Vascular Lesions of the Head and Neck: Diagnosis and Intervention

Guilherme Dabus

doi:10.3174/ajnr.A3348

American Journal of Neuroradiology

The diagnosis and management of vascular lesions in the head and neck is a complex task that requires the active participation of diagnostic and interventional neuroradiologists usually inserted within a multidisciplinary team. It is because of the importance and active role of our specialty in the successful management of these patients that we decided to compile this “Special Collection” bibliography of the American Journal of Neuroradiology articles related to the diagnosis and interventional management of head and neck vascular lesions. This collection is organized in 4 major sections:

Section 1: Vascular anomalies including hemangioma (vascular tumor), high-flow vascular malformations (AVM and AVF), and low-flow vascular malformations (venous and lymphatic)

Section 2: Tumors (excluding hemangiomas) which include the highly vascularized tumors in the head and neck area, predominantly paragangliomas and juvenile nasoangiofibromas

Section 3: Carotid Blowout Syndrome as a complication of advanced head and neck cancer associated with radiation therapy, resulting in life-threatening hemorrhage

Section 4: In this last section we have miscellaneous articles that are important to the practitioners of this field, including an article on functional angiographic anatomy in the head and neck and a couple of articles on epistaxis.

Each section was chosen because the role of the neuroradiologist in these cases is unequivocal in managing the diagnostic imaging as well as providing interventional treatment pertinent to each case. The articles selected show different management strategies, the association with intracranial abnormalities, and discussion on embryology, anatomy, and imaging characterization. Looking at the list of topics above, it is easy to assume that no large clinical trials or articles containing level 1 evidence of interventional treatment of such lesions will be available. Most of the articles in this collection are case series and reports of single-center experiences; nonetheless these types of papers continue to have a fundamental role in medical literature and practice. Therefore we selected manuscripts that, to our perception, would be most valuable as a reference, helping the difficult decision-making process of diagnosis and management of these lesions. We tried to give a broad view of all the possible treatment techniques and agents available when the interventional treatment was the main focus of the manuscript. In the same way, when selecting these manuscripts, there was an effort to give a balanced and fair opportunity for articles where the main focus was neuroimaging (diagnostic) and neurointervention. Probably because of the nature of the topic, the reader will notice that there is definitely a trend toward interventional papers. I would like to apologize to any authors who felt that their papers should be included in this collection. This was a good faith effort.

I would like to thank Dr. Mauricio Castillo, Editor-in-Chief of the American Journal of Neuroradiology, for giving me this tremendous opportunity to compile the special collection on diagnosis and interventional treatment of vascular lesions of the head and neck. It was truly a pleasure and I really hope you enjoy going through these articles as much as I did.