcer were detected with CEUS in 17.64%. The agreement for ulceration diagnosis was moderate between CDI and CEUS (kappa 0.473) and between CDI and MDCTA (kappa 0.473) and very good between CEUS and MDCTA (kappa 0.921). The sensitivity, specificity, and positive and negative predictive values of CDI for the diagnosis of ulceration were 41.2%, 97.95%, 87.5%, 82.8% respectively, while CEUS respective measures were 94.1%, 97.95%, 94.1%, and 97.95%.

Conclusion: CEUS outperformed CDI in terms of agreement with MDCTA and diagnostic accuracy for the diagnosis of ulcerated carotid plaque.

Key Points: • Superficial ulceration is a significant feature of carotid plaque vulnerability. • Color Doppler imaging has the potential to demonstrate carotid plaque ulceration but is characterized by limited sensitivity and moderate agreement with the reference method of multi-detector computed tomography angiography. • Contrast-enhanced ultrasound outperforms color Doppler imaging in terms of sensitivity for the detection of carotid plaque ulceration and in agreement with the reference method of multi-detector computed tomography angiography.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00330-018-5773-8DOI Listing
April 2019

Surgical Management of a Giant Adrenal Pseudocyst: A Case Report and Review of the Literature in the Last Decade.

Case Rep Surg 2018 1;2018:8473231. Epub 2018 Feb 1.

1st Propedeutic Surgical Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Adrenal pseudocysts are rare entities and occurred in the 5th and the 6th decades of life. They are discovered accidentally, while appearing with nonspecific clinical and imaging findings. We report a case of a 28-year-old woman presented in our Emergency Department complaining about upper abdomen pain. Computed tomography revealed a hypodense cystic lesion containing hyperdense material. The size of a mass was 11. 7 × 9.3 × 6.6 cm in diameter close to the pancreas, but the origin was from the left adrenal gland. The mass was excised with surgical laparotomy. Giant adrenal pseudocysts are rare entities. Final diagnosis usually confirmed with the pathology examination. Management of such adrenal lesions depends on the unique characteristics, the surgeon's experience, and local resources.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2018/8473231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820576PMC
February 2018

A case of sarcoidosis-associated pulmonary hypertension masquerading as chronic thromboembolic pulmonary hypertension.

Pulm Circ 2018 Jul-Sep;8(3):2045894018768289. Epub 2018 Mar 14.

1 First Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.

Occlusive vasculopathy due to the development and accumulation of granulomas at the level of intima of large vessels, as well as mediastinal lymph nodes and fibrosing mediastinitis secondary to sarcoidosis, causing extrinsic compression of mediastinal vascular structure are uncommon mechanisms of sarcoidosis-associated pulmonary hypertension. We present a case of a 62-year-old woman with a rare manifestation of sarcoidosis, which was misclassified and treated as chronic thromboembolic pulmonary hypertension for a long period. Fluorine-18-fluorodeoxyglucose positron emission tomography played a major role in accessing final diagnosis. Mechanisms that lead to development of pulmonary hypertension, the contribution of novel imaging modalities, and treatment options are discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/2045894018768289DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5950934PMC
March 2018

Bronchoesophageal fistula due to metastatic mediastinal lymphadenitis.

ANZ J Surg 2019 Apr 18;89(4):E170-E171. Epub 2017 Sep 18.

Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ans.14173DOI Listing
April 2019

Imaging of the ulcerated carotid atherosclerotic plaque: a review of the literature.

Insights Imaging 2017 Apr 3;8(2):213-225. Epub 2017 Feb 3.

Department of Radiology, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Carotid atherosclerotic disease constitutes a major modern health problem whose diagnosis primarily relies on imaging. Grading of stenosis has been long used as the main factor for risk stratification and guiding of management. Nevertheless, increasing evidence has shown that additional plaque characteristics such as plaque composition and surface morphology play an important role in the occurrence of symptoms, justifying the term "vulnerable plaque". Carotid plaque surface characteristics either in the form of surface irregularities or ulceration represent an important factor of vulnerability and are associated with the occurrence of neurologic symptoms. The delineation of the carotid plaque surface can be performed with virtually all imaging modalities including ultrasound, contrast-enhanced ultrasound, multi-detector computed tomography angiography, magnetic resonance angiography and the traditional reference method of angiography. These techniques have shown varying levels of diagnostic accuracy for the identification of ulcerated carotid plaques or plaque surface irregularities. As a consequence and given its high clinical significance, radiologists should be familiar with the various aspects of this entity, including its definition, classification, imaging findings on different imaging modalities and associations. The purpose of this review is to present the current literature regarding carotid plaque ulcerations and present illustrative images of ulcerated carotid plaques.

Teaching Points: • Plaque surface and ulceration represent risk factors for stroke in carotid disease. • Characterisation of the plaque surface and ulcerations can be performed with every modality. • US is the first-line modality for carotid disease and identification of ulcerations. • The administration of microbubbles increases US accuracy for diagnosis of carotid ulceration. • MDCTA and MRA are valuable for diagnosing ulceration and evaluating plaque composition.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s13244-017-0543-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359146PMC
April 2017

Man With Abdominal Pain.

Ann Emerg Med 2016 Jul;68(1):e1-2

Radiology Department, AHEPA University General Hospital of Thessaloniki, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.annemergmed.2015.11.016DOI Listing
July 2016

Multiple variations of the coeliac axis, hepatic and renal vasculature as incidental findings illustrated by MDCTA.

Surg Radiol Anat 2016 Aug 1;38(6):741-5. Epub 2015 Dec 1.

Department of Radiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Vascular anatomical variations are not uncommon and may affect any organ's arterial or venous vasculature. The coexistence of variations in different organic systems is less commonly found, but of great clinical significance in a series of clinical conditions like organ transplantation and surgical preoperative planning. Multidetector computed tomography angiography (MDCTA) has emerged as a valuable alternative to the conventional angiography for accurate evaluation of vascular anatomy and pathology. Radiologists should be familiar with each organ's vascular variations and always report them to the clinician, even if they represent an incidental finding. This case report presents a 52-year-old female patient undergoing abdominal MDCTA for characterization of a renal lesion. This examination revealed the presence of three hilar arteries on the left kidney, a main renal vein in combination with an additional renal vein in both sides along with a replaced right hepatic artery originating from the superior mesenteric artery. Moreover, both inferior phrenic arteries were found originating from the coeliac axis. 3D volume rendering technique images were used in the evaluation of vascular anatomy as illustrated in this case report.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00276-015-1598-1DOI Listing
August 2016

Contrast-enhanced ultrasonography of the carotids.

Ultrasonography 2015 Oct 10;34(4):312-23. Epub 2015 Mar 10.

Department of Radiology, G Gennimatas Hospital, Thessaloniki, Greece.

Contrast-enhanced ultrasonography of the carotids has recently emerged as a complementary examination to conventional carotid Doppler ultrasonography. It is an examination providing improved visualization of the vascular lumen, more accurate and detailed delineation of the vascular wall, and identification of atherosclerotic plaques. Moreover, contrast-enhanced ultrasonography has specific advantages over conventional ultrasonography and plays an important role in the diagnosis of the vulnerable carotid plaque, as it can identify intraplaque neovascularization and carotid plaque ulceration. Given the specific advantages and improved imaging of the carotids provided by this method, radiologists should be familiar with it. This pictorial essay illustrates the advantages of this technique and discusses its value in the imaging of carotid arteries.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14366/usg.15005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603203PMC
October 2015

Internal carotid artery floating thrombus in relapsing polychondritis.

J Neuroimaging 2015 Jan-Feb;25(1):142-4

Relapsing polychondritis is a rare autoimmune disease characterized by inflammation of cartilaginous tissues. It may be associated with systemic and cerebral vasculitis and exceptionally with ischemic stroke. Brain infarction associated with internal carotid artery thrombus, in a setting of relapsing polychondritis, has never been reported. We present a 52-year-old man without any known risk factors for stroke, treated with prednisone and azathioprine for relapsing polychondritis, who presented a minor left hemisphere stroke. Ultrasound of the neck vessels revealed an isoechogenic thrombus in the left internal carotid artery superimposed on a smooth moderately stenosing isoechogenic atheroma of the carotid bulb. The patient was treated with high-dose tinzaparin and was followed with serial ultrasound. After 16 days, the thrombus demonstrated a hypoechogenic core surrounded by a hyperechogenic rim and the following day it resolved completely. Thrombus formation on a small unruptured plaque may reflect involvement by relapsing polychondritis of the intimal proteoglycans that hold a role in the development of atheromatosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jon.12088DOI Listing
September 2015

Repair of Temporal Bone Encephalocele following Canal Wall Down Mastoidectomy.

Case Rep Otolaryngol 2014 22;2014:271824. Epub 2014 Sep 22.

1st Department of Otorhinolaryngology-Head and Neck Surgery, AHEPA Hospital, Aristotle University of Thessaloniki, 1 Stilponos Kyriakidi Street, 54636 Thessaloniki, Greece.

We report a rare case of a temporal bone encephalocele after a canal wall down mastoidectomy performed to treat chronic otitis media with cholesteatoma. The patient was treated successfully via an intracranial approach. An enhanced layer-by-layer repair of the encephalocele and skull base deficit was achieved from intradurally to extradurally, using temporalis fascia, nasal septum cartilage, and artificial dural graft. After a 22-month follow-up period the patient remains symptom free and no recurrence is noted.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2014/271824DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189909PMC
October 2014

Radiographic and ultrasonographic findings of uterine neoplasms in nine dogs.

J Am Anim Hosp Assoc 2014 Sep-Oct;50(5):330-7

School of Veterinary Medicine (M.P., L.P., N.P., P.P., C.S.) and School of Medicine (I.C., K.K., N.T., A.C.), Aristotle University of Thessaloniki, Thessaloniki, Greece; and Dick White Referrals Ltd., New Market, UK (S.J.).

The records of nine female intact dogs with histologically confirmed uterine tumors were reviewed retrospectively, and the related radiographic and ultrasonographic signs of the lesions detected were recorded. Radiography revealed a soft-tissue opacity between the urinary bladder and colon in six of seven dogs with uterine body and/or cervical tumors, and a soft-tissue opacity in the midventral abdomen in two dogs with uterine horn tumors. Ultrasonography revealed masses in all dogs with uterine body/cervical tumors and could delineate the origin of the mass in one of two dogs with uterine horn tumors. The mass was characterized ultrasonographically as solid in three dogs (all leiomyomas), solid with cystic component in four dogs (two adenocarcinomas, one leiomyoma, and one fibroleiomyoma), and cystic in two (both leiomyomas). Hyperechoic foci in the mass were observed in three dogs. Ultrasonography was a useful method for demonstrating uterine body and/or cervical tumors. However, it was not possible to ascertain sonographically that a mass originated in a uterine horn unless there was associated evidence of uterine horn to which the mass could be traced. The ultrasonographic appearance of uterine tumors was variable, and the type of neoplasm could only be determined by taking biopsies of the mass.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5326/JAAHA-MS-6130DOI Listing
July 2016

Treatment of infected thoracic aortic prosthetic grafts with the in situ preservation strategy: a review of its history, surgical technique, and results.

Heart Lung Circ 2014 Jan 12;23(1):24-31. Epub 2013 Sep 12.

Department of Cardiothoracic Surgery, Aristotle University Medical School, AHEPA University Hospital, Thessaloniki, Greece.

For cardiothoracic surgeons prosthetic graft infection still represents a difficult diagnostic and treatment problem to manage. An aggressive surgical strategy involving removal and in situ replacement of all the prosthetic material combined with extensive removal of the surrounding mediastinal tissue remains technically challenging in any case. Mortality and morbidity rates following such a major and risky surgical procedure are high due to the nature of the aggressive surgical approach and multi-organ failure typically caused by sepsis. However, removal of the infected prosthetic graft in patients who had an operation to reconstruct the ascending aorta and/or the aortic arch is not always possible or necessary for selected patients according to current alternative treatment options. Rather than following the traditional surgical concept of aggressive graft replacement nowadays a more conservative surgical approach with in situ preservation and coverage of the prosthetic graft by vascular tissue flaps can result in a good outcome. In this article, we review the relevant literature on this specific topic, particularly in terms of graft-sparing surgery for infected ascending/arch prosthetic grafts with special emphasis on staged treatment and the use of omentum transposition.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.hlc.2013.09.001DOI Listing
January 2014

Aorta-right atrial tunnel: imaging and surgical repair in an adult patient.

J Cardiothorac Vasc Anesth 2014 Oct 5;28(5):1314-8. Epub 2013 Sep 5.

Department of Radiology, Aristotle University Medical School, AHEPA University Hospital, Thessaloniki, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.jvca.2013.03.025DOI Listing
October 2014

Bilateral secondary neurolymphomatosis of the internal auditory canal nerves: a case report.

Am J Otolaryngol 2013 Sep-Oct;34(5):556-8. Epub 2013 May 8.

1st Department of Otorhinolaryngology - Head and Neck Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, 54636 Thessaloniki, Greece.

Background: Neurolymphomatosis describes the malignant lymphomatous infiltration of nerves.

Methods: We encountered a unique case of a 47-year-old patient with non-Hodgkin's lymphoma presenting with bilateral sensorineural hearing loss, vestibular dysfunction and bilateral facial nerve palsy.

Results: Magnetic resonance imaging demonstrated enhancement and thickening of internal auditory canal nerves bilaterally consistent with neurolymphomatosis. Patient was treated with combined intrathecal chemotherapy and total brain irradiation.

Conclusions: One must always remain vigilant for metastatic disease in patients with sensorineural hearing loss and/or vestibular dysfunction and facial nerve palsy in the context of known malignancy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amjoto.2013.04.002DOI Listing
April 2014

Ischemic cerebral infarction in a 5-year-old male child with neurofibromatosis type 1.

Childs Nerv Syst 2012 Nov 9;28(11):1989-91. Epub 2012 May 9.

2nd Department of Pediatrics, Aristotle University of Thessaloniki, AHEPA General Hospital, St. Kyriakidi 1, Thessaloniki 54636, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00381-012-1790-0DOI Listing
November 2012

The impact of carotid stenting on the hemodynamic parameters and cerebrovascular reactivity of the ipsilateral middle cerebral artery.

J Vasc Surg 2006 Nov;44(5):1016-22; discussion 1022

Fifth Surgical Clinic, Medical School, Aristotle University of Thessaloniki, Hippokrateio Hospital, Thessaloniki, Greece.

Objective: The study was conducted to determine the effect of carotid angioplasty and stenting (CAS) on the hemodynamic parameters and cerebrovascular reactivity (CVR) of the ipsilateral middle cerebral artery (MCA) and examine the relation between preprocedural exhausted CVR and perioperative neurologic events.

Methods: The study included 29 patients with severe extracranial carotid stenosis undergoing CAS. Transcranial Doppler imaging was performed before the procedure, 2 days, and 2 to 4 months postoperatively. Peak systolic velocity, end-diastolic velocity, mean flow velocity, and pulsatility index of the ipsilateral MCA were recorded at rest. CVR was assessed with the breath holding test: the increase of mean flow velocity and the breath holding index were calculated.

Results: Peak systolic and mean flow velocities increased significantly in both postoperative studies compared to the preoperative values, end-diastolic velocity was significantly elevated only in the first study, and pulsatility index did not change significantly. When stimulated by breath holding, preoperative mean flow velocity did not increase significantly compared with the resting values; however, it did increase significantly during breath holding in both studies after CAS. The breath holding index improved significantly from -0.35 (-0.71 to 0.55) to 0.38 (0.12 to 0.61) at 2 days (P = .049) and 0.44 (0.31 to 0.92) at 2 to 4 months (P = .020). Exhausted CVR of the MCA preoperatively was associated with increased risk of neurological complications during or after the procedure (P = .006).

Conclusions: CAS may improve the hemodynamic parameters and the vasomotor reactivity in the ipsilateral MCA. Exhausted CVR is associated with an increased risk of periprocedural neurologic complications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jvs.2006.07.025DOI Listing
November 2006