PMC5551290_01
This T1-weighted axial magnetic resonance imaging scan with gadolinium contrast shows a homogeneously enhancing lesion involving the posterior corpus callosum and internal capsule crossing midline. A biopsy with varioguide showed WHO grade IV glioblastoma multiforme
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F1
Magnetic resonance imaging (MRI) of the brain revealed a right frontal/posterior corpus callosal enhancing lesion involving the internal capsule and crossing the midline [Figure 1].
This T2-weighted sagittal magnetic resonance imaging scan demonstrates prominent vessels in the anterior cervical spinal cord
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F2
The subsequent cervical MRI and magnetic resonance angiogram (MRA) demonstrated a large venous varix (DAVF) at the C5-C6 level extending into the left neural foramen [Figures 2 and 3].
Injection of the left subclavian artery demonstrates a large venous varix at the C5-C6 levels within the region of the left neuroforamina. The venous drainage is into the anterior spinal vein
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F3
The subsequent cervical MRI and magnetic resonance angiogram (MRA) demonstrated a large venous varix (DAVF) at the C5-C6 level extending into the left neural foramen [Figures 2 and 3].
An ultraflow microcatheter was used to catheterize a branch of the left thyrocervical artery. Hand injection angiography shows the feeder and venous varices that were seen on the prior angiogram, which were then embolized with 0.3 mL of Onyx-34
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F4
She underwent successful complete embolization of two thyrocervical branches with direct communication to an enlarged anterior spinal artery; no residual feeders were noted [Figures 4 and 5].
In the delayed phase minimal venous drainage into the varices is present, filled from tiny collaterals too small to individually catheterize
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F5
She underwent successful complete embolization of two thyrocervical branches with direct communication to an enlarged anterior spinal artery; no residual feeders were noted [Figures 4 and 5].