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Carotid sinus

F Heran Dreyfus, O Galatoire, P Koskas, F Lafitte, E Nau, O Bergès
Orbito-palpebral vascular pathology represents 10% of all the diseases of this area. The lesion may be discovered during a brain CT scan or MRI, or because it causes clinical symptoms such as orbital mass, visual or oculomotor alteration, pain, proptosis, or acute bleeding due to a complication of the lesion (hemorrhage, thrombosis). We present these lesions using an anatomical, clinical, imaging and therapeutic approach. We distinguish four different entities. Vascular tumors have common imaging characteristics (hypersignal on T2 sequence, contrast enhancement, abnormal vascularization well depicted with ultrasound and Doppler, and possible bleeding)...
October 18, 2016: Journal Français D'ophtalmologie
Chai Kobkitsuksakul, Pakorn Jiarakongmun, Ekachat Chanthanaphak, Sirintara Pongpech
PURPOSE: The classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinüs with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages...
October 21, 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Joana F Sacramento, Maria J Ribeiro, Tiago Rodrigues, Elena Olea, Bernardete F Melo, Maria P Guarino, Rui Fonseca-Pinto, Cristiana R Ferreira, Joana Coelho, Ana Obeso, Raquel Seiça, Paulo Matafome, Sílvia V Conde
AIMS/HYPOTHESIS: We recently described that carotid body (CB) over-activation is involved in the aetiology of insulin resistance and arterial hypertension in animal models of the metabolic syndrome. Additionally, we have demonstrated that CB activity is increased in animal models of insulin resistance, and that carotid sinus nerve (CSN) resection prevents the development of insulin resistance and arterial hypertension induced by high-energy diets. Here, we tested whether the functional abolition of CB by CSN transection would reverse pre-established insulin resistance, dyslipidaemia, obesity, autonomic dysfunction and hypertension in animal models of the metabolic syndrome...
October 16, 2016: Diabetologia
Jorge Soliz, Rose Tam, Richard Kinkead
Perinatal exposure to adverse experiences disrupts brain development, including the brainstem network that regulates breathing. At adulthood, rats previously subjected to stress (in the form of neonatal maternal separation; NMS) display features reported in patients suffering from sleep disordered breathing, including an increased hypoxic ventilatory response and hypertension. This effect is also sex-specific (males only). Based on these observations, we hypothesized that NMS augments the carotid body's O2-chemosensitivity...
2016: Frontiers in Physiology
Min-Zhu Zhao, Yong-Guo Li, Peng Zhang, Jin-Cheng Xiong, Shi-Sheng Zhu, Xuan Xiao, Jian-Bo Li
In forensic medicine, the diagnosis of death due to neurogenic shock is considered to be an aporia, as lacking objective indicators and presenting atypical symptoms in autopsy. Medico-legal disputes and complaints occasionally result from this ambiguity. To explore potential objective indicators of neurogenic shock, we set up a model of neurogenic shock by applying an external mechanical force on the carotid sinus baroreceptor in rabbits. The serum atrial natriuretic peptide (ANP) level was measured by radioimmunoassay in the control group (n = 8), survival group (n = 15) and death group (n = 5) both before and after the insult...
October 10, 2016: International Journal of Legal Medicine
Giorgio Spatola, Laura Frosio, Marco Losa, Antonella Del Vecchio, Martina Piloni, Pietro Mortini
BACKGROUND: Gamma knife radiosurgery is an effective and safe treatment modality in the management of pituitary adenomas. Internal carotid occlusion is a rare but possible complication of Gamma Knife Radiosurgery for lesions within the cavernous sinus. AIM: To stress the importance of considering the Internal carotid artery as an organ at risk in cavernous sinus invading adenomas and reduce the dose delivered to this structure whenever possible. CASE DESCRIPTION: We report two cases of asymptomatic occlusion of the intracavernous segment of the internal carotid artery seven years after treatment in acromegalic patients...
November 2016: Reports of Practical Oncology and Radiotherapy
Emmanuel Lilitsis, Alexia Papaioannou, Aikaterini Hatzimichali, Konstantinos Spyridakis, Sofia Xenaki, George Chalkiadakis, Emmanuel Chrysos
BACKGROUND: We present a case of a patient with multinodular goiter disease who suffered asystole during head hyperextension for surgical positioning on the operational table. CASE PRESENTATION: Manipulation of carotid sinus may trigger bradycardia or even asystole even in patients without prior history of carotid sinus hypersensitivity. The time proximity between patient positioning and asystole, the late responsiveness to atropine, the immediate increase of heart rate after head elevation and the lack of any other trigger factor or prior history support the hypothesis of carotid sinus syndrome...
October 6, 2016: BMC Anesthesiology
Sumit Goyal, Ajit Kumar Sinha
A 22-year-old man had cerebral venous sinus thrombosis and his angiogram incidentally revealed an absent left common carotid artery with bovine origin of the left external carotid artery. There was also an associated low bifurcation of the right common carotid artery and basilar artery fenestration. The absence of a common carotid artery is a very rare angiographic finding, and an association with a bovine origin of the left external carotid artery has not been reported previously in the literature. Here we provide a description of the case along with a review of the literature and embryology...
October 5, 2016: BMJ Case Reports
Margarita G Todorova, Cameron F Parsa
BACKGROUND: Variable pupillary responses have been described with carotid-cavernous sinus fistulas. These often are associated with a decrease in visual acuity and attributed to retinal ischemia. We propose a novel pathophysiologic mechanism for changes in pupillary reactivity involving anatomic changes secondary to choroidal effusion. METHODS: To demonstrate proof-of-concept, we investigated 2 consecutive patients with carotid-cavernous sinus fistulas and pupillary disturbances using repeated refractions and anterior segment ultrasound biomicroscopy...
September 22, 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Diana Solari, Francesca Tesi, Matthias Unterhuber, Germano Gaggioli, Andrea Ungar, Marco Tomaino, Michele Brignole
OBJECTIVES: Most elderly patients affected by reflex vasodepressor syncope take one or more hypotensive drugs. The role of these drugs in causing syncope has not yet been established. We hypothesised that recurrence of syncope and presyncope can be reduced by discontinuing/reducing vasoactive therapy without increasing the risk of cardiovascular and neurological events. METHODS: This randomised, parallel, prospective, trial was conducted from January 2014 to March 2016 in four general hospitals...
September 23, 2016: Heart: Official Journal of the British Cardiac Society
Anthony Liberatore, Ronald M Lechan
Carotid-cavernous fistulas (CCFs) are rare, pathologic communications of the carotid artery and the venous plexus of the cavernous sinus. They can develop spontaneously in certain at risk individuals or following traumatic head injury. Typical clinical manifestations include headache, proptosis, orbital pain, and diplopia. We report a case of bilateral carotid-cavernous fistulas associated with these symptoms and also with pituitary enlargement and hypopituitarism, which improved following surgical intervention...
2016: Case Reports in Endocrinology
Alex Botsford, Jai Jai Shiva Shankar
INTRODUCTION: Indirect carotid cavernous fistulas are treated with coil embolization when they present with orbital/visual symptoms or if there is cortical venous reflux. Most of the time, the treatment is done by non-specifically packing the whole cavernous sinus with coils. The purpose of this case series was to examine whether DSA-Dynavision before embolization would improve treatment by shortening the procedure time, requiring fewer coils, or reducing the complication rate. MATERIALS AND METHOD: 8 patients with 9 fistula sites were retrospectively identified...
September 20, 2016: Journal of Neurointerventional Surgery
Shinya Watanabe, Hiroyoshi Akutsu, Shingo Takano, Tetsuya Yamamoto, Eiichi Ishikawa, Hiroaki Suzuki, Akira Matsumura
OBJECTIVE: Withdrawal of cabergoline is generally challenging, especially in patients with large or invasive macroprolactinomas. Therefore, we aimed to assess long-term results of cabergoline therapy for macroprolactinomas and remission achievement results after withdrawal in patients with macroprolactinomas. We also investigated clinical characteristics and factors related to remission after withdrawal. METHODS: This was an institutional review board-approved retrospective analysis...
September 21, 2016: Clinical Endocrinology
S Yu, L Zhang, J Zheng, Y Xu, Y Chen, Z Song
AIM: To compare the effects of exposure parameters on image quality and radiation dose for craniocervical computed tomography angiography (CTA) using adaptive iterative dose reduction in three dimensions (AIDR 3D) and filtered back projection (FBP) algorithms. MATERIALS AND METHODS: One hundred and eighty patients were divided into three groups; group A (120 kV, 300 mA, FBP), group B (100 kV, automatic mA, AIDR 3D) and group C (80kV, automatic mA, AIDR 3D). Image quality and radiation dose were evaluated for each group...
September 16, 2016: Clinical Radiology
Michihiro Tanaka
BACKGROUND: The distribution of intracranial dural AVFs (DAVFs) may be affected by the embryological bony structures that consist of membranous bone and endochondral bone. METHODS: We retrospectively analyzed the distribution of the shunt points in 58 consecutive cases of DAVFs. Shunt points were identified with selective digital subtraction angiography, high-resolution cone beam computed tomography (CT), or three-dimensional rotation angiography. All the shunt points were plotted on the map of the skull base in relation to the topography of the endochondral bone and the membranous bone...
2016: Acta Neurochirurgica. Supplement
Min Lang, Ghaith Habboub, Jeffrey P Mullin, Peter A Rasmussen
Carotid-cavernous fistula was one of the first intracranial vascular lesions to be recognized. This paper focuses on the historical progression of our understanding of the condition and its symptomatology-from the initial hypothesis of ophthalmic artery aneurysm as the cause of pulsating exophthalmos to the recognition and acceptance of fistulas between the carotid arterial system and cavernous sinus as the true etiology. The authors also discuss the advancements in treatment from Benjamin Travers' early common carotid ligation and wooden compression methods to today's endovascular approaches...
September 16, 2016: Journal of Neurosurgery
Saleem I Abdulrauf, Ahmed M Ashour, Eric Marvin, Jeroen Coppens, Brian Kang, Tze Yu Yeh Hsieh, Breno Nery, Juan R Penanes, Aysha K Alsahlawi, Shawn Moore, Hussam Abou Al-Shaar, Joanna Kemp, Kanika Chawla, Nanthiya Sujijantarat, Alaa Najeeb, Nadeem Parkar, Vilaas Shetty, Tina Vafaie, Jastin Antisdel, Tony A Mikulec, Randall Edgell, Jonathan Lebovitz, Matt Pierson, Paulo Henrique Pires de Aguiar, Paula Buchanan, Angela Di Cosola, George Stevens
INTRODUCTION: Numerical classification systems for the internal carotid artery (ICA) are available, but modifications have added confusion to the numerical systems. Furthermore, previous classifications may not be applicable uniformly to microsurgical and endoscopic procedures. The purpose of this study was to develop a clinically useful classification system. MATERIALS AND METHODS: We performed cadaver dissections of the ICA in 5 heads (10 sides) and evaluated 648 internal carotid arteries with computed tomography angiography...
July 2016: Journal of Craniovertebral Junction and Spine
Mohsen Moslehpour, Toru Kawada, Kenji Sunagawa, Masaru Sugimachi, Ramakrishna Mukkamala
The total baroreflex arc is the open-loop system relating carotid sinus pressure (CSP) to arterial pressure (AP). The nonlinear dynamics of this system were recently characterized. First, Gaussian white noise CSP stimulation was employed in open-loop conditions in normotensive and hypertensive rats with sectioned vagal and aortic depressor nerves. Then, nonparametric system identification was applied to measured CSP and AP to establish a second-order nonlinear Uryson model. The aim in this study was to assess the importance of higher-order nonlinear dynamics via development and evaluation of a third-order nonlinear model of the total arc using the same experimental data...
September 14, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Hideaki Hasuo, Kenji Kanbara, Hiroko Sakuma, Rie Matsumori, Mikihiko Fukunaga
BACKGROUND: Carotid sinus syndrome (CSS) can cause prodromal symptoms of syncope such as dizziness and nausea. Patients with end-stage cancer lose self-efficacy associated with reduced activities of daily life (ADL). Herein, we report a case of end-stage cancer in which self-efficacy was enhanced as the patient gained self-control of prodromal symptoms of syncope. CASE PRESENTATION: A 70-year-old patient with end-stage esophageal cancer and enlarged supraclavicular lymph nodes developed CSS...
2016: BioPsychoSocial Medicine
Barbara J Morgan, Melissa L Bates, Rodrigo Del Rio, Zunyi Wang, John M Dopp
Chronic exposure to intermittent hypoxia (CIH) elicits plasticity of the carotid sinus and phrenic nerves via reactive oxygen species (ROS). To determine whether CIH-induced alterations in ventilation, metabolism, and heart rate are also dependent on ROS, we measured responses to acute hypoxia in conscious rats after 14 and 21 d of either CIH or normoxia (NORM), with or without concomitant administration of allopurinol (xanthine oxidase inhibitor), combined allopurinol plus losartan (angiotensin II type 1 receptor antagonist), or apocynin (NADPH oxidase inhibitor)...
September 2, 2016: Respiratory Physiology & Neurobiology
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