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https://www.readbyqxmd.com/read/27920936/steroid-resistant-tolosa-hunt-syndrome-with-a-de-novo-intracavernous-aneurysm-a-case-report
#1
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
#2
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 male presented with hypacusis and abducens nerve palsy. Radiological 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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/27857875/dual-endoscopic-endonasal-transsphenoidal-and-precaruncular-transorbital-approaches-for-clipping-of-the-cavernous-carotid-artery-a-cadaveric-simulation
#7
Jeremy Ciporen, Brandon Lucke-Wold, Aclan Dogan, Justin S Cetas, William E Cameron
Background Endoscopic skull base approaches are being used to address complicated neurovascular pathology. These approaches are safest when proximal vascular control of the cavernous carotid artery (CavCA) can be obtained. Methods We present a cadaver-based anatomic simulation study showing the feasibility of clip placement for the CavCA as it courses through the cavernous sinus. The arterial vessels were injected with red microfil (Flow Tech, Carver, Massachusetts) to enhance visibility. The endoscope was directed through a precaruncular transorbital approach and instrumentation was managed through an endonasal transsphenoidal approach...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27803834/surgical-approach-to-the-cavernous-sinus-for-a-trigeminal-schwannoma-resection-technical-note-and-case-report
#8
Riccardo Caruso, Alessandro Pesce, Venceslao Wierzbicki, Luigi Marrocco, Emanuele Piccione
We report a rare case of schwannoma of the lateral wall of the cavernous sinus, an exceedingly rare lesion affecting this anatomical district, and discuss salient aspects of the surgical approach to the cavernous sinus, which are traditionally considered technically challenging due to the high risk of postoperative morbidity and mortality related to the presence of the cranial nerves and internal carotid artery.
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27798852/a-rare-case-of-absent-left-common-carotid-artery-with-bovine-origin-of-the-left-external-carotid-artery
#9
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 8, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27798328/cerebral-venous-sinuses-thrombosis-in-both-transverse-sinus-and-torcula-multistep-endovascular-treatment-and-stenting
#10
G Cabral de Andrade, A Lesczynsky, V M Clímaco, E R Pereira, P O Marcelino, Aoc Franco, D F De Almeida
PURPOSE: Cerebral venous sinus thrombosis (CVST) is an unusual and potentially life-threatening condition with variable and nonspecific clinical symptoms and high morbimortality rates. Standard therapy consists of systemic anticoagulation; although there is no clear evidence about the best choice for treatment, intravenous heparin is used as the first-line treatment modality. Intravenous sinus thrombolysis can be an effective and relatively safe treatment for acutely deteriorating patients who have not responded to conventional therapy...
October 26, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27798326/traumatic-arteriovenous-fistula-between-the-extracranial-middle-meningeal-artery-and-the-pterygoid-plexus-a-case-report-and-literature-review
#11
Jinlu Yu, Yunbao Guo, Zhongxue Wu, Kan Xu
The formation of a traumatic arteriovenous fistula (AVF) between the extracranial middle meningeal artery (MMA) and the pterygoid plexus (PP) is very rare, and understanding of this condition is limited. This paper reports the case of an 8-year-old who suffered minor injuries after a high fall four months prior to admission and showed good recovery after one month. However, the child gradually developed exophthalmos of the left eye and conjunctival redness one month prior to admission. Auscultation revealed an intracranial murmur near the left side of the face, in the temporal region...
October 26, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27796449/endovascular-treatment-of-carotico-cavernous-fistulas-with-acrylic-glue-a-series-of-nine-cases
#12
Marcus Ohlsson, Arturo Consoli, Georges Rodesch
INTRODUCTION: Injuries to the internal carotid artery close to the cavernous sinus may result in a fistulous connection between the artery and the venous sinus. Symptoms include pulsatile tinnitus, intracranial bruit, ophthalmological symptoms, and risk of intracerebral hematoma in cases of cortical venous reflux. Previous treatment strategies have included detachable latex balloons, coils, covered stents, or combinations thereof. Today, detachable latex balloons are phased out or withdrawn from several markets...
October 29, 2016: Neuroradiology
https://www.readbyqxmd.com/read/27781074/heuber-maneuver-in-evaluation-of-direct-carotid-cavernous-fistula
#13
Rengarajan Rajagopal, Neeraj Mehta, Sonal Saran, Pushpinder S Khera
Carotid-cavernous fistulas are abnormal communications between the carotid system and the cavernous sinus. Elevated venous pressure produces congestion in the orbit with resultant transudation of fluid and increased intraocular pressure, thereby leading to secondary glaucoma which may result in visual loss. Immediate treatment is hence, warranted in these cases. The planning of endovascular management is dependent on many parameters, the most important of which are the size and location of the fistula. Since these are high-flow fistulas, assessment requires certain manoeuvers...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27774925/improving-paranasal-sinus-computed-tomography-reporting-prior-to-functional-endoscopic-sinus-surgery-an-ent-uk-panel-perspective
#14
S G Mistry, D R Strachan, E L Loney
BACKGROUND: Functional endoscopic sinus surgery is recognised to have a significant complication profile (e.g. blindness, cerebrospinal fluid leak and intracranial sepsis). Pre-operative computed tomography imaging is considered mandatory for surgical planning to reduce intra-operative risk. A radiological report is the 'gold standard' in image interpretation; however, because of a lack of otolaryngological or radiological guidance, its contents may be variable. By surveying practising otolaryngologists, this study aimed to provide some guidance which may be used by radiologists to produce more surgically relevant radiological reports...
October 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27769582/-orbito-palpebral-vascular-pathology
#15
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
https://www.readbyqxmd.com/read/27767958/noncavernous-arteriovenous-shunts-mimicking-carotid-cavernous-fistulae
#16
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 sinus 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...
November 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/27744526/functional-abolition-of-carotid-body-activity-restores-insulin-action-and-glucose-homeostasis-in-rats-key-roles-for-visceral-adipose-tissue-and-the-liver
#17
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...
January 2017: Diabetologia
https://www.readbyqxmd.com/read/27729873/neonatal-maternal-separation-augments-carotid-body-response-to-hypoxia-in-adult-males-but-not-female-rats
#18
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
https://www.readbyqxmd.com/read/27726028/serum-atrial-natriuretic-peptide-anp-as-an-objective-indicator-for-the-diagnosis-of-neurogenic-shock-animal-experiment-and-human-case-report
#19
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
https://www.readbyqxmd.com/read/27721669/asymptomatic-internal-carotid-artery-occlusion-after-gamma-knife-radiosurgery-for-pituitary-adenoma-report-of-two-cases-and-review-of-the-literature
#20
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
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