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https://www.readbyqxmd.com/read/28195506/the-use-of-diffusion-weighted-imaging-to-evaluate-pathology-outside-the-brain-parenchyma-in-neuroimaging-studies
#1
Philip Benjamin, Faraan Khan, Andrew D MacKinnon
Diffusion weighted imaging (DWI) has transformed the radiological assessment of a variety of cerebral pathologies, in particular acute stroke. In neuroimaging studies, DWI can also be used to evaluate pathology outside the brain parenchyma, although it is sometimes underutilised for this purpose. In this pictorial review, the principles of diffusion-weighted imaging are outlined and thirteen cases of abnormal diffusion outside the brain parenchyma are illustrated in order to show DWI as a useful sequence for the evaluation of the following recommended review areas: the dural venous sinuses, internal carotid arteries, meninges, ventricles, cavernous sinus and orbits, skull base, and lymph nodes...
February 14, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28191380/transorbital-approach-for-endovascular-occlusion-of-carotid-cavernous-fistulas-technical-note-and-review-of-the-literature
#2
Ching-Jen Chen, Panagiotis Mastorakos, James P Caruso, Dale Ding, Paul J Schmitt, Thomas J Buell, Daniel M Raper, Avery Evans, Steven A Newman, Mary E Jensen
Carotid-cavernous fistulas (CCFs) pose an anatomically and physiologically challenging problem for clinicians. The most common method of treatment for these lesions is transvenous endovascular embolization via the inferior petrosal sinus or the facial vein. When transvenous access is not possible, an alternate approach must be devised. We describe a case example with bilateral Barrow Type B CCFs, which were inaccessible using the traditional transvenous approach. Hence, a direct transorbital approach, performed under fluoroscopic guidance, was employed to successfully obliterate the CCF...
January 12, 2017: Curēus
https://www.readbyqxmd.com/read/28187920/holter-electrocardiogram-monitoring-in-patients-with-acute-ischaemic-stroke-find-afrandomised-an-open-label-randomised-controlled-trial
#3
Rolf Wachter, Klaus Gröschel, Götz Gelbrich, Gerhard F Hamann, Pawel Kermer, Jan Liman, Joachim Seegers, Katrin Wasser, Anna Schulte, Falko Jürries, Anna Messerschmid, Nico Behnke, Sonja Gröschel, Timo Uphaus, Anne Grings, Tugba Ibis, Sven Klimpe, Michaela Wagner-Heck, Magdalena Arnold, Evgeny Protsenko, Peter U Heuschmann, David Conen, Mark Weber-Krüger
BACKGROUND: Atrial fibrillation is a major risk factor for recurrent ischaemic stroke, but often remains undiagnosed in patients who have had an acute ischaemic stroke. Enhanced and prolonged Holter-electrocardiogram-monitoring might increase detection of atrial fibrillation. We therefore investigated whether enhanced and prolonged rhythm monitoring was better for detection of atrial fibrillation than standard care procedures in patients with acute ischaemic stroke. METHODS: Find-AFRANDOMISED is an open-label randomised study done at four centres in Germany...
February 7, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28184348/refractory-spontaneous-chronic-subdural-hematoma-a-rare-presentation-of-an-intracranial-arteriovenous-fistula
#4
El Kim
The author has encountered a 67-year-old man with dural arteriovenous fistula (AVF) presenting as a non-traumatic chronic subdural hematoma (CSDH). This previously healthy patient was hospitalized due to progressive headache with subacute onset. He underwent burr-hole surgery twice for evacuating the left CSDH that was thickest at the posterior temporal area. The operative procedure and finding was not extraordinary, but subdural hematoma slowly progressed for days following the revision surgery. After investigation by super-selective external carotid angiography, a dural AVF found near the transverse-sigmoid sinus was diagnosed...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28180047/the-pedicled-buccal-fat-pad-anatomical-study-of-the-new-flap-for-skull-base-defect-reconstruction-after-endoscopic-endonasal-transpterygoid-surgery
#5
Denis A Golbin, Nikolay V Lasunin, Vasily A Cherekaev, Georgiy A Polev
Objectives To evaluate the efficacy and safety of using a buccal fat pad for endoscopic skull base defect reconstruction. Design Descriptive anatomical study with an illustrative case presentation. Setting Anatomical study was performed on 12 fresh human cadaver specimens with injected arteries (24 sides). Internal carotid artery was exposed in the coronal plane via the endoscopic transpterygoid approach. The pedicled buccal fat pad was used for reconstruction. Participants: 12 human cadaver head specimens; one patient operated using the proposed technique...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28163497/successful-endovascular-neurosurgical-practice-in-resource-poor-exclusive-rural-neuro-hospital-setup
#6
Kamble Jayaprakash Harsha
AIM: The aim of this study to evaluate the feasibility of establishing endovascular neurosurgery in remote resource-poor neuro-hospital setup and evaluate its outcome. MATERIALS AND METHODS: Retrospective analysis of diagnostic and therapeutic endovascular neurosurgical procedures performed during September 2013-June 2016. RESULTS: A total of 174 diagnostic cerebral and spinal digital subtraction angiograms and 70 major endovascular neurosurgeries were performed during the period...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28127130/endovascular-therapy-using-flow-diversion-for-giant-internal-carotid-artery-pseudoaneurysm-arising-in-the-setting-of-an-invasive-pituitary-macroadenoma
#7
Amin F Saad, Almas Syed, Keyan B Marashi, Brian D O'Rourke, Joseph H Hise, Michael J Opatowsky, Kennith F Layton
This report illustrates the unusual occurrence of a pseudoaneurysm arising in the setting of a skull base mass and describes the first reported use of endovascular flow diversion therapy in such a setting. A 63-year-old man with occasional headaches during the preceding month presented with the acute onset of severe left retroorbital headache and oculomotor nerve palsy. Computed tomography (CT) and CT angiogram revealed a destructive skull base mass with an associated giant probable pseudoaneurysm of the cavernous segment of the left internal carotid artery...
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28114856/a-novel-technique-to-reduce-contrast-exposure-during-subclavian-interventions
#8
Saurabh Sanon, Gregory W Barsness, Rajiv Gulati
We describe a novel technique to minimize total body contrast exposure during endovascular angiography. A patient with severe renal impairment and history of contrast-induced nephropathy was referred for subclavian artery intervention. Angiography and intervention was performed via transfemoral access, while a transradial sheathless-guiding catheter was used to aspirate injected contrast/blood mix from the downstream axillary artery. Semiquantitative analysis indicated approximately 50% of the injected contrast was retrieved...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28111701/thrombosis-of-venous-outflows-of-the-cavernous-sinus-possible-aetiology-of-the-cortical-venous-reflux-in-case-of-indirect-carotid-cavernous-fistulas
#9
Thomas Robert, Philippe Sylvestre, Raphaël Blanc, Daniele Botta, Gabriele Ciccio, Stanislas Smajda, Hocine Redjem, Michel Piotin
BACKGROUND: The presence of a cortical venous reflux (CVR) in a carotid-cavernous fistula (CCF) is well described and is considered to be a criterion for urgent treatment. This reflux is often associated with direct/traumatic CCF and the high-flow of the fistula alone explains the reflux. For indirect CCF, the pathophysiology of a CVR is unclear. METHODS: All patients treated endovascularly for an indirect CCF with a cortical venous reflux between 2003 and 2015 were included...
January 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28093349/combining-internal-carotid-ligation-with-low-flow-bypass-for-treating-large-giant-cavernous-sinus-segment-aneurysms-a-report-of-four-cases
#10
Chuan Chen, Bo Hou, Wen-Shen Li, Ying Guo
OBJECTIVE: We summarize the treatment effectiveness and experience of four cases that underwent internal carotid ligation combined with low-flow bypass as a treatment for large-giant cavernous sinus segment aneurysms (CS ICA aneurysms). METHOD: Surgery-suitable patients with large-giant CS ICA aneurysms received internal carotid ligation combined with low-flow superficial temporal artery - middle cerebral artery bypass surgery. All the patients were followed up for aneurysm prognosis, anastomosis patency, and occurrences of low flow-related ischemic complications...
January 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28061497/cerebellar-hemorrhage-due-to-a-direct-carotid-cavernous-fistula-after-surgery-for-maxillary-cancer
#11
Yoshinobu Kamio, Hisaya Hiramatsu, Mika Kamiya, Shuhei Yamashita, Hiroki Namba
Infratentorial cerebral hemorrhage due to a direct carotid-cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS)...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28003168/endoscopic-endonasal-surgery-for-remission-of-cushing-disease-caused-by-ectopic-intracavernous-macroadenoma-case-report-and-literature-review
#12
Maria Koutourousiou, Welby I Winstead
BACKGROUND: Complete surgical resection of an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma is the gold standard of treatment of Cushing disease. Ectopic location of these adenomas is an extremely rare condition that may compromise the diagnosis and surgical success. We present the first case of an ectopic intracavernous ACTH-secreting macroadenoma totally resected with endoscopic endonasal surgery (EES). CASE DESCRIPTION: A 36-year-old woman presented with Cushing syndrome...
December 18, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27995807/optimal-scan-timing-for-artery-vein-separation-at-whole-brain-ct-angiography-using-a-320-row-mdct-volume-scanner
#13
Takashi Shirasaka, Akio Hiwatashi, Koji Yamashita, Masatoshi Kondo, Hiroshi Hamasaki, Yamato Shimomiya, Yasuhiko Nakamura, Yoshinori Funama, Hiroshi Honda
OBJECTIVE: A 320-row multidetector CT (MDCT) is expected for a good artery-vein separation in terms of temporal resolution. However, a shortened scan duration may lead to insufficient vascular enhancement. We assessed the optimal scan timing for the artery-vein separation at whole-brain CT angiography (CTA) when bolus tracking was used at 320-row MDCT. METHODS: We analyzed 60 patients, who underwent whole-brain four-dimensional CTA. Difference in CT attenuation between the internal carotid artery (ICA) and the superior sagittal sinus (Datt) was calculated in each phase...
February 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/27974431/bet-2-ice-water-immersion-other-vagal-manoeuvres-or-adenosine-for-svt-in-children
#14
REVIEW
Marion Campbell, Silvia Ruiz Buitrago
A short cut review was carried out to establish whether a vagal manoeuvre was better than or as good as adenosine at safely terminating supraventricular tachycardia in children. Forty unique papers were found in Medline and Embase using the reported searches, of which five were relevant. A hand search of the forty unique citations identified a further nine relevant papers. Thus, 14 papers presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated...
January 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27920936/steroid-resistant-tolosa-hunt-syndrome-with-a-de-novo-intracavernous-aneurysm-a-case-report
#15
Hiroshi Takasuna, Rie Sasaki, Makoto Shiraishi, Masatomo Doi, Daisuke Wakui, Hidemichi Ito, Kotaro Oshio, Yuichiro Tanaka
BACKGROUND: We report a case of steroid-resistant Tolosa-Hunt syndrome (THS) with recurrent bilateral painful ophthalmoplegia, accompanied with sphenoid sinusitis, pituitary abscess, and an aneurysm arising from the cavernous portion of the internal carotid artery. CASE DESCRIPTION: A 53-year-old woman suffered severe left painful ophthalmoplegia. A magnetic resonance image (MRI) revealed thickness of the left cavernous sinus (CS). Steroid was administrated under the diagnosis of THS, and the symptom transiently diminished...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27916722/unique-diagnostic-features-and-surgical-strategy-for-intracranial-carotid-sympathetic-plexus-schwannoma-case-report-and-literature-review
#16
Hajime Takase, Kohta Araki, Shunsuke Seki, Kana Takase, Hidetoshi Murata, Nobutaka Kawahara
BACKGROUND: Intracranial carotid sympathetic plexus schwannoma (CSPS) is extremely rare; thus differential diagnostic criteria, optimal surgical strategies, and even a precise definition are lacking. Here we describe a case of CSPS and propose a definition and classification for previously reported cases. CASE DESCRIPTION: A 54-year-old man presented with hypacusis and abducens nerve palsy. Radiologic examinations revealed a well-enhanced mass at the right medial temporal base with erosion of the petrous apex and intact perilesional cortical bone...
December 1, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27890105/use-of-postmortem-computed-tomography-angiography-to-detect-vascular-injuries-accompanying-skull-base-fracture
#17
Hikaru Kuninaka, Yoichiro Takahashi, Rie Sano, Keiko Takahashi, Rieko Kubo, Yoshihiko Kominato, Hiroyuki Takei, Susumu Kobayashi, Takehiro Shimada, Hiroyuki Tokue, Sachiko Awata, Satoshi Hirasawa
A 58-year-old woman who had presented for upper gastrointestinal barium examination accidently slipped from the movable bed, and her head became compressed between the end of the bed and the side wall. She suffered massive bleeding from her nose and ear followed by cardiac arrest, and subsequent attempts at cardiopulmonary resuscitation failed. A medicolegal autopsy was performed to reveal the cause of death, as part of the investigation of the accident. During the autopsy, postmortem cerebral CT angiography was carried out by injection of 5% gelatin-barium emulsion as a radiopaque contrast medium into the bilateral common carotid arteries, demonstrating transudation of the contrast medium into the right acoustic meatus and the sphenoidal sinus cavity...
November 2016: Legal Medicine
https://www.readbyqxmd.com/read/27879599/total-human-eye-allotransplantation-developing-surgical-protocols-for-donor-and-recipient-procedures
#18
Edward H Davidson, Eric W Wang, Jenny Y Yu, Juan C Fernandez-Miranda, Dawn J Wang, Nikisha Richards, Maxine Miller, Joel S Schuman, Kia M Washington
BACKGROUND: Vascularized composite allotransplantation of the eye is an appealing, novel method for reconstruction of the nonfunctioning eye. The authors' group has established the first orthotopic model for eye transplantation in the rat. With advancements in immunomodulation strategies together with new therapies in neuroregeneration, parallel development of human surgical protocols is vital for ensuring momentum toward eye transplantation in actual patients. METHODS: Cadaveric donor tissue harvest (n = 8) was performed with orbital exenteration, combined open craniotomy, and endonasal approach to ligate the ophthalmic artery with a cuff of paraclival internal carotid artery, for transection of the optic nerve at the optic chiasm and transection of cranial nerves III to VI and the superior ophthalmic vein at the cavernous sinus...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27861945/rapid-hemostasis-in-a-sheep-model-using-particles-that-propel-thrombin-and-tranexamic-acid
#19
James R Baylis, Andres Finkelstein-Kulka, Luis Macias-Valle, Jamil Manji, Michael Lee, Elina Levchenko, Christopher Okpaleke, Salahuddin Al-Salihi, Amin Javer, Christian J Kastrup
OBJECTIVES/HYPOTHESIS: Bleeding during endoscopic sinus surgery and open surgeries can easily obstruct the surgeons' field of view and increase morbidity and risk of intraoperative complications. Intraoperative bleeding could potentially be addressed by a hemostatic agent that safely disperses itself through the escaping blood. We tested the safety and efficacy of a self-propelling formulation of thrombin and tranexamic acid (SPTT) in stopping bleeding in a paranasal sinus injury and in an open surgical carotid injury sheep model...
November 10, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27858390/eagle-syndrome-presented-with-neurological-symptoms
#20
Elçin Aydin, Hüseyin Quliyev, Celal Çinar, Halil Bozkaya, İsmail Oran
AIM: Eagle syndrome is a rare entity that causes recurrent throat pain, neck pain, dysphagia, or facial pain by elongated styloid process or calcified stylohyoid ligament. Clinical findings related to the lower cranial nerves compression have also been reported. In some cases it is reported that carotid artery compression or dissection can be seen due to elongated styloid process and it is called carotid artery syndrome. Carotid artery compression causes flow reduction and carotidynia or neurological symptoms can be seen...
October 14, 2016: Turkish Neurosurgery
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