Middle stenosis

McPherson CM, Woo D, Cohen PL, Panciob AM, Kissela BM, CarrozzeUa JA, Tomsick TA, ZuccareUo M. Early carotid endarterectomy for critical carotid artery stenosis after thrombolysis therapy in acute ischemic stroke in the middle cerebral artery. Stroke 2001 32 2075-2080. 

Gl Tract Esophageal web stricture or stenosis in the upper to middle third of the esophagus01 Exocrine Pancreatic insufficiency Anorexia Nausea Vomiting Diarrhea Weight loss Failure to thrive (infants and children)... 

Transcranial Doppler can determine the presence of intracranial sclerosis (e.g., middle cerebral artery stenosis). 

Fig. 5. 9a,b. Subacute wall-adherent thrombus (a). After embolic infarction of the middle cerebral artery ultrasound has identified an echolucent structure within the ICA, highly suggestive of thrombus. Tl-weighted spin echo image with fat saturation confirms an intraluminal thrombus (a) with a mild stenosis (a, b), gradually resolving over weeks... 

Wong KS, Gao S, Chan YL et al (2002) Mechanisms of acute cerebral infarctions in patients with middle cerebral artery stenosis a diffusion-weighted imaging and microemboli monitoring study. Ann Neurol 52 74-81... 

Fig. 15.2. Diffusion-weighted imaging in a 54-year-old patient with acute onset of severe left-sided hemiplegia shows a territorial infarction in the right middle cerebral artery territory, as well as additional bilateral hemodynamic lesions. Ultrasound examination in this patient showed high-grade internal carotid artery stenosis on both sides...

Fig. 15.13. A 76-year-old woman with a subtotal stenosis of the left internal carotid artery shows no sufficient collateral flow and only faint flow signal in the left middle cerebral artery (upper row), severe hypoperfusion (time-to-peak maps) of the left middle cerebral artery territory (middle row) and small acute hemodynamic stroke lesions on DWI (bottom row). The patient was later successfully treated with carotid endarterectomy...

Moyamoya syndrome (Ch. 6) causes gradual stenosis or occlusion of the terminal portions of the internal carotid arteries or middle cerebral arteries. This leads to formation of an abnormal collateral network of fragile vessels, which occasionally rupture. It has been proposed that constructing a bypass to relieve the pressure on the collaterals would be beneficial, for example between the superficial temporal artery and the middle cerebral... 

Fig 9 5 Coronary sinus venography showing stenosis at the middle part of the main vessel (left anterior oblique in precluding left ventricular (LV) lead advancement. Angioplasty balloon inflation (b). Over-the-wire implantation of the LV lead in a lateral branch of the coronary sinus (c)... 

An 8-year-old girl presented with bilateral moderate conductive hearing loss, bilateral microtia, left external auditory canal stenosis, and right external auditory canal atresia, after prenatal isotretinoin exposure. Co-morbidities included developmental delay, ventricular septal defects, hypotonia, and retinal maldevelopment. The left EAC was sharply upsloping with a 2-mm-diameter meatus. A CT scan showed normal middle and inner ears bilaterally. Serial CT scans over 6 years showed progressive development of a left canal cholesteatoma. 

Fig. ll.5a,b. Malformation. Axial (a) and coronal (b) MPR. Atresia auris congenita of middle degree-membranous atresia (star) and stenosis of the external auditory canal (EAC), hypoplasia of the tympanic cavity, reduced mastoid pneumati-... 

Fig. 40.12. Symptomatic high-grade stenosis of the middle cerebral artery. Stent angioplasty, DSA, 3D-DSA, and FD-3D-DSA. Result of angioplasty, native FD-CT showing the stent...

FIGURE 11.41 Left, Carotid bifurcation with severe stenosis at the origin of the internal carotid artery (arrow). Middle, Balloon catheter inserted in stenotic artery to enlarge the constriction. Right, After enlargement, a stent is implanted to prevent early restenosis. CCA, common carotid artery ICA, internal carotid artery ECA, external carotid artery. 

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