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https://www.readbyqxmd.com/read/29145656/refining-operative-strategies-for-optic-nerve-decompression-a-morphometric-analysis-of-transcranial-and-endoscopic-endonasal-techniques-using-clinical-parameters
#1
Steven L Gogela, Lee A Zimmer, Jeffrey T Keller, Norberto Andaluz
BACKGROUND: Various approaches can be considered for decompression of the intracanalicular optic nerve. Although clinical experience has been reported, no quantitative study has yet compared the extent of decompression achieved by an endoscopic endonasal versus transcranial approach. OBJECTIVE: Toward this aim, our morphometric analysis compared both approaches by quantifying the circumferential degree of optic canal decompression that is possible before any meningeal violation, which would result in cerebrospinal fluid (CSF) leak...
May 3, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29119070/superior-ophthalmic-vein-access-for-embolization-of-an-indirect-carotid-cavernous-fistula
#2
Ali S Haider, Prabhat Garg, Dean Leonard, Tijani Osumah, Umair Khan, Steven Vayalumkal, Lyndon K Lee, Phu Nguyen, Grant Gilliland, Kennith F Layton
Carotid cavernous fistulae (CCF) are defined as abnormal connections between the carotid circulation and cavernous sinus. CCFs can be categorized as being direct or indirect. Direct CCFs are usually associated with trauma, whereas indirect CCFs are associated with revascularization following cavernous sinus thrombosis. We present a case of a 53-year-old male who presented with tinnitus, proptosis, conjunctivitis, and blurry vision. The patient had a recent endovascular transvenous embolization that was only partially successful, with a residual carotid cavernous fistula draining to the left superior ophthalmic vein and multiple cortical veins...
September 1, 2017: Curēus
https://www.readbyqxmd.com/read/29118300/improvement-of-left-ventricular-ejection-fraction-by-baroreflex-activation-therapy-in-a-young-man-with-dilated-cardiomyopathy
#3
Marcel Halbach, Thorsten Fritz, Navid Madershahian, Roman Pfister, Hannes Reuter
The progression of heart failure with reduced ejection fraction is promoted by sympathovagal imbalance. Baroreflex activation therapy (BAT) by the electrical stimulation of baroreceptors at the carotid sinus significantly improved exercise capacity and NT-proBNP levels in a randomized trial; however, no significant difference in left ventricular ejection fraction (LV-EF) between groups was found. Here, we report the case of a 30-year-old man with a long history of dilated cardiomyopathy and severely reduced LV-EF despite optimal medical therapy, who was treated with BAT since October 2014 and showed a remarkable improvement in both symptoms and LV-EF under this treatment...
November 8, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29118022/tonic-aortic-depressor-nerve-stimulation-does-not-impede-baroreflex-dynamic-characteristics-concomitantly-mediated-by-the-stimulated-nerve
#4
Toru Kawada, Michael J Turner, Shuji Shimizu, Atsunori Kamiya, Toshiaki Shishido, Masaru Sugimachi
Although electrical activation of the carotid sinus baroreflex (baroreflex activation therapy) is being explored as a device therapy for resistant hypertension, possible effects on baroreflex dynamic characteristics of interaction between electrical stimulation and pressure inputs are not fully elucidated. To examine whether the electrical stimulation of the baroreceptor afferent nerve impedes normal short-term arterial pressure (AP) regulation mediated by the stimulated nerve, we electrically stimulated the right aortic depressor nerve (ADN) while estimating the baroreflex dynamic characteristics by imposing pressure inputs to the isolated baroreceptor region of the right ADN in nine anesthetized rats...
November 8, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29114001/impaired-central-pulsatile-hemodynamics-in-children-and-adolescents-with-marfan-syndrome
#5
Andrea Grillo, Paolo Salvi, Susan Marelli, Lan Gao, Lucia Salvi, Andrea Faini, Giuliana Trifirò, Renzo Carretta, Alessandro Pini, Gianfranco Parati
BACKGROUND: Marfan syndrome is characterized by aortic root dilation, beginning in childhood. Data about aortic pulsatile hemodynamics and stiffness in pediatric age are currently lacking. METHODS AND RESULTS: In 51 young patients with Marfan syndrome (12.0±3.3 years), carotid tonometry was performed for the measurement of central pulse pressure, pulse pressure amplification, and aortic stiffness (carotid-femoral pulse wave velocity). Patients underwent an echocardiogram at baseline and at 1 year follow-up and a genetic evaluation...
November 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29110750/aortic-elasticity-and-carotid-intima-media-thickness-in-children-with-mitral-valve-prolapse
#6
Elif Erolu, Figen Akalın, Nilüfer Çetiner, Berna Şaylan Çevik
Aim We aimed to study the dimensions, systolic and diastolic functions of the left ventricle; dimensions and elasticity of the aorta; and carotid intima-media thickness and flow-mediated dilatation of the brachial artery in mitral valve prolapse. METHODS: The study group consisted of 43 patients (mean age=13.3±3.9) and 42 healthy children (mean age=12.9±3.4). Left ventricular end-diastolic, end-systolic, left atrial diameters, interventricular septum, and left ventricular posterior wall thickness were measured...
November 7, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29099499/carotid-cavernous-fistula-current-concepts-in-aetiology-investigation-and-management
#7
A D Henderson, N R Miller
A carotid-cavernous fistula (CCF) is an abnormal communication between arteries and veins within the cavernous sinus and may be classified as either direct or dural. Direct CCFs are characterized by a direct connection between the internal carotid artery (ICA) and the cavernous sinus, whereas dural CCFs result from an indirect connection involving cavernous arterial branches and the cavernous sinus. Direct CCFs frequently are traumatic in origin and also may be caused by rupture of an ICA aneurysm within the cavernous sinus, Ehlers-Danlos syndrome type IV, or iatrogenic intervention...
November 3, 2017: Eye
https://www.readbyqxmd.com/read/29098418/bilateral-carotid-cavernous-sinus-fistula-a-case-report-and-review-of-the-literature
#8
REVIEW
Gavin Docherty, Maryam Eslami, Kailun Jiang, Jason S Barton
Carotid cavernous fistula (CCF) is an abnormal vascular shunt from the carotid artery to the cavernous sinus. They are commonly classified based on hemodynamics, etiology or anatomically. Hemodynamic classification refers to whether the fistula is high or low flow. Etiology is commonly secondary to trauma or can occur spontaneously in the setting of aneurysm or medical conditions predisposing to arterial wall defects. Bilateral carotid cavernous fistulas are rare. We present a case of bilateral CCF secondary to trauma...
November 2, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29071741/is-right-atrioventricular-valve-always-tricuspid
#9
Ahmet Guner, Alev Kılıcgedik, Muzaffer Kahyaoglu, Mehmet Celik, Gokhan Kahveci
A 71-year-old male with a medical history of hypertension was admitted to emergency department with hypertensive pulmonary edema. The patient appeared anxious and diaphoretic, and physical examination revealed tachypnea, crepitant rales in the both lungs and a systolic ejection murmur at the right sternal border, radiating to the both carotid arteries. The electrocardiography showed sinus tachycardia with indications of left ventricle hypertrophy Before the aortic valve surgery, transesophageal echocardiography (TEE) was performed for detailed evaluation of the aortic valve...
October 26, 2017: Echocardiography
https://www.readbyqxmd.com/read/29067619/transparent-model-of-temporal-bone-and-vestibulocochlear-organ-made-by-3d-printing
#10
Ryoji Suzuki, Naoto Taniguchi, Fujio Uchida, Akimitsu Ishizawa, Yoshinori Kanatsu, Ming Zhou, Kodai Funakoshi, Hideo Akashi, Hiroshi Abe
The vestibulocochlear organ is composed of tiny complex structures embedded in the petrous part of the temporal bone. Landmarks on the temporal bone surface provide the only orientation guide for dissection, but these need to be removed during the course of dissection, making it difficult to grasp the underlying three-dimensional structures, especially for beginners during gross anatomy classes. We report herein an attempt to produce a transparent three-dimensional-printed model of the human ear. En bloc samples of the temporal bone from donated cadavers were subjected to computed tomography (CT) scanning, and on the basis of the data, the surface temporal bone was reconstructed with transparent resin and the vestibulocochlear organ with white resin to create a 1:1...
October 24, 2017: Anatomical Science International
https://www.readbyqxmd.com/read/29053902/sonographic-evaluation-of-the-vagus-nerves-protocol-reference-values-and-side-to-side-differences
#11
Johann Otto Pelz, Elena Belau, Philipp Henn, Niels Hammer, Joseph Classen, David Weise
INTRODUCTION: Reported sonographic reference values for the vagus nerves (VNs) vary greatly. We aimed to generate reference values in a large cohort and examine intrarater, interrater, and across-ultrasound systems agreement. METHODS: The VNs of 60 healthy subjects were examined by 2 sonographers and with 2 ultrasound systems. Cross-sectional areas (CSAs) of each VN were assessed at the level of the carotid sinus [proximal measurement level (ML)] and thyroid gland (distal ML)...
October 20, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/29053078/contralateral-transmaxillary-corridor-an-augmented-endoscopic-approach-to-the-petrous-apex
#12
Chirag R Patel, Eric W Wang, Juan C Fernandez-Miranda, Paul A Gardner, Carl H Snyderman
OBJECTIVE The endoscopic endonasal approach (EEA) has been shown to be an effective means of accessing lesions of the petrous apex. Lesions that are lateral to the paraclival segment of the internal carotid artery (ICA) require lateralization of the paraclival segment of the ICA or a transpterygoid infrapetrous approach. In this study the authors studied the feasibility of adding a contralateral transmaxillary (CTM) corridor to provide greater access to the petrous apex with decreased need for manipulation of the ICA...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29042328/ruptured-persistent-trigeminal-artery-causing-direct-cavernous-sinus-fistula-treated-with-pipeline-embolization-and-minimal-coiling
#13
Nam K Yoon, Al-Wala Awad, James M Gee, Philipp Taussky
BACKGROUND: Rupture of a persistent trigeminal artery associated with development of a cavernous sinus fistula in a traumatic setting is rare. They are typically treated with coil embolization of the cavernous sinus. CASE DESCRIPTION: We present the case of a 42-year-old woman who developed a direct cavernous carotid fistula after a motor-vehicle accident. Angiographic imaging revealed a rupture point of a persistent trigeminal artery as it connected with the cavernous segment of the internal carotid artery (ICA), causing a cavernous sinus fistula...
October 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29038360/carotid-sinus-hypersensitivity-block-of-the-sternocleidomastoid-muscle-does-not-affect-responses-to-carotid-sinus-massage-in-healthy-young-adults
#14
Matthew G Lloyd, James M Wakeling, Michael S Koehle, Robert J Drapala, Victoria E Claydon
The arterial baroreflex is crucial for short-term blood pressure control - abnormal baroreflex function predisposes to syncope and falling. Hypersensitive responses to carotid baroreflex stimulation using carotid sinus massage (CSM) are common in older adults and may be associated with syncope. The pathophysiology of this hypersensitivity is unknown, but chronic denervation of the sternocleidomastoid muscles is common in elderly patients with carotid sinus hypersensitivity (CSH), and is proposed to interfere with normal integration of afferent firing from the carotid baroreceptors with proprioceptive feedback from the sternocleidomastoids, producing large responses to CSM...
October 2017: Physiological Reports
https://www.readbyqxmd.com/read/29038082/supraorbital-approach-for-resection-of-clinoidal-meningioma
#15
Rimal H Dossani, Piyush Kalakoti, Bharat Guthikonda
Meningiomas of the clinoid region pose formidable surgical challenge. Pterional craniotomy is the traditional approach, and often associated with high-risk post-surgical morbidities. In the current presentation, we describe an elderly male with a clinoidal meningioma that underwent a minimally invasive supra-orbital craniotomy for tumor resection. Patient presentation, neuroimaging, and surgical techniques (patient position, incision, anatomical consideration, and surgical steps) are described meticulously...
October 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29026931/imaging-patterns-of-rhino-orbital-cerebral-mucormycosis-in-immunocompromised-patients-when-to-suspect-complicated-mucormycosis
#16
Peter Raab, Ludwig Sedlacek, Stefanie Buchholz, Stefan Stolle, H Lanfermann
PURPOSE: The aim of this study was to describe radiological imaging findings of a complicated sinusitis, which should raise the suspicion of rhino-orbital-cerebral mucormycosis as being the underlying cause. METHODS: In this retrospective analysis, we describe the cases and imaging findings of 8 patients with proven mucormycosis. These patients presented mostly with new facial or orbital swelling and were referred for imaging to our institution. Magnetic resonance imaging and computed tomography images were classified as abnormal or normal with respect to orbital, paranasal and cerebral signal results...
October 12, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29021312/incompletely-obliterated-cranial-arteriovenous-fistulae-are-safely-and-effectively-treated-with-adjuvant-%C3%AE%C2%B5-aminocaproic-acid
#17
Brian M Howard, Jonathan A Grossberg, Adam Prater, C Michael Cawley, Jacques E Dion, Frank C Tong
BACKGROUND: Administration of ε-aminocaproic acid (εACA), as adjuvant therapy following incompletely embolized cranial dural arteriovenous (dAVFs) and direct carotid artery to cavernous sinus fistulae (CCFs), is a strategy to promote post-procedural thrombosis. However, the efficacy of εACA to treat incompletely obliterated dAVFs and CCFs has not been published. The purpose of this study was to determine if administration of εACA following incomplete embolization of cranial dAVFs or CCFs was associated with an increased likelihood of cure on follow-up imaging compared with patients not given adjuvant εACA...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29020587/carotid-sinus-massage
#18
REVIEW
Mathieu Pasquier, Mathieu Clair, Etienne Pruvot, Olivier Hugli, Pierre-Nicolas Carron
New England Journal of Medicine, Volume 377, Issue 15, October 2017.
October 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28984118/intracerebral-hemorrhage-in-the-context-of-cerebral-amyloid-angiopathy-and-varied-time-of-onset-of-cerebral-venous-thrombosis-a-case-report
#19
Tadeusz A Mendel, Beata Błażejewska-Hyżorek, Grażyna M Szpak, Tomasz Stępień, Eliza Lewandowska, Sylwia Tarka, Iwona Kurkowska-Jastrzębska, Teresa Wierzba-Bobrowicz
In patients with cerebral venous thrombosis (CVT) the incidence of intracerebral hemorrhage (ICH) is estimated at about 37% and subarachnoid hemorrhage (SAH) at 1% of patients. A case with coincident occurrence of ICH, SAH and CVT in a patient with cerebral amyloid angiopathy (CAA) is reported. A 79-year-old woman was admitted to the Neurological Department after the occurrence of generalized seizures, the first in her life. On admission she was unconscious with right hemiparesis and deviation of eyes to the left...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28975005/safety-of-intraventricular-rt-pa-for-pan-ventricular-ivh-caused-by-a-ruptured-avm-a-case-report
#20
Sushrut Dharmadhikari, Ashutosh Mahapatra, Anita Tipirneni, Dileep Yavagal, Amer M Malik
Intraventricular recombinant tissue plasminogen activator (IVT rt-PA) has improved outcomes for intraventricular hemorrhage (IVH). Patients with suspected or untreated arteriovenous malformations (AVMs) have been excluded from clinical trials. We present a patient with IVH secondary to a ruptured AVM safely treated with IVT rt-PA. A 48-year-old Hispanic male with a history of dermatomyositis presented to the emergency department with sudden left-sided weakness. En route to computed tomography (CT), he became lethargic...
October 2017: Neurohospitalist
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