Basal ganglia haemorrhage is a common form of intracerebral haemorrhage, and usually as a result of poorly controlled long-standing hypertension. The stigmata of chronic hypertensive encephalopathy are often present (see cerebral microhaemorrhages).
Other sites of hypertensive haemorrhages are ...
Basilar artery hypoplasia is a rare vascular anomaly of the basilar artery.
Basilar artery hypoplasia is usually accompanied by one or more fo the following:
persistent carotid-vertebrobasilar anastomoses
hypoplastic V4 segments of the vertebral arteries
Blunt cerebrovascular injury (BCVI) is an uncommon but serious consequence of blunt trauma to the head and neck.
It is often part of multi-trauma with a significant series of blunt trauma CTA reporting an incidence of approximately 1% 3. A large systematic review and meta-analysis...
Brachiocephalic trunk pseudoaneurysms are rare.
The brachiocephalic trunk is the second most common site of chest vascular injury. Pseudoaneurysms can measure up to 4-5 cm in length with a diameter of 1.2 cm.
Most common causes are traumatic or iatrogenic injuries.
Treatment and ...
Breast aneurysms are a rarely seen cause of a breast mass.
true aneurysm: occurs post trauma and is seen as a slowly enlarging pulsatile mass
false aneurysm / pseudoaneurysm: occurs in acute trauma, post percutaneous biopsy, due to spontaneous haemorrhage secondary to coagulo...
Breast varix is, as the name suggests, varices in the breast that are focally dilated veins in the breast.
If varices are seen bilaterally then a cause for central venous obstruction (superior vena cava syndrome) could be the underlying aetiology with the varices being a part of the...
Bronchial arterial aneurysm refers to any form of aneurysmal dilatation involving any segment of the bronchial artery. The term is sometimes used synonymously with a bronchial arterial pseudoaneurysm 2.
They are a rare entity and are reported in <1% of those who undergo selective ...
Buerger disease, also known as thromboangiitis obliterans, is non-necrotising arteritis found predominantly in young male smokers.
Patients may initially present with nonspecific symptoms such as hand and foot claudication, which eventually progresses to ischaemic ulcerat...
Calciphylaxis, or calcific ureamic arteriolopathy, is a rare condition which manifests as subcutaneous vascular calcification and cutaneous necrosis (small blood vessels of the fat tissue and the skin). Some authors describe as a syndrome of vascular calcification, thrombosis and skin necrosis.
Cardiac myxomas, although uncommon are one of the commonest primary cardiac tumours and account for ~50% primary benign cardiac tumours.
Cardiac myxomas are the most common primary cardiac tumour in adults but are relatively infrequent in childhood, where cardiac rhabdomyomas are...
Cardiac venous malformations (also known as cardiac haemangiomas) consists of a slow flow venous malformation and is composed of numerous non-neoplastic endothelial-lined thin-walled channels with interspersed fat and fibrous septae.
It is important to note that according to newer ...
Carotid artery stenosis also referred as extracranial carotid artery stenosis, is usually caused by an atherosclerotic process and is one of the major causes of stroke and transient ischemic attack (TIA) 1.
This article refers to stenosis involving carotid bulb and the proximal segment of inte...
Celiac artery dissection is a type of arterial dissection. It is rarely seen as a primary phenomenon and is most often encountered due to propagation of an aortic dissection.
Celiac artery dissection is usually iatrogenic but may also be secondary to:
Central nervous system (CNS) vasculitides represent a heterogeneous group of inflammatory diseases affecting the walls of blood vessels in the brain, spinal cord, and the meninges.
Please refer to the article on vasculitis for a general discussion of that entity.
The aim of this article will ...
Cerebral arteriovenous malformations (CAVMs), also known as classic brain AVMs, are a common form of cerebral vascular malformation and are composed of a nidus of vessels through which arteriovenous shunting occurs.
This article corresponds to the classic form of arteriovenous malf...
Cerebral proliferative angiopathy (CPA), previously known as diffuse nidus type AVM, is a cerebral vascular malformation separated from classic brain AVM and characterised by the presence of normal brain parenchyma interspersed throughout the tangle of vessels that corresponds to the nidus 1,2.
Cervical aortic arch is a rare aortic arch anomaly characterised by an elongated, high-lying aortic arch extending at or above the level of the medial ends of the clavicles.
Patients with cervical aortic arch are usually asymptomatic. Symptomatic patients may present with...
Chronic mesenteric ischaemia is an uncommon type of intestinal ischaemia usually affecting elderly patients as a result of significant stenosis of two or more mesenteric arteries.
Normally seen in patients older than 60 years of age and is three times more common in women.
Chronic periaortitis is an inflammatory condition which typically involves the infrarenal portion of the abdominal aorta. It is a rare disease usually occuring in middle-aged men.
It has various clinical presentations:
idiopathic retroperitoneal fibrosis (IRF)
perianeurysmal retroperitoneal f...
Chronic pulmonary emboli are mainly a consequence of incomplete resolution of pulmonary thromboembolism.
vascular CT signs include
direct pulmonary artery signs
calcified thrombus - calcific pulmonary ...
Cirsoid aneurysms are rare arteriovenous malformations of the scalp and extremities.
Patients often present with a slow-growing pulsatile mass and may also experience bleeding, tinnitus and/or a headache 3.
Cirsoid aneurysms develop due to an abnormal arteri...
CNS capillary telangiectasiae(s) are small, asymptomatic low flow vascular lesions of the brain.
As these lesions are asymptomatic, diagnosis usually matches the age of first imaging with MRI, and as such are most frequently found in middle-aged and elderly adults. Their incidenc...
Congenitally corrected transposition of the great arteries, also known as levo- or L-loop transposition (L-TGA), is a rare cardiovascular anomaly with inversion of the ventricles and great arteries.
This anomaly comprises less than 1% of all congenital heart diseases 1,2,7.
Congenital portosystemic shunts are rare anatomical abnormalities linked to abnormal embryological venous development. They can be extrahepatic or intrahepatic. In either case, the underlying abnormality is shunting of blood from the portal venous system to the systemic venous system thus avoid...
Constrictive pericarditis (or perhaps better termed pericardial constriction) is a type of pericarditis which leads to diastolic dysfunction and potentially symptoms of right heart failure.
No single demographic is affected as there are numerous causes of constrictive pericarditi...
Coral reef aorta (CRA) is a rare disease, described as hard calcifications involving the arterial wall which protrude into the lumen. It predominantly involves the posterior thoracic and abdominal aorta. CRA luminal lesions can cause significant aortic stenosis.
Patients usually p...
Coronary artery aneurysms (CAA's) are an uncommon, predominantly incidental finding.
CAA is most common in men 3, likely reflecting the increased rates of atherosclerosis in men compared to women. Prevalence varies in the literature between 0.1-5% 4.
Coronary artery disease (CAD) is the leading cause of mortality globally.
CAD is asymptomatic in most of the population. When severe enough it can cause angina, or an acute coronary syndrome including myocardial infarction. CAD may also present with heart failure or sudd...
Microvascular obstruction (MVO), also known as no reflow phenomenon, is an established complication encountered in coronary angioplasty for prolonged acute myocardial infarction.
The phenomenon results from obstruction of the myocardial microcirculation, which is composed of vessel...
Cortical vein thrombosis, also known as superficial cerebral vein thrombosis, is a subset of cerebral venous thrombosis involving the superficial cerebral veins besides the dural sinus, often coexisting with deep cerebral vein thrombosis or dural venous sinus thrombosis. It has different clinica...
Cryoglobulinaemic vasculitis (CV) is a form of immune mediated primary vasculitis involving small to medium sized vessels. It may involve multiple organs and can have a range of clinical presentations.
There are three main types of cryoglobulinaemia which are grouped, as per the Br...
Cystic adventitial disease (CAD) is an uncommon vascular pathology predominantly affecting peripheral vessels. The vast majority of cases occur in arteries with venous involvement being an even extremely rare occurrence 8.
It typically affects young to middle-aged individuals with...
Cystic hygroma, also known as cystic or nuchal lymphangioma, refers to the cystic variety of congenital lymphangioma which, most commonly, occur in the cervicofacial regions, particularly at the posterior cervical triangle.
They usually occur in the fetal/infantile and paediatri...
Atrial situs refers to the relative position of cardiac atria in relation to abdominal viscera and the midline.
Identification of atrial situs is an important initial step in the antenatal and postnatal diagnosis of cardiac structural and situs anomalies.
Double outlet right ventricle (DORV) is a congenital cardiac anomaly where both the aorta and pulmonary trunk arise from the morphologically right ventricle. It is reported to account for ~2% of congenital cardiac defects 1. It is usually classed as a conotruncal anomaly. There is almost always ...
Dural sinus occlusive disease (DSOD) is an infective form of dural sinus thrombosis (thrombophlebitis) commonly seen in the setting of acute otomastoiditis. It typically presents with:
sixth nerve palsy - due to involvement of Dorello's canal
altered conscious st...
Dysphagia lusoria is an impairment of swallowing due to compression from an aberrant right subclavian artery (arteria lusoria).
Most patients with aberrant right subclavian arteries do not have symptoms. Some present with mild dysphagia, while a small minority have a seve...
Epithelioid haemangioendothelioma (EHE) is a rare relatively low grade vascular tumour. It occurs around medium to large venous structures.
It consists of rounded or slightly spindle-shaped eosinophilic endothelial (epitheloid) cells with rounded nuclei and prominent cytoplasmic vacu...
Femoral artery pseudoaneurysms are usually iatrogenic as the femoral artery is the vessel of choice for most endovascular arterial interventions.
inadequate compression following endovascular intervention
improper arterial puncture tec...
Giant cerebral aneurysms are ones that measure >25 mm in greatest dimension.
Giant cerebral aneurysms account for ~5% of all intracranial aneurysms 1,3. They occur in the 5th-7th decades and are more common in females 2.
Patients can present with symptoms ...
Haemangiopericytoma is a term formerly used to describe a continuum of mesenchymal tumours with elevated cellularity found throughout the body in soft tissue and bone. After many years of controversy, haemangiopericytomas have been shown to not only share histological features similar to solitar...
Haemangiopericytomas of the spleen are very rare vascular neoplasma with only a few case reports available at the time of writing.
Splenic haemangiopericytomas are typically asymptomatic or can result in splenomegaly.
These are soft tissue vascular neoplasms a...
Haemosuccus pancreaticus, also known as pseudohaemobilia or haemoductal pancreatitis, is defined as upper gastrointestinal tract haemorrhage originating from the pancreatic duct into the duodenum via the ampulla of Vater, or major pancreatic papilla.
male:female ratio is 7:1
Hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), is a condition arising from occlusion of hepatic venules.
right upper quadrant pain
abnormal liver function tests
Toxic injury to liver s...
Hereditary haemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare inherited disorder characterised by abnormal blood vessel formation in the skin, mucous membranes, and organs including the lungs, liver, and central nervous system.
Idiopathic dilatation of the pulmonary trunk is a rare congenital anomaly comprising of pulmonary trunk enlargement with or without dilatation of the right and left pulmonary arteries.
For this diagnosis, exclusion of pulmonary and cardiac diseases (mainly pulmonary valve stenosis) and confirma...
Idiopathic portal hypertension (noncirrhotic portal hypertension or Banti syndrome) is a term that has been given to portal hypertension occurring without hepatic cirrhosis, parasitic infection, or portal venous thrombosis.
Rare condition. More common in India and Japan.
Idiopathic retroperitoneal fibrosis (IRF) is a subtype of retroperitoneal fibrosis where no obvious cause is found. It includes a spectrum of diseases which are characterized by fibroinflammatory tissue encasing the abdominal aorta and the iliac arteries. This process may extend into the retrope...
Iliofemoral deep vein thrombosis occurs when a thrombus in the iliac vein (common, external or internal) or common femoral vein obstructs the venous outflow from the lower limb leading to marked oedema.
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Incomplete double aortic arch is a rare vascular ring anomaly wherein a segment of the minor aortic arch, usually the left, is atretic.
As in the case of other vascular rings, this anomaly can cause 1:
Some patients may reach adulthood with...
Inferior mesenteric artery aneurysms are among the rarest of all visceral artery aneurysms.
Aneurysms of the inferior mesenteric artery (IMA) only account for <1% of all visceral artery aneurysms 1,2. These aneurysms are more common in men than in women 3.
Inferior vena caval (IVC) thrombosis is an essential diagnosis while evaluating any neoplastic lesion, or portal hypertension. It is also important to differentiate bland thrombus from tumour thrombus.
Patient can present with many features which include
bilateral pedal oede...
Inferior vena cava (IVC) webs are an uncommon condition characterised by obstruction of the hepatic segment of the inferior vena cava by a membrane or fibrous band. This is often associated with occlusion of one or more of the hepatic veins.
If there is hepatic vein invol...
Inflammatory abdominal aortic aneurysm (IAAA) is a variant of abdominal aortic aneurysm (AAA) characterised by inflammatory thickening of the aneurysm wall, perianeurysmal fibrosis and adherence to surrounding structures.
They account for ~5 to 10% of all AAAs.
The inter-arterial course of the left coronary artery, also known as the malignant course of the left coronary artery, is defined as the origin of the left main or left anterior descending coronary artery from the right coronary sinus of Valsalva with a course between the ascending aorta and the...
Ischaemic stroke results from a sudden cessation of adequate amounts of blood reaching parts of the brain. Ischaemic strokes can be divided according to territory affected or mechanism.
Stroke is the second most common cause of morbidity worldwide (after myocardial infarction) and...
Isolated periaortitis is a non-aneurysmal form of chronic periaortitis.
Periaortitis may be a local immune response to antigens like oxidized-low density lipoproteins and ceroid found in the atherosclerotic plaques of the abdominal aorta. The disease tends primarily to involve the va...
Kawasaki disease (KD) is a small to medium vessel vasculitis predominantly affecting young children. It can affect any body organ but there is a predilection for the coronary vessels.
An autoimmune aetiology has been postulated. It is generally self limiting but acute fatalities are ...
Klippel-Trénaunay-Weber syndrome (KTWS) is a syndrome combination of capillary malformations, soft-tissue or bone hypertrophy, and varicose veins or venous malformations. It is considered an angio-osteo-hypertrophic syndrome.
KTS classically comprises a triad of:
port wine nevi
bony or soft t...
Left ventricular pseudoaneurysms are false aneurysms that result from contained myocardial rupture, and are a rare complication of a myocardial infarction (MI). They should not be confused with left ventricular aneurysms, which are true aneurysms containing all the layers (endocardium, myocardiu...
Leiomyosarcomas (LMS) are extremely rare malignant neoplasms that originate from smooth muscle cells and may be considered the malignant counterpart of a leiomyoma. They are classified as a soft tissue tumour and account for ~8% of malignant soft tissue tumours 10.
Lipomatous hypertrophy of the interatrial septum (LHIS) is a relatively uncommon disorder of the heart characterised by benign fatty infiltration of the interatrial septum. It is commonly found in elderly and obese patients as an asymptomatic incidentally discovered finding.
Liquefactive necrosis is a form of necrosis where there is transformation of the tissue into a liquid viscous mass.
In liquefactive necrosis, the affected cell is completely digested by hydrolytic enzymes leading to a soft, circumscribed lesion which can consist of fluid with remains...
Luetic aneurysms (also called syphilitic aneurysms) are a type of aneurysm occurring usually secondary to syphilitic aortitis.
For a general discussion, and for links to other system specific manifestations, please refer to the article on syphilis.
The responsible organism is a sp...
Lymphangiomas are benign lesions of vascular origin that show lymphatic differentiation. It is considered the lymphatic equivalent of a haemangioma of blood vessels.
This article focuses the general features of lymphangiomas. For a specific discussion in other locations, please refer to the ar...
Major aortopulmonary collateral arteries (MAPCAs) are persistent tortuous fetal arteries that arise from the descending aorta and supply blood to pulmonary arteries in the lungs usually at the posterior aspect of hilum.
Embryologically, the intersegmental arteries regress with the no...
Malignant vascular tumours rare, accounting for <1% of all sarcomas.
Moyamoya disease is an idiopathic, non inflammatory, non atherosclerotic progressive vasculo-occlusive disease involving the circle of Willis, typically the supraclinoid internal carotid arteries.
The term moyamoya disease should be reserved for an idiopathic, sometimes familial, ...
Musculoskeletal haemangiopericytomas are now considered to be a cellular and more aggressive version of solitary fibrous tumours, and the term has largely been abandoned.
These tumours are most frequently seen in middle-aged adults (~ 4th decade).
Mycotic aneurysms are aneurysms arising from infection of the arterial wall, usually bacterial. It is a complication of the haematogenous spread of bacterial infection, classically from the heart.
The epidemiology of mycotic aneurysms mirrors that of identifiable risk factors:
Non-AIDS associated Kaposi's sarcoma is a localized process which rarely involves lymph nodes or organs.
For a discussion of Kaposi sarcoma in general, please refer to Kaposi sarcoma.
Sporadic (non-AIDS associated) Kaposi sarcoma is mostly seen in elderly males from Mediterran...
Partial anomalous pulmonary venous return (PAPVR), also known as partial anomalous pulmonary venous connection (PAPVC), is a rare congenital cardiovascular condition in which some of the pulmonary veins, but not all, drain into the systemic circulation rather than in the left atrium.
Penetrating atherosclerotic ulcers (PAU) is a pathology that involves the aortic wall and along with aortic dissection and aortic intramural haematoma from the spectrum known as acute aortic syndrome.
Typically, penetrating atherosclerotic ulcers are seen in older male patients w...
Peri-aneurysmal retroperitoneal fibrosis is a subtype of a spectrum of retroperitoneal fibrosis. It is characterised by association with an inflammatory aneurysm, adventitial and peri-adventitial inflammation, medial thinning and chronic retroperitoneal inflammatory process which is associated w...
Peripheral arterial disease is a common and debilitating condition.
The age-adjusted prevalence of peripheral arterial disease is ~12% 3.
Atherosclerosis is the leading cause of occlusive arterial disease of the extremities in patients over 40 years of age with the hig...
A persistent right umbilical vein (PRUV) is an uncommon vascular anomaly which is often detected in utero.
The estimated prevalence is at ~2 per 1000 births 1-2.
In the normal situation, the right umbilical vein begins to obliterate in the ~4th week of gestation and di...
Polyarteritis nodosa (PAN) is a systemic inflammatory necrotising vasculitis that involves small to medium sized arteries (larger than arterioles).
Polyarteritis nodosa (PAN) is commoner in males and typically presents around the 5th to 7th decades. Twenty to thirty percent of p...
Popliteal artery aneurysms are the most common peripheral arterial aneurysm and the second most common aneurysm after abdominal aortic aneurysms.
Overall these are uncommon. There is an increased incidence with age and a strong male preponderance (M:F ratio 10 to 30:1),
Posterior cerebral artery (PCA) infarcts arise, as the name says, from occlusion of the posterior cerebral artery. It is a type of posterior circulation infarction.
Symptoms include contralateral homonymous hemianopia and quadrantic visual field defects. Because the PCA s...
Pseudocoarctation of the aorta is a very rare anomaly characterised by kinking or buckling of the descending aorta at the level of the ligamentum arteriosum without a pressure gradient across the lesion.
It is thought to be of congenital origin, and characterised by elongation and ki...
Pseudoxanthoma elasticum (PXE), also known as Grönblad–Strandberg syndrome is a systemic condition charaterised by degeneration of elastic fibers. It has multi-organ manifestations.
Its prevalence is estimated to be around 1 in 25,000 9.
Patients may prese...
Pulmonary arterial aneurysms (PAA's) refer a focal dilatation of the pulmonary arterial system.
Overall it is considered a rare entity with autopsy prevalence rates of around 1 in 14,000 to 100,000 4-5.
A true pulmonary artery aneurysm results from dilatation of all th...
Pulmonary artery atresia (or sometimes known as pulmonary atresia) is one of congenital cardiovascular anomaly in which there is complete disruption between the right ventricular outflow tract (RVOT) and the pulmonary trunk.
The estimated incidence is 1 in 10,000 births.
Pulmonary artery sarcomas are extremely rare tumours that originate from the intimal mesenchymal cells of the pulmonary artery. It is frequently misdiagnosed as pulmonary thromboembolism.
Primary malignant tumours of the pulmonary arteries are very rare with an incidence of 0.00...
Pulmonary embolism (PE) refers to embolic occlusion of the pulmonary arterial system. The majority of cases result from thrombotic occlusion, and therefore the condition is frequently termed pulmonary thromboembolism which is what this article mainly covers.
Other embolic sources include:
Pulmonary gas emboli are a specific type of pulmonary emboli.
Presentation can vary dependant on the degree of air emboli where patients with small amount of air can be asymptomatic. Commonly reported clinical manifestations include sudden dyspnoea, chest pain, hypotensi...
Pulmonary hypertension is defined as a resting mean pulmonary arterial pressure of 25 mmHg or greater at right heart catheterisation, which is a haemodynamic feature that is shared by all types of pulmonary hypertension in the Dana Point classification system. A resting mean pulmonary arterial p...
Pulmonary vein atresia represents a spectrum of disorder where the pulmonary veins fail to form in varying degrees.
It can be broadly divided into
unilateral pulmonary vein atresia
bilateral pulmonary vein atresia - common pulmonary vein atresia
anomalous pulmonary venous drainage...
Pulmonary vein stenosis refers to a spectrum of condition characterised by narrowing to the pulmonary veins. It can be congenital or acquired.
primary pulmonary vein stenosis - occurs in children
secondary pulmonary vein stenosis - occurs in adults and usually associated with some identifiable...
Pulmonary vein thrombosis is a rare but potentially serious condition with a number of underlying possible aetiologies.
Often the signs and symptoms are nonspecific and can range from acute (pulmonary infarction) to more insidious (progressive or recurrent pulmonary oedem...
Raynaud phenomenon (RP) describes a localised vasculopathy whereby there is an exaggerated vascular response to cold temperature or emotional stresses.
Raynaud phenomenon is classified as being either 'primary' or idiopathic, or 'secondary' to another underlying condition (as discu...
Renal arterial cut-off sign as the name suggests is an abrupt termination of the vascular contrast opacified renal arterial lumen. It may be associated with or without any contrast extravasation
It is seen in a vascular injury like segmental or main renal artery thrombosis or occlusion.
Renal arteriovenous fistulae (AVFs) are anomalous direct communications between arteries and veins in the kidney, which may be confused with a renal arteriovenous malformation (AVM).
The incidence of renal AVF is variable, estimated at 0.3-19% in native kidneys and 6-8% in ren...