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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
Ethan L Fulwood, Doug M Boyer, Richard F Kay
The pterion, on the lateral aspect of the cranium, is where the zygomatic, frontal, sphenoid, squamosal, and parietal bones approach and contact. The configuration of these bones distinguishes New and Old World anthropoids: most extant platyrrhines exhibit contact between the parietal and zygomatic bones, while all known catarrhines exhibit frontal-alisphenoid contact. However, it is thought that early stem-platyrrhines retained the apparently primitive catarrhine condition. Here we re-evaluate the condition of key fossil taxa using μCT (micro-computed tomography) imaging...
November 2016: Journal of Human Evolution
Jang-Ho Park, Joon-Ho Ahn, Jun-Bum Park, Soohyun Joe
Charles Bonnet syndrome (CBS) can develop after trans-sphenoidal adenomectomy (TSA); however, the neural mechanisms remain unknown. Sensory deprivation and releasing phenomenon are both hypothetical explanations for this condition; however, there is no definite evidence that strongly supports either supposition. We report the first case of CBS after TSA without optic nerve atrophy. Postoperatively, the patient's vision seemed to be relatively well preserved, apart from the left-side hemianopsia in the right eye...
September 2016: Psychiatry Investigation
June Yowtak, Suash Sharma, Scott E Forseen, Cargill H Alleyne
BACKGROUND: Mixed tumors of adenomatous and neuronal cells in the sellar region are an uncommon finding. The origins of these heterogeneous tumors are unknown and management of these lesions still debated. We report a very rare case of anterior gray matter pituicytic heterotopia with monomorphic anterior pituitary cells that likely represents a variant of non-secreting pituitary adenoma - neuronal choristoma (PANCH) without any ganglion cells. We also review the current literature for the different clinical presentations of PANCH...
October 12, 2016: World Neurosurgery
Aneesh Mohimen, Santhosh Kumar, E R Jayadevan
PURPOSE: To describe a rare clinical entity of intra-osseous skull base arterio-venous fistula managed with transvenous fistula embolization. CASE DETAILS: 57 year old lady presented with complaints of headache and episodic tinnitus with progressive left sided visual deterioration. Cross sectional imaging of the head revealed multiple vascular channels in the sphenoid bone and in bilateral masticator spaces. Catheter angiography showed presence of a large osseous arterio-venous fistula (AVF) epicentered in the body of sphenoid and left pterygoid plates with arterial feeders from bilateral external carotid arteries and venous drainage...
October 11, 2016: World Neurosurgery
Ramesh R Dargad, Jai D Parekh, Rohit R Dargad
Acromegaly is a rare condition with an approximate incidence of 3-4 new cases per million per year and occurs as a result of excess secretion of growth hormone (GH). It is associated with several cardiovascular manifestations of which dilated cardiomyopathy with systolic and diastolic dysfunction is relatively rare but associated with increased mortality. There are very few documented cases of acromegaly with dilated cardiomyopathy in Indian female patients in literature, thus justifying the uniqueness of our case...
June 2016: Journal of the Association of Physicians of India
Tao Xie, Wei Sun, Xiaobiao Zhang, Tengfei Liu, Hailing Ding, Fan Hu, Yong Yu, Ye Gu
BACKGROUND: In this study, we investigated the value of three-dimensional (3D) fast-imaging employing steady-state acquisition (FIESTA) magnetic resonance imaging (MRI) in detecting non-iatrogenic cerebrospinal fluid (CSF) rhinorrhoea and compared it with regular MRI and 3D magnetisation prepared rapid acquisition gradient echo (MPRAGE) MRI sequences, as well as high-resolution computed tomography (HRCT) imaging. We also present the endoscopic experiences of such cases. METHOD: From June 2011 to Feb 2016, 17 patients with non-iatrogenic cerebrospinal fluid rhinorrhoea were included...
October 13, 2016: Acta Neurochirurgica
Rolfe M Radcliffe, Yasmine Messiaen, Nita L Irby, Thomas J Divers, Curtis W Dewey, Katharyn J Mitchell, Lauren V Schnabel, Abraham J Bezuidenhout, Peter V Scrivani, Norm G Ducharme
OBJECTIVE: To report a transnasal, endoscopically guided ventral surgical approach for accessing the cranial and caudal segments of the sphenopalatine sinus for mass removal in a horse. STUDY DESIGN: Case report. ANIMAL: Adult horse with acute onset blindness referable to a soft tissue mass within the sphenopalatine sinus. CLINICAL REPORT: A 7-year-old Warmblood gelding presented with a history of running into a fence and falling...
October 12, 2016: Veterinary Surgery: VS
Andrea Romano, Valeria Coppola, Mariangela Lombardi, Luigi Lavorato, Domenica Di Stefano, Emanuela Caroli, Maria Camilla Rossi Espagnet, Francesca Tavanti, Giuseppe Minniti, Giuseppe Trillò, Alessandro Bozzao
PURPOSE: Our hypothesis was that pituitary macroadenomas show different areas of consistency detectable by enhanced magnetic resonance imaging (MRI) with Dynamic study during gadolinium administration. MATERIALS AND METHODS: We analysed 21 patients with pituitary macroadenomas between June 2013 and June 2015. All patients underwent trans-sphenoidal surgery and neurosurgeon described macroadenomas consistency. Similarly, two neuroradiologists manually drew regions of interest (ROIs) inside the solid-appearing portions of macroadenoma and in the normal white matter both on dynamic and post-contrast acquisitions...
October 11, 2016: Pituitary
Daniele Starnoni, Roy Thomas Daniel, Mercy George, Mahmoud Messerer
BACKGROUND: Spontaneous meningoencephaloceles of the lateral sphenoid sinus are rare entities and their peculiar location represent a surgical challenge due to the importance of a wide exposure and skull base reconstruction. They are thought to arise from congenital base defect of the lateral sphenoid or in some cases have been postulated to represent a rare manifestation of altered CSF dynamics. We report the first case in literature of a Chiari malformation type I and a lateral sphenoid encephaloceles revising the theoretical etiology and surgical technique of endoscopic repair...
October 8, 2016: World Neurosurgery
Nidan Qiao, Zhao Ye, Xuefei Shou, Yongfei Wang, Shiqi Li, Min Wang, Yao Zhao
OBJECTIVE: The relationship between functional and structural measurements is of fundamental importance in monitoring treatment and progression in patients with pituitary adenoma. In the present study, we examined the association between longitudinal changes in standard automated perimetry (SAP), retinal nerve fiber layer (RNFL) thickness and multifocal visual evoked potential (mfVEP) amplitude after transsphenoidal surgery. METHODS: Thirty patients with pituitary adenoma were recruited from Huashan Hospital between September 2010 and January 2014...
September 6, 2016: Clinical Neurology and Neurosurgery
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
Mohamed Said Abbas, Mohammad Najm AlBerawi, Issam Al Bozom, Nissar F Shaikh, Khalid Yacout Salem
BACKGROUND Pituitary macroadenoma is a common benign tumor that usually presents with visual field defects or hormonal abnormalities. Cerebral infarction can be a complication of a large pituitary adenoma. We report a rare case of bilateral anterior cerebral arteries infarcts by a large pituitary macroadenoma with apoplexy. CASE REPORT A 48-year-old male patient presented with altered conscious level and sudden loss of vision for one-day duration. Magnetic resonance imaging of the brain showed a large seller and suprasellar hemorrhagic mass of pituitary origin, with associated bilateral areas of diffusion restriction in the frontal parasagittal regions, consistent with infarctions...
October 6, 2016: American Journal of Case Reports
Ayman A El Shazly, Mohammed A El Wardany, Tamer A Abo El Ezz
CONTEXT: Many reconstructive techniques have been proposed to prevent postoperative cerebrospinal fluid (CSF) leakage after trans-sphenoidal pituitary surgery. However, no total agreement has been reached to the best technique. AIM: Assessment of the efficacy of sellar repair with autologous muscle and composite septal cartilage grafts for treatment of intraoperative and delayed postoperative CSF leakage following trans-sphenoidal pituitary surgery without the use of postoperative external lumbar CSF drain...
October 2016: Asian Journal of Neurosurgery
Stefan Linsler, Sebastian Antes, Sebastian Senger, Joachim Oertel
OBJECTIVE: The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) and magnetic resonance imaging (MRI). Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood. MATERIALS AND METHODS: We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infiltrated...
October 2016: Journal of Neurosciences in Rural Practice
Philip G Chen, Jae Murphy, Les M Alloju, Sam Boase, Peter-John Wormald
OBJECTIVES: Nasal irrigation is standard in the management of chronic rhinosinusitis both before and after surgical intervention. Numerous irrigation devices are commercially available. The aim of this study was to compare the efficacy of a handheld pulse irrigation device against the gold standard manual squeeze bottle after endoscopic sinus surgery (ESS). METHODS: Five cadaveric specimens were prepared with video visualization ports into each sinus. Endoscopic sinus surgery was performed on each cadaver from minimal to maximal dissection...
September 29, 2016: Annals of Otology, Rhinology, and Laryngology
Sercan Gode, Huseyin Biceroglu, Goksel Turhal, Umut Erdogan, Murat S Ates, Isa Kaya, Erkin Ozgiray, Rasit Midilli, Bulent Karci
Endoscopic endonasal approach has been successfully used for the management of pituitary tumors; however, the loss of septal mucosa especially around sphenoethmoidal recess and posterior nasal septum might be a disadvantage of this technique. The aim of this study is to describe a variation of the endonasal approach, "double nasoseptal flap" technique in endoscopic transsphenoidal pituitary surgery, and to evaluate its outcomes. The technique depends on fully harvested bigger nasoseptal flap on one side and smaller on the other...
September 28, 2016: European Archives of Oto-rhino-laryngology
M P Powell, G J Narimova, Z Ju Halimova
Transsphenoidal surgery (TSS) was introduced into the Republic of Uzbeksistan in 2005, and has been developed there since. The principal center for the management of all pituitary disease is in a single site for a nation of approxiamately 30 million population. Results in the surgery of Cushing's disease (CD) are a marker of surgical technical skill in TSS. All previously published series come from the developed world where sophisticated investigations and management are available. Many of these investigations are not available in Uzbekistan...
September 23, 2016: World Neurosurgery
Yingbai Chen, Yunhai Tu, Ben Chen, Jieliang Shi, Bo Yu, Wencan Wu
PURPOSE: To assess the feasibility and efficacy of endoscopic transnasal removal of cavernous hemangiomas of the optic canal. DESIGN: Retrospective, non-comparative case series. METHODS: Eleven consecutive patients (11 eyes) with cavernous hemangioma of the optic canal underwent endoscopic trans-ethmoidal-sphenoidal removal of the tumor at the Eye Hospital of Wenzhou Medical University from January 2009 to March 2016. In each case, the indication for surgery was decreased visual acuity due to the tumor...
September 23, 2016: American Journal of Ophthalmology
Lucas S Stepanko, Manuel O Lagravère
OBJECTIVE: Rapid maxillary expansion (RME) is used to expand the maxilla and increase arch perimeter; yet, there are few reports on its effects on the sphenoid bone. With cone-beam computed topography (CBCT), it is possible to visualize sphenoid bone changes. The purpose of this study was to investigate sphenoid bone changes observed in conjunction with RME treatments, using CBCT. METHODS: Sixty patients (34 women and 26 men, aged 11-17 years) underwent RME as part of their orthodontic treatment...
September 2016: Korean Journal of Orthodontics
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